2007-2022 年用于前列腺癌检测的活检前核磁共振成像的使用趋势。

IF 5.1 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2024-09-21 DOI:10.1038/s41391-024-00896-y

Simon John Christoph Soerensen, Shufeng Li, Marvin E Langston, Richard E Fan, Mirabela Rusu, Geoffrey A Sonn

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引用次数: 0

摘要

背景：临床指南倾向于在前列腺活检前进行核磁共振成像，因为其优点已得到证实。然而，美国各地的采用模式尚不明确：本研究使用 Merative™ Marketscan® 商业和医疗保险数据库对 2007-2022 年间 726,663 名男性的 872,829 例前列腺活检进行了分析。活检前 90 天内的盆腔核磁共振成像是主要结果。描述性统计和广义估计方程评估了随时间推移的变化、城乡差异和州一级的差异：结果：活检前核磁共振成像的使用率从2007年的0.5%大幅增至2022年的35.5%，城市地区（2022年为36.1%）与农村地区（2022年为28.3%）的采用速度相比更快。地域差异明显，加利福尼亚州、纽约州和明尼苏达州的使用率较高，而东南部和西部山区的使用率较低：这项研究揭示了前列腺癌诊断的模式正在向核磁共振成像引导的方法转变，这是受不断发展的指南和临床证据的影响。特别是在农村地区和特定区域，使用率方面的差异凸显了有必要采取有针对性的干预措施，以确保公平使用先进的诊断技术。

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Trends in pre-biopsy MRI usage for prostate cancer detection, 2007-2022.

Background: Clinical guidelines favor MRI before prostate biopsy due to proven benefits. However, adoption patterns across the US are unclear.

Methods: This study used the Merative™ Marketscan® Commercial & Medicare Databases to analyze 872,829 prostate biopsies in 726,663 men from 2007-2022. Pre-biopsy pelvic MRI within 90 days was the primary outcome. Descriptive statistics and generalized estimating equations assessed changes over time, urban-rural differences, and state-level variation.

Results: Pre-biopsy MRI utilization increased significantly from 0.5% in 2007 to 35.5% in 2022, with faster adoption in urban areas (36.1% in 2022) versus rural areas (28.3% in 2022). Geographic disparities were notable, with higher utilization in California, New York, and Minnesota, and lower rates in the Southeast and Mountain West.

Conclusions: The study reveals a paradigm shift in prostate cancer diagnostics towards MRI-guided approaches, influenced by evolving guidelines and clinical evidence. Disparities in access, particularly in rural areas and specific regions, highlight the need for targeted interventions to ensure equitable access to advanced diagnostic techniques.

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.