Characteristics associated with the use of diagnostic prostate biopsy and biopsy outcomes in Australian men

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Cancer Epidemiol Biomarkers Prev. 2021 Jun 21:cebp.1571.2020. doi: 10.1158/1055-9965.EPI-20-1571. Online ahead of print.


BACKGROUND: Population characteristics associated with the use of prostate biopsy are poorly understood. We described the use of diagnostic prostate biopsy and subsequent biopsy outcomes in a population-based Australian cohort.

METHODS: 91,764 men from the Sax Institute’s 45 and Up Study (New South Wales (NSW), Australia) recruited during 2006-2009 were included. Self-completed baseline questionnaires and linked administrative health data were used. Study period was from the date of recruitment to December 2013. Cox regression and logistic regression identified factors associated with receipt of biopsy and subsequent prostate cancer diagnosis.

RESULTS: During the study period 5089 participants had a diagnostic prostate biopsy, 2,805 men (55.1% of those biopsied) received a cancer diagnosis. Men with a family history of prostate cancer (HR 1.55, 95%CI 1.43-1.68), severe lower urinary tract symptoms (HR 1.62, 95%CI 1.41-1.86) or a record of medication for benign prostatic hyperplasia (HR 1.34, 95%CI 1.23-1.47) had increased risks of receiving a biopsy. Men with a family history of prostate cancer had increased odds of a positive biopsy (OR 1.21, 95%CI 1.01-1.43). High alcohol consumption ({greater than or equal to}21 drinks per week compared to 1-6 drinks per week) was associated with decreased risk of biopsy (HR 0.88, 95%CI 0.80-0.96) but increased odds of a positive biopsy (OR 1.63, 95%CI 1.32-2.02).

CONCLUSIONS: Certain characteristics are associated with both undertaking diagnostic prostate biopsy and positive biopsy outcomes.

IMPACT: This highlights the need to improve management of specific groups of men, especially those with clinical symptoms that overlap with prostate cancer, in their investigation for prostate cancer.

PMID:34155065 | DOI:10.1158/1055-9965.EPI-20-1571