Utilization and cancer detection by U.S. prostate biopsies (2005-2011).

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 107-107
Author(s):  
Carl A. Olsson ◽  
Deepak A. Kapoor ◽  
Savvas E. Mendrinos ◽  
Ann E. Anderson ◽  
David G. Bostwick
Keyword(s):  
Cancer Detection ◽  
Prostate Biopsy ◽  
National Standard ◽  
Reference Laboratory ◽  
Similar Data ◽  
National Reference Laboratory ◽  
National Reference ◽  
Positive Biopsy ◽  
Significant Difference ◽  
Biopsy Rate

107 Background: To assess the positive biopsy rate and core sampling pattern in patients undergoing prostate biopsy in the US at a national reference laboratory and pathology laboratories integrated into urology group practices and analyze the relationship between positive biopsy rates and number of specimen vials per biopsy (sv/b). Methods: For the years 2005-11, we collected pathology data from a national reference laboratory (NRL) including number of urologists and urology practices referring samples, total specimen vials submitted per prostate biopsy, and final diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia or atypical small acinar proliferation. Over the same period, similar data was gathered from urology practices with in-house laboratories performing global pathology services (urology practice labs, UPL) identified by a member survey of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials/biopsy were calculated in aggregate and separately for each site of service. Results: From 2005-11, 437,937 biopsies were submitted in 4,230,129 vials (9.4 sv/b); overall positive biopsy rate was 40.3%, identical at both the NRL and UPL (p=0.97). Nationally, the number of specimen vials/biopsy increased sharply from a mean of 8.8 during 2005-8 to 10.3 from 2009-11 (difference 1.5 sv/b, p=0.03). For the most recent 3 year period (2009-11), there was no significant difference between the NRL (10.0 sv/b) and UPL (10.6 sv/b) (p=0.08). Positive biopsy rate correlated strongly (p<0.01) with number of specimen vials/biopsy. Conclusions: The positive prostate biopsy rate of 40.3% is identical across sites of service. Although there was a national trend towards increased specimen vials/biopsy from 2005-11, from 2009-11 there was no significant difference in specimen vials/biopsy across sites of service. Increased cancer detection rate correlated significantly with increased number of specimens examined. Segregation of prostate biopsy cores into 10-12 unique specimen vials has been adopted by urologists across sites of service and can be considered the de facto national standard of care.

Utilization and cancer detection by U.S. prostate biopsies (2005-2011).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16076-e16076
Author(s):  
Carl A. Olsson ◽  
Deepak A. Kapoor ◽  
Ann E. Anderson ◽  
Savvas E. Mendrinos ◽  
David G. Bostwick
Keyword(s):  
Cancer Detection ◽  
Prostate Biopsy ◽  
National Standard ◽  
Reference Laboratory ◽  
Similar Data ◽  
National Reference Laboratory ◽  
National Reference ◽  
Positive Biopsy ◽  
Significant Difference ◽  
Biopsy Rate

e16076 Background: To assess the positive biopsy rate and core sampling pattern in patients undergoing prostate biopsy in the US at a national reference laboratory and pathology laboratories integrated into urology group practices and analyze the relationship between positive biopsy rates and number of specimen vials per biopsy (v/b). Methods: For the years 2005-11, we collected pathology data from a national reference laboratory (NRL) including number of urologists and urology practices referring samples, total specimen vials submitted per prostate biopsy, and final diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia or atypical small acinar proliferation. Over the same period, similar data was gathered from urology practices with in-house laboratories performing global pathology services (urology practice labs, UPL) identified by a member survey of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials/biopsy were calculated in aggregate and separately for each site of service. Results: From 2005-11, 437,937 biopsies were submitted in 4,230,129 vials (9.4 v/b); overall positive biopsy rate was 40.3%, identical at both the NRL and UPL (p=0.97). Nationally, the number of specimen vials/biopsy increased sharply from a mean of 8.8 during 2005-8 to 10.3 from 2009-11 (difference 1.5 v/b, p=0.03). For the most recent 3 year period (2009-11), there was no significant difference between the NRL (10.0 v/b) and UPL (10.6 v/b) (p=0.08). Positive biopsy rate correlated strongly (p<0.01) with number of specimen vials/biopsy. Conclusions: The positive prostate biopsy rate of 40.3% is identical across sites of service. Although there was a national trend towards increased specimen vials/biopsy from 2005-11, from 2009-11 there was no significant difference in specimen vials/biopsy across sites of service. Increased cancer detection rate correlated significantly with increased number of specimens examined. Segregation of prostate biopsy cores into 10-12 unique specimen vials has been adopted by urologists across sites of service and can be considered the de facto national standard of care.

scholarly journals Can a supervised algorithmic assessment of men for prostate cancer improve the quality of care? A retrospective evaluation of a prostate assessment pathway in Saskatchewan

2017 ◽  
Vol 11 (9) ◽  
pp. E338-43
Author(s):  
Bonnie Liu ◽  
Kunal Jana ◽  
Gary Groot
Keyword(s):  
Prostate Cancer ◽  
Risk Stratification ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Wait Time ◽  
Low Risk ◽  
Time Data ◽  
Significant Difference ◽  
High Risk Cancer ◽  
Biopsy Rate

Introduction: The Saskatoon Prostate Assessment Pathway (SPAP) was developed in 2013 in part to decrease the wait times between physician referral and biopsy for patients with suspected prostate cancer. Using an algorithm carefully designed to optimize appropriate prostate biopsy rates, physicians can directly refer patients for biopsy through the SPAP without seeing a urologist. All other patients are referred to the Saskatoon Urology Associates (SUA). The present study evaluates the performance of the algorithm.Methods: 971 patients seen at the SUA and 302 patients seen through the SPAP were identified. Information on age, biopsy status and outcome, risk stratification, and time between referral and biopsy was collected. Biopsy wait time data was analyzed using gamma distribution. Association between referral method and biopsy rate, and between referral method and risk stratification, was analyzed using Z-test.Results: The expected wait time from referral to biopsy for patients seen through SUA was 2.63 times longer than those seen through SPAP (34 vs. 91 days). The biopsy rate of patients seen in the SPAPwas significantly higher than those by SUA (88% vs. 69%, 95% confidence interval [CI] 0.14–0.26; p<0.00001). There was no significant difference in positive biopsy rates for patients seen through the SPAP vs. SUA (81% vs. 74%, 95% CI -0.011,0.14; p=0.095), for detection of low-risk cancer, (12% vs. 10%, 95% CI -0.034,0.080; p=0.44), or for clinically relevant cancer, i.e., intermediate- and high-risk cancer, for SPAP vs. SUA (56.54% vs. 56.68%, 95% CI -0.091,0.089; p=0.49).Conclusions: The algorithm used in the SPAP is effective in decreasing wait time to prostate biopsy and has the same cancer/pre-cancer detection rate, but at the cost of a higher biopsy rate. Both referralmechanisms result in few low-risk cancer detection biopsies, finding primarily cases of high- or intermediate-risk cancer.

scholarly journals Laboratory capacity of Greek hospitals for diagnosis of salmonellosis and surveillance systems’ performance in the years of economic crisis, 2010–2016

2018 ◽  
Vol 147 ◽  
Author(s):  
K. Mellou ◽  
E. Saranti-Papasaranti ◽  
G. Mandilara ◽  
T. Georgakopoulou
Keyword(s):  
Public Hospitals ◽  
Geographical Region ◽  
Reference Laboratory ◽  
Laboratory System ◽  
Surveillance Systems ◽  
National Reference Laboratory ◽  
Notification System ◽  
National Reference ◽  
Laboratory Capacity ◽  
Mandatory Notification

AbstractAusterity might have affected the capacity of public hospitals in Greece to diagnose salmonellosis (laboratory capacity) over the period 2010–2016, as well as the performance of the existing surveillance systems. The scope of this paper is to present data on laboratory capacity over these years, as well as the results of a two-source capture-recapture study (data from Mandatory Notification System and National Reference Laboratory System for Salmonella). The main findings were that: (a) laboratory capacity was high and steady besides the financial crisis, (b) the estimated number of laboratory-confirmed cases (n = 6017, 95% CI 5892–6142) resulted in an incidence rate (7.9 cases/100 000 population) almost twice than that reported by the two systems Mandatory Notification System (MNS); 4.1 and National Reference Laboratory System (NRLS); 4.5 cases/100 000 population, (c) underreporting was high for both systems (MNS; 47.5% and NRLS; 42.8%) and (d) differences by geographical region, size and type of hospital were identified. We suggest that (a) specific interventions are needed to increase completeness of the systems by type of hospital and geographical region, (b) record linkage can help in estimating the disease burden in a more valid way than each system separately and (c) a common electronic database in order to feed one system to the other could significantly increase completeness of both systems.

scholarly journals Evaluation of optimal urine screening and confirmation cut-off values for opiates, at a national reference laboratory

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Çiğdem Karakükcü ◽  
Mehmet Zahid Çıracı ◽  
Derya Kocer ◽  
Mine Yüce Faydalı ◽  
Muhittin Abdulkadir Serdar
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
Urine Samples ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
Urine Screening ◽  
National Reference ◽  
Positive Rate ◽  
Sensitivity Specificity

Abstract Objectives To obtain optimal immunoassay screening and LC-MS/MS confirmation cut-offs for opiate group tests to reduce false positive (FP) and false negative (FN) rates. Methods A total of 126 urine samples, −50 opiate screening negative, 76 positive according to the threshold of 300 ng/mL by CEDIA method – were confirmed by a full-validated in-house LC-MS/MS method. Sensitivity, specificity, FP, and FN rates were determined at cut-off concentrations of both 300 and 2,000 ng/mL for morphine and codeine, and 10 ng/mL for heroin metabolite 6-mono-acetyl-morphine (6-MAM). Results All CEDIA opiate negative urine samples were negative for morphine, codeine and 6-MAM. Although sensitivity was 100% for each cut-off; specificity was 54.9% at CEDIA cut-off 300 ng/mL vs. LC-MS/MS cut-off 300 ng/mL and, 75% at CEDIA cut-off 2,000 ng/mL vs. LC-MS/MS cut-off 2,000 ng/mL. False positive rate was highest (45.1%) at CEDIA cut-off 300 ng/mL. At CEDIA cut-off 2,000 ng/mL vs. LC-MS/MS cut-off 300 ng/mL, specificity increased to 82.4% and FP rate decreased to 17.6%. All 6-MAM positive samples had CEDIA concentration ≥2,000 ng/mL. Conclusions 2,000 ng/mL for screening and 300 ng/mL for confirmation cut-offs are the most efficient thresholds for the lowest rate of FP opiate results.

scholarly journals Cancer Detection Rates of Systematic and Targeted Prostate Biopsies after Biparametric MRI

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Maudy C. W. Gayet ◽  
Anouk A. M. A. van der Aa ◽  
Harrie P. Beerlage ◽  
Bart Ph Schrier ◽  
Maaike Gielens ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Significant Pathology ◽  
Study Population ◽  
Clinically Significant ◽  
Control Study

Objective. To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. Methods. An in-patient control study of 82 men undergoing SB and subsequent TB in case of positive prostate MRI between 2015 and 2017 in the Jeroen Bosch Hospital, the Netherlands. Results. Prostate cancer (PCa) was detected in 54.9% with 70.7% agreement between TB and SB. Significant PCa (Gleason score ≥7) was detected in 24.4%. The CDR with TB and SB was 35.4% and 48.8%, respectively (p=0.052). The CDR of significant prostate cancer with TB and SB was both 20.7%. Clinically significant pathology upgrading occurred in 7.3% by adding TB to SB and 22.0% by adding SB to TB. Conclusions. There is no statistically significant difference between CDRs of SB and TB. Both SB and TB miss significant PCas. Moreover, pathology upgrading occurred more often by adding SB to TB than vice versa. This indicates that the omission of SB in this study population might not be justified.

scholarly journals Spectral Karyotyping for identification of constitutional chromosomal abnormalities at a national reference laboratory

2012 ◽  
Vol 5 (1) ◽  
pp. 3 ◽  
Author(s):  
Arturo Anguiano ◽  
Boris T Wang ◽  
Shirong R Wang ◽  
Fatih Z Boyar ◽  
Loretta W Mahon ◽  
...  
Keyword(s):  
Chromosomal Abnormalities ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
Spectral Karyotyping ◽  
National Reference
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