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Landmark Survey of Prostate Biopsies Shows Increased Cancer Detection with 10 to 12-core Biopsies

Posted on: March 19, 2013

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The findings of the largest reported study on prostate biopsies were released at the recent American Society of Clinical Oncology Genitourinary Cancers Symposium in Orlando. The research confirmed that cancer detection rates are enhanced when 10 to 12-specimens are obtained during the biopsy.

"The study, which included over 4.2 million specimens collected from nearly 440,000 biopsies, confirms that biopsy regimens with 10 to 12 specimen cores results in an increased detection of prostate cancer," said Carl A. Olsson, MD, FACS, co-author of the study, chief medical officer of Integrated Medical Professionals. "Increased cancer detection rate correlated significantly with increased number of specimens examined."

The study, Utilization and cancer detection by U.S. prostate biopsies (2005-2011), assessed positive biopsy rates and core sampling patterns in patients whose prostate biopsies were submitted to either a national reference laboratory (NRL) or laboratory integrated into a urology group practice (UPL). The study analyzed the relationship between positive biopsy rates and number of specimen vials per biopsy. The vials per biopsy were calculated in aggregate and separately for each site of service.

Research found that from 2005-11, the average positive prostate biopsy rate of 40.3% was identical at both the NRL and UPL. Furthermore, the sharpest increase in the number of specimen vials obtained per biopsy was noted between the period 2005-08, corresponding to the development of extended core sampling regimens. The study showed that at present, there is no significant difference in number of specimen vials submitted per biopsy, regardless of site of service.

"This data, which represents the work product of over 2,000 urologists, indicates that physicians modified their clinical patterns to reflect best practices as suggested by the peer-reviewed literature," continued Deepak A. Kapoor, MD, principal author and president of the Large Urology Group Practice Association. "The fact that there was no difference in either positive biopsy rate or specimen vials submitted across sites of service definitively demonstrates that appropriate medical necessity, not physician ownership, determines utilization of services."

The American Association of Clinical Urologists (AACU), American Urological Association (AUA), and the Large Urology Group Practice Association (LUGPA) joined together in applauding the release of the findings and stand in support of sampling at least 10 to 12 cores to ensure highest amount of cancers are detected. The 10 to 12 sampling protocol is now a de facto national standard.

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