Trends in the Adoption of MRI Associated Biopsy for Active Surveillance Within the First Year After Localized Prostate Cancer Diagnosis: A SEER-Medicare Cohort Study.

BACKGROUND

Active surveillance strategies have evolved to incorporate new technologies, such as MRI. However, trends in the adoption of this technology within the first year after cancer diagnosis as part of the initial active surveillance activity remain unclear.

METHODS

Using SEER-Medicare data, this cross-sectional study examined trends in the use of various active surveillance strategies, including MRI associated biopsy, within the first year of cancer diagnosis among men diagnosed with localized prostate cancer between 2010-2011 and 2018-2019. Patients were stratified by Gleason score, age, and race/ethnicity.

RESULTS

Among patients without active treatment in the first year after localized prostate cancer diagnosis, the unadjusted proportion undergoing MRI associated biopsy as an active surveillance strategy increased from 0.8% in 2010-2011 to 3.16% in 2018-2019 for GS ≤ 6, and from 0.7% to 4.69% over the same period for GS ≥ 7. Patients aged 66-74 had consistently higher probabilities of undergoing MRI associated biopsy than patients aged 75+, and non-Hispanic White patients had consistently higher probabilities of undergoing MRI associated biopsy than non-Hispanic Black.

CONCLUSIONS

The use of new active surveillance strategies, such as MRI associated biopsy, were low in overall use but increased over time from 2010-2011 to 2018-2019, with notable differences across patient subgroups defined by age and race/ethnicity.