Presentation Authors: Boris Gershman, Providence, RI, Paul Maroni, Denver, CO, Jon Tilburt, Rochester, MN, Robert Volk, PhD, Houston, TX, Badrinath Konety, MD, Minneapolis, MN, Alexander Kutikov, MD, Marc Smaldone, Marc Smaldone, Philadelphia, PA, Victor Chen, Cleveland, OH, Simon Kim*, Denver, CO
Introduction: Integration of prediction tools for prostate cancer (PCa) is essential to high quality treatment decisions and shared decision-making. Yet, little is known about the degree of confidence in existing tools and whether they are used in clinical practice from radiation oncologists (RO) and urologists (URO). Herein, we performed a national survey of specialists about perceived attitudes and use of prediction tools.
Methods: In 2017, we surveyed 940 URO and 911 RO to query their confidence in and use of the Dâ€™Amico criteria, Kattan Nomogram, and CAPRA score from a 4-wave mailing. The statistical analysis involved bivariate association and multivariable logistic regression analyses to identify physician characteristics associated with survey response and use of active surveillance (AS) for low-risk PCa.
Results: Overall, 691 (37.3%) specialists completed the surveys with similar response rates from RO and URO (35.7% vs. 38.7%; p=.18). Two thirds (Range: 65.6% - 68.4%) of respondents reported being â€œsomewhat confidentâ€, but only a fifth selected â€œvery confidentâ€ for each prediction tool (18.0% - 20.1%). 19.1% of specialists in the survey reported not using any prediction tools in clinical practice, which was higher amongst URO than RO (23.9% vs. 13.4%; p < 0.001). Lack of using prediction tools was also associated with low use of AS ( < 5%) in their low-risk PCa patients (OR: 2.47; p = 0.01).
Conclusions: While a majority of RO and URO view existing prediction tools for localized PCa with some degree of confidence, a fifth of specialists reported not using any such tools in clinical practice. Lack of using such tools was associated with low utilization of AS for low-risk PCa.
Source of Funding: Conquer Cancer Foundation