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Prostate Cancer Treatment Trends Show Urologists' Bias

Cheryl Clark, for HealthLeaders Media, July 17, 2014

Patients diagnosed by urologists specializing in radiotherapy, cryotherapy or external beam radiation therapy were more likely to get treated with—you guessed it—radiotherapy, cryotherapy, or external beam radiation therapy, a study shows.

To the hammer, all the world is a nail.


Karen Hoffman, MD

Karen Hoffman, MD

And to the surgeon, all patient care is a scalpel, or so the saying goes.

And so it is for urologists, those doctors who diagnose low-risk prostate cancer in men with a life expectancy of less than 10 years, a patient group that should be managed with observation, not treatment, guidelines recommend.

Men diagnosed by urologists whose claims history indicates a preponderance of prostatectomy procedures were more likely to get a prostatectomy than any other form of care including watchful waiting.

Likewise, patients diagnosed by urologists specializing in radiotherapy or cryotherapy or external beam radiation therapy were more likely to get treated with—you guessed it—radiotherapy, cryotherapy, or external beam radiation therapy.

Yet these were all patients diagnosed with the same extremely low severity of disease.

These were the not-so-surprising but important take-aways this week from a study in JAMA Internal Medicine by Karen Hoffman, MD, a radiation oncologist at MD Anderson Cancer Center in Houston. Her look at a large national sample of men diagnosed with low-risk prostate cancer reveals a crying need for greater transparency in physicians' practice biases.

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1 comments on "Prostate Cancer Treatment Trends Show Urologists' Bias"


Marty (7/18/2014 at 12:58 PM)
I can say that from my experience as a patient, the choice of treatment was my own. While I was first diagnosed by a urologist whose practice was prostatectomy, after he explained the risks and my various options, I self selected my choice of treatment, HDR Brachytherapy. So perhaps the findings to some degree are simply reflecting the self selection of the patients - my treating physician of course specialized in HDR Brachytherapy.