Prostate Cancer Treatment Trends Show Urologists' Bias

Cheryl Clark, 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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