Prostate Cancer is the second leading cause of death in American men. More than 910,000 cases of this syndrome were reported globally (in the year 2008) and this number is expected to increase to 1.7 million by the end of 2030. The American Cancer Society estimates that in the year 2014, more than 233,000 new cases of prostate cancer will be diagnosed and about 29,480 men will die of this ailment.
This condition occurs mainly in older men and is rarely found in men below the age of 40 years. More than 6 cases in 10 are diagnosed in men aged 65 years or above. Generally, the signs and symptoms are not apparent in the early stages of this disease and will differ from one person to another. The potential risk factors include old age, genetic conditions, alcohol consumption, vitamin or mineral interactions, and other dietary habits.
Importance of Routine Screening Tests
For early detection of cancer symptoms, urologists recommend screening tests. Regular and standard screening tests will not only help patients to better manage the disease symptoms but also improve patient function thereby enhancing their quality of life. The American Cancer Society recommends that men should take an informed decision with their physician whether to be tested for prostate cancer, beginning at the age of 50.
A routine and timely test facilitates early diagnosis and helps determine the correct treatment modality required. Even though there is no regular screening program for this form of cancer, physicians make a comprehensive diagnostic evaluation of the symptoms by conducting screening tests such as prostate-specific antigen (PSA) blood test and digital rectal exam (DRE).
Medicare provides coverage for an annual preventive prostate cancer screening PSA test and DRE once every 12 months for all male beneficiaries age 50 and older.
Healthcare providers should utilize accurate diagnostic codes to ensure correct reimbursement. V76.44 is the ICD-9 code to report screening for malignant neoplasms of the prostate.
Diagnosing Urologists Influence Treatment Decisions – New Study
A new study conducted by researchers at the University of Texas, MD Anderson Cancer Center in Houston shows that diagnosing physicians (particularly urologists) can significantly influence the decision making of those men having low risk prostate cancer and the type of treatment option selected. The study published online in JAMA Internal Medicine (July 14, 2014) examines the prominent reasons for active surveillance being underused in men with low-risk disease.
The study aimed to identify the unusual variation that exists in managing the ailment with the physician playing a more important role than accepted patient factors that affect surveillance use. As part of the survey, researchers analyzed 12,068 men (aged 66 years and older) diagnosed with low-risk prostate cancer from the year 2006 to 2009. They also wanted to identify the impact of the diagnosing urologist on treatment decisions, quantify the rate of surveillance versus treatment and identify urologist and patient factors associated with surveillance selection. Eighty percent of the men received treatment and 20% underwent surveillance. The observation rates showed significant variation across urologists (from 4.5% to 64.2%), and radiation oncologists (from 2% to 47%).
It was found that the diagnosing physician accounted for more than double the rate of difference seen in treatment vs. observation decisions (when compared against patient characteristics like age, PSA level and co morbidities). Patients diagnosed by urologists (who treated low-risk prostate cancer) had more chances of receiving the same treatment and therapy their diagnosing urologist used.
The study results emphasize the fact that physicians influence the treatment decisions including the type of treatment method selected. Researchers also point out various limitations related to the study such as shifting practice patterns affecting treatment decisions, and the failure to measure certain core factors such as family history and patient anxiety that may have an impact on treatment choices.