Kim Simon P, Meropol Neal J, Gross Cary P, Tilburt Jon C, Konety Badrinath, Yu James B, Abouassaly Robert, Weight Christopher J, Williams Stephen B, Shah Nilay D
University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH; Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH; Yale University, Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, New Haven, CT.
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH; Flatiron Health, New York, NY.
Urol Oncol. 2018 Nov;36(11):501.e15-501.e21. doi: 10.1016/j.urolonc.2018.07.002. Epub 2018 Sep 3.
Genetic testing has been recently put forth as a strategy to improve decision-making in the management of localized prostate cancer. Little is known about how frequently prostate cancer specialists are using these tests, or whether they consider them important or effective. We performed a national survey of radiation oncologists and urologists on their perceptions and self-reported use of genetic testing.
From January to July 2017, a 4-wave mail survey was performed involving 915 radiation oncologists and 940 urologists about genetic testing and decision-making for localized prostate cancer. The survey queried the frequency and type of genetic test and the degree of importance and confidence of such tests. Pearson chi-square and multivariable logistic regression analyses were performed to identify respondent characteristics associated with outcomes.
Overall response rate was 37.3% (n = 691). One in six specialists reported frequently using genetic tests with urologists more likely than radiation oncologists to do so (26% vs. 4%; OR: 3.51, p < 0.001) and their perceived higher importance (46% vs. 20%; adjusted OR: 3.51, p < 0.001) as well as their confidence in doing so (70% vs. 39%; OR: 3.81, p < 0.001) for decision-making for localized prostate cancer. Prolaris and Oncotype represented the most commonly cited tumor-based genetic testings.
Few radiation oncologists and urologists report frequently using genetic testing for treatment decision-making among patients diagnosed with localized prostate cancer, though more urologists use these tests and believe they yield meaningful results.
基因检测最近被提出作为一种改善局限性前列腺癌管理决策的策略。对于前列腺癌专家使用这些检测的频率,或者他们是否认为这些检测重要或有效,人们知之甚少。我们对放射肿瘤学家和泌尿科医生进行了一项全国性调查,了解他们对基因检测的看法以及自我报告的使用情况。
2017年1月至7月,对915名放射肿瘤学家和940名泌尿科医生进行了一项四波邮件调查,内容涉及局限性前列腺癌的基因检测和决策。该调查询问了基因检测的频率和类型以及此类检测的重要程度和可信度。进行了Pearson卡方检验和多变量逻辑回归分析,以确定与结果相关的受访者特征。
总体回复率为37.3%(n = 691)。六分之一的专家报告经常使用基因检测,泌尿科医生比放射肿瘤学家更有可能这样做(26%对4%;OR:3.51,p < 0.001),他们认为基因检测对局限性前列腺癌决策更重要(46%对20%;调整后OR:3.51,p < 0.001),并且对其信心也更高(70%对39%;OR:3.81,p < 0.001)。Prolaris和Oncotype是最常被提及的基于肿瘤的基因检测。
很少有放射肿瘤学家和泌尿科医生报告经常使用基因检测来为诊断为局限性前列腺癌的患者进行治疗决策,尽管更多的泌尿科医生使用这些检测并认为它们能产生有意义的结果。