PD26-06 A SIGNIFICANT PROPORTION OF MEN WITH A HISTORY OF PROSTATE CANCER RECEIVING TESTOSTERONE THERAPY DO NOT RECEIVE APPROPRIATE PSA MONITORING
Bibliographic record
Abstract
INTRODUCTION AND OBJECTIVE: Health practitioners are hesitant to prescribe testosterone replacement therapy for men with history of prostate cancer. Emerging data suggests that testosterone therapy is safe in men with treated prostate cancer. We characterized the prescription and laboratory monitoring patterns of patients with diagnosed prostate cancer receiving testosterone therapy in a North American healthcare system. METHODS: We performed a population-based study of men aged 66 years or older +/- a history of prostate cancer that were newly treated with testosterone replacement therapy (oral, injection, gel, and patches) between the years 2008 and 2015 in Ontario, Canada using the Ontario Drug Benefit database and the Canadian Institute for Health Information. Patient age, type of therapy, practitioner type, and laboratory value data were extracted. Proportional data was evaluated using a Chi-Square test on PRISM 8 (GraphPad Software, Inc.). RESULTS: A total of 574 men with a history of prostate cancer and 14,929 men without prostate cancer all over the age of 65 received testosterone replacement therapy between 2008 and 2015. Men with a history of prostate cancer represented 4% (n=574) of total testosterone prescriptions during this time period. A greater proportion of men with a history of prostate cancer had their prostate specific antigen (PSA) checked (71%, n=410) within one year of testosterone prescription than the general population (67%, n=9,540; p<0.001); however, this rate remained inadequately low. There was no difference in PSA monitoring by age group in men with a history of prostate cancer (p=0.84). Men with a history of prostate cancer were more likely to be treated with testosterone by a Urologist compared to the general population – prostate cancer (56% GP/FP; 37% Urology; 7% Endocrinology) vs all other patients (77% GP/FP; 17% Urology; 6% Endocrinology; p<0.01). Urologists were more likely to check PSA levels (79%) in men with a history of prostate cancer on testosterone than GP/FPs and Endocrinologists (68% and 69%; p=0.03). CONCLUSIONS: Only 70% of men who receive testosterone with a history of prostate cancer have their PSA checked. Although PSA screening has witnessed a decline among general practitioners, appropriate education for testing PSA among men diagnosed with prostate cancer is critical. Source of Funding: None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.012 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".