MP74-09 THE PREVALENCE OF EXTREME SERUM PROSTATE SPECIFIC ANTIGEN LEVELS DURING THE COVID-19 PANDEMIC
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Detection & Screening VI (MP74), Moderated Poster 741 May 2024MP74-09 THE PREVALENCE OF EXTREME SERUM PROSTATE SPECIFIC ANTIGEN LEVELS DURING THE COVID-19 PANDEMIC Amanda E. Hird, Rano Matta, Refik Saskin, Erind Dvorani, Sarah Neu, Sender Herschorn, and Robert K. Nam Amanda E. HirdAmanda E. Hird , Rano MattaRano Matta , Refik SaskinRefik Saskin , Erind DvoraniErind Dvorani , Sarah NeuSarah Neu , Sender HerschornSender Herschorn , and Robert K. NamRobert K. Nam View All Author Informationhttps://doi.org/10.1097/01.JU.0001008632.59099.b9.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic resulted in decreased prostate specific antigen (PSA) testing for prostate cancer screening and its impact remains uncharacterized. Our objective was to compare incident PSA testing rates, PSA levels, and prostate cancer treatment rates before and during the pandemic after the state of emergency (SoE) was declared. METHODS: This was a population-based, retrospective cohort study among men 50-80 years of age in Ontario, Canada undergoing incident PSA testing from November 23, 2018 until July 9, 2021. The period of the province-wide SoE was declared on March 17, 2020 due to the rise of COVID-19 infection rates. Working backwards and forwards from this date, 30-day time periods were constructed, beginning November 23, 2018 and ending July 9, 2021 during which incident PSA testing rates were measured. Our primary outcome was the rate of incident PSA testing before and after the SoE declaration. Secondary endpoints included comparison of incident PSA levels and prostate cancer treatment rates. RESULTS: We identified 835,402 men who underwent incident PSA testing. There was a 20% decrease in PSA testing during the pandemic (RR=0.80, 95%CI: 0.80-0.81, p<0.001), compared to before. There was a higher proportion of extreme PSA levels after the SoE with a higher proportion of patients with a PSA greater than 20 ng/mL (rate ratio=1.63 95%CI: 1.54-1.73, p<.0001) and greater than 100 ng/mL (rate ratio=1.98, 95%CI: 1.77-2.20, p<.0001), compared to before. This effect was highest for those aged 50-59 years. More patients required active treatment (5,201, 59.5% prior to the pandemic vs. 5,072, 64.2%, p<0.001 after the SoE declaration), including the use of androgen deprivation therapy alone or in combination with radiation. CONCLUSIONS: The COVID-19 SoE resulted in patients experiencing a two-fold increase in the risk of having an extreme PSA level (>100 ng/mL) and higher odds of treatment for advanced disease. This data will provide more information to decision-makers when considering future pandemic planning. Source of Funding: This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long–Term Care (MOHLTC). This study also received funding from the Ajmera Family Chair in Urologic Oncology awarded to RKN © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1196 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Amanda E. Hird More articles by this author Rano Matta More articles by this author Refik Saskin More articles by this author Erind Dvorani More articles by this author Sarah Neu More articles by this author Sender Herschorn More articles by this author Robert K. Nam More articles by this author Expand All Advertisement PDF downloadLoading ...
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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".