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  1. Article ; Online: Real-world utilization, patient characteristics, and treatment patterns among men with localized prostate cancer tested with the 17-gene genomic prostate score® (GPS

    Nguyen, Amy M / Carter, Gebra Cuyun / Wilson, Lesley-Ann Miller / Canfield, Steven

    The Prostate

    2024  

    Abstract: Objectives: Descriptive study focusing on real-world utilization and characteristics of men with prostate cancer tested with the 17-gene Genomic Prostate Score® (GPS™) assay by linking administrative claims and electronic health record (EHR) data with ... ...

    Abstract Objectives: Descriptive study focusing on real-world utilization and characteristics of men with prostate cancer tested with the 17-gene Genomic Prostate Score® (GPS™) assay by linking administrative claims and electronic health record (EHR) data with GPS results.
    Methods: This retrospective, observational cohort study (January 1, 2013 to December 31, 2020) included men aged 40-80 years with localized prostate cancer claims, continuous enrollment in Optum's Integrated Claims data set, ≥1 day of EHR clinical activity, and a GPS result. Men were classified as undergoing definitive therapy (DT) (prostatectomy, radiation, or focal therapy) or active surveillance (AS). AS and DT distribution were analyzed across GPS results, National Comprehensive Cancer Network® (NCCN®) risk, and race. Costs were assessed 6 months after the first GPS result (index); clinical outcomes and AS persistence were assessed during the variable follow-up. All variables were analyzed descriptively.
    Results: Of 834 men, 650 (77.9%) underwent AS and 184 (22.1%) DT. Most men had Quan-Charlson comorbidity scores of 1-2 and a tumor stage of T1c (index). The most common Gleason patterns were 3 + 3 (79.6%) (AS cohort) and 3 + 4 (55.9%) (DT cohort). The mean (standard deviation) GPS results at index were 23.2 (11.3) (AS) and 30.9 (12.9) (DT). AS decreased with increasing GPS result and NCCN risk. Differences between races were minimal. Total costs were substantially higher in the DT cohort.
    Conclusions: Most men with GPS-tested localized prostate cancer underwent AS, indicating the GPS result can inform clinical management. Decreasing AS with increasing GPS result and NCCN risk suggests the GPS complements NCCN risk stratification.
    Language English
    Publishing date 2024-04-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604707-5
    ISSN 1097-0045 ; 0270-4137
    ISSN (online) 1097-0045
    ISSN 0270-4137
    DOI 10.1002/pros.24709
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  2. Article ; Online: Making the GRADE: Providing Clinical Practice Guidance to the European Association of Urology.

    Canfield, Steven E / Omar, Muhammad Imran / Ribal, Maria J

    European urology

    2023  Volume 85, Issue 4, Page(s) 405–406

    MeSH term(s) Humans ; Urology ; Societies, Medical ; Europe
    Language English
    Publishing date 2023-03-25
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 193790-x
    ISSN 1873-7560 ; 1421-993X ; 0302-2838
    ISSN (online) 1873-7560 ; 1421-993X
    ISSN 0302-2838
    DOI 10.1016/j.eururo.2023.03.006
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  3. Article ; Online: Current Landscape of Surgical Assessment Models in Urology Residency Training. Reply.

    Conroy, Lauren M / Slovacek, Hannah / Blum, Kyle A / Canfield, Steven E / Mann, Phillip

    The Journal of urology

    2023  Volume 210, Issue 2, Page(s) 253

    MeSH term(s) Humans ; Internship and Residency ; Urology/education ; Curriculum ; Surveys and Questionnaires ; Clinical Competence
    Language English
    Publishing date 2023-05-17
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000003520
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  4. Article ; Online: Current Landscape of Surgical Assessment Models in Urology Residency Training.

    Conroy, Lauren M / Slovacek, Hannah / Blum, Kyle A / Canfield, Steven E / Mann, Phillip

    The Journal of urology

    2022  Volume 209, Issue 3, Page(s) 474–484

    Abstract: Purpose: Assessing trainees' surgical proficiency is an important aspect of urological surgical training. The current standard is the Urology Milestone Project, initially implemented in 2013. This evaluation is limited in that it contains only 3 ... ...

    Abstract Purpose: Assessing trainees' surgical proficiency is an important aspect of urological surgical training. The current standard is the Urology Milestone Project, initially implemented in 2013. This evaluation is limited in that it contains only 3 questions on surgical competency per surgical modality with assessments occurring semi-annually without real-time operative feedback. However, since the Urology Milestones Project's inception a plethora of competency-based surgical assessment tools have been described. We aim to perform a comprehensive review of the literature of these available tools and analyze their strengths and weaknesses as a way of providing a repository of available assessment strategies for further development of a more comprehensive and standardized assessment tool.
    Materials and methods: A review of the primary literature was performed using key words such as "surgical assessment tools urology," "surgical assessment tools prostate," "bladder surgical assessment tools," "renal surgical assessment tools urology," and "surgical assessment tools urology task specific." Technical and nontechnical skill assessments were included. One reviewer identified and analyzed studies that published assessment tools for use in surgical and urological training.
    Results: A total of 1,497 articles published between 1997-2022 were identified. Of these, 34 met the inclusion criteria. Eighteen (52.9%) were specialty nonspecific and 16 (47.1%) were specific for urological training. Of the 18 tools developed for general surgical principles, 12 (66.7%) had some form of validity, 9 (50.0%) were significantly reliable, and 2 (11.1%) were externally validated. Of the 16 tools developed specifically for use in urology training, 13 (81.3%) had some form of validity, 7 (43.8%) were significantly reliable, and none were externally validated. Of these 16 tools, 12 (75.0%) were procedure-specific and 4 (25.0%) were developed for general use in endourological procedures.
    Conclusions: Surgical training is evolving toward a competency-based model, as evidenced by the increase in assessment tools created within the past 10 years. These instruments not only provide objective feedback to trainees, but also monitor progression. However, they are heterogeneous in construct and utilization. There remains a need for the adoption of a standardized, valid, and reliable tool, ie, both procedure-specific and generalizable across multiple procedures for use in urology training.
    MeSH term(s) Male ; Humans ; Urology/education ; Internship and Residency ; Clinical Competence ; Urologic Surgical Procedures/education ; Endoscopy
    Language English
    Publishing date 2022-11-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000003079
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  5. Article ; Online: Use of weight loss medications in relation with prostate, colorectal and male breast cancers among older men: SEER-Medicare 2007-2015.

    Lopez, David S / Kim, Hyunkyoung / Polychronopoulou, Efstathia / Torres-Sanchez, Luisa E / Villasante-Tezanos, Alejandro / Baillargeon, Jacques / Canfield, Steven / Kuo, Yong-Fang

    Journal of cancer research and clinical oncology

    2023  Volume 149, Issue 11, Page(s) 8255–8265

    Abstract: Background: The association of weight loss medications with prostate (PCa), colorectal (CRC) or male breast cancers, including assessment of these cancers combined (HRCs, hormone-associated cancers) remain poorly understood. Testosterone replacement ... ...

    Abstract Background: The association of weight loss medications with prostate (PCa), colorectal (CRC) or male breast cancers, including assessment of these cancers combined (HRCs, hormone-associated cancers) remain poorly understood. Testosterone replacement therapy (TTh) is reported to be inversely associated with obesity, PCa and CRC, but it is unclear whether TTh modifies the association of weight loss medications with HRCs.
    Methods: In 49,038 men (≥ 65 years) of SEER-Medicare, we identified 15,471 men diagnosed with PCa, 4836 with CRC, and 141 with male breast cancers. Pre-diagnostic prescription of weight loss medications and TTh was ascertained for this analysis. Weighted multivariable-adjusted conditional logistic and Cox proportional hazards (mortality) models were conducted.
    Results: We found an inverse association between use of weight loss medications and incident PCa (OR 0.59, 95% CI 0.57-0.62), CRC (OR 0.86, 95% CI 0.80-0.92), and HRCs (OR 0.65, 95% CI 0.62-0.68). Similar associations were observed for advanced stage at diagnosis of PCa and CRC. Effects of weight loss medications on PCa and HRC remained significant irrespective of the use of TTh but were only suggestive with CRC with positive TTh use. No associations were observed with male breast cancer and HRCs mortality.
    Conclusion: Pre-diagnostic use of weight loss medications reduced the incidence of PCa, CRC, and HRCs. These associations persisted in the same direction irrespective of the history of TTh use. Future studies are needed to confirm these findings and to identify underlying biological mechanisms of weight loss medications and TTh on the risk of cancer.
    MeSH term(s) Humans ; Male ; Aged ; United States/epidemiology ; Medicare ; Prostate ; Breast Neoplasms, Male ; Colorectal Neoplasms ; Weight Loss ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/epidemiology
    Language English
    Publishing date 2023-04-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 134792-5
    ISSN 1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
    ISSN (online) 1432-1335
    ISSN 0171-5216 ; 0084-5353 ; 0943-9382
    DOI 10.1007/s00432-023-04778-z
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  6. Article: Prostate Cancer Mortality and Use of 5-Alpha Reductase Inhibitors.

    Foldes, Cara A / Wang, Run / Canfield, Steven E

    The world journal of men's health

    2019  Volume 38, Issue 2, Page(s) 139–140

    Language English
    Publishing date 2019-10-15
    Publishing country Korea (South)
    Document type Editorial
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.190129
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  7. Article ; Online: Evaluating the impact of pre-diagnostic use of statins and testosterone replacement therapy on mortality outcomes in older men with hormone-related cancers: Surveillance, Epidemiology, and End Results-Medicare 2007-2015.

    Hussain, Maryam R / Abdelgadir, Omer / Polychronopoulou, Efstathia / Tsilidis, Konstantinos K / Alzweri, Laith / Villasante-Tezanos, Alejandro / Baillargeon, Jacques / Canfield, Steven / Kuo, Yong-Fang / Lopez, David S

    Andrology

    2024  

    Abstract: Background: The link between the pre-diagnostic use of statins and testosterone replacement therapy and their impact on hormone-related cancers, prostate cancer, colorectal cancer, and male breast cancer survival remains a topic of controversy. Further, ...

    Abstract Background: The link between the pre-diagnostic use of statins and testosterone replacement therapy and their impact on hormone-related cancers, prostate cancer, colorectal cancer, and male breast cancer survival remains a topic of controversy. Further, there is a knowledge gap concerning the joint effects of statins and testosterone replacement therapy on hormone-related cancer survival outcomes.
    Objective: To examine the independent and joint effects of pre-diagnostic use of statins and testosterone replacement therapy on the risk of all-cause and cause-specific mortality among older men diagnosed with hormone-related cancers, including prostate cancer, colorectal cancer, and male breast cancer.
    Methods: In 41,707 men (≥65 years) of Surveillance, Epidemiology, and End Results-Medicare 2007-2015, we identified 31,097 prostate cancer, 10,315 colorectal cancer, and 295 male breast cancer cases. Pre-diagnostic prescription of statins and testosterone replacement therapy was ascertained and categorized into four groups (Neither users, statins alone, testosterone replacement therapy alone, and Dual users). Multivariable-adjusted Cox proportional hazards and competing-risks (Fine-Gray subdistribution hazard) models were conducted.
    Results: No significant associations were found in Cox-proportional hazard models for hormone-related cancers. However, in the Fine-Gray competing risk models among high-grade hormone-related cancers, statins alone had an 11% reduced risk of hormone-related cancer-specific death (hazard ratio: 0.89; 95% confidence interval: 0.81-0.99; p 0.0451). In the prostate cancer cohort with both statistical models, the use of testosterone replacement therapy alone had a 24% lower risk of all-cause death (hazard ratio: 0.76; 95% confidence interval: 0.59-0.97; p 0.0325) and a 57% lower risk of prostate cancer-specific death (hazard ratio: 0.43; 95% confidence interval: 0.24-0.75; p 0.0029). Similar inverse associations were found among aggressive prostate cancer cases with testosterone replacement therapy alone and statins alone. No significant associations were found in the colorectal cancer and male breast cancer sub-groups.
    Conclusion: Pre-diagnostic use of statins and testosterone replacement therapy showed a survival benefit with reduced mortality in high-grade hormone-related cancer patients (only statins) and aggressive prostate cancer patients in both statistical models. Findings of testosterone replacement therapy use in aggressive prostate cancer settings could facilitate clinical trials. Further studies with extended follow-up periods are needed to substantiate these findings.
    Language English
    Publishing date 2024-02-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2696108-8
    ISSN 2047-2927 ; 2047-2919
    ISSN (online) 2047-2927
    ISSN 2047-2919
    DOI 10.1111/andr.13616
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  8. Article ; Online: ACP Journal Club. Radical prostatectomy reduced mortality and disease progression over the long term more than watchful waiting in early prostate cancer.

    Canfield, Steven E

    Annals of internal medicine

    2011  Volume 155, Issue 2, Page(s) JC1–2

    Language English
    Publishing date 2011-07-19
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/0003-4819-155-2-201107190-02002
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  9. Article ; Online: ACP Journal Club. Adding short-term androgen-deprivation therapy to radiotherapy improved survival in localized prostate cancer.

    Canfield, Steven E

    Annals of internal medicine

    2011  Volume 155, Issue 10, Page(s) JC5–07

    MeSH term(s) Androgen Antagonists/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Humans ; Male ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/radiotherapy
    Chemical Substances Androgen Antagonists
    Language English
    Publishing date 2011-11-15
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/0003-4819-155-10-201111150-02007
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  10. Article ; Online: Review: Newer and older drugs do not differ for lower urinary tract symptoms due to benign prostatic hyperplasia.

    Foldes, Cara / Canfield, Steven E

    Annals of internal medicine

    2016  Volume 165, Issue 8, Page(s) JC45

    Language English
    Publishing date 2016-10-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/ACPJC-2016-165-8-045
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