(HealthDay News) — Adherence to established prostate cancer quality of care measures is frequently low, with considerable regional variation, according to a study published in the April issue of The Journal of Urology.

Florian R. Schroeck, MD, from the University of Michigan in Ann Arbor, and colleagues conducted a retrospective study to examine regional variation in adherence to quality measures for 53,614 patients with newly diagnosed prostate cancer. Patients were identified from Surveillance, Epidemiology, and End Results-Medicare data for 2001 to 2007, and were assigned to 661 regions.

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The researchers observed extensive patient-level variation in adherence, varying from 33% for treatment by a high-volume provider to 76% for adjuvant androgen deprivation therapy receipt while undergoing radiation for high-risk cancer. 

Considerable regional variation was observed in adherence to several measures, including pretherapy counseling by a urologist and radiation oncologist, which ranged from 9% to 89%; avoiding bone scan overuse in low-risk cancer, which ranged from 16% to 96%; treatment by a high-volume provider, which ranged from 1% to 90%; and follow-up with a radiation oncologist, which varied from 14% to 86% (all P < 0.001).

“We found low adherence rates for most established prostate cancer quality of care measures. Within most measures regional variation in adherence was pronounced,” the researchers wrote. “Measures with low adherence and a large amount of regional variation may be important low hanging targets for quality improvement.”

One author disclosed financial ties to Amgen; one author disclosed financial ties to Elsevier.


  1. Schroeck FR, Kaufman SR, Jacobs BL, et al. Regional Variation in Quality of Prostate Cancer Care. J Urol. 2014;191(4):957–963.