The diminishing role of transurethral resection of the prostate.

Abstract

This study provides an update of patterns in transurethral resection of the prostate (TURP) rates in the United States and the extent of TURP-detected prostate cancer incidence rates. Analyses are based on data from the National Hospital Discharge Survey, the Surveillance, Epidemiology, and End Results Program, and the U.S. Census Bureau for the years 1996 through 2006. TURP procedure rates were 6, 14, and 18 times greater in men aged 60 to 69, 70 to 79, and >or=80 years compared with men aged 50 to 59, respectively. During 1996-2006, the estimated annual percentage change in TURP rates was -10.5 (95% confidence interval [95% CI] -14.1 to -6.7) for ages 50 to 59, -7.4 (95% CI -9.2 to -5.6) for ages 60 to 69, -6.2 (95% CI -7.6 to -4.8) for ages 70 to 79, and -7.7 (95% CI -9.5 to -5.8) for ages >or=80 years. TURP-detected prostate cancer incidence rates were 2, 7, and 17 times greater in men aged 60 to 69, 70 to 79, and >or=80 years compared with men aged 50 to 59, respectively. The estimated annual percentage change in trend was -17.8 (-20.6, -15.0) for ages 50 to 59, -14.8 (-16.6, -13.0) for ages 60 to 69, -10.8 (-12.0, -9.7) for ages 70 to 79, and -8.2 (-10.0, -6.5) for ages >or=80 years. Trends in prostate cancer incidence rates peaked in 2002 and decreased thereafter. Some of the decreasing trend in rates among older age groups is because of a decrease in TURPs and consequently a decrease in incidental TURP-detected cases. TURP procedure rates and incidental TURP-detected prostate cancer incidence rates have declined and will likely continue to decline in the future.