Renal Mass Biopsy Underused in U.S.

The proportion of patients undergoing the procedure has stayed at 6%-7% annually.
The proportion of patients undergoing the procedure has stayed at 6%-7% annually.

ORLANDO—Despite a growing body of evidence supporting the use of percutaneous renal mass biopsy (RMB), this diagnostic procedure is underused in the United States, and the proportion of patients undergoing this test has not changed over recent years, researchers reported at the American Urological Association 2014 annual meeting.

Using 2003-2010 data from the Premier Perspective Database, Tudor Borza, MD, of Brigham and Women's Hospital in Boston, and colleagues studied 354,803 patients with renal masses and 23,311 who underwent RMB to guide therapy. The proportion of patients undergoing RMB remained stable at around 15% annually during the study period, Dr. Borza's group reported.

Patients aged 80 years and older were 50% more likely than those younger than 50 years to undergo RMB. Black and Hispanic patients had a significant 60% increased odds of undergoing the procedure compared with white patients.

Compared with patients who had Charlson Comorbidity Index (CCI) of 0, those with a CCI of 1 or 2 or more had a significant 40% and 3.2 times increased likelihood of undergoing RMB, respectively. Predictors of not undergoing RMB included age 60-69 years, private insurance, and treatment at rural hospitals.

“We speculate that RMB is preferentially used to confirm a malignancy in patients who are poor candidates for intervention,” the authors concluded.

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