Factors associated with adherence to an end-of-study biopsy: lessons from the prostate cancer prevention trial (SWOG-Coordinated Intergroup Study S9217)

Cancer Epidemiol Biomarkers Prev. 2014 Aug;23(8):1638-48. doi: 10.1158/1055-9965.EPI-14-0202. Epub 2014 Jul 15.

Abstract

Background: The Prostate Cancer Prevention Trial (PCPT) was a 7-year randomized, double-blind, placebo-controlled trial of the efficacy of finasteride for the prevention of prostate cancer with a primary outcome of histologically determined prevalence of prostate cancer at the end of 7 years.

Methods: A systematic modeling process using logistic regression identified factors available at year 6 that are associated with end-of-study (EOS) biopsy adherence at year 7, stratified by whether participants were ever prompted for a prostate biopsy by year 6. Final models were evaluated for discrimination. At year 6, 13,590 men were available for analysis.

Results: Participants were more likely to have the EOS biopsy if they were adherent to study visit schedules and procedures and/or were in good health (P < 0.01). Participants at larger sites and/or sites that received retention and adherence grants were also more likely to have the EOS biopsy (P < 0.05).

Conclusions: Our results show good adherence to study requirements 1 year before the EOS biopsy was associated with greater odds that a participant would comply with the invasive EOS requirement.

Impact: Monitoring adherence behaviors may identify participants at risk of nonadherence to more demanding study end points. Such information could help frame adherence intervention strategies in future trials.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • 5-alpha Reductase Inhibitors / therapeutic use
  • Biopsy*
  • Double-Blind Method
  • Finasteride / therapeutic use
  • Humans
  • Male
  • Patient Compliance / statistics & numerical data*
  • Prostatic Neoplasms / prevention & control*
  • ROC Curve
  • Research Design*

Substances

  • 5-alpha Reductase Inhibitors
  • Finasteride