Identifying the use and barriers to the adoption of renal tumour biopsy in the management of small renal masses

Authors

  • Patrick O. Richard Centre Hospitalier Universitaire de Sherbrooke
  • Lisa Martin
  • Luke T. Lavallée
  • Philippe D. Violette
  • Maria Komisarenko
  • Andrew J. Evans
  • Kunal Jain
  • Michael A.S. Jewett
  • Antonio Finelli

DOI:

https://doi.org/10.5489/cuaj.5065

Abstract

Introduction: Renal tumour biopsies (RTBs) can provide the histology of small renal masses (SRMs) prior to treatment decisionmaking. However, many urologists are reluctant to use RTB as a standard of care. This study characterizes the current use of RTB in the management of SRMs and identifies barriers to a more widespread adoption.

Methods: A web-based survey was sent to members of the Canadian and Quebec Urological Associations who had registered email address (n=767) in June 2016. The survey examined physicians’ practice patterns, RTB use, and potential barriers to RTB. Chi-squared tests were used to assess for differences between respondents.

Results: The response rate was 29% (n=223), of which 188 respondents were eligible. A minority of respondents (12%) perform RTB in >75% of cases, while 53% never perform or perform RTB in <25% of cases. Respondents with urological oncology fellowship training were more likely to request a biopsy than their colleagues without such training. The most frequent management-related reason for not using routine RTB was a belief that biopsy won’t alter management, while the most frequent pathology-related reason was the risk of obtaining a false-negative or a non-diagnostic biopsy.

Conclusions: Adoption of RTBs remains low in Canada. Concerns about the accuracy of RTB and its ability to change clinical practice are the largest barriers to adoption. A knowledge translation strategy is needed to address these concerns. Future studies are also required in order to define where RTB is most valuable and how to best to implement it.

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Author Biography

Patrick O. Richard, Centre Hospitalier Universitaire de Sherbrooke

Urology Oncology fellow

Department of surgical oncology, Division of urology

Published

2018-03-26

How to Cite

Richard, P. O., Martin, L., Lavallée, L. T., Violette, P. D., Komisarenko, M., Evans, A. J., Jain, K., Jewett, M. A., & Finelli, A. (2018). Identifying the use and barriers to the adoption of renal tumour biopsy in the management of small renal masses. Canadian Urological Association Journal, 12(8). https://doi.org/10.5489/cuaj.5065

Issue

Section

Original Research