Prostate Cancer: Detection & Screening VI Podium Sunday, May 8, 2016 10:30 AM-12:30 PM PD26-01 CHANGES IN CLINICO-PATHOLOGICAL CHARACTERISTICS AT PROSTATE CANCER DIAGNOSIS DETECTED ON PROSTATE BIOPSIES IN DANISH MEN FROM 1995 TO 2011 Nina Klemann*, John T. Helgstrand, M. Andreas Røder, Klaus Brasso, Copenhagen N, Denmark; Birgitte Grønkær Toft, Ben Vainer, Copenhagen Ø, Denmark; Peter Iversen, Copenhagen N, Denmark INTRODUCTION AND OBJECTIVES: The incidence of pros- tate cancer (PCa) in Denmark has increased dramatically during the past two decades. PCa now accounts for 25% of all male cancers in Denmark, a change that parallels an increased use of PSA testing among healthy men. We hypothesized that this development has had a tremendous impact on clinico-pathological parameters at diagnosis of PCa over time, due to lead time bias. METHODS: We analyzed data from the Danish Prostate Can- cer Registry (DaPCaR) created at our institution, which includes all Danish men who have undergone histopathological examination of prostate tissue in the period 1995-2011. We identified all diagnostic biopsies, defined as the first needle core biopsy containing PCa, and described changes in age at diagnosis, biopsy Gleason score (GS) and clinical T-category. RESULTS: A total of 37,723 diagnostic biopsy-sets were identified. In 1995, a total of 343 men were diagnosed with PCa on needle core biopsy vs 3958 men in 2011. Median age at diagnosis decreased from 72 years in 2005 to 69 years in 2011 (p<0,0001). The percentage of patients aged 65 years or younger at the time of diag- nosis was 21.9% in 1995 compared to 32.9% in 2011. We observed several changes in the distribution of biopsy GS. The most prominent changes in GS were seen from 2005 and onwards, where the total number of patients diagnosed with PCa GS6 decreased from 34.8% to 28.2% with a concurrent increment in men with GS¼7 from 27.7% to 36.8%(p<0,0001). Biopsy GS 8 increased only very slightly from 33.4% to 33,6% from 2005 to 2011 (p<0,0001). Also, a change in tumor stage at diagnosis was observed with 31.7% classified with localized disease in 1995 compared to 66.8% in 2011 (p<0.0001). CONCLUSIONS: The number of patients diagnosed with PCa on needle core biopsies increased more than ten-fold during the investigated time period. Significant changes in all primary diagnostic clinico-pathological characteristics were observed. The number of men with low and intermediate risk features of PCa increased dramatically which can be speculated to be a result of PSA based detection even though PSA screening has not been recommended in Denmark. A lead time on diagnosis is supported by the fact that the median age at diagnosis decreased with 3 years during a 16-year time span. The increment in men diagnosed with GS¼7 from 2005 is suspected to be a consequence of revised international consensus guidelines and is unlikely to reflect changes in tumor biology. Source of Funding: The Capitol Region of Denmarks Fund for Science and Innovation The Capitol Region of Denmarks Fund for Health Research The Krista and Viggo Petersen Foundation The Danish Cancer Society PD26-02 USING A PREBIOPSY CHECKLIST TO UNDERSTAND RISK FACTORS ASSOCIATED WITH INFECTION-RELATED HOSPITALIZATION FOLLOWING PROSTATE BIOPSY Richard Sarle*, Dearborn, MI; Yuqing Gao, David Miller, Susan Linsell, Andrew Brachulis, Apoorv Dhir, Ann Arbor, MI; Dinesh Telang, Grosse Pointe, MI; James Montie, Khurshid Ghani, Ann Arbor, MI INTRODUCTION AND OBJECTIVES: A better understanding of risk factors for infection-related hospitalization following prostate biopsy may help guide quality improvement strategies that reduce these events. We examined determinants of hospitalization using a specif- ically designed prebiopsy checklist implemented in the Michigan Urological Surgery Improvement Collaborative (MUSIC). METHODS: MUSIC is a consortium of diverse urology practices that maintains a prospective registry with detailed data for all patients undergoing prostate biopsy. A prebiopsy checklist was designed in concordance with AUA White Paper recommendations, to prospectively collect data on patient risk factors for infection including history of 1) diabetes 2) patient/family member occupational exposure to healthcare facility 3) antibiotic use within six months of biopsy 4) international travel within six months of biopsy 5) prior biopsy, and 6) steroid/ immunosuppressant drugs. For this analysis, we identified all men who underwent a biopsy following implementation of the checklist, from July 2013 to August 2015. We then compared the frequency of infection- related hospitalization according to presence of risk factors. RESULTS: Among 13,933 men undergoing biopsy, the prebiopsy checklist was completed in 9396 patients (67.4%) from 37 MUSIC practices. The median age of patients was 64.5 years (interquartile range 11). Overall, in patients with a completed checklist, the infection-related hospitalization rate was 0.70%. 3477 patients (37.0%) had no risk factors on the checklist. In patients hospitalized, the most common risk factor was prior antibiotic use (31.8%) (Table 1). The rate of infection-related hospitalization was significantly higher in patients with 2 or more risk factors (p<0.01; Figure 1). CONCLUSIONS: A prebiopsy checklist can help identify patients at greater risk of infectious related complications from prostate biopsy. Those with two or more risk factors may warrant additional management strategies to reduce the risk of hospitalization. e644 THE JOURNAL OF UROLOGY â Vol. 195, No. 4S, Supplement, Sunday, May 8, 2016