IMPORTANCEThe clinical decisions that arise from prostate magnetic resonance imaging (MRI) and genomic testing in patients with prostate cancer are not well understood.
OBJECTIVETo evaluate the association between regional uptake of prostate MRI and genomic testing and observation vs treatment for prostate cancer.
DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study of commercial insurance claims for prostate MRI and genomic testing included 65 530 patients 40 to 89 years of age newly diagnosed with prostate cancer from July 1, 2012, through June 30, 2019.EXPOSURES Patient-and regional-level use of prostate MRI and genomic testing.
MAIN OUTCOMES AND MEASURES Observation vs definitive treatment for prostate cancer.Patient-level analyses examined the association between receipt of testing or residing in a hospital referral region (HRR) that adopted testing and observation. In regional-level analyses, the dependent variable was the change in the proportion of patients observed for prostate cancer at the HRR level