As mentioned in this article, previous studies at tertiary centers have demonstrated higher pathology reclassification rates on diagnostic prostate biopsies performed by an external urology practice versus internally (references 4—6 in article). The inevitable bias against the external, or community, diagnostic biopsy has prompted many tertiary centers to perform confirmatory biopsies at the time of referral in patients opting for active surveillance rather than waiting 12-24 months as recommended by AUA/ASTRO/SUO guidelines (reference 4 in article). This paper challenges the bias that community diagnostic biopsy is suboptimal.
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