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Sociodemographic Disparities in Cure-Intended Treatment in Localized Prostate Cancer

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Abstract

Purpose

Disparities in prostate cancer (PCa) morbidity and mortality occur across various populations. We investigated the sociodemographic correlates of treatment and disparities in the application of cure-intended (i.e., radical prostatectomy [RP], radiation therapy [RT]) treatment strategies in localized PCa among Texas residents diagnosed with PCa.

Methods

We analyzed data from the Texas Cancer Registry on men diagnosed with stage T1 or T2 PCa between 2004 and 2009. Multinomial logistic regression analysis was used to explore independent associations between cure-intended treatment modalities and sociodemographic characteristics (age, race/ethnicity, socioeconomic status [SES], and geographic location (rural versus urban)) using patients who did not receive definitive treatment as comparison group.

Results

Of 46,971 patients with available treatment data, age-adjusted treatment rates were 39.1% RP, 30.7% RT, and 30.2% for all other non-curative modalities. Compared to patients under 60 years, those ≥60 were less likely to receive RP, patients between 60 and 80 years were more likely to undergo RT, while those 80 years or older were less likely. Non-Hispanic blacks (OR =0.55, 95% CI, 0.50–0.59) and Hispanics (OR = 0.68, 95%CI, 0.62–0.74) were less likely to receive RP compared with whites. Hispanics were significantly less likely to receive RT (OR = 0.78, 95%CI, 0.72–0.85) than blacks and whites. People of low SES were 35% (OR = 0.65, 95%CI, 0.60–0.69) and 15% (OR = 0.85, 95%CI, 0.79–0.90) less likely to receive RP and RT, respectively, compared with those of high SES. Rural-urban status was not associated with cure-intended treatment.

Conclusion

Potential sociodemographic disparities exist in the application of cure-intended treatment in localized prostate cancer in Texas particularly in race/ethnicity and SES.

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References

  1. U. S. Cancer Statistics Working Group. United States Cancer Statistics:1999–2007 Incidence and Mortality Web-based Report. In. Atlanta: US: Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. 2010.

  2. Surveillance Epidemiology and End Results. SEER Stats Fact Sheet: Prostate. 2013. http://www.seer.cancer.gov/statfacts/html/prost.html

  3. Schymura MJ, Kahn AR, German RR, Hsieh MC, Cress RD, Finch JL, Fulton JP, Shen T, Stuckart E. Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1). BMC Cancer. 2010;10(152):152.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wilt TJ, MacDonald R, Rutks I, Shamliyan TA, Taylor BC, Kane RL. Systematic review: comparative effectiveness and harms of treatments for clinically localized prostate cancer. Ann Intern Med. 2008;148(6):435–48.

    Article  PubMed  Google Scholar 

  5. Sun F, Oyesanmi O, Fontanarosa J, Reston J, Guzzo T, Schoelles K. Therapies for Clinically Localized Prostate Cancer: Update of a 2008 Systematic Review. Comparative Effectiveness Review No. 146. (Prepared by the ECRI Institute–Penn Medicine Evidence-based Practice Center under Contract No. 290-2007-10063.) AHRQ Publication No. 15-EHC004-EF.. In: Comparative Effectiveness Review. Rockville, MD: Agency for Healthcare Research and Quality; 2014.

  6. Thompson I, Thrasher JB, Aus G, Burnett AL. Guideline for the Management of Clinically Localized Prostate Cancer: 2007 Update. American Urological Association Education and Research In.; 2007.

  7. Hoffman RM, Hunt WC, Gilliland FD, Stephenson RA, Potosky AL. Patient satisfaction with treatment decisions for clinically localized prostate carcinoma. Results from the Prostate Cancer Outcomes Study. Cancer. 2003;97(7):1653–62.

    Article  PubMed  Google Scholar 

  8. Krieger N, Chen JT, Waterman PD, Soobader MJ, Subramanian SV, Carson R. Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the public health disparities geocoding project. Am J Epidemiol. 2002;156(5):471–82.

    Article  PubMed  Google Scholar 

  9. Surveillance, Epidemiology and End Results Program Beale Codes. 2016. http://seer.cancer.gov/seerstat/variables/ses/beale_codes/yr1969_2002/.

  10. Desch CE, Penberthy L, Newschaffer CJ, Hillner BE, Whittemore M, McClish D, Smith TJ, Retchin SM. Factors that determine the treatment for local and regional prostate cancer. Med Care. 1996;34(2):152–62.

    Article  CAS  PubMed  Google Scholar 

  11. Shavers VL, Brown ML, Potosky AL, Klabunde CN, Davis WW, Moul JW, Fahey A. Race/ethnicity and the receipt of watchful waiting for the initial management of prostate cancer. J Gen Intern Med. 2004;19(2):146–55.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Shteynshlyuger A, Kibel AS. Counterpoint: prostate carcinoma treatment for the young patient—the case for radical prostatectomy. Brachytherapy. 2010;9(3):195–8. discussion 199-201

    Article  PubMed  Google Scholar 

  13. Harlan LC, Potosky A, Gilliland FD, Hoffman R, Albertsen PC, Hamilton AS, Eley JW, Stanford JL, Stephenson RA. Factors associated with initial therapy for clinically localized prostate cancer: prostate cancer outcomes study. J Natl Cancer Inst. 2001;93(24):1864–71.

    Article  CAS  PubMed  Google Scholar 

  14. Underwood W, De Monner S, Ubel P, Fagerlin A, Sanda MG, Wei JT. Racial/ethnic disparities in the treatment of localized/regional prostate cancer. J Urol. 2004;171(4):1504–7.

    Article  PubMed  Google Scholar 

  15. de Camargo CM, Comber H, Sharp L. Age remains the major predictor of curative treatment non-receipt for localised prostate cancer: a population-based study. Br J Cancer. 2013;109(1):272–9.

    Article  Google Scholar 

  16. Gross CP, Smith BD, Wolf E, Andersen M. Racial disparities in cancer therapy: did the gap narrow between 1992 and 2002? Cancer. 2008;112(4):900–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wang EH, Yu JB, Abouassally R, Meropol NJ, Cooper G, Shah ND, Williams SB, Gonzalez C, Smaldone MC, Kutikov A, et al. Disparities in treatment of patients with high-risk prostate cancer: results from a population-based cohort. Urology. 2016;95:88–94.

    Article  PubMed  Google Scholar 

  18. CSDH. Closing the gap: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. In. Geneva: World Health Organization; 2008.

  19. Herd P, Goesling B, House JS. Socioeconomic position and health: the differential effects of education versus income on the onset versus progression of health problems. J Health Soc Behav. 2007;48(3):223–38.

    Article  PubMed  Google Scholar 

  20. Rapiti E, Fioretta G, Schaffar R, Neyroud-Caspar I, Verkooijen HM, Schmidlin F, Miralbell R, Zanetti R, Bouchardy C. Impact of socioeconomic status on prostate cancer diagnosis, treatment, and prognosis. Cancer. 2009;115(23):5556–65.

    Article  PubMed  Google Scholar 

  21. Krupski TL, Kwan L, Afifi AA, Litwin MS. Geographic and socioeconomic variation in the treatment of prostate cancer. J Clin Oncol. 2005;23(31):7881–8.

    Article  PubMed  Google Scholar 

  22. Fairley L, Baker M, Whiteway J, Cross W, Forman D. Trends in non-metastatic prostate cancer management in the Northern and Yorkshire region of England, 2000–2006. Br J Cancer. 2009;101(11):1839–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Baldwin LM, Andrilla CH, Porter MP, Rosenblatt RA, Patel S, Doescher MP. Treatment of early-stage prostate cancer among rural and urban patients. Cancer. 2013;119(16):3067–75.

    Article  PubMed  Google Scholar 

  24. Steenland K, Goodman M, Liff J, Diiorio C, Butler S, Roberts P, Smith JL, Ekwueme D, Hall IJ. The effect of race and rural residence on prostate cancer treatment choice among men in Georgia. Urology. 2011;77(3):581–7.

    Article  PubMed  Google Scholar 

  25. Scherr KA, Fagerlin A, Hofer T, Scherer LD, Holmes-Rovner M, Williamson LD, Kahn VC, Montgomery JS, Greene KL, Zhang B, Ubel PA. Physician recommendations trump patient preferences in prostate cancer treatment decisions. Med Decis Mak. 2017;37:56–69.

    Article  Google Scholar 

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Correspondence to Jude K. A. des Bordes.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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des Bordes, J.K.A., Lopez, D.S., Swartz, M.D. et al. Sociodemographic Disparities in Cure-Intended Treatment in Localized Prostate Cancer. J. Racial and Ethnic Health Disparities 5, 104–110 (2018). https://doi.org/10.1007/s40615-017-0348-y

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  • DOI: https://doi.org/10.1007/s40615-017-0348-y

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