Abstract
Purpose
Racial disparities are apparent in the management and outcomes for prostate cancer; however, disparities in compliance to quality measures for radiation therapy for prostate cancer have not been previously studied. Therefore, the goal of the study was to characterize disparities in the compliance rates with quality measures.
Methods
The comparative effectiveness analysis of radiation therapy and surgery study is a population-based, prospective cohort study that enrolled 3708 men with clinically localized prostate cancer from 2011 to 2012. Compliance with 5 radiation-specific quality measures endorsed by national consortia as of 2011 was assessed, and compliance was compared by race using logistic regression.
Results
Overall, 604 men received definitive external beam radiation therapy (EBRT) of which 20% were self-reported black, 74% non-Hispanic white, and 6% Hispanic. Less than two-thirds of black and Hispanic men received EBRT that was compliant with all available quality measures (p = 0.012). Compared to white men, black men were less likely to receive dose-escalated EBRT (95% vs. 87%, p = 0.011) and less likely to avoid unnecessary pelvic radiation for low-risk disease (99% vs. 20%, p < 0.001). Compared to white men, Hispanic men were less likely to undergo image guidance (87% vs. 71%, p = 0.04). Black and Hispanic men were more likely to receive EBRT from low-quality providers than white men.
Conclusions
Addressing disparities in access to providers that meet quality guidelines, and improving adherence to evidence-based processes of care may decrease racial/ethnic disparities in prostate cancer outcomes.
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References
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Funding
This work was supported by the American Cancer Society (MSRG-15-103-01-CPHPS to M.J.R.); by the US Agency for Healthcare Research and Quality (1R01HS019356, 1R01HS022640-01); and through a contract from the Patient-Centered Outcomes Research Institute.
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Lee, D.J., Zhao, Z., Huang, LC. et al. Racial variation in receipt of quality radiation therapy for prostate cancer. Cancer Causes Control 29, 895–899 (2018). https://doi.org/10.1007/s10552-018-1065-5
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DOI: https://doi.org/10.1007/s10552-018-1065-5