Treatment for older prostate cancer patients

Disparities in a southern state

Maria Pisu, Joann S. Oliver, Young Il Kim, Keith Elder, Michelle Martin, Lisa C. Richardson

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Black prostate cancer patients are less likely to receive aggressive therapy (AT) than Whites: reported rates for patients ≥65 years old are about 55% versus 65%. Little is known about treatment rates in socioeconomically deprived states with large Black populations like Alabama. STUDY DESIGN: Medicare claims and Alabama Statewide Cancer Registry records were linked for Alabamian men in Medicare fee-for-service diagnosed with loco-regional prostate cancer in 2000-2002. The association between race and likelihood of: (1) AT (prostatectomy or external beam radiation therapy [EBRT] or brachytherapy); (2) hormone therapy (primary androgen deprivation therapy [ADT] or orchiectomy); (3) <30 days of EBRT; and (4) <6 months of ADT, was investigated adjusting for age, clinical tumor stage, grade, Comorbidity Index, and census tract proportion of Black residents, of persons living below poverty and with ≤ high school. Results: Of 3561 patients, 71.2% received AT and 38.3% hormone therapy. Blacks were less likely to receive AT (64.3% vs. 73.0%, adjusted [adj.] OR: 0.80, CI: 0.67-0.96). There was no difference between Blacks and Whites in the likelihood of receiving hormone therapy (40.8% vs. 37.7%, adj. OR: 1.10, CI: 0.91-1.34), <30 days of EBRT (30.5% vs. 31.5%, adj. OR: 0.98, CI: 0.72-1.32) or <6 months of ADT (50.7% vs. 54.0%, adj. OR: 0.84, CI: 0.63-1.12). Conclusions: In Alabama, there were racial differences in utilization of aggressive treatment for locoregional prostate cancer. Research should investigate factors associated with prostate cancer treatment among older men, such as patient behavior and access to care.

Original languageEnglish (US)
Pages (from-to)915-922
Number of pages8
JournalMedical care
Volume48
Issue number10
DOIs
StatePublished - Jan 1 2010

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Prostatic Neoplasms
Therapeutics
Androgens
Radiotherapy
Hormones
Medicare
Fee-for-Service Plans
Orchiectomy
Brachytherapy
Censuses
Poverty
Prostatectomy
Registries
Comorbidity
Neoplasms

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Pisu, M., Oliver, J. S., Kim, Y. I., Elder, K., Martin, M., & Richardson, L. C. (2010). Treatment for older prostate cancer patients: Disparities in a southern state. Medical care, 48(10), 915-922. https://doi.org/10.1097/MLR.0b013e3181eb31a8

Treatment for older prostate cancer patients : Disparities in a southern state. / Pisu, Maria; Oliver, Joann S.; Kim, Young Il; Elder, Keith; Martin, Michelle; Richardson, Lisa C.

In: Medical care, Vol. 48, No. 10, 01.01.2010, p. 915-922.

Research output: Contribution to journalArticle

Pisu, M, Oliver, JS, Kim, YI, Elder, K, Martin, M & Richardson, LC 2010, 'Treatment for older prostate cancer patients: Disparities in a southern state', Medical care, vol. 48, no. 10, pp. 915-922. https://doi.org/10.1097/MLR.0b013e3181eb31a8
Pisu, Maria ; Oliver, Joann S. ; Kim, Young Il ; Elder, Keith ; Martin, Michelle ; Richardson, Lisa C. / Treatment for older prostate cancer patients : Disparities in a southern state. In: Medical care. 2010 ; Vol. 48, No. 10. pp. 915-922.
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abstract = "Background: Black prostate cancer patients are less likely to receive aggressive therapy (AT) than Whites: reported rates for patients ≥65 years old are about 55{\%} versus 65{\%}. Little is known about treatment rates in socioeconomically deprived states with large Black populations like Alabama. STUDY DESIGN: Medicare claims and Alabama Statewide Cancer Registry records were linked for Alabamian men in Medicare fee-for-service diagnosed with loco-regional prostate cancer in 2000-2002. The association between race and likelihood of: (1) AT (prostatectomy or external beam radiation therapy [EBRT] or brachytherapy); (2) hormone therapy (primary androgen deprivation therapy [ADT] or orchiectomy); (3) <30 days of EBRT; and (4) <6 months of ADT, was investigated adjusting for age, clinical tumor stage, grade, Comorbidity Index, and census tract proportion of Black residents, of persons living below poverty and with ≤ high school. Results: Of 3561 patients, 71.2{\%} received AT and 38.3{\%} hormone therapy. Blacks were less likely to receive AT (64.3{\%} vs. 73.0{\%}, adjusted [adj.] OR: 0.80, CI: 0.67-0.96). There was no difference between Blacks and Whites in the likelihood of receiving hormone therapy (40.8{\%} vs. 37.7{\%}, adj. OR: 1.10, CI: 0.91-1.34), <30 days of EBRT (30.5{\%} vs. 31.5{\%}, adj. OR: 0.98, CI: 0.72-1.32) or <6 months of ADT (50.7{\%} vs. 54.0{\%}, adj. OR: 0.84, CI: 0.63-1.12). Conclusions: In Alabama, there were racial differences in utilization of aggressive treatment for locoregional prostate cancer. Research should investigate factors associated with prostate cancer treatment among older men, such as patient behavior and access to care.",
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N2 - Background: Black prostate cancer patients are less likely to receive aggressive therapy (AT) than Whites: reported rates for patients ≥65 years old are about 55% versus 65%. Little is known about treatment rates in socioeconomically deprived states with large Black populations like Alabama. STUDY DESIGN: Medicare claims and Alabama Statewide Cancer Registry records were linked for Alabamian men in Medicare fee-for-service diagnosed with loco-regional prostate cancer in 2000-2002. The association between race and likelihood of: (1) AT (prostatectomy or external beam radiation therapy [EBRT] or brachytherapy); (2) hormone therapy (primary androgen deprivation therapy [ADT] or orchiectomy); (3) <30 days of EBRT; and (4) <6 months of ADT, was investigated adjusting for age, clinical tumor stage, grade, Comorbidity Index, and census tract proportion of Black residents, of persons living below poverty and with ≤ high school. Results: Of 3561 patients, 71.2% received AT and 38.3% hormone therapy. Blacks were less likely to receive AT (64.3% vs. 73.0%, adjusted [adj.] OR: 0.80, CI: 0.67-0.96). There was no difference between Blacks and Whites in the likelihood of receiving hormone therapy (40.8% vs. 37.7%, adj. OR: 1.10, CI: 0.91-1.34), <30 days of EBRT (30.5% vs. 31.5%, adj. OR: 0.98, CI: 0.72-1.32) or <6 months of ADT (50.7% vs. 54.0%, adj. OR: 0.84, CI: 0.63-1.12). Conclusions: In Alabama, there were racial differences in utilization of aggressive treatment for locoregional prostate cancer. Research should investigate factors associated with prostate cancer treatment among older men, such as patient behavior and access to care.

AB - Background: Black prostate cancer patients are less likely to receive aggressive therapy (AT) than Whites: reported rates for patients ≥65 years old are about 55% versus 65%. Little is known about treatment rates in socioeconomically deprived states with large Black populations like Alabama. STUDY DESIGN: Medicare claims and Alabama Statewide Cancer Registry records were linked for Alabamian men in Medicare fee-for-service diagnosed with loco-regional prostate cancer in 2000-2002. The association between race and likelihood of: (1) AT (prostatectomy or external beam radiation therapy [EBRT] or brachytherapy); (2) hormone therapy (primary androgen deprivation therapy [ADT] or orchiectomy); (3) <30 days of EBRT; and (4) <6 months of ADT, was investigated adjusting for age, clinical tumor stage, grade, Comorbidity Index, and census tract proportion of Black residents, of persons living below poverty and with ≤ high school. Results: Of 3561 patients, 71.2% received AT and 38.3% hormone therapy. Blacks were less likely to receive AT (64.3% vs. 73.0%, adjusted [adj.] OR: 0.80, CI: 0.67-0.96). There was no difference between Blacks and Whites in the likelihood of receiving hormone therapy (40.8% vs. 37.7%, adj. OR: 1.10, CI: 0.91-1.34), <30 days of EBRT (30.5% vs. 31.5%, adj. OR: 0.98, CI: 0.72-1.32) or <6 months of ADT (50.7% vs. 54.0%, adj. OR: 0.84, CI: 0.63-1.12). Conclusions: In Alabama, there were racial differences in utilization of aggressive treatment for locoregional prostate cancer. Research should investigate factors associated with prostate cancer treatment among older men, such as patient behavior and access to care.

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