Treatment for older prostate cancer patients: disparities in a southern state.

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.

journal_name

Med Care

journal_title

Medical care

authors

Pisu M,Oliver JS,Kim YI,Elder K,Martin M,Richardson LC

doi

10.1097/MLR.0b013e3181eb31a8

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

915-22

issue

10

eissn

0025-7079

issn

1537-1948

journal_volume

48

pub_type

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