The Impact of Patient Demographics on Prostate Cancer Treatment Choice
CUA Online Library. Kim B. 06/22/13; 31398; UP-19
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THE IMPACT OF PATIENT DEMOGRAPHICS ON PROSTATE CANCER TREATMENT CHOICE
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D., Richard Contreras, M.S., Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S., Steven J. Jacobsen, M.D. Ph.D., Gary W. Chien, M.D.: Los Angeles, CA
Purpose: Many factors can influence prostate cancer treatment choice, and these are not limited simply to clinical disease characteristics. Prostate cancer affects men within a diverse age, ethnic, and socioeconomic cohort. The purpose of this study was to identify demographic characteristics associated with treatment choice within a large managed-care organization.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were asked to participate in a quality of life study at 14 regional hospitals at Kaiser Permanente Southern California, the largest managed-care organization in California. Men were subsequently counseled and underwent surgery, external beam radiation therapy (EBRT), brachytherapy, active surveillance, watchful waiting, or hormone therapy. Select demographic and clinical parameters were compared between treatment groups using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, of which 1,014 (41.6%) had surgery, 248 (10.2% total; 7.1% EBRT, 3.1% brachytherapy) underwent radiation treatment, 759 (31.2%) chose active surveillance or watchful waiting, and 415 (17.0%) received hormone therapy (primary or neoadjuvant). Significant demographic factors identified included age, marital status, ethnicity, and regional education and income levels (p<0.05) (Table). Primary language distributions were similar in all treatment groups. Significant clinical factors studied included prostate-specific antigen (PSA) level, biopsy Gleason sum, family history of prostate cancer, Charlson co-morbidity index, and smoking history (p<0.05). Body mass index (BMI) was similar across treatment groups.
Conclusions: These data suggest that the choice of prostate cancer treatment may be influenced by multiple demographic factors, in addition to common disease parameters. Acknowledging these and other social health determinants may be important in guiding therapeutic decisions for prostate cancer.
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D., Richard Contreras, M.S., Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S., Steven J. Jacobsen, M.D. Ph.D., Gary W. Chien, M.D.: Los Angeles, CA
Purpose: Many factors can influence prostate cancer treatment choice, and these are not limited simply to clinical disease characteristics. Prostate cancer affects men within a diverse age, ethnic, and socioeconomic cohort. The purpose of this study was to identify demographic characteristics associated with treatment choice within a large managed-care organization.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were asked to participate in a quality of life study at 14 regional hospitals at Kaiser Permanente Southern California, the largest managed-care organization in California. Men were subsequently counseled and underwent surgery, external beam radiation therapy (EBRT), brachytherapy, active surveillance, watchful waiting, or hormone therapy. Select demographic and clinical parameters were compared between treatment groups using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, of which 1,014 (41.6%) had surgery, 248 (10.2% total; 7.1% EBRT, 3.1% brachytherapy) underwent radiation treatment, 759 (31.2%) chose active surveillance or watchful waiting, and 415 (17.0%) received hormone therapy (primary or neoadjuvant). Significant demographic factors identified included age, marital status, ethnicity, and regional education and income levels (p<0.05) (Table). Primary language distributions were similar in all treatment groups. Significant clinical factors studied included prostate-specific antigen (PSA) level, biopsy Gleason sum, family history of prostate cancer, Charlson co-morbidity index, and smoking history (p<0.05). Body mass index (BMI) was similar across treatment groups.
Conclusions: These data suggest that the choice of prostate cancer treatment may be influenced by multiple demographic factors, in addition to common disease parameters. Acknowledging these and other social health determinants may be important in guiding therapeutic decisions for prostate cancer.
THE IMPACT OF PATIENT DEMOGRAPHICS ON PROSTATE CANCER TREATMENT CHOICE
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D., Richard Contreras, M.S., Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S., Steven J. Jacobsen, M.D. Ph.D., Gary W. Chien, M.D.: Los Angeles, CA
Purpose: Many factors can influence prostate cancer treatment choice, and these are not limited simply to clinical disease characteristics. Prostate cancer affects men within a diverse age, ethnic, and socioeconomic cohort. The purpose of this study was to identify demographic characteristics associated with treatment choice within a large managed-care organization.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were asked to participate in a quality of life study at 14 regional hospitals at Kaiser Permanente Southern California, the largest managed-care organization in California. Men were subsequently counseled and underwent surgery, external beam radiation therapy (EBRT), brachytherapy, active surveillance, watchful waiting, or hormone therapy. Select demographic and clinical parameters were compared between treatment groups using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, of which 1,014 (41.6%) had surgery, 248 (10.2% total; 7.1% EBRT, 3.1% brachytherapy) underwent radiation treatment, 759 (31.2%) chose active surveillance or watchful waiting, and 415 (17.0%) received hormone therapy (primary or neoadjuvant). Significant demographic factors identified included age, marital status, ethnicity, and regional education and income levels (p<0.05) (Table). Primary language distributions were similar in all treatment groups. Significant clinical factors studied included prostate-specific antigen (PSA) level, biopsy Gleason sum, family history of prostate cancer, Charlson co-morbidity index, and smoking history (p<0.05). Body mass index (BMI) was similar across treatment groups.
Conclusions: These data suggest that the choice of prostate cancer treatment may be influenced by multiple demographic factors, in addition to common disease parameters. Acknowledging these and other social health determinants may be important in guiding therapeutic decisions for prostate cancer.
Brian J. Kim, M.D., Kimberly R. Porter, Ph.D., Richard Contreras, M.S., Luis Salazar, M.D., Anil A. Thomas, M.D., Jeff M. Slezak, M.S., Steven J. Jacobsen, M.D. Ph.D., Gary W. Chien, M.D.: Los Angeles, CA
Purpose: Many factors can influence prostate cancer treatment choice, and these are not limited simply to clinical disease characteristics. Prostate cancer affects men within a diverse age, ethnic, and socioeconomic cohort. The purpose of this study was to identify demographic characteristics associated with treatment choice within a large managed-care organization.
Materials and Methods: From March 2011 to April 2013, all men with biopsy-proven prostate cancer were asked to participate in a quality of life study at 14 regional hospitals at Kaiser Permanente Southern California, the largest managed-care organization in California. Men were subsequently counseled and underwent surgery, external beam radiation therapy (EBRT), brachytherapy, active surveillance, watchful waiting, or hormone therapy. Select demographic and clinical parameters were compared between treatment groups using chi-squared and ANOVA tests.
Results: A total of 2,436 men were enrolled in the study, of which 1,014 (41.6%) had surgery, 248 (10.2% total; 7.1% EBRT, 3.1% brachytherapy) underwent radiation treatment, 759 (31.2%) chose active surveillance or watchful waiting, and 415 (17.0%) received hormone therapy (primary or neoadjuvant). Significant demographic factors identified included age, marital status, ethnicity, and regional education and income levels (p<0.05) (Table). Primary language distributions were similar in all treatment groups. Significant clinical factors studied included prostate-specific antigen (PSA) level, biopsy Gleason sum, family history of prostate cancer, Charlson co-morbidity index, and smoking history (p<0.05). Body mass index (BMI) was similar across treatment groups.
Conclusions: These data suggest that the choice of prostate cancer treatment may be influenced by multiple demographic factors, in addition to common disease parameters. Acknowledging these and other social health determinants may be important in guiding therapeutic decisions for prostate cancer.
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