Temporal trends and demographic characteristics associated with initial treatment modality in localized prostate cancer in Texas, 2004-2009
Introduction No general consensus exits on the optimal treatment of localized prostate cancer (PCa) due to lack of concrete evidence from comparative effectiveness studies. Major treatment modalities are radical prostatectomy (RP), radiation therapy (RT) and conservative treatment (CT). Treatment modalities have varied over time and across populations. Factors associated with treatment identified in previous studies may not be applicable to all populations due to differences in population characteristics, temporal changes in diagnosis, treatment techniques and practice patterns. The purpose of this study was to determine the current treatment trends in localized PCa and the sociodemographic factors associated with treatment. Methods Data on men diagnosed with localized PCa for 2004-2009 from the Texas Cancer Registry were analyzed using logistic regression models to identify independent associations between treatment and sociodemographic characteristics. Results A total of 52, 626 localized PCa cases met the inclusion criteria. RP was used in 38.5%, RT in 30.9% and CT in 30.6%. From 2004 to 2009, age-adjusted percentage use of RP increased from 37.9% to 40.9% (p=0.66), RT use fell from 37.8% to 23.1% (p=0.01) and CT use increased from 24.3% to 36.0% (p=0.04). Compared to patients <60 >years, odds (95% confidence interval) of receiving RP were 0.40 (0.38-0.42), 0.08 (0.08-0.09) and 0.01 (0.01-0.02) for 60-69, 70-79 and ≥80 years age categories respectively. The odds of blacks and Hispanics receiving RP were respectively 0.56 (0.52-0.60) and 0.78 (0.72-0.84) compared to whites. Odds of receiving RT were respectively 2.21 (2.07-2.35), 4.64 (4.34-4.95) and 2.72 (2.47-3.00) for 60-69, 70-79 and ≥80 years, compared to <60 years. The odds of blacks receiving RT were 1.34>(1.25-1.44) compared to whites. Odds of receiving CT were respectively 1.68 (1.57-1.79), 3.37 (3.16-3.60) and 10.82 (9.82-11.92) for 60-69, 70-79 and ¡Ý80 years compared to <60years. The odds of blacks, Hispanics and Asians receiving CT were respectively 1.39 (1.30-1.50), 1.36 (1.27-1.47) and 1.28 (1.02-1.60) compared to whites. Conclusion While the use of RP remained steady, RT use declined and CT use increased. Age, race/ethnicity, socioeconomic status and geographic location were all associated with treatment.
Public health|Ethnic studies|Epidemiology|Oncology
des Bordes, Jude Kofi Atta, "Temporal trends and demographic characteristics associated with initial treatment modality in localized prostate cancer in Texas, 2004-2009" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3639464.