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Racial differences in patterns of treatment among men diagnosed with de novo advanced prostate cancer: A SEER-Medicare investigation.

Publication ,  Journal Article
Beebe-Dimmer, JL; Ruterbusch, JJ; Cooney, KA; Bolton, A; Schwartz, K; Schwartz, AG; Heath, E
Published in: Cancer Med
June 2019

PURPOSE: Approximately 5% of men were initially diagnosed with (also referred to as de novo) advanced stage prostate cancer and experience far poorer survival compared to men diagnosed with local or regionally advanced disease. Given the number of new therapies targeting metastatic and castrate-resistant disease, we sought to describe recent treatment patterns by race for de novo AJCC stage IV prostate cancer. METHODS: We used Surveillance, Epidemiology, and End Results (SEER) data linked to Medicare files to identify men aged 66 and older diagnosed in 2004-2014 with advanced prostate cancer, and examined patterns of treatment among all patients and stratified by race/ethnicity. RESULTS: There were 8828 eligible patients identified, and non-Hispanic black (NHB) patients were more likely to go without treatment (P < 0.001) compared to non-Hispanic white (NHW) patients, even after accounting for early mortality and TNM stage. The frequency of nearly all forms of treatment was lower among NHB with the exception of orchiectomy, which was significantly higher (10.1% vs 6.1%, P < 0.001), and the use of the progesterone Megace among Medicare Part D enrollees (24.6% vs 15.0%, P < 0.001). CONCLUSIONS: Results from this study of elderly Medicare patients presenting with advanced stage prostate cancer suggest that NHB men are less likely to pursue aggressive treatment options. With the reduction in screening for prostate cancer, presumably tied to USPSTF recommendations, and the increasing incidence of men diagnosed with de novo metastatic disease, understanding drivers of treatment-related decisions are critical in reducing racial disparities in advanced prostate cancer outcomes.

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Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

June 2019

Volume

8

Issue

6

Start / End Page

3325 / 3335

Location

United States

Related Subject Headings

  • United States
  • SEER Program
  • Prostatic Neoplasms
  • Practice Patterns, Physicians'
  • Neoplasm Staging
  • Neoplasm Metastasis
  • Medicare
  • Male
  • Humans
  • Healthcare Disparities
 

Citation

APA
Chicago
ICMJE
MLA
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Beebe-Dimmer, J. L., Ruterbusch, J. J., Cooney, K. A., Bolton, A., Schwartz, K., Schwartz, A. G., & Heath, E. (2019). Racial differences in patterns of treatment among men diagnosed with de novo advanced prostate cancer: A SEER-Medicare investigation. Cancer Med, 8(6), 3325–3335. https://doi.org/10.1002/cam4.2092
Beebe-Dimmer, Jennifer L., Julie J. Ruterbusch, Kathleen A. Cooney, Adam Bolton, Kendra Schwartz, Ann G. Schwartz, and Elisabeth Heath. “Racial differences in patterns of treatment among men diagnosed with de novo advanced prostate cancer: A SEER-Medicare investigation.Cancer Med 8, no. 6 (June 2019): 3325–35. https://doi.org/10.1002/cam4.2092.
Beebe-Dimmer JL, Ruterbusch JJ, Cooney KA, Bolton A, Schwartz K, Schwartz AG, et al. Racial differences in patterns of treatment among men diagnosed with de novo advanced prostate cancer: A SEER-Medicare investigation. Cancer Med. 2019 Jun;8(6):3325–35.
Beebe-Dimmer, Jennifer L., et al. “Racial differences in patterns of treatment among men diagnosed with de novo advanced prostate cancer: A SEER-Medicare investigation.Cancer Med, vol. 8, no. 6, June 2019, pp. 3325–35. Pubmed, doi:10.1002/cam4.2092.
Beebe-Dimmer JL, Ruterbusch JJ, Cooney KA, Bolton A, Schwartz K, Schwartz AG, Heath E. Racial differences in patterns of treatment among men diagnosed with de novo advanced prostate cancer: A SEER-Medicare investigation. Cancer Med. 2019 Jun;8(6):3325–3335.
Journal cover image

Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

June 2019

Volume

8

Issue

6

Start / End Page

3325 / 3335

Location

United States

Related Subject Headings

  • United States
  • SEER Program
  • Prostatic Neoplasms
  • Practice Patterns, Physicians'
  • Neoplasm Staging
  • Neoplasm Metastasis
  • Medicare
  • Male
  • Humans
  • Healthcare Disparities