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Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007.

Publication ,  Journal Article
Dinan, MA; Robinson, TJ; Zagar, TM; Scales, CD; Curtis, LH; Reed, SD; Lee, WR; Schulman, KA
Published in: Int J Radiat Oncol Biol Phys
April 1, 2012

PURPOSE: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. METHODS AND MATERIALS: We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. RESULTS: There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. CONCLUSIONS: Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

April 1, 2012

Volume

82

Issue

5

Start / End Page

e781 / e786

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Conformal
  • Prostatic Neoplasms
  • Prostatectomy
  • Oncology & Carcinogenesis
  • Medicare
  • Male
  • Incidence
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dinan, M. A., Robinson, T. J., Zagar, T. M., Scales, C. D., Curtis, L. H., Reed, S. D., … Schulman, K. A. (2012). Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007. Int J Radiat Oncol Biol Phys, 82(5), e781–e786. https://doi.org/10.1016/j.ijrobp.2011.11.024
Dinan, Michaela A., Timothy J. Robinson, Timothy M. Zagar, Charles D. Scales, Lesley H. Curtis, Shelby D. Reed, W Robert Lee, and Kevin A. Schulman. “Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007.Int J Radiat Oncol Biol Phys 82, no. 5 (April 1, 2012): e781–86. https://doi.org/10.1016/j.ijrobp.2011.11.024.
Dinan MA, Robinson TJ, Zagar TM, Scales CD, Curtis LH, Reed SD, et al. Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007. Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):e781–6.
Dinan, Michaela A., et al. “Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007.Int J Radiat Oncol Biol Phys, vol. 82, no. 5, Apr. 2012, pp. e781–86. Pubmed, doi:10.1016/j.ijrobp.2011.11.024.
Dinan MA, Robinson TJ, Zagar TM, Scales CD, Curtis LH, Reed SD, Lee WR, Schulman KA. Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007. Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):e781–e786.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

April 1, 2012

Volume

82

Issue

5

Start / End Page

e781 / e786

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Conformal
  • Prostatic Neoplasms
  • Prostatectomy
  • Oncology & Carcinogenesis
  • Medicare
  • Male
  • Incidence