Skip Navigation LinksHome > October 2010 - Volume 48 - Issue 10 > Treatment for Older Prostate Cancer Patients: Disparities in...
Medical Care:
doi: 10.1097/MLR.0b013e3181eb31a8
Original Article

Treatment for Older Prostate Cancer Patients: Disparities in a Southern State

Pisu, Maria PhD*; Oliver, JoAnn S. PhD†; Kim, Young-Il PhD*; Elder, Keith PhD‡; Martin, Michelle PhD*; Richardson, Lisa C. MD, MPH§

Collapse Box

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.

© 2010 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.