In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 5_suppl ( 2012-02-10), p. 108-108
Abstract:
108 Background: Our study investigates the influence of regional variations of radiation oncology and urology services on the treatment modality chosen for prostate cancer (PCa) management. Methods: PCa treatment choice and patient data from 2004-2007 were obtained from the NCI Surveillance, Epidemiology, and End Results (SEER) database and combined with the health system data from the Area Resource File. The health system characteristics analyzed were radiation oncologist (RO) density, urologist (U) density, primary care provider (PCP) density, IMRT equipped hospital density, general radiation therapy (RT) equipped hospital density, and median household income. Patient factors analyzed included race, marital status, and age. Separate logistic regression models were built to test the association between health system characteristics and whether patients received any form of RT (EBRT, brachytherapy, or a combination) or just surgical treatment. Results: Overall of the 108,612 patients in our sample, 43.7% received some form of RT. Patients residing in Health Service Areas (HSAs) with increased RO densities were more likely to receive some form of radiation to treat PCa (OR 1.07 [SE 0.02, p 〈 .001]). Conversely increased U density was associated decreased use of RT (OR .95 [SE .01, p 〈 .001]). Presence of IMRT equipped and general RT equipped hospitals were both associated with increased use of radiation therapy (OR 1.53 [SE .05, p 〈 .001] and OR 1.13 [SE .03, p 〈 .001] respectively). Alternatively, 39.3% of patients in our sample received just surgical interventions. Patients residing in HSAs with increased RO densities were less likely to receive only surgical treatment for PCa (OR .91 [SE .01, p 〈 .001]). Increased U density was associated with increased likelihood of only surgical treatment for PCa (OR 1.09 [SE 0.01, p 〈 .001]). Presence of IMRT equipped and general RT hospitals were both associated with decreased use of only surgical treatment for PCa (OR .82 [SE .03, p 〈 .001] and OR .82 [SE .02, p 〈 .001] respectively). Conclusions: Radiation oncologist and urologist capacities influence the regional variations in the treatment choice for prostate cancer.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.5_suppl.108
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
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