Dataset Information

Racial Differences in the Surgical Care of Medicare Beneficiaries With Localized Prostate Cancer.

ABSTRACT: There is extensive evidence suggesting that black men with localized prostate cancer (PCa) have worse cancer-specific mortality compared with their non-Hispanic white counterparts.To evaluate racial disparities in the use, quality of care, and outcomes of radical prostatectomy (RP) in elderly men (? 65 years) with nonmetastatic PCa.This retrospective analysis of outcomes stratified according to race (black vs non-Hispanic white) included 2020 elderly black patients (7.6%) and 24,462 elderly non-Hispanic white patients (92.4%) with localized PCa who underwent RP within the first year of PCa diagnosis in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database between 1992 and 2009. The study was performed in 2014.Process of care (ie, time to treatment, lymph node dissection), as well as outcome measures (ie, complications, emergency department visits, readmissions, PCa-specific and all-cause mortality, costs) were evaluated using Cox proportional hazards regression. Multivariable conditional logistic regression and quantile regression were used to study the association of racial disparities with process of care and outcome measures.The proportion of black patients with localized prostate cancer who underwent RP within 90 days was 59.4% vs 69.5% of non-Hispanic white patients (P

SUBMITTER: Schmid M

PROVIDER: S-EPMC5018381 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Racial Differences in the Surgical Care of Medicare Beneficiaries With Localized Prostate Cancer.

Schmid Marianne M Meyer Christian P CP Reznor Gally G Choueiri Toni K TK Hanske Julian J Sammon Jesse D JD Abdollah Firas F Chun Felix K H FK Kibel Adam S AS Tucker-Seeley Reginald D RD Kantoff Philip W PW Lipsitz Stuart R SR Menon Mani M Nguyen Paul L PL Trinh Quoc-Dien QD

JAMA oncology 20160101 1

<h4>Importance</h4>There is extensive evidence suggesting that black men with localized prostate cancer (PCa) have worse cancer-specific mortality compared with their non-Hispanic white counterparts.<h4>Objective</h4>To evaluate racial disparities in the use, quality of care, and outcomes of radical prostatectomy (RP) in elderly men (≥ 65 years) with nonmetastatic PCa.<h4>Design, setting, and participants</h4>This retrospective analysis of outcomes stratified according to race (black vs non-Hisp ...[more]

PMID: 26502115

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Project description:BACKGROUND:Racial disparities in prostate cancer treatment and outcomes are widespread and poorly understood. In the current study, the authors sought to determine whether access to care, measured across multiple dimensions, contributed to racial differences in prostate cancer. METHODS:The Philadelphia Area Prostate Cancer Access Study (P2 Access) included 2374 men diagnosed with localized prostate cancer between 2012 and 2014. Men were surveyed to assess their experiences accessing care (response rate of 51.1%). The authors determined appointment availability at 151 urology practices using simulated patient telephone calls and calculated travel distances using geospatial techniques. Multivariable logistic regression models were used to determine the association between 5 different domains of access (availability, accessibility, accommodation, affordability, and acceptability) and receipt of treatment, perceived quality of care, and physician-patient communication. RESULTS:There were 1907 non-Hispanic white and 394 black men in the study cohort. Overall, approximately 85% of the men received definitive treatment with no differences noted by race. Black men were less likely to report a high quality of care (69% vs 81%; P<.001) and good physician-patient communication (60% vs 71%; P<.001) compared with white men. In adjusted models, none of the 5 domains of access were found to be associated with definitive treatment overall or with radical prostatectomy. All access domains were associated with perceived quality of care and communication, although these domains did not mediate racial disparities. CONCLUSIONS:To the authors' knowledge, the current study presents the first comprehensive assessment of prostate cancer care access, treatment, and patient experience, demonstrating that although access was related to overall perceived quality of care and better physician-patient communication, it did not appear to explain observed racial differences. Cancer 2017;123:4449-57. © 2017 American Cancer Society.

Dataset Information

Racial Differences in the Surgical Care of Medicare Beneficiaries With Localized Prostate Cancer.

Publications

Racial Differences in the Surgical Care of Medicare Beneficiaries With Localized Prostate Cancer.

Similar Datasets

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