Islam K M, Wen Jiajun
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Prostate Cancer. 2015;2015:829439. doi: 10.1155/2015/829439. Epub 2015 Apr 20.
Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients' decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. Conclusion. Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients' well-being.
引言。前列腺癌是美国男性中最常见的癌症。前列腺癌的手术结果仍不一致。社会经济因素等障碍可能在患者拒绝推荐的癌症导向手术的决定中起作用。方法。使用内布拉斯加州癌症登记数据计算推荐进行癌症导向手术的前列腺癌患者比例和手术拒绝率。应用多变量逻辑回归分析与手术拒绝相关的社会经济指标。结果。1995年至2012年，内布拉斯加州有14,876名前列腺癌患者被推荐进行癌症导向手术，其中576人拒绝手术。18年间手术总体拒绝率为3.9%。早期前列腺癌患者更有可能拒绝手术。黑人、单身或由医疗补助/医疗保险覆盖的患者拒绝手术的几率增加。结论。社会经济因素与拒绝推荐的前列腺癌手术治疗有关。应消除此类障碍，以提高手术治疗的利用率和患者的福祉。
