Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Unit 1465, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA.
J Racial Ethn Health Disparities. 2018 Feb;5(1):104-110. doi: 10.1007/s40615-017-0348-y. Epub 2017 Feb 15.
Disparities in prostate cancer (PCa) morbidity and mortality occur across various populations. We investigated the sociodemographic correlates of treatment and disparities in the application of cure-intended (i.e., radical prostatectomy [RP], radiation therapy [RT]) treatment strategies in localized PCa among Texas residents diagnosed with PCa.
We analyzed data from the Texas Cancer Registry on men diagnosed with stage T1 or T2 PCa between 2004 and 2009. Multinomial logistic regression analysis was used to explore independent associations between cure-intended treatment modalities and sociodemographic characteristics (age, race/ethnicity, socioeconomic status [SES], and geographic location (rural versus urban)) using patients who did not receive definitive treatment as comparison group.
Of 46,971 patients with available treatment data, age-adjusted treatment rates were 39.1% RP, 30.7% RT, and 30.2% for all other non-curative modalities. Compared to patients under 60 years, those ≥60 were less likely to receive RP, patients between 60 and 80 years were more likely to undergo RT, while those 80 years or older were less likely. Non-Hispanic blacks (OR =0.55, 95% CI, 0.50-0.59) and Hispanics (OR = 0.68, 95%CI, 0.62-0.74) were less likely to receive RP compared with whites. Hispanics were significantly less likely to receive RT (OR = 0.78, 95%CI, 0.72-0.85) than blacks and whites. People of low SES were 35% (OR = 0.65, 95%CI, 0.60-0.69) and 15% (OR = 0.85, 95%CI, 0.79-0.90) less likely to receive RP and RT, respectively, compared with those of high SES. Rural-urban status was not associated with cure-intended treatment.
Potential sociodemographic disparities exist in the application of cure-intended treatment in localized prostate cancer in Texas particularly in race/ethnicity and SES.
前列腺癌（PCa）的发病率和死亡率在不同人群中存在差异。我们研究了德克萨斯州居民中 PCa 的社会人口统计学相关性，以及局限性 PCa 中以治愈为目的（即根治性前列腺切除术[RP]、放疗[RT]）治疗策略的应用和差异。
我们分析了 2004 年至 2009 年间德克萨斯癌症登记处诊断为 PCa 的男性患者的数据。使用未接受确定性治疗的患者作为对照组，多变量逻辑回归分析用于探索以治愈为目的的治疗方式与社会人口统计学特征（年龄、种族/族裔、社会经济地位[SES]和地理位置（农村与城市））之间的独立关联。
在 46971 名有治疗数据的患者中，年龄调整后的治疗率为 39.1%RP、30.7%RT 和 30.2%的所有其他非治愈方式。与 60 岁以下的患者相比，60 岁以上的患者接受 RP 的可能性较低，60-80 岁的患者更有可能接受 RT，而 80 岁或以上的患者接受 RP 的可能性较低。与白人相比，非西班牙裔黑人（OR=0.55，95%CI，0.50-0.59）和西班牙裔（OR=0.68，95%CI，0.62-0.74）接受 RP 的可能性较低。与黑人相比，西班牙裔接受 RT 的可能性显著降低（OR=0.78，95%CI，0.72-0.85），而与白人相比，接受 RT 的可能性也较低。与 SES 较高的人相比，SES 较低的人接受 RP（OR=0.65，95%CI，0.60-0.69）和 RT（OR=0.85，95%CI，0.79-0.90）的可能性分别降低了 35%和 15%。城乡状况与以治愈为目的的治疗无关。
在德克萨斯州，特别是在种族/族裔和 SES 方面，局限性前列腺癌中以治愈为目的的治疗的应用存在潜在的社会人口统计学差异。
