1 Department of Clinical Pharmacy, University of California, San Francisco, CA, USA.
2 College of Pharmacy, Texas A&M University, College Station, TX, USA.
Am J Mens Health. 2019 Mar-Apr;13(2):1557988319835326. doi: 10.1177/1557988319835326.
Prostate cancer (PCa) is the leading cancer in men in the United States. This study evaluated direct costs of treating urinary problems after PCa treatments and determined predictors of long-term costs for urinary problems. Data from the Cancer of Prostate Strategic Urologic Research Endeavor registry was analyzed for this study. Annual treatment costs for urinary problems for up to 14 years were compared among different primary PCa treatments, which included radical prostatectomy, external beam radiation therapy, brachytherapy, and watchful waiting. A multivariate generalized estimating equation (GEE) model with bootstrapping was estimated to identify the predictors associated with treatment costs for urinary problems. A total of 3,062 eligible patients were identified with a mean age of 65 years at diagnosis. Mean annual treatment cost for urinary problems across all patients with PCa was $118/patient. Those greater than 74 years old had the highest cost ($238/patient). Mean annual cost for urinary problems among only those with urinary problems was $432. Multivariate regression showed patients undergoing radical prostatectomy had significantly lower (-63%, p = .01) costs for urinary problems than those treated with watchful waiting. This study helps to understand the importance of treating urinary problems associated with different PCa treatments and highlights their medical care costs. The pattern of treatment costs for urinary problems across all PCa treatments suggests that clinicians need to offer treatment for urinary problems to all PCa patients over longer time periods, even to those choosing watchful waiting.
前列腺癌（PCa）是美国男性中最常见的癌症。本研究评估了 PCa 治疗后治疗尿失禁问题的直接成本，并确定了尿失禁问题长期成本的预测因素。本研究分析了癌症前列腺战略泌尿科研究 Endeavor 登记处的数据。对不同的原发性 PCa 治疗方法（包括根治性前列腺切除术、外照射放疗、近距离放射治疗和观察等待）进行了长达 14 年的尿失禁问题年度治疗成本比较。采用具有 bootstrap 的多变量广义估计方程（GEE）模型来确定与尿失禁问题治疗成本相关的预测因素。共确定了 3062 名符合条件的患者，诊断时的平均年龄为 65 岁。所有 PCa 患者的尿失禁问题平均年治疗费用为 118 美元/患者。74 岁以上的患者费用最高（238 美元/患者）。仅患有尿失禁问题的患者中，尿失禁问题的年平均费用为 432 美元。多变量回归显示，接受根治性前列腺切除术的患者尿失禁问题的治疗费用明显低于选择观察等待的患者（降低 63%，p =.01）。本研究有助于了解治疗不同 PCa 治疗相关尿失禁问题的重要性，并强调了其医疗成本。所有 PCa 治疗方法的尿失禁问题治疗成本模式表明，临床医生需要在更长的时间内为所有 PCa 患者提供尿失禁问题的治疗，即使是选择观察等待的患者。
