Sociodemographic factors associated with prostatectomy utilization and concordance with the physician data query for prostate cancer (United States).
OBJECTIVE
Data from the California Cancer Registry were used to model the effect of race/ethnicity, census-derived socioeconomic status (SES), age, year, and stage at diagnosis on prostatectomy utilization in men diagnosed with prostate cancer from 1990 through 1993. Treatment received was compared with the National Cancer Institute's Physician Data Query (PDQ) to evaluate concordance.


METHODS
Odds ratios (OR) and 95% confidence intervals (CI) were estimated to assess the likelihood of (a) receiving a prostatectomy and (b) receiving a treatment in concordance with the PDQ. Non-concordance was defined as a prostatectomy performed on a patient who was either diagnosed with AJCC stage III or IV prostate cancer, or was older than 70 years. All other treatments were considered compliant with the PDQ.


RESULTS
Regardless of the stage at diagnosis, men who were younger and lived in a neighborhood with higher income and education levels were the most likely to receive a prostatectomy as opposed to other treatments. Black men were the least likely to be treated with prostatectomy (OR = 0.6, CI = 0.5-0.6), and the differential was evident within all income levels examined. With respect to the PDQ, black men were 1.4 times more likely to receive concordant treatment than white men (OR = 1.4, CI = 1.3-1.5).


CONCLUSIONS
California black men are receiving less aggressive treatment (that is more concordant with the PDQ) when diagnosed with prostate cancer.
Morris
C R
CR
California Cancer Registry, Public Health Institute, Sacramento, USA. cyllene@ccr.ca.gov
Snipes
K P
KP
Schlag
R
R
Wright
W E
WE
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D005006:Ethnicity / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000601:surgery*; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data