title: Socioeconomic and clinical factors influence the interval between positive prostate biopsy and radical prostatectomy.
abstract: OBJECTIVE
  To examine socioeconomic and clinical factors that may predict a longer interval between prostate biopsy and radical prostatectomy (RP).
  
  
  METHODS
  The Columbia University Urologic Oncology Database was queried for patients who underwent RP from 1990-2010. Time to surgery (TTS) was defined as the period between the most recent positive prostate biopsy and date of surgery. Clinical factors examined included: age, D'Amico risk group, year of surgery, body mass index, and comorbidities. Socioeconomic factors included race/ethnicity, relationship status, income, and distance to treatment center. The relationship between clinical/socioeconomic factors and TTS was evaluated using univariate and multivariate regression models.
  
  
  RESULTS
  Two-thousand five-hundred seventy-three patients were included in the analysis. Median TTS was 48 days (IQR 35-70, range 43-1103), and 71% of patients underwent RP within 60 days after the most recent positive biopsy. On multivariate analysis, living further from the medical center was associated with shorter TTS (P = .01), whereas more recent year of surgery (P = .01), comorbid cardiovascular disease (P = .007), African-American (P = .005) or Hispanic race (P = .005), divorced relationship status (P = .01), and lower income (P = .003) were all associated with longer TTS.
  
  
  CONCLUSIONS
  Patients often experience widely variable intervals between the diagnosis and treatment of localized prostate cancer. Longer intervals before surgery may point to disparities in access to prostate cancer care, and not increased decision-making time by the patient.
authors.affiliation: Department of Urology, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA.
authors.forename: Max
authors.initials: M
authors.lastname: Pitman
authors.forename: Ruslan
authors.initials: R
authors.lastname: Korets
authors.forename: Max
authors.initials: M
authors.lastname: Kates
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Hruby
authors.forename: James M
authors.initials: JM
authors.lastname: McKiernan
mesh_terms: D000368:Aged; D001706:Biopsy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology