title: Racial Differences in Diffusion of Intensity-Modulated Radiation Therapy for Localized Prostate Cancer.
abstract: Intensity-modulated radiation therapy (IMRT), an innovative treatment option for prostate cancer, has rapidly diffused over the past decade. To inform our understanding of racial disparities in prostate cancer treatment and outcomes, this study compared diffusion of IMRT in African American (AA) and Caucasian American (CA) prostate cancer patients during the early years of IMRT diffusion using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. A retrospective cohort of 947 AA and 10,028 CA patients diagnosed with localized prostate cancer from 2002 through 2006, who were treated with either IMRT or non-IMRT as primary treatment within 1 year of diagnoses was constructed. Logistic regression was used to examine potential differences in diffusion of IMRT in AA and CA patients, while adjusting for socioeconomic and clinical covariates. A significantly smaller proportion of AA compared with CA patients received IMRT for localized prostate cancer (45% vs. 53%, p < .0001). Racial differences were apparent in multivariable analysis though did not achieve statistical significance, as time and factors associated with race (socioeconomic, geographic, and tumor related factors) explained the preponderance of variance in use of IMRT. Further research examining improved access to innovative cancer treatment and technologies is essential to reducing racial disparities in cancer care.
authors: University of Georgia, College of Pharmacy, Athens, GA, USA ecobran@uga.edu.
authors: Ewan K
authors: EK
authors: Cobran
authors: University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA.
authors: Ronald C
authors: RC
authors: Chen
authors: UNC, Eshelman School of Pharmacy, Chapel Hill, NC, USA.
authors: Robert
authors: R
authors: Overman
authors: UNC, Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors: Anne-Marie
authors: AM
authors: Meyer
authors: UNC, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
authors: Tzy-Mey
authors: TM
authors: Kuo
authors: UNC, Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors: Jonathon
authors: J
authors: O'Brien
authors: UNC, Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors: Til
authors: T
authors: Sturmer
authors: University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA.
authors: Nathan C
authors: NC
authors: Sheets
authors: University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA.
authors: Gregg H
authors: GH
authors: Goldin
authors: University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA.
authors: Dolly C
authors: DC
authors: Penn
authors: University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA.
authors: Paul A
authors: PA
authors: Godley
authors: UNC, Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors: William R
authors: WR
authors: Carpenter
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D006801:Humans; D016015:Logistic Models; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States; D044465:White People / Q000523:psychology*
keywords: Epidemiology and End Results (SEER)–Medicare; Surveillance; diffusion; intensity-modulated radiation therapy (IMRT); radiation therapy
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