Changing Patterns of Primary Treatment in Korean Men with Prostate Cancer Over 10 Years: A Nationwide Population Based Study.
OBJECTIVE
We investigated changing patterns of primary treatment in Korean men with prostate cancer (PC) and impact of sociodemographic factors on treatment choice from a nationwide cohort over 10 years.


METHODS
We conducted a cohort study of a 2% nationwide random sample of Korean National Health Insurance. A total of 1,382 patients who had undergone active treatments for newly diagnosed PC between 2003 and 2013 were included. Time trends in primary treatment of PC, including radical surgery, radiation therapy (RT), and androgen deprivation therapy (ADT) were analyzed.


RESULTS
Total number of patients undergoing active treatments increased significantly (162%). Surgery cases showed the most significant increase, from 22.4% in 2003 to 45.4% in 2013, while the relative proportion of ADT showed a tendency to decrease from 60.3% in 2003 to 45.4% in 2013, and the relative proportion of RT was variable over 10 years (from 7.2% to 18.4%). While treatment patterns differed significantly according to age (p < 0.001) and income classes (p=0.014), there were differences in primary treatment according to residential area. In multinomial logistic regression analysis, older patients showed significant association with ADT or RT compared to surgery, while patients with higher income showed significant association with surgery.


CONCLUSIONS
Treatment pattern in Korean PC patients has changed remarkably over the last 10 years. Sociodemographic factors do affect the primary treatment choice. Our results will be valuable in overviewing changing patterns of primary treatment in Korean PC patients and planning future health policy for PC.
Department of Urology, Eulji University Hospital, Daejeon, Korea.
Jinsung
J
Park
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Beomseok
B
Suh
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Dong Wook
DW
Shin
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jun Hyuk
JH
Hong
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hanjong
H
Ahn
D000328:Adult; D000368:Aged; D000726:Androgen Antagonists / Q000191:economics / Q000627:therapeutic use*; D015331:Cohort Studies; D006291:Health Policy; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000191:economics / Q000639:trends*; D011471:Prostatic Neoplasms / Q000628:therapy*; D011878:Radiotherapy / Q000191:economics / Q000639:trends*; D012959:Socioeconomic Factors; D055815:Young Adult
D000726:Androgen Antagonists
Practice patterns; Prostatectomy; Prostatic neoplasms; Radiotherapy