title: Sociodemographic Disparities in Cure-Intended Treatment in Localized Prostate Cancer.
abstract: Disparities in prostate cancer (PCa) morbidity and mortality occur across various populations. We investigated the sociodemographic correlates of treatment and disparities in the application of cure-intended (i.e., radical prostatectomy [RP], radiation therapy [RT]) treatment strategies in localized PCa among Texas residents diagnosed with PCa.
  
  
  
  We analyzed data from the Texas Cancer Registry on men diagnosed with stage T1 or T2 PCa between 2004 and 2009. Multinomial logistic regression analysis was used to explore independent associations between cure-intended treatment modalities and sociodemographic characteristics (age, race/ethnicity, socioeconomic status [SES], and geographic location (rural versus urban)) using patients who did not receive definitive treatment as comparison group.
  
  
  
  Of 46,971 patients with available treatment data, age-adjusted treatment rates were 39.1% RP, 30.7% RT, and 30.2% for all other non-curative modalities. Compared to patients under 60 years, those ≥60 were less likely to receive RP, patients between 60 and 80 years were more likely to undergo RT, while those 80 years or older were less likely. Non-Hispanic blacks (OR =0.55, 95% CI, 0.50-0.59) and Hispanics (OR = 0.68, 95%CI, 0.62-0.74) were less likely to receive RP compared with whites. Hispanics were significantly less likely to receive RT (OR = 0.78, 95%CI, 0.72-0.85) than blacks and whites. People of low SES were 35% (OR = 0.65, 95%CI, 0.60-0.69) and 15% (OR = 0.85, 95%CI, 0.79-0.90) less likely to receive RP and RT, respectively, compared with those of high SES. Rural-urban status was not associated with cure-intended treatment.
  
  
  
  Potential sociodemographic disparities exist in the application of cure-intended treatment in localized prostate cancer in Texas particularly in race/ethnicity and SES.
authors.affiliation: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Unit 1465, 1515 Holcombe Blvd, Houston, TX, 77030, USA. desbordes@netzero.net.
authors.forename: Jude K A
authors.initials: JKA
authors.lastname: des Bordes
authors.affiliation: Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA.|Division of Urology, The University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Lopez
authors.affiliation: Department of Biostatistics, The University of Texas School of Public Health, Houston, TX, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Swartz
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Volk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States
keywords: Demographic factors; Prostate cancer; Treatment disparities; Treatment modalities