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dc.contributor.authorRose, Adam J.
dc.contributor.authorBackus, Bertina M.
dc.contributor.authorGershman, Susan T.
dc.contributor.authorSantos, Palmira
dc.contributor.authorAsh, Arlene S.
dc.contributor.authorBattaglia, Tracy A.
dc.date2022-08-11T08:10:42.000
dc.date.accessioned2022-08-23T17:17:20Z
dc.date.available2022-08-23T17:17:20Z
dc.date.issued2007-04-21
dc.date.submitted2010-07-01
dc.identifier.citationMed Care. 2007 May;45(5):440-7. <a href="http://dx.doi.org/10.1097/01.mlr.0000257144.29928.f0">Link to article on publisher's site</a>
dc.identifier.issn0025-7079 (Linking)
dc.identifier.doi10.1097/01.mlr.0000257144.29928.f0
dc.identifier.pmid17446830
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47604
dc.description.abstractBACKGROUND: Most studies have found that black men are less likely to receive aggressive therapy for nonmetastatic prostate cancer, even after controlling for covariates. However, previous studies have not accounted for the clustering of outcomes by facility. OBJECTIVE: We sought to compare the proportions of black and white men receiving aggressive therapy for newly diagnosed nonmetastatic prostate cancer between 1998 and 2002, accounting for the clustering of outcomes by facility. METHODS: We used the Massachusetts Cancer Registry of all cancer diagnosed in residents of Massachusetts. We used logistic regression, clustering by the facility where the tumor was diagnosed, to predict the probability that a patient would receive any aggressive therapy, and the specific therapeutic choices of radical prostatectomy, external-beam radiation therapy, and brachytherapy. Predictors included race, age, poverty, insurance status, marital status, year of diagnosis, and tumor grade. RESULTS: Black men were similarly likely to receive aggressive therapy compared with white men (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.62-1.01). However, there was a racial difference in the receipt of particular types of therapy: black men were significantly more likely to receive radiation therapy (OR 1.39, 95% CI 1.16-1.68) and less likely to receive radical prostatectomy (OR 0.53, 95% CI 0.38-0.74). CONCLUSIONS: Among men diagnosed with nonmetastatic prostate cancer in Massachusetts from 1998 to 2002, black men received aggressive therapy at rates approaching those of whites. However, they were more likely to receive radiation therapy and less likely to receive radical prostatectomy.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=17446830&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1097/01.mlr.0000257144.29928.f0
dc.subject*African Americans
dc.subjectAged
dc.subjectAged, 80 and over
dc.subject*European Continental Ancestry Group
dc.subjectForecasting
dc.subject*Health Services Accessibility
dc.subjectHumans
dc.subjectIntensive Care
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMassachusetts
dc.subjectMiddle Aged
dc.subject*Neoplasm Metastasis
dc.subjectPhysician's Practice Patterns
dc.subjectProstatic Neoplasms
dc.subjectRegistries
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titlePredictors of aggressive therapy for nonmetastatic prostate carcinoma in Massachusetts from 1998 to 2002
dc.typeJournal Article
dc.source.journaltitleMedical care
dc.source.volume45
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/732
dc.identifier.contextkey1378880
html.description.abstract<p>BACKGROUND: Most studies have found that black men are less likely to receive aggressive therapy for nonmetastatic prostate cancer, even after controlling for covariates. However, previous studies have not accounted for the clustering of outcomes by facility.</p> <p>OBJECTIVE: We sought to compare the proportions of black and white men receiving aggressive therapy for newly diagnosed nonmetastatic prostate cancer between 1998 and 2002, accounting for the clustering of outcomes by facility.</p> <p>METHODS: We used the Massachusetts Cancer Registry of all cancer diagnosed in residents of Massachusetts. We used logistic regression, clustering by the facility where the tumor was diagnosed, to predict the probability that a patient would receive any aggressive therapy, and the specific therapeutic choices of radical prostatectomy, external-beam radiation therapy, and brachytherapy. Predictors included race, age, poverty, insurance status, marital status, year of diagnosis, and tumor grade.</p> <p>RESULTS: Black men were similarly likely to receive aggressive therapy compared with white men (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.62-1.01). However, there was a racial difference in the receipt of particular types of therapy: black men were significantly more likely to receive radiation therapy (OR 1.39, 95% CI 1.16-1.68) and less likely to receive radical prostatectomy (OR 0.53, 95% CI 0.38-0.74).</p> <p>CONCLUSIONS: Among men diagnosed with nonmetastatic prostate cancer in Massachusetts from 1998 to 2002, black men received aggressive therapy at rates approaching those of whites. However, they were more likely to receive radiation therapy and less likely to receive radical prostatectomy.</p>
dc.identifier.submissionpathqhs_pp/732
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages440-7


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