Sociodemographic Factors Impact Prostate Cancer Treatment Initiation
For men with low-risk prostate cancer undergoing active surveillance, sociodemographic factors are associated with initiation of active treatment.
(HealthDay News) -- For men with low-risk prostate cancer undergoing active surveillance, sociodemographic factors are associated with initiation of active treatment, according to a study published in The Journal of Urology.
Scott P. Kelly, Ph.D., from the Georgetown University Medical Center in Washington, D.C., and colleagues conducted a retrospective study of men diagnosed with low-risk prostate cancer between 2004 and 2012 who did not receive any treatment within the first year of diagnosis. Patients were followed for at least two years to determine the factors associated with time from diagnosis to active treatment.
The researchers identified 2,228 eligible men, of whom 27 percent began active treatment at a median of 2.9 years. Independent of baseline and follow-up clinical measures, non-Hispanic black men were slightly more likely to begin active treatment than non-Hispanic white men (hazard ratio [HR], 1.3; 95 percent confidence interval [CI], 1.0 to 1.7).
Of those men who remained on observation, the rate of rebiopsy within 24 months of diagnosis was slightly lower for non-Hispanic black men than non-Hispanic white men (HR, 0.70; 95 percent CI, 0.6 to 1.0). Independent of race, initiation of active treatment was associated with Gleason grade progression (HR, 3.3; 95 percent CI, 2.7 to 4.1) and prostate-specific antigen doubling time less than 48 months (HR, 2.9; 95 percent CI, 2.3 to 3.7).
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"Sociodemographic factors such as ethnicity and education may independently influence the patient decision to pursue active treatment and serial biopsies during active surveillance," the authors write. "These factors are important for further studies of prostate cancer treatment decision making."
- Kelly SP, Van Den Eeden SK, Hoffman RM, et al. Sociodemographic and Clinical Predictors of Switching to Active Treatment among a Large, Ethnically Diverse Cohort of Men with Low Risk Prostate Cancer on Observational Management. The Journal of Urology. 2016 Apr 14. doi: http://dx.doi.org/10.1016/j.juro.2016.04.045. [Epub ahead of print]