MP6-05 THE IMPACT OF SOCIO-DEMOGRAPHIC FACTORS ON ACTIVE SURVEILLANCE CHOICE IN MEN WITH LOW-RISK PROSTATE CANCER

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness I1 Apr 2014MP6-05 THE IMPACT OF SOCIO-DEMOGRAPHIC FACTORS ON ACTIVE SURVEILLANCE CHOICE IN MEN WITH LOW-RISK PROSTATE CANCER Brian Kim, Madhur Merchant, Jeff Slezak, Kimberly Porter, Joy Gelfond, Steven J. Jacobsen, and Gary W. Chien Brian KimBrian Kim More articles by this author , Madhur MerchantMadhur Merchant More articles by this author , Jeff SlezakJeff Slezak More articles by this author , Kimberly PorterKimberly Porter More articles by this author , Joy GelfondJoy Gelfond More articles by this author , Steven J. JacobsenSteven J. Jacobsen More articles by this author , and Gary W. ChienGary W. Chien More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.239AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The decision to undergo active surveillance (AS) in men with low-risk prostate cancer is multi-factorial. Previous studies have shown disparities in utilization and choice of prostate cancer care in different socio-demographic groups. This has partly been attributed to unequal access to the level of healthcare. The purpose of this study was to evaluate whether select patient socio-demographic characteristics influence the selection of AS versus immediate treatment when all subjects within our large managed-care organization have equal access to healthcare. METHODS Men with low-risk prostate cancer were enrolled between March 2011 and October 2013 at 13 Kaiser Permanente Southern California medical centers. Men were considered to be on AS if they had cT1-T2a stage prostate cancer, prostate-specific antigen (PSA) <10 ng/ml, a prostate biopsy revealing Gleason grade ≤6, fewer than 3 biopsy cores positive, ≤50% cancer in any core, and had not undergone immediate therapy within six months of their diagnosis. Patients in the AS cohort were then compared to men who received immediate treatment (surgery, radiation, other) with respect to all obtainable socio-demographic factors using the Wilcoxon Rank-Sum and Chi-squared tests. RESULTS Of the 4754 total patients with newly diagnosed prostate cancer, 681 men satisfied our inclusion criteria and were enrolled in the study; 414 (60.8%) of whom chose AS and 267 (39.2%) who had immediate treatment. Patients on AS were significantly older (62.8 vs. 60.5 years, p<0.0003). Univariate analysis revealed that Caucasian men were more likely to choose AS, whereas Black and Hispanic men were more likely to undergo immediate therapy (p<0.0035). In addition, primarily English-speaking patients, and those living in regions with higher income and education levels were more likely to choose AS (p<0.05). After multivariate adjusted analysis however, differences in ethnicity, language, income, and education levels were no longer observed between cohorts. CONCLUSIONS There were no socio-demographic factors, apart from age, that influenced the choice of AS versus immediate therapy in men with low-risk prostate cancer. Patients within ethnic minorities and lower socio-economic groups appeared to receive equal access to care and treatment counseling. This illustrates a potential benefit of comprehensive health organizations, in which the delivery-of-care is almost exclusively patient-centered. © 2014FiguresReferencesRelatedDetails Volume 191 Issue 4S April 2014 Page: e57-e58 Advertisement Copyright & Permissions© 2014Metrics Author Information Brian Kim More articles by this author Madhur Merchant More articles by this author Jeff Slezak More articles by this author Kimberly Porter More articles by this author Joy Gelfond More articles by this author Steven J. Jacobsen More articles by this author Gary W. Chien More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...