Medical oncology referral and systemic therapy of patients with advanced stage urothelial carcinoma.
J Comp Eff Res
; 9(13): 945-957, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-32964721
ABSTRACT
Aim:
To understand physician visit patterns among patients with stage IV (including nonmetastatic [M0] and metastatic [M1] disease) urothelial carcinoma (UC) and understand factors associated with a timely referral to a medical oncologist and systemic treatment. Patients &methods:
Retrospective analysis of Surveillance, Epidemiology and End Results-Medicare data.Results:
First physician encounter was with a urologist (M0 69%; M1 53%) or primary care physician ([PCP]; M0 19%, M1 25%) for the majority of patients around UC diagnosis. After the index urologist encounter, most patients had a subsequent medical oncologist visit at a median of 52 days (M0 69.5 days, M1 33 days). In an adjusted model, older age, index PCP visit, higher comorbidities and M0 disease were negatively associated with a medical oncologist referral. Among those referred to a medical oncologist, older age, Hispanic or non-Hispanic Black race and not being married were negatively associated with subsequent chemotherapy receipt (p < 0.05).Conclusion:
Many patients with advanced UC encounter multiple specialists during their disease course. Older patients or those with a first UC-related encounter with a PCP are less likely to be referred to medical oncology. Once referred to medical oncology, social determinants, including race and marital status, are relevant predictors of receiving chemotherapy.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
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Carcinoma
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Medicare
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Neoplasias Urológicas
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Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Aged
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Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Comp Eff Res
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos