The effect of socioeconomic status, race, and insurance type on newly diagnosed metastatic prostate cancer in the United States (2004-2013).
Urol Oncol
; 36(3): 91.e1-91.e6, 2018 03.
Article
em En
| MEDLINE
| ID: mdl-29153624
ABSTRACT
BACKGROUND:
Understanding the characteristics of men who initially present with metastatic prostate cancer (mPCa) can better enable directed improvement initiatives. The objective of this study was to assess the relationship between socioeconomic status (SES) and newly diagnosed mPCa. MATERIALSMETHODS:
All men diagnosed with PCa in the National Cancer Data Base from 2004 to 2013 were identified. Characteristics of men presenting with and without metastatic disease were compared. A 4-level composite metric of SES was created using Census-based income and education data. Multivariable logistic regression was used to evaluate the association between SES, race/ethnicity, and insurance and the risk of presenting with mPCa at the time of diagnosis.RESULTS:
Of 1,034,754 patients diagnosed with PCa, 4% had mPCa at initial presentation. Lower SES (first vs. fourth quartile; odds ratio [OR] = 1.39, 95% CI 1.35-1.44), black and Hispanic race/ethnicity (vs. white; OR = 1.47, 95% CI 1.43-1.51 and OR = 1.22, 95% CI 1.17-1.28, respectively), and having Medicaid or no insurance (vs. Medicare or private; OR = 3.91, 95% CI 3.78-4.05) were each independently associated with higher odds of presenting with mPCa after adjusting for all other covariates.CONCLUSIONS:
Lower SES, race/ethnicity, and having Medicaid or no insurance were each independently associated with higher odds of presenting with metastases at the time of PCa diagnosis. Our findings may partially explain current PCa outcomes disparities and inform future efforts to reduce disparities.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Classe Social
/
Adenocarcinoma
/
Grupos Raciais
/
Seguro Saúde
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Aged
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Urol Oncol
Assunto da revista:
NEOPLASIAS
/
UROLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Israel