Integrated prostate cancer centers might cause an overutilization of radiotherapy for low-risk prostate cancer: A comparison of treatment trends in the United States and Germany from 2004 to 2011

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Benjamin HagerJohannes Huber

Abstract

Aim of the study was to analyze changes in primary treatment for low-risk prostate cancer across different healthcare systems. We compared "Surveillance Epidemiology and End Results" data (USA) with data from four German federal epidemiological cancer registries, both from 2004 to 2011. We excluded metastatic disease and patients aged ⩾80 years. Thereof, we identified 132,506 (USA) and 54,159 (Germany) patients with low-risk according to the 2014 EAU guidelines. We tested treatment trends for statistical significance with a linear regression model. Active treatment was radical prostatectomy (RP) in 36.1% vs. 66.2% and radiotherapy (RT) in 38.4% vs. 11.8%. No active treatment (NAT) was reported in 24.2% vs. 16.2% (p<0.001 each). Through the study period the use of RP decreased from 37.1% to 34.2% in the USA (p=0.04) and was constant at a mean of 66.2% in Germany (p=0.8). The use of RT in the USA decreased from 42.8% to 31.8% (p<0.001), while it was stable in Germany (p=0.09). The NAT group grew from 18.0% to 33.2% in the USA (p<0.001), while it was stable in Germany until 2009 (p=0.3). From 2009 to 2011 there also was an increase of the NAT group in Germany from 15.2% to 19.4% (p=0.001). In contrast to former evidence we found t...Continue Reading

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Citations

Aug 24, 2016·Prostate Cancer and Prostatic Diseases·C GroebenJ Huber
May 22, 2016·BJU International·Alexander WinterUNKNOWN Association of Population-based Cancer Registries in Germany (GEKID) Cancer Survival Working Group
Jun 24, 2017·European Journal of Cancer Prevention : the Official Journal of the European Cancer Prevention Organisation (ECP)·Bernd Holleczek, Alexander Katalinic
Mar 5, 2020·Journal of Cancer Research and Clinical Oncology·Daniel MedenwaldDirk Vordermark

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