Trends and practices for managing low-risk prostate cancer: a SEER-Medicare study.

Prostate Cancer and Prostatic Diseases
Richard M HoffmanKenneth G Nepple

Abstract

Expectant management (EM) has been widely recommended for men with low-risk prostate cancers (PCa). We evaluated trends in EM and the sociodemographic and clinical factors associated with EM, initiating a National Comprehensive Cancer Network guideline-concordant active surveillance (AS) monitoring protocol, and switching from EM to active treatment (AT). We used the SEER-Medicare database to identify men ages 66+ diagnosed with a low-risk PCa (PSA < 10 ng/mL, Gleason ≤ 6, stage ≤ T2a) in 2010-2013 with ≥1 year of follow-up. We used claims data to capture (1) PCa treatments, including surgical procedures, radiotherapy, and hormone therapy, and (2) AS monitoring procedures, including PSA tests and prostate biopsy. We defined EM as receiving no AT within 1 year of diagnosis. We used multivariable regression techniques to identify factors associated with EM, initiating AS monitoring, and switching to AT. During the study period, EM increased from 29.4% to 49.0%, p < 0.01. Age < 77, being married/partnered, non-Hispanic ethnicity, higher median ZIP code income, lower PSA levels, stage T1c, and more recent year of diagnosis were associated with EM. Nearly 39% of the EM cohort initiated AS monitoring; age <77, White race, being marri...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Jan 9, 2001·Journal of Clinical Epidemiology·C N KlabundeJ L Warren
May 19, 2007·The Journal of Urology·Ian ThompsonUNKNOWN AUA Prostate Cancer Clinical Guideline Update Panel
Mar 12, 2009·Journal of the National Cancer Institute·Gerrit DraismaHarry de Koning
Feb 10, 2010·Journal of the National Comprehensive Cancer Network : JNCCN·James L Mohler
Apr 6, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jeffrey J TosoianH Ballentine Carter
Nov 20, 2012·European Urology·Meelan BulMonique J Roobol
Dec 19, 2012·The Journal of Urology·Scott E EggenerBertrand Guillonneau
Aug 12, 2014·The Journal of Urology·Adam B WeinerScott E Eggener
Aug 28, 2014·European Urology·Paul R WombleUNKNOWN Michigan Urological Surgery Improvement Collaborative
Sep 10, 2014·The Journal of Urology·Chad R RitchDaniel A Barocas
Dec 17, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Laurence KlotzAndrew Loblaw
May 12, 2015·CA: a Cancer Journal for Clinicians·Christopher P FilsonMark S Litwin
Jun 30, 2015·JAMA Internal Medicine·Matthew J MauriceHui Zhu
Jul 8, 2015·JAMA : the Journal of the American Medical Association·Matthew R Cooperberg, Peter R Carroll
Sep 15, 2016·The New England Journal of Medicine·Freddie C HamdyUNKNOWN ProtecT Study Group
Sep 25, 2016·The Journal of Urology·Amy N LuckenbaughUNKNOWN Michigan Urological Surgery Improvement Collaborative
Apr 5, 2017·The Journal of Urology·Florian A DistlerBoris A Hadaschik
Apr 30, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B A MahalP L Nguyen
Sep 14, 2017·Cancer·Björn LöppenbergQuoc-Dien Trinh
Jun 16, 2018·Advances in Radiation Oncology·Lindsay M BurtJonathan D Tward
May 23, 2019·The New England Journal of Medicine·Santino ButlerBrandon A Mahal
Oct 22, 2019·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Richard M HoffmanKathryn Taylor
Dec 28, 2019·The New England Journal of Medicine·Bashir Al Hussein Al AwamlhJonathan E Shoag
Nov 4, 2020·JAMA : the Journal of the American Medical Association·Rishi DekaBrent S Rose
Dec 29, 2020·JAMA Network Open·Samuel L WashingtonMatthew R Cooperberg

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.