Cancer patients who are treated in county hospitals are more likely to receive surgical treatment than patients at private hospitals, which had higher rates of using radiation therapy-based treatment, according to an article published online in the January 25 issue of Cancer.
A study of economically disadvantaged men in California who received state government-funded treatment for prostate cancer found that the type of hospital where a patient goes to receive care may significantly influence the type of treatment he receives, according to lead author Dr. J. Kellogg Parsons of the University of California, San Diego's Moores Cancer Center in La Jolla, CA (Cancer, January 25, 2010).
The results also indicate that if the initial provider of clinical advice is a single physician specialist, such as a urologist, the treatment recommendation may differ from the recommendations made by a multidisciplinary team of oncology specialists.
Over a five-year period from 2001 through 2005, 551 men with newly diagnosed localized prostate cancer who received treatment in county hospitals (56%) had a higher likelihood of undergoing surgery as a primary treatment, compared with men treated in private hospitals (44%). Overall, patients treated at private hospitals were nearly 2.5 times more likely to receive radiation therapy as the primary treatment and more than 4.5 times likely to receive androgen deprivation therapy.
The men were among 772 men enrolled in Improving Access, Counseling, and Treatment for Californians with Prostate Cancer (IMPACT), a state-funded program providing prostate cancer treatment for low-income men with no health insurance. Patients diagnosed with metastatic prostate cancer were excluded from the study.
A network of county and private hospitals that volunteered to participate in the IMPACT program provided the treatment. Patients were assigned to hospitals based on geographic proximity. All patients received standardized education about prostate cancer treatment provided by IMPACT support staff.
Type of initial treatment for localized prostate cancer
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After conducting multinomial regression analysis to compare types of treatments that patients received, there was no significant difference between groups with respect to age, enrollment year, Gleason score, Charlson comorbidity index, clinical T stage, prostate-specific antigen or D'Amico risk criteria, the authors reported. However, compared with county hospital patients, private patients were three times as likely to be Caucasian and half as likely to undergo surgery.
By Cynthia E. Keen
AuntMinnie.com staff writer
January 25, 2010
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