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• W3175668736 abstract "No AccessJournal of UrologyAdult Urology1 Nov 2021The Association between Income Status and Treatment Selection for Prostate Cancer in a Universal Health Care System: A Population-Based AnalysisThis article is commented on by the following:Editorial Comment Justin D. Oake, Oksana Harasemiw, Navdeep Tangri, Thomas W. Ferguson, Jeff W. Saranchuk, Rahul K. Bansal, Darrel E. Drachenberg, and Jasmir G. Nayak Justin D. OakeJustin D. Oake Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author , Oksana HarasemiwOksana Harasemiw Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author , Navdeep TangriNavdeep Tangri Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada Financial interest and/or other relationship with Astra Zeneca, Tricida Inc., ClinPredict Inc., Roche Inc., Otsuka Inc., Janssen, Boehringer Ingelheim/Eli Lilly, PulseData and Mesentech. More articles by this author , Thomas W. FergusonThomas W. Ferguson Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author , Jeff W. SaranchukJeff W. Saranchuk Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada More articles by this author , Rahul K. BansalRahul K. Bansal Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Financial interest and/or other relationship with Sanofi Canada. More articles by this author , Darrel E. DrachenbergDarrel E. Drachenberg Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada More articles by this author , and Jasmir G. NayakJasmir G. Nayak ‡Correspondence: Z3013–409 Taché Ave., Winnipeg, Manitoba , Canada, R2H 2A6 telephone: 204-237-2571; E-mail Address: [email protected] Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001942AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Treatment selection for localized prostate cancer is guided by risk stratification and patient preferences. While socioeconomic status (SES) disparities exist for access to care, less is known about the effect of SES on treatment decision-making. We sought to evaluate whether income status was associated with the treatment selected (radical prostatectomy [RP] vs radiation therapy [RT]) for nonmetastatic prostate cancer in a universal health care system. Materials and Methods: All men from Manitoba, Canada who were diagnosed with nonmetastatic prostate cancer between 2005 and 2016 and subsequently treated with RP or RT were identified using a provincial cancer database. SES was defined as neighborhood income by postal code and divided into income quintiles (Q1–Q5, with Q1 the lowest quintile and Q5 the highest). Multivariable logistic regression nested models were used to compare whether SES was associated with treatment type received. Results: We identified 3,966 individuals who were diagnosed with nonmetastatic prostate cancer and were treated with RP (2,354) or RT (1,612). After adjusting for demographic and clinicopathological characteristics, as income quintile increased, men were incrementally more likely to undergo RP than RT (range Q2 vs Q1: adjusted OR 1.40, 95% CI 1.01–1.93; Q5 vs Q1: adjusted OR 2.30, 95% CI 1.70–3.12). Conclusions: As income levels increased there was a stepwise incremental increase in the odds of receiving RP over RT for localized prostate cancer. These results may inform initiatives to better understand the values, priorities and barriers that patients experience when making treatment decisions in a universal health care system. References 1. : Clinically localized prostate cancer: AUA/ASTRO/SUO guideline. Part I: Risk stratification, shared decision making, and care options. J Urol 2018; 199: 683. Link, Google Scholar 2. : Why do men choose one treatment over another? A review of patient decision making for localized prostate cancer. Cancer 2006; 106: 1865. 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Google Scholar 28. : Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry. Eur Urol 2015; 68: 600. Google Scholar 29. : How do patients choose between active surveillance, radical prostatectomy, and radiotherapy? The effect of a preference-sensitive decision aid on treatment decision making for localized prostate cancer. Urol Oncol 2017; 35: 37.e9. Google Scholar 30. : Assessing ecologic proxies for household income: a comparison of household and neighbourhood level income measures in the study of population health status. Health Place 1999; 5: 157. Google Scholar Funding Support: Funding for this study was provided by a GFT grant from the University of Manitoba Department of Surgery (JDO, JWS, RKB, JGN) and a grant from the Canadian Institute of Health Research (NT). Author Contributions: JDO, OH, NT, JGN designed the study. OH and TWF collected the data and performed the statistical analysis. JDO drafted the manuscript. OH, NT, TWF, JWS, RKB, DED and JGN all contributed to revising the manuscript. JGN led the project and critically revised and approved the final manuscript. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByNayak J (2022) The Association between Income Status and Treatment Selection for Prostate Cancer in a Universal Health Care System: A Population-Based Analysis. Reply.Journal of Urology, VOL. 207, NO. 4, (938-939), Online publication date: 1-Apr-2022.Grosso A, Di Maida F, Mari A and Minervini A (2022) The Association between Income Status and Treatment Selection for Prostate Cancer in a Universal Health Care System: A Population-Based Analysis. Letter.Journal of Urology, VOL. 207, NO. 4, (937-938), Online publication date: 1-Apr-2022.Related articlesJournal of UrologyAug 16, 2021, 12:00:00 AMEditorial Comment Volume 206Issue 5November 2021Page: 1204-1211 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsincomesocial determinants of healthsocioeconomic factorsprostatic neoplasmsAcknowledgmentsWe wish to acknowledge the contributions of Dr. Julian Kim and Dr. Aldrich Ong in critically appraising this study. We wish to acknowledge the assistance of the staff at the Manitoba Centre for Health Policy for their help in accessing the data used in our analysis, and extend thanks to the Manitoba Vital Statistics Agency, Manitoba Health and Health Living, Diagnostic Services of Manitoba and CancerCare Manitoba for provision of data. The results and conclusions herein are those of the authors and no official endorsement by the Manitoba Vital Statistics Agency, Manitoba Health and Healthy Living, Diagnostic Services of Manitoba or CancerCare Manitoba should be inferred.MetricsAuthor Information Justin D. Oake Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author Oksana Harasemiw Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author Navdeep Tangri Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada Financial interest and/or other relationship with Astra Zeneca, Tricida Inc., ClinPredict Inc., Roche Inc., Otsuka Inc., Janssen, Boehringer Ingelheim/Eli Lilly, PulseData and Mesentech. More articles by this author Thomas W. Ferguson Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author Jeff W. Saranchuk Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada More articles by this author Rahul K. Bansal Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Financial interest and/or other relationship with Sanofi Canada. More articles by this author Darrel E. Drachenberg Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada More articles by this author Jasmir G. Nayak Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada ‡Correspondence: Z3013–409 Taché Ave., Winnipeg, Manitoba , Canada, R2H 2A6 telephone: 204-237-2571; E-mail Address: [email protected] More articles by this author Expand All Funding Support: Funding for this study was provided by a GFT grant from the University of Manitoba Department of Surgery (JDO, JWS, RKB, JGN) and a grant from the Canadian Institute of Health Research (NT). Author Contributions: JDO, OH, NT, JGN designed the study. OH and TWF collected the data and performed the statistical analysis. JDO drafted the manuscript. OH, NT, TWF, JWS, RKB, DED and JGN all contributed to revising the manuscript. JGN led the project and critically revised and approved the final manuscript. Advertisement PDF DownloadLoading ..." @default.
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