171 Marital Status and Prostate Cancer Outcomes

Tyson, Mark; Andrews, Paul; Etzioni, David A.; Ferrigni, Robert G.; Humphreys, Mitchell R.; Swanson, Scott K.; Castle, Erik P.

doi:10.1016/j.juro.2012.02.222

Cited by 46 publications

(57 citation statements)

References 6 publications

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“…Hispanic men actually had higher guideline concordance in this study than other populations, contrary to what has been demonstrated in the Medicare population. 10 Additionally, unmarried patients fare worse with respect to many health and prostate cancer-specific outcomes 31 including cancer surveillance in this study, suggesting that this population might also benefit from tailored interventions to ensure quality prostate cancer surveillance.…”

Section: Discussionmentioning

confidence: 85%

Association between PSA values and surveillance quality after prostate cancer surgery

et al. 2019

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Background Although prostate‐specific antigen (PSA) testing is used for prostate cancer detection and posttreatment surveillance, thresholds in these settings differ. The screening cutoff of 4.0 ng/mL may be inappropriately used during postsurgery surveillance, where 0.2 ng/mL is typically used, creating missed opportunities for effective salvage radiation treatment. We performed a study to determine whether guideline concordance with annual postoperative PSA surveillance increases when PSA values exceed 4 ng/mL, which represents a screening threshold that is not relevant after surgery. Methods We used US Veterans Health Administration data to perform a retrospective longitudinal cohort study of men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. We used logistic regression to examine the association between postoperative PSA levels and receipt of an annual PSA test. Results Among 10 400 men and 38 901 person‐years of follow‐up, annual guideline concordance decreased from 95% in year 1 to 79% in year 7. After adjustment, guideline concordance was lower for the youngest and oldest men, Black, and unmarried men. Guideline concordance significantly increased as PSA exceeded 4 ng/mL (adjusted odds ratio 2.20 PSA > 4‐6 ng/mL vs PSA > 1‐4 ng/mL, 95% confidence interval 1.20‐4.03; P = .01). Conclusions Guideline concordance with prostate cancer surveillance increased when PSA values exceeded 4 ng/mL, suggesting a screening threshold not relevant after prostate cancer surgery, where 0.2 ng/mL is considered treatment failure, is impacting cancer surveillance quality. Clarification of PSA thresholds for early detection vs cancer surveillance, as well as emphasizing adherence for younger and Black men, appears warranted.

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Section: Discussionmentioning

confidence: 85%

Association between PSA values and surveillance quality after prostate cancer surgery

et al. 2019

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“…In addition, tumor registries can provide incidence and mortality data on patients with rare histologic subtypes that are not included in RCTs or institutional cohorts [53]. Cancer registries are also used to examine differences in incidence and mortality rates according to patient characteristics such as age, comorbidity status, race, socioeconomic status, and disease severity [54][55][56][57][58][59]. Potential risk factors and prognostic factors can be identified from these data as well [13].…”

Section: 4mentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate cancer, outcomes, statistical approaches, population-based cohorts, registries of outcomes, and epidemiological studies, alone or in combination. We limited our search to studies published between January 2005 and January 2015. Evidence synthesis: Several population-based and prospective disease-specific registries are currently available for prostate cancer. Studies performed using these data sources provide important information on incidence and mortality, disease characteristics at presentation, risk factors, trends in utilization of health care services, disparities in access to treatment, quality of care, long-term oncologic and health-related quality of life outcomes, and costs associated with management of the disease. Although data from these registries have some limitations, statistical methods are available that can address certain biases and increase the internal and external validity of such analyses. In the future, improvements in data quality, collection of tissue samples, and the availability of data feedback to health care providers will increase the relevance of studies built on population-based and disease-specific registries. Conclusions: The strengths and limitations of PCa registries should be carefully considered when planning studies using these databases. Although randomized controlled trials still provide the highest level of evidence, large registries play an important and growing role in advancing PCa research and care. Patient summary: Several population-based and prospective disease-specific registries for prostate cancer are currently available. Analyses of data from these registries yield information that is clinically relevant for the management of patients with prostate cancer.

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“…This measure is one that patients generally feel comfortable reporting, and it can be compared across countries [22]. Evidence suggests that support outside the health care system, including marital status, plays a significant role in prostate cancer outcomes [24]. The working group recommended inclusion of both marital status and living status (eg, I live with partner/ spouse/family/friends or I live alone).…”

Section: Demographicsmentioning

confidence: 99%