Trends in the Use of Active Surveillance and Treatments in Medicare Beneficiaries Diagnosed with Localized Prostate Cancer

Overview

Journal Urol Oncol

Publisher Elsevier

Date 2020 Dec 14

PMID 33308973

Citations 14

Authors

Yu Liu

Ingrid J Hall

Christopher Filson

David H Howard

Affiliations

Soon will be listed here.

Abstract

Background: The treatment for men diagnosed with localized prostate cancer has changed over time given the increased attention to the harms associated with over-diagnosis and the development of protocols for active surveillance.

Methods: We examined trends in the treatment of men diagnosed with localized prostate cancer between 2004 and 2015, using the most recently available data from Surveillance, Epidemiology, and End Results Program (SEER)-Medicare. Patients were stratified by Gleason score, age, and race groups.

Results: The use of active surveillance increased from 22% in 2004-2005 to 50% in 2014-2015 for patients with a Gleason score of 6 or below and increased from 9% in 2004-2005 to 13% in 2014-2015 for patients with a Gleason score of 7 or above. Patients with a Gleason score of 7 or above had increased use of intensity-modulated radiation therapy and prostatectomy, especially among patients aged 75 years and older. Among patients with a Gleason score of 6 or below non-Hispanic black men were less likely to undergo active surveillance than non-Hispanic white men.

Conclusions: There has been a large increase in the use of active surveillance among men with a Gleason score of 6 or below. However, non-Hispanic black men with a Gleason score of 6 or below are less likely to receive active surveillance.

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References

Loeb S, Folkvaljon Y, Curnyn C, Robinson D, Bratt O, Stattin P . Uptake of Active Surveillance for Very-Low-Risk Prostate Cancer in Sweden. JAMA Oncol. 2016; 3(10):1393-1398. PMC: 5559339. DOI: 10.1001/jamaoncol.2016.3600. View

Mayberry R, Mili F, Ofili E . Racial and ethnic differences in access to medical care. Med Care Res Rev. 2000; 57 Suppl 1:108-45. DOI: 10.1177/1077558700057001S06. View

Mohler J . The 2010 NCCN clinical practice guidelines in oncology on prostate cancer. J Natl Compr Canc Netw. 2010; 8(2):145. DOI: 10.6004/jnccn.2010.0010. View

Hosain G, Sanderson M, Du X, Chan W, Strom S . Racial/ethnic differences in treatment discussed, preferred, and received for prostate cancer in a tri-ethnic population. Am J Mens Health. 2012; 6(3):249-57. PMC: 3368001. DOI: 10.1177/1557988311432467. View

Diez Roux A, Merkin S, Arnett D, Chambless L, Massing M, Nieto F . Neighborhood of residence and incidence of coronary heart disease. N Engl J Med. 2001; 345(2):99-106. DOI: 10.1056/NEJM200107123450205. View

Freedland S, Isaacs W . Explaining racial differences in prostate cancer in the United States: sociology or biology?. Prostate. 2004; 62(3):243-52. DOI: 10.1002/pros.20052. View

Aihara M, Lebovitz R, Wheeler T, Kinner B, Ohori M, Scardino P . Prostate specific antigen and gleason grade: an immunohistochemical study of prostate cancer. J Urol. 1994; 151(6):1558-64. DOI: 10.1016/s0022-5347(17)35302-8. View

Hamdy F, Donovan J, Athene Lane J, Mason M, Metcalfe C, Holding P . 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med. 2016; 375(15):1415-1424. DOI: 10.1056/NEJMoa1606220. View

Nguyen P, Gu X, Lipsitz S, Choueiri T, Choi W, Lei Y . Cost implications of the rapid adoption of newer technologies for treating prostate cancer. J Clin Oncol. 2011; 29(12):1517-24. PMC: 3082972. DOI: 10.1200/JCO.2010.31.1217. View

10.

Mitchell J . Urologists' use of intensity-modulated radiation therapy for prostate cancer. N Engl J Med. 2013; 369(17):1629-37. DOI: 10.1056/NEJMsa1201141. View

11.

Dess R, Hartman H, Mahal B, Soni P, Jackson W, Cooperberg M . Association of Black Race With Prostate Cancer-Specific and Other-Cause Mortality. JAMA Oncol. 2019; 5(7):975-983. PMC: 6547116. DOI: 10.1001/jamaoncol.2019.0826. View

12.

. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008; 149(3):185-91. DOI: 10.7326/0003-4819-149-3-200808050-00008. View

13.

Sundi D, Ross A, Humphreys E, Han M, Partin A, Carter H . African American men with very low-risk prostate cancer exhibit adverse oncologic outcomes after radical prostatectomy: should active surveillance still be an option for them?. J Clin Oncol. 2013; 31(24):2991-7. PMC: 3739860. DOI: 10.1200/JCO.2012.47.0302. View

14.

Hahn C, Kavanagh B, Bhatnagar A, Jacobson G, Lutz S, Patton C . Choosing wisely: the American Society for Radiation Oncology's top 5 list. Pract Radiat Oncol. 2014; 4(6):349-55. DOI: 10.1016/j.prro.2014.06.003. View

15.

Noone A, Lund J, Mariotto A, Cronin K, McNeel T, Deapen D . Comparison of SEER Treatment Data With Medicare Claims. Med Care. 2014; 54(9):e55-64. PMC: 4981219. DOI: 10.1097/MLR.0000000000000073. View

16.

Houston K, King J, Li J, Jemal A . Trends in Prostate Cancer Incidence Rates and Prevalence of Prostate Specific Antigen Screening by Socioeconomic Status and Regions in the United States, 2004 to 2013. J Urol. 2017; 199(3):676-682. PMC: 11181155. DOI: 10.1016/j.juro.2017.09.103. View

17.

Butler S, Muralidhar V, Chavez J, Fullerton Z, Mahal A, Nezolosky M . Active Surveillance for Low-Risk Prostate Cancer in Black Patients. N Engl J Med. 2019; 380(21):2070-2072. PMC: 7374756. DOI: 10.1056/NEJMc1900333. View

18.

Hall I, Richardson L . Commentary on the State-of-the-Science Conference on the role of active surveillance in the management of men with localized prostate cancer. J Natl Cancer Inst Monogr. 2012; 2012(45):135-9. PMC: 3540865. DOI: 10.1093/jncimonographs/lgs040. View

19.

Klabunde C, Potosky A, Legler J, Warren J . Development of a comorbidity index using physician claims data. J Clin Epidemiol. 2001; 53(12):1258-67. DOI: 10.1016/s0895-4356(00)00256-0. View

20.

Modi P, Kaufman S, Qi J, Lane B, Cher M, Miller D . National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms. Urology. 2018; 120:96-102. PMC: 6462187. DOI: 10.1016/j.urology.2018.06.037. View