Factors Stimulating Treatment in a Certified Breast or Prostate Cancer Center

Abstract

The German Cancer Society (DKG) offers certification of oncological centres since 2003. Meanwhile more than 260 and more than 120 certified centres for breast and prostate cancer, respectively, exist in Germany. Aim of the herein performed investigation was the identification of factors that stimulate treatment of patients with breast or prostate cancer in a certified centre. This study was based on information available in the database of the Cancer Registry of Rhineland-Palatinate, Germany. The impact of age, region of residence, tumor status, grading and presence of metastasis on patient’s decision with respect to a certain medical facility was analyzed by adjusted logistic regression. This investigation included data of 13,020 breast cancer and 10,904 prostate cancer patients diagnosed in the years 2016 to 2020. Overall, 59 % and 28 % of breast and prostate cancer patients, respectively, were treated in a DKG-certified centre. The analyses showed that residence in an urban region was associated with treatment in a certified centre (breast: OR 0.42, 95% CI (0.37-0.48); prostate: OR 0.46 95% CI (0.40-0.53)). In addition, older breast cancer patients were more often treated in hospitals without certificate (OR 1.13, 95% CI (1.04-1.24). Prostate cancer showed no association with age but early tumor stage (T1) were more often treated in hospitals without certificate (OR 1.23, 95% CI (1.03-1.46). In contrast, patients with more advanced tumors, T2 and T3, were likely to be reported by DKG-certified centres (OR 0.58, 95% CI (0.41-0.81) and OR 0.67, 95% CI (0.47-0.96), respectively). Most breast and more than a quarter of prostate cancer patients were treated in DKG-certified centres. The region of residence seemed to affect the decision for a certain facility for all patients. Whereas age at diagnosis and tumor status played a role for breast and prostate cancer patients, respectively.