Rationale and design of the National Program of Cancer Registries' breast, colon, and prostate cancer patterns of care study

McDavid, Kathleen; Schymura, Maria J.; Armstrong, Lori; Santilli, Loretta; Schmidt, Beth; Byers, Tim; Steele, C. Brooke; O’Connor, Lilia; Schlag, Nancy C.; Roshala, Winny; Darcy, Dottie; Matanoski, Genevieve M.; Shen, Tiefu; Bol, Kirk A.

doi:10.1007/s10552-004-1555-5

Cited by 16 publications

(6 citation statements)

References 22 publications

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“…28 In brief, the NPCR POC Study is a collaborative inquiry by 7 state registries (California, Colorado, Illinois, Louisiana, New York, Rhode Island, and South Carolina) and is funded and coordinated by the Centers for Disease Control and Prevention (CDC). The purpose of the POC Study is to assess the adequacy of cancer treatment in the United States and to relate treatment to outcomes.…”

Section: Methodsmentioning

confidence: 99%

The impact of socioeconomic status on survival after cancer in the United States

Byers

Wolf

Bauer³

et al. 2008

Cancer

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355

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BACKGROUND.Understanding the ways in which socioeconomic status (SES) affects mortality is important for defining strategies to eliminate the unequal burden of cancer by race and ethnicity in the United States.METHODS.Disease stage, treatment, and 5‐year mortality rates were ascertained by reviewing medical records, and SES was determined by analyzing income and education at the census tract level for 4844 women with breast cancer, 4332 men with prostate cancer, and 4422 men and women with colorectal cancer who were diagnosed in 7 U.S. states in 1997.RESULTS.Low SES was associated with more advanced disease stage and with less aggressive treatment for all 3 cancers. The hazard ratio (HR) for 5‐year all‐cause mortality associated with low SES was elevated after a diagnosis of breast cancer when the analysis was adjusted for age (HR, 1.59; 95% confidence interval [CI], 1.35‐1.87). Adjustment for mediating factors of race/ethnicity, comorbid conditions, cancer stage, and treatment reduced the association. The age‐adjusted mortality risk associated with low SES was elevated after a diagnosis of prostate cancer (HR, 1.33; 95% CI, 1.13‐1.57), and multivariate adjustments for mediating factors also reduced that association. There was less association between SES and mortality after a diagnosis of colorectal cancer. For all 3 cancer sites, low SES was a much stronger predictor of mortality among individuals aged <65 years and among individuals from racial/ethnic minority groups.CONCLUSIONS.The current results indicated that low SES is a risk factor for all‐cause mortality after a diagnosis of cancer, largely because of a later stage at diagnosis and less aggressive treatment. These findings support the need to focus on SES as an underlying factor in cancer disparities by race and ethnicity. Cancer 2008. © 2008 American Cancer Society.

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Section: Methodsmentioning

confidence: 99%

The impact of socioeconomic status on survival after cancer in the United States

Byers

Wolf

Bauer³

et al. 2008

Cancer

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355

166

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“…The sampling methodology for this study has been explained in detail elsewhere [6,7]. In brief, random samples of cancer patients diagnosed in 1997 were selected from the databases of the participating central cancer registries.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1)

et al. 2010

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BackgroundDespite the large number of men diagnosed with localized prostate cancer, there is as yet no consensus concerning appropriate treatment. The purpose of this study was to describe the initial treatment patterns for localized prostate cancer in a population-based sample and to determine the clinical and patient characteristics associated with initial treatment and overall survival.MethodsThe analysis included 3,300 patients from seven states, diagnosed with clinically localized prostate cancer in 1997. We examined the association of sociodemographic and clinical characteristics with four treatment options: radical prostatectomy, radiation therapy, hormone therapy, and watchful waiting. Diagnostic and treatment information was abstracted from medical records. Socioeconomic measures were derived from the 2000 Census based on the patient's residence at time of diagnosis. Vital status through December 31, 2002, was obtained from medical records and linkages to state vital statistics files and the National Death Index. Multiple logistic regression analysis and Cox proportional hazards models identified factors associated with initial treatment and overall survival, respectively.ResultsPatients with clinically localized prostate cancer received the following treatments: radical prostatectomy (39.7%), radiation therapy (31.4%), hormone therapy (10.3%), or watchful waiting (18.6%). After multivariable adjustment, the following variables were associated with conservative treatment (hormone therapy or watchful waiting): older age, black race, being unmarried, having public insurance, having non-screen detected cancer, having normal digital rectal exam results, PSA values above 20, low Gleason score (2-4), comorbidity, and state of residence. Among patients receiving definitive treatment (radical prostatectomy or radiation therapy), older age, being unmarried, PSA values above 10, unknown Gleason score, state of residence, as well as black race in patients under 60 years of age, were associated with receipt of radiation therapy. Overall survival was related to younger age, being married, Gleason score under 8, radical prostatectomy, and state of residence. Comorbidity was only associated with risk of death within the first three years of diagnosis.ConclusionsIn the absence of clear-cut evidence favoring one treatment modality over another, it is important to understand the factors that inform treatment selection. Since state of residence was a significant predictor of both treatment as well as overall survival, true regional differences probably exist in how physicians and patients select treatment options. Factors affecting treatment choice and treatment effectiveness need to be further explored in future population-based studies.

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“…For the period 1998-2002, the percent of unstaged cases reported in SEER was 2% for breast cancer [3], 4% for prostate cancer [4], and 5% for cancer of the colon and rectum [5]. These proportions can be higher in state-based registries and subgroups of the population, however, ranging from 7.5% in one source, to over 10% in another, depending on the source of data, and the subgroup of the population being examined [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Complexity of care needs and unstaged cancer in elders: A population-based study

Koroukian

Beaird

et al. 2007

Cancer Detection and Prevention

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Rationale and design of the National Program of Cancer Registries' breast, colon, and prostate cancer patterns of care study

Cited by 16 publications

References 22 publications

The impact of socioeconomic status on survival after cancer in the United States

The impact of socioeconomic status on survival after cancer in the United States

Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1)

Complexity of care needs and unstaged cancer in elders: A population-based study

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