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Cancer Causes & Control

, Volume 29, Issue 10, pp 895–899 | Cite as

Racial variation in receipt of quality radiation therapy for prostate cancer

  • Daniel J. Lee
  • Zhiguo Zhao
  • Li-Ching Huang
  • Tatsuki Koyoma
  • Matthew J. Resnick
  • David F. Penson
  • Daniel A. Barocas
  • Karen E. Hoffman
Brief report
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Abstract

Purpose

Racial disparities are apparent in the management and outcomes for prostate cancer; however, disparities in compliance to quality measures for radiation therapy for prostate cancer have not been previously studied. Therefore, the goal of the study was to characterize disparities in the compliance rates with quality measures.

Methods

The comparative effectiveness analysis of radiation therapy and surgery study is a population-based, prospective cohort study that enrolled 3708 men with clinically localized prostate cancer from 2011 to 2012. Compliance with 5 radiation-specific quality measures endorsed by national consortia as of 2011 was assessed, and compliance was compared by race using logistic regression.

Results

Overall, 604 men received definitive external beam radiation therapy (EBRT) of which 20% were self-reported black, 74% non-Hispanic white, and 6% Hispanic. Less than two-thirds of black and Hispanic men received EBRT that was compliant with all available quality measures (p = 0.012). Compared to white men, black men were less likely to receive dose-escalated EBRT (95% vs. 87%, p = 0.011) and less likely to avoid unnecessary pelvic radiation for low-risk disease (99% vs. 20%, p < 0.001). Compared to white men, Hispanic men were less likely to undergo image guidance (87% vs. 71%, p = 0.04). Black and Hispanic men were more likely to receive EBRT from low-quality providers than white men.

Conclusions

Addressing disparities in access to providers that meet quality guidelines, and improving adherence to evidence-based processes of care may decrease racial/ethnic disparities in prostate cancer outcomes.

Keywords

Prostate cancer Racial disparities Radiation therapy Quality measures 

Notes

Funding

This work was supported by the American Cancer Society (MSRG-15-103-01-CPHPS to M.J.R.); by the US Agency for Healthcare Research and Quality (1R01HS019356, 1R01HS022640-01); and through a contract from the Patient-Centered Outcomes Research Institute.

Compliance with ethical standards

Conflicts of interest

No author has any relevant conflicts of interest.

References

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Daniel J. Lee
    • 1
  • Zhiguo Zhao
    • 2
  • Li-Ching Huang
    • 2
  • Tatsuki Koyoma
    • 2
  • Matthew J. Resnick
    • 1
  • David F. Penson
    • 1
  • Daniel A. Barocas
    • 1
  • Karen E. Hoffman
    • 3
  1. 1.Department of Urology, Center for Quantitative SciencesVanderbilt University Medical CenterNashvilleUSA
  2. 2.Department of Biostatistics, Center for Quantitative SciencesVanderbilt University Medical CenterNashvilleUSA
  3. 3.Department of Radiation OncologyMD Anderson Cancer CenterHoustonUSA

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