MP23-17 SOCIOECONOMIC FACTORS PREDICT DELAY IN PROSTATE CANCER TREATMENT DECISION AND INITIATION

Abstract

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making III (MP23)1 Sep 2021MP23-17 SOCIOECONOMIC FACTORS PREDICT DELAY IN PROSTATE CANCER TREATMENT DECISION AND INITIATION Patrick Probst, Hunter Kraus, Will Fry, Aditya Sathe, Jackson Eber, Jay Fowke, Patricia Goedecke, Maurizio Buscarini, Christopher Ledbetter, Anthony Patterson, and Robert Wake Patrick ProbstPatrick Probst More articles by this author , Hunter KrausHunter Kraus More articles by this author , Will FryWill Fry More articles by this author , Aditya SatheAditya Sathe More articles by this author , Jackson EberJackson Eber More articles by this author , Jay FowkeJay Fowke More articles by this author , Patricia GoedeckePatricia Goedecke More articles by this author , Maurizio BuscariniMaurizio Buscarini More articles by this author , Christopher LedbetterChristopher Ledbetter More articles by this author , Anthony PattersonAnthony Patterson More articles by this author , and Robert WakeRobert Wake More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002014.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although prostate cancer is typically a slow-growing malignancy, pathology and risk stratification can progress in as quick as 3 months. Socioeconomic status (SES) and health disparities have been identified as predictors of worse oncologic and survival outcomes in men with prostate cancer. We sought to identify specific SES characteristics that contribute to delayed treatment decision (TD) and initiation (TI) in a majority black patient population. METHODS: After receiving IRB approval, men with a positive prostate biopsy between Jan. 2013 and Dec. 2019 at the Memphis VA Medical Center were retrospectively reviewed. Those with a known prostate cancer diagnosis or metastatic disease were excluded. Demographic data was compiled using census information corresponding to patient zip codes at time of biopsy. Time from biopsy to TD and time from TD to TI, were recorded (Table 1a.) Univariate chi-square analyses were performed to determine predictors of treatment selection while multivariable logistic regression analysis determined predictors of delayed TD and delayed TI. Delayed TD was defined as >100 days while delayed TI was defined as >150 days. RESULTS: 630 men with mean age of 63.3 years (41-79) and predominantly black (71.9%) met inclusion criteria. Race, age group and cancer risk stratification were strongly associated with type of therapy selected (p <0.0006). When controlling for age and risk, no demographic or socioeconomic factors were significantly associated with delayed TD. However, race and income approached statistical significance. Non-white men were 39% more likely to have a delayed time to decision (p=0.0633). Patients with average income <$40,000 were 78% more likely to have delayed TD (p=0.0769). Men <60 years old were 38% less likely to have delayed TI (p=0.0418). Those with low risk disease and poverty level >30% were 7.4x (p <0.0001) and 2x (p=0.0132) more likely to have delayed TI, respectively. Finally, white men were 67% more likely to have a delay in treatment initiation (p=0.0411). CONCLUSIONS: Individualized patient-specific education and adequate time to consider all therapies should be given to men with newly diagnosed prostate cancer. However, particular attention to those with lower SES is needed to avoid delays in therapy decision and ultimately treatment initiation. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e408-e409 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Probst More articles by this author Hunter Kraus More articles by this author Will Fry More articles by this author Aditya Sathe More articles by this author Jackson Eber More articles by this author Jay Fowke More articles by this author Patricia Goedecke More articles by this author Maurizio Buscarini More articles by this author Christopher Ledbetter More articles by this author Anthony Patterson More articles by this author Robert Wake More articles by this author Expand All Advertisement Loading ...