Differences between rural and urban prostate cancer patients
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Differences between rural and urban prostate cancer patients. / Stolzenbach, Lara Franziska; Deuker, Marina; Collà-Ruvolo, Claudia; Nocera, Luigi; Tian, Zhe; Maurer, Tobias; Tilki, Derya; Briganti, Alberto; Saad, Fred; Mirone, Vincenzo; Chun, Felix K H; Graefen, Markus; Karakiewicz, Pierre I.
in: WORLD J UROL, Jahrgang 39, Nr. 7, 07.2021, S. 2507-2514.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Differences between rural and urban prostate cancer patients
AU - Stolzenbach, Lara Franziska
AU - Deuker, Marina
AU - Collà-Ruvolo, Claudia
AU - Nocera, Luigi
AU - Tian, Zhe
AU - Maurer, Tobias
AU - Tilki, Derya
AU - Briganti, Alberto
AU - Saad, Fred
AU - Mirone, Vincenzo
AU - Chun, Felix K H
AU - Graefen, Markus
AU - Karakiewicz, Pierre I
PY - 2021/7
Y1 - 2021/7
N2 - BACKGROUND: We hypothesized that the residency status (rural area [RA] vs urban clusters [UC] vs urban areas [UA]) affects stage and cancer-specific mortality (CSM) in contemporary newly diagnosed prostate cancer (PCa) patients of all stages, regardless of treatment.METHODS: Newly diagnosed PCa patients with available residency status were abstracted from the Surveillance, Epidemiology, and End Results database (2004-2016). Propensity-score (PS) matching, cumulative incidence plots, multivariate competing-risks regression (CRR) models were used.RESULTS: Of 531,468 PCa patients of all stages, 6653 (1.3%) resided in RA, 50,932 (9.6%) in UC and 473,883 (89.2%) in UA. No statistically significant or clinically meaningful differences in stage at presentation or CSM were recorded. Conversely, 10-year other cause-mortality (OCM) rates were 27.2% vs 23.7% vs 18.9% (p < 0.001) in RA vs UC vs UA patients, respectively. In CRR models, RA (subhazard ratio [SHR] 1.38; p < 0.001) and UC (SHR 1.18; p < 0.001) were independent predictors for higher OCM relative to UA. These differences remained statistically significant in fully PS-adjusted multivariate CRR models.CONCLUSION: RA, and to a lesser extent UC, PCa patients are at higher risk of OCM than UA patients. Higher OCM may indicate shorter life expectancy and should be considered in treatment decision making.
AB - BACKGROUND: We hypothesized that the residency status (rural area [RA] vs urban clusters [UC] vs urban areas [UA]) affects stage and cancer-specific mortality (CSM) in contemporary newly diagnosed prostate cancer (PCa) patients of all stages, regardless of treatment.METHODS: Newly diagnosed PCa patients with available residency status were abstracted from the Surveillance, Epidemiology, and End Results database (2004-2016). Propensity-score (PS) matching, cumulative incidence plots, multivariate competing-risks regression (CRR) models were used.RESULTS: Of 531,468 PCa patients of all stages, 6653 (1.3%) resided in RA, 50,932 (9.6%) in UC and 473,883 (89.2%) in UA. No statistically significant or clinically meaningful differences in stage at presentation or CSM were recorded. Conversely, 10-year other cause-mortality (OCM) rates were 27.2% vs 23.7% vs 18.9% (p < 0.001) in RA vs UC vs UA patients, respectively. In CRR models, RA (subhazard ratio [SHR] 1.38; p < 0.001) and UC (SHR 1.18; p < 0.001) were independent predictors for higher OCM relative to UA. These differences remained statistically significant in fully PS-adjusted multivariate CRR models.CONCLUSION: RA, and to a lesser extent UC, PCa patients are at higher risk of OCM than UA patients. Higher OCM may indicate shorter life expectancy and should be considered in treatment decision making.
U2 - 10.1007/s00345-020-03483-7
DO - 10.1007/s00345-020-03483-7
M3 - SCORING: Journal article
C2 - 33155063
VL - 39
SP - 2507
EP - 2514
JO - WORLD J UROL
JF - WORLD J UROL
SN - 0724-4983
IS - 7
ER -
