Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer

Brandon A Mahal; David R Ziehr; Ayal A Aizer; Andrew S Hyatt; Jesse D Sammon; Marianne Schmid; Toni K Choueiri; Jim C Hu; Christopher J Sweeney; Clair J Beard; Anthony V D'Amico; Neil E Martin; Christopher Lathan; Simon P Kim; Quoc-Dien Trinh; Paul L Nguyen

doi:10.1016/j.urolonc.2014.04.014

Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer

Standard

Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer. / Mahal, Brandon A; Ziehr, David R; Aizer, Ayal A; Hyatt, Andrew S; Sammon, Jesse D; Schmid, Marianne; Choueiri, Toni K; Hu, Jim C; Sweeney, Christopher J; Beard, Clair J; D'Amico, Anthony V; Martin, Neil E; Lathan, Christopher; Kim, Simon P; Trinh, Quoc-Dien; Nguyen, Paul L.

In: UROL ONCOL-SEMIN ORI, Vol. 32, No. 8, 01.11.2014, p. 1285-1291.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Mahal, BA, Ziehr, DR, Aizer, AA, Hyatt, AS, Sammon, JD, Schmid, M, Choueiri, TK, Hu, JC, Sweeney, CJ, Beard, CJ, D'Amico, AV, Martin, NE, Lathan, C, Kim, SP, Trinh, Q-D & Nguyen, PL 2014, 'Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer', UROL ONCOL-SEMIN ORI, vol. 32, no. 8, pp. 1285-1291. https://doi.org/10.1016/j.urolonc.2014.04.014

APA

Mahal, B. A., Ziehr, D. R., Aizer, A. A., Hyatt, A. S., Sammon, J. D., Schmid, M., Choueiri, T. K., Hu, J. C., Sweeney, C. J., Beard, C. J., D'Amico, A. V., Martin, N. E., Lathan, C., Kim, S. P., Trinh, Q-D., & Nguyen, P. L. (2014). Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer. UROL ONCOL-SEMIN ORI, 32(8), 1285-1291. https://doi.org/10.1016/j.urolonc.2014.04.014

Vancouver

Mahal BA, Ziehr DR, Aizer AA, Hyatt AS, Sammon JD, Schmid M et al. Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer. UROL ONCOL-SEMIN ORI. 2014 Nov 1;32(8):1285-1291. https://doi.org/10.1016/j.urolonc.2014.04.014

Bibtex

@article{64e7bdb1e7c44e32aca5bd297bad997a,

title = "Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer",

abstract = "OBJECTIVES: Treating high-risk prostate cancer (CaP) with definitive therapy improves survival. We evaluated whether having health insurance reduces racial disparities in the use of definitive therapy for high-risk CaP.MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results Program was used to identify 70,006 men with localized high-risk CaP (prostate-specific antigen level > 20 ng/ml or Gleason score 8-10 or stage > cT3a) diagnosed from 2007 to 2010. We used multivariable logistic regression to analyze the 64,277 patients with complete data to determine the factors associated with receipt of definitive therapy.RESULTS: Compared with white men, African American (AA) men were significantly less likely to receive definitive treatment (adjusted odds ratio [AOR] = 0.60; 95% CI: 0.56-0.64; P < 0.001) after adjusting for sociodemographics and known CaP prognostic factors. There was a significant interaction between race and insurance status (P interaction = 0.01) such that insurance coverage was associated with a reduction in racial disparity between AA and white patients regarding receipt of definitive therapy. Specifically, the AOR for definitive treatment for AA vs. white was 0.38 (95% CI: 0.27-0.54, P < 0.001) among uninsured men, whereas the AOR was 0.62 (95% CI: 0.57-0.66, P < 0.001) among insured men.CONCLUSIONS: AA men with high-risk CaP were significantly less likely to receive potentially life-saving definitive treatment when compared with white men. Having health insurance was associated with a reduction in this racial treatment disparity, suggesting that expansion of health insurance coverage may help reduce racial disparities in the management of aggressive cancers.",

author = "Mahal, {Brandon A} and Ziehr, {David R} and Aizer, {Ayal A} and Hyatt, {Andrew S} and Sammon, {Jesse D} and Marianne Schmid and Choueiri, {Toni K} and Hu, {Jim C} and Sweeney, {Christopher J} and Beard, {Clair J} and D'Amico, {Anthony V} and Martin, {Neil E} and Christopher Lathan and Kim, {Simon P} and Quoc-Dien Trinh and Nguyen, {Paul L}",

year = "2014",

month = nov,

day = "1",

doi = "10.1016/j.urolonc.2014.04.014",

language = "English",

volume = "32",

pages = "1285--1291",

journal = "UROL ONCOL-SEMIN ORI",

issn = "1078-1439",

publisher = "Elsevier Inc.",

number = "8",

}

RIS

TY - JOUR

T1 - Getting back to equal: The influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer

AU - Mahal, Brandon A

AU - Ziehr, David R

AU - Aizer, Ayal A

AU - Hyatt, Andrew S

AU - Sammon, Jesse D

AU - Schmid, Marianne

AU - Choueiri, Toni K

AU - Hu, Jim C

AU - Sweeney, Christopher J

AU - Beard, Clair J

AU - D'Amico, Anthony V

AU - Martin, Neil E

AU - Lathan, Christopher

AU - Kim, Simon P

AU - Trinh, Quoc-Dien

AU - Nguyen, Paul L

PY - 2014/11/1

Y1 - 2014/11/1

N2 - OBJECTIVES: Treating high-risk prostate cancer (CaP) with definitive therapy improves survival. We evaluated whether having health insurance reduces racial disparities in the use of definitive therapy for high-risk CaP.MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results Program was used to identify 70,006 men with localized high-risk CaP (prostate-specific antigen level > 20 ng/ml or Gleason score 8-10 or stage > cT3a) diagnosed from 2007 to 2010. We used multivariable logistic regression to analyze the 64,277 patients with complete data to determine the factors associated with receipt of definitive therapy.RESULTS: Compared with white men, African American (AA) men were significantly less likely to receive definitive treatment (adjusted odds ratio [AOR] = 0.60; 95% CI: 0.56-0.64; P < 0.001) after adjusting for sociodemographics and known CaP prognostic factors. There was a significant interaction between race and insurance status (P interaction = 0.01) such that insurance coverage was associated with a reduction in racial disparity between AA and white patients regarding receipt of definitive therapy. Specifically, the AOR for definitive treatment for AA vs. white was 0.38 (95% CI: 0.27-0.54, P < 0.001) among uninsured men, whereas the AOR was 0.62 (95% CI: 0.57-0.66, P < 0.001) among insured men.CONCLUSIONS: AA men with high-risk CaP were significantly less likely to receive potentially life-saving definitive treatment when compared with white men. Having health insurance was associated with a reduction in this racial treatment disparity, suggesting that expansion of health insurance coverage may help reduce racial disparities in the management of aggressive cancers.

AB - OBJECTIVES: Treating high-risk prostate cancer (CaP) with definitive therapy improves survival. We evaluated whether having health insurance reduces racial disparities in the use of definitive therapy for high-risk CaP.MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results Program was used to identify 70,006 men with localized high-risk CaP (prostate-specific antigen level > 20 ng/ml or Gleason score 8-10 or stage > cT3a) diagnosed from 2007 to 2010. We used multivariable logistic regression to analyze the 64,277 patients with complete data to determine the factors associated with receipt of definitive therapy.RESULTS: Compared with white men, African American (AA) men were significantly less likely to receive definitive treatment (adjusted odds ratio [AOR] = 0.60; 95% CI: 0.56-0.64; P < 0.001) after adjusting for sociodemographics and known CaP prognostic factors. There was a significant interaction between race and insurance status (P interaction = 0.01) such that insurance coverage was associated with a reduction in racial disparity between AA and white patients regarding receipt of definitive therapy. Specifically, the AOR for definitive treatment for AA vs. white was 0.38 (95% CI: 0.27-0.54, P < 0.001) among uninsured men, whereas the AOR was 0.62 (95% CI: 0.57-0.66, P < 0.001) among insured men.CONCLUSIONS: AA men with high-risk CaP were significantly less likely to receive potentially life-saving definitive treatment when compared with white men. Having health insurance was associated with a reduction in this racial treatment disparity, suggesting that expansion of health insurance coverage may help reduce racial disparities in the management of aggressive cancers.

U2 - 10.1016/j.urolonc.2014.04.014

DO - 10.1016/j.urolonc.2014.04.014

M3 - SCORING: Journal article

C2 - 24846344

VL - 32

SP - 1285

EP - 1291

JO - UROL ONCOL-SEMIN ORI

JF - UROL ONCOL-SEMIN ORI

SN - 1078-1439

IS - 8

ER -