Disparities associated with advanced prostate cancer stage at diagnosis

Nicole M. Marlow, Michael T. Halpern, Alexandre L. Pavluck, Elizabeth M. Ward, Amy Y. Chen

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

This study expands on a previous report (focusing on health insurance status and race/ethnicity) to present effects of age, socioeconomic status, hospital type, and other factors (e.g., type of Medicaid and Medicare coverage, insurance-by-race/ethnicity interactions) on advanced-stage (III/IV) at prostate cancer diagnosis. Invasive (Stages I-IV) prostate cancer cases diagnosed during 1998-2004 were extracted from the National Cancer Database (N5687,464). Independent of health-insurance and race/ethnicity, socioeconomic status was a significant predictor of advanced stage at diagnosis, with patients residing in areas with lower socioeconomic characteristics having significantly increased odds. Those treated at community-cancer-centers had significantly decreased odds (versus teaching/ research-facilities). Significantly increased odds were also observed among uninsured- Blacks, Medicare-insured-Blacks, Medicaid-insured- Blacks, Medicare-insured-Hispanics, and Medicare-insured-other-racial/ethnic- minorities 65 years old and older (versus corresponding White-populations). The impact of prostate cancer screening on reducing mortality remains debatable. Still, our results suggest improvements in multiple factors that affect access-to-care may achieve earlier diagnosis and, therefore, a potentially more treatable disease.

Original languageEnglish (US)
Pages (from-to)112-131
Number of pages20
JournalJournal of health care for the poor and underserved
Volume21
Issue number1
DOIs
StatePublished - Feb 1 2010

Keywords

  • Health insurance
  • Prostate cancer
  • Racial/ethnic minority groups
  • Stage at diagnosis
  • Under-insured
  • Uninsured

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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