San Francisco, CA—More than 1 in 10 patients with metastatic prostate cancer never receive anticancer treatment for their disease, according to an examination of the National Cancer Database. Lack of private health insurance and lower income play a role in the lack of anticancer treatment, based on a new analysis. Alexander C. Small, a fourth-year medical student at Mount Sinai School of Medicine, New York City, sought to characterize the population of patients with advanced prostate cancer who did not receive treatment. He presented his findings at the 2012 Genitourinary Cancers Symposium. From the National Cancer Database, he identified 59,074 patients diagnosed with stage IV prostate cancer between 2000 and 2008. Of these, 6582 (11.1%) received no anticancer therapy (in cluding chemotherapy, hormonal therapy, radiation, or surgery). With every 10-year increase in age, the prevalence of untreated metastatic prostate cancer increased 43%. Blacks were 32% more likely and Hispanics were 41% more likely than whites to receive no treatment.
With every $10,000 increase in income, the prevalence of untreated meta-static prostate cancer decreased by 7%. Patients with Medicaid were 57% more likely to be untreated, patients with Medicare were 82% more likely to be untreated, and uninsured patients were 96% more likely to be untreated than patients with private insurance. “While tumor biology likely plays a role with regard to rapid disease onset and progression, these data suggest that age, racial, and socioeconomic disparities exist in the treatment of metastatic prostate cancer,” Mr Small concluded.—WK
