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Differences accordi...
Differences according to socioeconomic status in the management and mortality in men with high risk prostate cancer
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- Berglund, Anders (author)
- Uppsala universitet,Endokrinkirurgi
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Garmo, Hans (author)
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Robinson, David (author)
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- Tishelman, Carol (author)
- Karolinska Institutet
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- Holmberg, Lars (author)
- Uppsala universitet,Endokrinkirurgi
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- Bratt, Ola (author)
- Lund University,Lunds universitet,Urologi,Forskargrupper vid Lunds universitet,Urology,Lund University Research Groups
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- Adolfsson, Jan (author)
- Karolinska Institutet
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- Stattin, Pär (author)
- Umeå universitet,Urologi och andrologi
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- Lambe, Mats (author)
- Karolinska Institutet
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(creator_code:org_t)
- Elsevier BV, 2012
- 2012
- English.
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In: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 48:1, s. 75-84
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Background: Outcomes for many cancer forms are associated with socioeconomic status (SES).We investigated if SES was associated with management and mortality in men with high risk prostate cancer.Material and methods: A nation-wide population-based cohort in Prostate Cancer Data Base Sweden (PCBaSe), a merged database including data on incident prostate cancer identified in the National Prostate Cancer Register (NPCR) between 1997 and 2006. High risk PCa was defined as T3 tumour, and/or Gleason score 8–10 and/or PSA 20–50 ng/mL. Use of bone scan, curative treatment, and mortality in relation to SES was assessed by logistic, Cox, and competing risk regression with hazard ratios (HR), sub-distributed HR and 95% confidence intervals (CI) adjusted for co-morbidity, age, calendar period and clinical subgroups.Results: Amongst 17,522 high risk prostate cancer patients, a bone scan was more often performed in higher white-collar than in blue-collar workers (OR 1.30; 95% CI 1.21–1.40). Amongst men without metastases, the likelihood of intention to treat was higher in higher white-collar workers (OR 1.43; 95% CI 1.28–1.57). In men who received curative treatment, the likelihood was higher to undergo radical prostatectomy for higher white-collar patients (OR 1.29; 95% CI 1.10–1.47). In men without metastases, not only overall mortality was lower amongst higher white-collar workers (HR, 0.76; 95% CI 0.60–0.97), but also prostate cancer-specific mortality (sHR 0.70; 95% CI, 0.49–0.99).Conclusions: We conclude that socioeconomic disparities in the management and mortality in men with high risk prostate cancer exist also within the setting of a National Health Care System aiming to provide care on equal terms to all residents.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- diagnostic intensity
- high risk prostatic neoplasm
- mortality
- socioeconomic status
- treatment
- Sweden
- Diagnostic intensity
- High risk prostatic neoplasm
- Mortality
- Socioeconomic status
- Treatment
- Sweden
Publication and Content Type
- ref (subject category)
- art (subject category)
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