Comparison of the treatment of men with prostate cancer between the US and England: an international population-based study.

Autor: Parry MG; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK. mparry@rcseng.ac.uk.; Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK. mparry@rcseng.ac.uk., Nossiter J; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK., Morris M; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK., Sujenthiran A; Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.; Flatiron, London, UK., Skolarus TA; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, University of Michigan, Ann Arbor, MI, USA.; Department of Urology, University of Michigan, Ann Arbor, MI, USA., Berry B; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK., Nathan A; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.; University College London, London, UK., Cathcart P; Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK., Aggarwal A; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.; Department of Radiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK., van der Meulen J; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK., Trinh QD; Harvard Medical School, Boston, USA.; Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA., Payne H; Department of Oncology, University College London Hospitals, London, UK., Clarke NW; Department of Urology, The Christie NHS Foundation Trust, Manchester, UK.; Department of Urology, Salford Royal NHS Foundation Trust, Salford, UK.
Jazyk: angličtina
Zdroj: Prostate cancer and prostatic diseases [Prostate Cancer Prostatic Dis] 2023 Jun; Vol. 26 (2), pp. 287-292. Date of Electronic Publication: 2022 Jan 10.
DOI: 10.1038/s41391-021-00482-6
Abstrakt: Introduction: The treatment of prostate cancer varies between the United States (US) and England, however this has not been well characterised using recent data. We therefore investigated the extent of the differences between US and English patients with respect to initial treatment.
Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify men diagnosed with prostate cancer in the US and the treatments they received. We also used the National Prostate Cancer Audit (NPCA) database for the same purposes among men diagnosed with prostate cancer in England. Next, we used multivariable regression to estimate the adjusted risk ratio (aRR) of receiving radical local treatment for men with non-metastatic prostate cancer according to the country of diagnosis (US vs. England). The five-tiered Cambridge Prognostic Group (CPG) classification was included as an interaction term.
Results: We identified 109,697 patients from the SEER database, and 74,393 patients from the NPCA database, who were newly diagnosed with non-metastatic prostate cancer between April 1st 2014 and December 31st 2016 with sufficient information for risk stratification according to the CPG classification. Men in the US were more likely to receive radical local treatment across all prognostic groups compared to men in England (% radical treatment US vs. England, CPG1: 38.1% vs. 14.3% - aRR 2.57, 95% CI 2.47-2.68; CPG2: 68.6% vs. 52.6% - aRR 1.27, 95% CI 1.25-1.29; CPG3: 76.7% vs. 67.1% - aRR 1.12, 95% CI 1.10-1.13; CPG4: 82.6% vs. 72.4% - aRR 1.09, 95% CI 1.08-1.10; CPG5: 78.2% vs. 71.7% - aRR 1.06, 95% CI 1.04-1.07) CONCLUSIONS: Treatment rates were higher in the US compared to England raising potential over-treatment concerns for low-risk disease (CPG1) in the US and under-treatment of clinically significant disease (CPG3-5) in England.
(© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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