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Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States

In this study, we examined the effects of individual-level and area-level characteristics on advanced prostate cancer diagnosis among Medicare eligible older men (ages 70+ years). We analyzed patients from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2000-2007) li...

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Autores principales: Jayasekera, Jinani, Onukwugha, Eberechukwu, Cadham, Christopher, Tom, Sarah, Harrington, Donna, Naslund, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595651/
https://www.ncbi.nlm.nih.gov/pubmed/31263375
http://dx.doi.org/10.1177/1179554919855116
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author Jayasekera, Jinani
Onukwugha, Eberechukwu
Cadham, Christopher
Tom, Sarah
Harrington, Donna
Naslund, Michael
author_facet Jayasekera, Jinani
Onukwugha, Eberechukwu
Cadham, Christopher
Tom, Sarah
Harrington, Donna
Naslund, Michael
author_sort Jayasekera, Jinani
collection PubMed
description In this study, we examined the effects of individual-level and area-level characteristics on advanced prostate cancer diagnosis among Medicare eligible older men (ages 70+ years). We analyzed patients from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2000-2007) linked to US Census and County Business Patterns data. Cluster-adjusted logistic regression models were used to quantify the effects of individual preventive health behavior, clinical and demographic characteristics, area-level health services supply, and socioeconomic characteristics on stage at diagnosis. The fully adjusted model was used to estimate county-specific effects and predicted probabilities of advanced prostate cancer. In the adjusted analyses, low intensity of annual prostate-specific antigen (PSA) testing and other preventive health behavior, high comorbidity, African American race, and lower county socioeconomic and health services supply characteristics were statistically significantly associated with a higher likelihood of distant prostate cancer diagnosis. The fully adjusted predicted proportions of advanced prostate cancer diagnosis across 158 counties ranged from 3% to 15% (mean: 6%, SD: 7%). County-level socioeconomic and health services supply characteristics, individual-level preventive health behavior, demographic and clinical characteristics are determinants of advanced stage prostate cancer diagnosis among older Medicare beneficiaries; other health care-related factors such as family history, lifestyle choices, and health-seeking behavior should also be considered as explanatory factors.
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spelling pubmed-65956512019-07-01 Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States Jayasekera, Jinani Onukwugha, Eberechukwu Cadham, Christopher Tom, Sarah Harrington, Donna Naslund, Michael Clin Med Insights Oncol Original Research In this study, we examined the effects of individual-level and area-level characteristics on advanced prostate cancer diagnosis among Medicare eligible older men (ages 70+ years). We analyzed patients from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2000-2007) linked to US Census and County Business Patterns data. Cluster-adjusted logistic regression models were used to quantify the effects of individual preventive health behavior, clinical and demographic characteristics, area-level health services supply, and socioeconomic characteristics on stage at diagnosis. The fully adjusted model was used to estimate county-specific effects and predicted probabilities of advanced prostate cancer. In the adjusted analyses, low intensity of annual prostate-specific antigen (PSA) testing and other preventive health behavior, high comorbidity, African American race, and lower county socioeconomic and health services supply characteristics were statistically significantly associated with a higher likelihood of distant prostate cancer diagnosis. The fully adjusted predicted proportions of advanced prostate cancer diagnosis across 158 counties ranged from 3% to 15% (mean: 6%, SD: 7%). County-level socioeconomic and health services supply characteristics, individual-level preventive health behavior, demographic and clinical characteristics are determinants of advanced stage prostate cancer diagnosis among older Medicare beneficiaries; other health care-related factors such as family history, lifestyle choices, and health-seeking behavior should also be considered as explanatory factors. SAGE Publications 2019-06-26 /pmc/articles/PMC6595651/ /pubmed/31263375 http://dx.doi.org/10.1177/1179554919855116 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Jayasekera, Jinani
Onukwugha, Eberechukwu
Cadham, Christopher
Tom, Sarah
Harrington, Donna
Naslund, Michael
Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States
title Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States
title_full Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States
title_fullStr Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States
title_full_unstemmed Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States
title_short Epidemiological Determinants of Advanced Prostate Cancer in Elderly Men in the United States
title_sort epidemiological determinants of advanced prostate cancer in elderly men in the united states
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595651/
https://www.ncbi.nlm.nih.gov/pubmed/31263375
http://dx.doi.org/10.1177/1179554919855116
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