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Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review

PURPOSE: Major advances in radiation therapy (RT) for prostate cancer increase the importance of equity in the use of RT. We sought to assess the evolution of RT utilization disparities in prostate cancer to inform clinicians and health care organizations of persistent areas of need that can be addr...

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Detalles Bibliográficos
Autores principales: Gardner, Ulysses, McClelland, Shearwood, Deville, Curtiland
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046798/
https://www.ncbi.nlm.nih.gov/pubmed/35494548
http://dx.doi.org/10.1016/j.adro.2022.100943
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author Gardner, Ulysses
McClelland, Shearwood
Deville, Curtiland
author_facet Gardner, Ulysses
McClelland, Shearwood
Deville, Curtiland
author_sort Gardner, Ulysses
collection PubMed
description PURPOSE: Major advances in radiation therapy (RT) for prostate cancer increase the importance of equity in the use of RT. We sought to assess the evolution of RT utilization disparities in prostate cancer to inform clinicians and health care organizations of persistent areas of need that can be addressed in their practices and policies. METHODS AND MATERIALS: A comprehensive PubMed literature search was undertaken in June 2020 and subsequently in March 2021. Studies were excluded that were not based in the United States, did not examine health disparities or inequities, did not examine RT or related resource utilization, or did not examine prostate cancer. DISCUSSION: Of 257 studies found, 32 met inclusion criteria. Health disparities were most prominently reported by race, socioeconomic status, geographic location, insurance status, practice characteristics, and age. Older men were less likely to receive definitive RT or prostatectomy. Black men were less likely to receive curative therapy or dose-escalated RT. Black, Hispanic, and Asian men were less likely to receive proton therapy. Lower income was associated with decreased prostate-specific antigen testing and treatment with proton therapy or stereotactic body RT. Medicaid patients were less likely to receive definitive treatments. Rural residents were less likely to receive RT. Minority-serving hospitals were less likely to offer definitive treatments for prostate cancer. CONCLUSIONS: Sociodemographic disparities and inequities in RT for prostate cancer persist. Robust efforts are imperative to eliminate disparities to improve outcomes for all patients with prostate cancer.
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spelling pubmed-90467982022-04-29 Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review Gardner, Ulysses McClelland, Shearwood Deville, Curtiland Adv Radiat Oncol Critical Review PURPOSE: Major advances in radiation therapy (RT) for prostate cancer increase the importance of equity in the use of RT. We sought to assess the evolution of RT utilization disparities in prostate cancer to inform clinicians and health care organizations of persistent areas of need that can be addressed in their practices and policies. METHODS AND MATERIALS: A comprehensive PubMed literature search was undertaken in June 2020 and subsequently in March 2021. Studies were excluded that were not based in the United States, did not examine health disparities or inequities, did not examine RT or related resource utilization, or did not examine prostate cancer. DISCUSSION: Of 257 studies found, 32 met inclusion criteria. Health disparities were most prominently reported by race, socioeconomic status, geographic location, insurance status, practice characteristics, and age. Older men were less likely to receive definitive RT or prostatectomy. Black men were less likely to receive curative therapy or dose-escalated RT. Black, Hispanic, and Asian men were less likely to receive proton therapy. Lower income was associated with decreased prostate-specific antigen testing and treatment with proton therapy or stereotactic body RT. Medicaid patients were less likely to receive definitive treatments. Rural residents were less likely to receive RT. Minority-serving hospitals were less likely to offer definitive treatments for prostate cancer. CONCLUSIONS: Sociodemographic disparities and inequities in RT for prostate cancer persist. Robust efforts are imperative to eliminate disparities to improve outcomes for all patients with prostate cancer. Elsevier 2022-03-18 /pmc/articles/PMC9046798/ /pubmed/35494548 http://dx.doi.org/10.1016/j.adro.2022.100943 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Critical Review
Gardner, Ulysses
McClelland, Shearwood
Deville, Curtiland
Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review
title Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review
title_full Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review
title_fullStr Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review
title_full_unstemmed Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review
title_short Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review
title_sort disparities in the utilization of radiation therapy for prostate cancer in the united states: a comprehensive review
topic Critical Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046798/
https://www.ncbi.nlm.nih.gov/pubmed/35494548
http://dx.doi.org/10.1016/j.adro.2022.100943
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