Purpose

This study aimed to evaluate the association of race/ethnicity, patient care experiences (PCEs), and receipt of definitive treatment and treatment modality among older adults in the United States (US) with localized prostate cancer (PCa).

Methods

Using Surveillance, Epidemiology and End Results dataset linked to Medicare Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) for 2007–2015, we identified men aged ≥ 65 years who completed a CAHPS survey within one year before and one year after PCa diagnosis. Associations of race/ethnicity (non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, non-Hispanic Asian (NHA), and other) and of interactions between race/ethnicity and PCEs (getting needed care, getting care quickly, doctor communication, and care coordination) with the receipt of definitive PCa treatment and treatment modality within 3 and 6 months of diagnosis were examined using logistic regressions.

Results

Among 1,438 PCa survivors, no racial/ethnic disparities in the receipt of definitive treatment were identified. However, NHB patients were less likely to receive surgery (vs. radiation) within 3 and 6 months of PCa diagnosis than NHW patients (OR 0.397, p = 0.006 and OR 0.419, p = 0.005), respectively. Among NHA patients, a 1-point higher score for getting care quickly was associated with lower odds (OR 0.981, p = 0.043) of receiving definitive treatment within 3 months of PCa diagnosis, whereas among NHB patients, a 1-point higher score for doctor communication was associated with higher odds (OR 1.023, p = 0.039) of receiving definitive treatment within 6 months of PCa diagnosis.

Discussion

We observed differential associations between PCEs and receipt of definitive treatment based on patient race/ethnicity. Further research is needed to explore these associations.

中文翻译：

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前列腺癌幸存者中种族/民族和患者护理经历与接受明确治疗的关联：一项 SEER-CAHPS 研究

目的

本研究旨在评估美国 (US) 老年人局限性前列腺癌 (PCa) 中种族/民族、患者护理经历 (PCE) 以及接受明确治疗和治疗方式之间的关系。

方法

使用与 2007-2015 年医疗保险消费者对医疗保健提供者和系统评估 (SEER-CAHPS) 相关的监测、流行病学和最终结果数据集，我们确定了在 PCa 诊断前一年和诊断后一年内完成 CAHPS 调查的 65 岁以上男性。种族/民族（非西班牙裔白人 (NHW)、非西班牙裔黑人 (NHB)、西班牙裔、非西班牙裔亚裔 (NHA) 等）以及种族/民族与 PCE 之间的相互作用（获得所需护理、获得使用逻辑回归检查诊断后 3 个月和 6 个月内接受明确的 PCa 治疗和治疗方式的快速护理、医生沟通和护理协调）。

结果

在 1,438 名 PCa 幸存者中，在接受明确治疗方面没有发现种族/民族差异。然而，NHB 患者在 PCa 诊断后 3 个月和 6 个月内接受手术（相对于放疗）的可能性低于 NHW 患者（OR 0.397，p  = 0.006 和 OR 0.419，p  = 0.005）。在 NHA 患者中，快速获得护理的得分高 1 分与 PCa 诊断后 3 个月内接受明确治疗的几率较低相关（OR 0.981，p  = 0.043），而在 NHB 患者中，快速获得护理的得分高 1 分与 PCa 诊断后 3 个月内接受明确治疗的几率较低相关（OR 0.981，p = 0.043）。医生沟通与 PCa 诊断后 6 个月内接受明确治疗的几率较高（OR 1.023， p = 0.039）相关。

讨论

我们根据患者种族/民族观察了 PCE 与接受明确治疗之间的差异关联。需要进一步研究来探索这些关联。