Socioeconomic Status May Affect Quality of Care, Outcomes in Prostate Cancer
by James Nam, PharmD
January 24, 2018
Researchers accessed the National Prostate Cancer Register of Sweden to evaluate the treatment strategies and outcomes for 74,643 patients with Pca.
Patients with prostate cancer (Pca) with a high socioeconomic status (SES) may receive better treatment compared with men of a lower SES, according to a study published in the International Journal of Cancer.1
Previous studies showed that high SES–patients with Pca have better survival outcomes, but the quality of care provided to men of low SES with the same severity of disease was previously unassessed.
For this cohort study, researchers accessed the National Prostate Cancer Register of Sweden to evaluate the treatment strategies and outcomes for 74,643 patients with Pca. The authors analyzed outcomes by evaluating patient educational levels, annual disposable income, and marital status. The median follow-up was 3.3 years.
High SES–individuals were more likely to have Pca detected upon prostate specific antigen (PSA) testing, less likely to receive a diagnosis of advanced disease, less likely to wait more than 3 months to receive radical prostatectomy, and less likely to wait longer than the median time prior to starting radiotherapy.
High SES–patients with intermediate- and high-risk PCa were also more likely to receive curative treatment and less likely to have positive surgical margins post prostatectomy.
Patients with high incomes had modest, but significantly lower, mortality rates after 6 years of follow-up compared with men with the lowest incomes with high-risk or metastatic disease with no comorbidities.
Patients with a high SES had substantially lower rates of all-cause mortality.
The authors concluded that “while the reasons for these inequalities in cancer care according to SES remain unknown, these findings underscore the importance of adherence to guidelines to ensure optimal and equal care for all patients diagnosed with cancer.”