Decrease in Racial Disparities in the Staging Evaluation for Prostate Cancer After Publication of Staging Guidelines

Nitya E. Abraham, Fei Wan, Chantal Montagnet, Yu Ning Wong, Katrina Armstrong

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: We compared how men with incident prostate cancer were staged before and after the 1995 publication of National Comprehensive Cancer Network, American Urological Association and American College of Radiology staging guidelines, and determined whether there were racial differences in the staging evaluation. Materials and Methods: We performed a retrospective cohort study of the use of bone scan and pelvic imaging (pelvic computerized tomography or magnetic resonance imaging) in 96,986 men with incident prostate cancer from 1991 to 1994 compared to 1995 to 1999 from Surveillance, Epidemiology and End Results-Medicare linked data files. Results: During 1991 to 1994 bone scan was done in 83.1% and 73.7% of men who would and would not have met guideline criteria for staging, respectively. From 1995 to 1999 bone scan use decreased slightly in men who met guideline criteria (74.4%) but it decreased substantially in men who did not meet guideline criteria (55.2%). Between 1991 to 1994 and 1995 to 1999 rates of pelvic imaging increased for men who did and decreased for men who did not meet guideline criteria for staging (45.5% to 57.2% and 48.4% to 41.5%, respectively). On multivariate analysis in men who did not meet guideline criteria there was no change in the association between the use of staging tests and race from 1991 to 1994, to 1995 to 1999. However, of men who met guideline criteria for staging black men were less likely to undergo bone scan and less likely to undergo pelvic imaging than white men diagnosed in 1991 to 1994 but this racial difference was not seen during 1995 to 1999. Conclusions: Using a population based cohort this study reveals a decrease in racial disparity and an increase in evidence based use of staging tests in men with incident prostate cancer in the period after the publication of National Comprehensive Cancer Network, American Urological Association and American College of Radiology guidelines.

Original languageEnglish (US)
Pages (from-to)82-87
Number of pages6
JournalJournal of Urology
Volume178
Issue number1
DOIs
StatePublished - Jul 2007
Externally publishedYes

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Publications
Prostatic Neoplasms
Guidelines
Radiology
Bone and Bones
Cohort Studies
Pelvic Bones
Information Storage and Retrieval
Medicare
Neoplasms
Epidemiology
Multivariate Analysis
Retrospective Studies
Tomography
Magnetic Resonance Imaging

Keywords

  • African Americans
  • neoplasm staging
  • practice guidelines
  • prostate
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Decrease in Racial Disparities in the Staging Evaluation for Prostate Cancer After Publication of Staging Guidelines. / Abraham, Nitya E.; Wan, Fei; Montagnet, Chantal; Wong, Yu Ning; Armstrong, Katrina.

In: Journal of Urology, Vol. 178, No. 1, 07.2007, p. 82-87.

Research output: Contribution to journalArticle

Abraham, Nitya E. ; Wan, Fei ; Montagnet, Chantal ; Wong, Yu Ning ; Armstrong, Katrina. / Decrease in Racial Disparities in the Staging Evaluation for Prostate Cancer After Publication of Staging Guidelines. In: Journal of Urology. 2007 ; Vol. 178, No. 1. pp. 82-87.
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abstract = "Purpose: We compared how men with incident prostate cancer were staged before and after the 1995 publication of National Comprehensive Cancer Network, American Urological Association and American College of Radiology staging guidelines, and determined whether there were racial differences in the staging evaluation. Materials and Methods: We performed a retrospective cohort study of the use of bone scan and pelvic imaging (pelvic computerized tomography or magnetic resonance imaging) in 96,986 men with incident prostate cancer from 1991 to 1994 compared to 1995 to 1999 from Surveillance, Epidemiology and End Results-Medicare linked data files. Results: During 1991 to 1994 bone scan was done in 83.1{\%} and 73.7{\%} of men who would and would not have met guideline criteria for staging, respectively. From 1995 to 1999 bone scan use decreased slightly in men who met guideline criteria (74.4{\%}) but it decreased substantially in men who did not meet guideline criteria (55.2{\%}). Between 1991 to 1994 and 1995 to 1999 rates of pelvic imaging increased for men who did and decreased for men who did not meet guideline criteria for staging (45.5{\%} to 57.2{\%} and 48.4{\%} to 41.5{\%}, respectively). On multivariate analysis in men who did not meet guideline criteria there was no change in the association between the use of staging tests and race from 1991 to 1994, to 1995 to 1999. However, of men who met guideline criteria for staging black men were less likely to undergo bone scan and less likely to undergo pelvic imaging than white men diagnosed in 1991 to 1994 but this racial difference was not seen during 1995 to 1999. Conclusions: Using a population based cohort this study reveals a decrease in racial disparity and an increase in evidence based use of staging tests in men with incident prostate cancer in the period after the publication of National Comprehensive Cancer Network, American Urological Association and American College of Radiology guidelines.",
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