Race and time from diagnosis to radical prostatectomy: Does equal access mean equal timely access to the operating room? - Results from the SEARCH database

Lionel L. Bañez, Martha Kennedy Terris, William J. Aronson, Joseph C. Presti, Christopher J. Kane, Christopher L. Amling, Stephen J. Freedland

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: African American men with prostate cancer are at higher risk for cancer-specific death than Caucasian men. We determine whether significant delays in management contribute to this disparity. We hypothesize that in an equal-access health care system, time interval from diagnosis to treatment would not differ by race. Methods: We identified 1,532 African American and Caucasian men who underwent radical prostatectomy (RP) from 1988 to 2007at one of four Veterans Affairs Medical Centers that comprise the Shared Equal-Access Regional Cancer Hospital (SEARCH) database with known biopsy date. We compared time from biopsy to RP between racial groups using linear regression adjusting for demographic and clinical variables. We analyzed risk of potential clinically relevant delays by determining odds of delays >90 and >180 days. Results: Median time interval from diagnosis to RP was 76 and 68 days for African Americans and Caucasianmen, respectively (P = 0.004). After controlling for demographic and clinical variables, race was not associated with the time interval between diagnosis and RP (P = 0.09). Furthermore, race was not associated with increased risk of delays >90 (P = 0.45) or >180 days (P = 0.31). Conclusions: In a cohort of men undergoing RP in an equal-access setting, there was no significant difference between racial groups with regard to time interval from diagnosis to RP. Thus, equal-access includes equal timely access to the operating room. Given our previous finding of poorer outcomes among African Americans, treatment delays do not seem to explain these observations. Our findings need to be confirmed in patients electing other treatment modalities and in other practice settings.

Original languageEnglish (US)
Pages (from-to)1208-1212
Number of pages5
JournalCancer Epidemiology Biomarkers and Prevention
Volume18
Issue number4
DOIs
StatePublished - Apr 1 2009

Fingerprint

Cancer Care Facilities
Operating Rooms
Prostatectomy
Databases
African Americans
Demography
Biopsy
Veterans
Linear Models
Prostatic Neoplasms
Therapeutics
Delivery of Health Care
Neoplasms

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Race and time from diagnosis to radical prostatectomy : Does equal access mean equal timely access to the operating room? - Results from the SEARCH database. / Bañez, Lionel L.; Terris, Martha Kennedy; Aronson, William J.; Presti, Joseph C.; Kane, Christopher J.; Amling, Christopher L.; Freedland, Stephen J.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 18, No. 4, 01.04.2009, p. 1208-1212.

Research output: Contribution to journalArticle

Bañez, Lionel L. ; Terris, Martha Kennedy ; Aronson, William J. ; Presti, Joseph C. ; Kane, Christopher J. ; Amling, Christopher L. ; Freedland, Stephen J. / Race and time from diagnosis to radical prostatectomy : Does equal access mean equal timely access to the operating room? - Results from the SEARCH database. In: Cancer Epidemiology Biomarkers and Prevention. 2009 ; Vol. 18, No. 4. pp. 1208-1212.
@article{4f9c41a683c64cc8b2e57c372d54690a,
title = "Race and time from diagnosis to radical prostatectomy: Does equal access mean equal timely access to the operating room? - Results from the SEARCH database",
abstract = "Background: African American men with prostate cancer are at higher risk for cancer-specific death than Caucasian men. We determine whether significant delays in management contribute to this disparity. We hypothesize that in an equal-access health care system, time interval from diagnosis to treatment would not differ by race. Methods: We identified 1,532 African American and Caucasian men who underwent radical prostatectomy (RP) from 1988 to 2007at one of four Veterans Affairs Medical Centers that comprise the Shared Equal-Access Regional Cancer Hospital (SEARCH) database with known biopsy date. We compared time from biopsy to RP between racial groups using linear regression adjusting for demographic and clinical variables. We analyzed risk of potential clinically relevant delays by determining odds of delays >90 and >180 days. Results: Median time interval from diagnosis to RP was 76 and 68 days for African Americans and Caucasianmen, respectively (P = 0.004). After controlling for demographic and clinical variables, race was not associated with the time interval between diagnosis and RP (P = 0.09). Furthermore, race was not associated with increased risk of delays >90 (P = 0.45) or >180 days (P = 0.31). Conclusions: In a cohort of men undergoing RP in an equal-access setting, there was no significant difference between racial groups with regard to time interval from diagnosis to RP. Thus, equal-access includes equal timely access to the operating room. Given our previous finding of poorer outcomes among African Americans, treatment delays do not seem to explain these observations. Our findings need to be confirmed in patients electing other treatment modalities and in other practice settings.",
author = "Ba{\~n}ez, {Lionel L.} and Terris, {Martha Kennedy} and Aronson, {William J.} and Presti, {Joseph C.} and Kane, {Christopher J.} and Amling, {Christopher L.} and Freedland, {Stephen J.}",
year = "2009",
month = "4",
day = "1",
doi = "10.1158/1055-9965.EPI-08-0502",
language = "English (US)",
volume = "18",
pages = "1208--1212",
journal = "Cancer Epidemiology Biomarkers and Prevention",
issn = "1055-9965",
publisher = "American Association for Cancer Research Inc.",
number = "4",

}

TY - JOUR

T1 - Race and time from diagnosis to radical prostatectomy

T2 - Does equal access mean equal timely access to the operating room? - Results from the SEARCH database

AU - Bañez, Lionel L.

AU - Terris, Martha Kennedy

AU - Aronson, William J.

AU - Presti, Joseph C.

AU - Kane, Christopher J.

AU - Amling, Christopher L.

AU - Freedland, Stephen J.

PY - 2009/4/1

Y1 - 2009/4/1

N2 - Background: African American men with prostate cancer are at higher risk for cancer-specific death than Caucasian men. We determine whether significant delays in management contribute to this disparity. We hypothesize that in an equal-access health care system, time interval from diagnosis to treatment would not differ by race. Methods: We identified 1,532 African American and Caucasian men who underwent radical prostatectomy (RP) from 1988 to 2007at one of four Veterans Affairs Medical Centers that comprise the Shared Equal-Access Regional Cancer Hospital (SEARCH) database with known biopsy date. We compared time from biopsy to RP between racial groups using linear regression adjusting for demographic and clinical variables. We analyzed risk of potential clinically relevant delays by determining odds of delays >90 and >180 days. Results: Median time interval from diagnosis to RP was 76 and 68 days for African Americans and Caucasianmen, respectively (P = 0.004). After controlling for demographic and clinical variables, race was not associated with the time interval between diagnosis and RP (P = 0.09). Furthermore, race was not associated with increased risk of delays >90 (P = 0.45) or >180 days (P = 0.31). Conclusions: In a cohort of men undergoing RP in an equal-access setting, there was no significant difference between racial groups with regard to time interval from diagnosis to RP. Thus, equal-access includes equal timely access to the operating room. Given our previous finding of poorer outcomes among African Americans, treatment delays do not seem to explain these observations. Our findings need to be confirmed in patients electing other treatment modalities and in other practice settings.

AB - Background: African American men with prostate cancer are at higher risk for cancer-specific death than Caucasian men. We determine whether significant delays in management contribute to this disparity. We hypothesize that in an equal-access health care system, time interval from diagnosis to treatment would not differ by race. Methods: We identified 1,532 African American and Caucasian men who underwent radical prostatectomy (RP) from 1988 to 2007at one of four Veterans Affairs Medical Centers that comprise the Shared Equal-Access Regional Cancer Hospital (SEARCH) database with known biopsy date. We compared time from biopsy to RP between racial groups using linear regression adjusting for demographic and clinical variables. We analyzed risk of potential clinically relevant delays by determining odds of delays >90 and >180 days. Results: Median time interval from diagnosis to RP was 76 and 68 days for African Americans and Caucasianmen, respectively (P = 0.004). After controlling for demographic and clinical variables, race was not associated with the time interval between diagnosis and RP (P = 0.09). Furthermore, race was not associated with increased risk of delays >90 (P = 0.45) or >180 days (P = 0.31). Conclusions: In a cohort of men undergoing RP in an equal-access setting, there was no significant difference between racial groups with regard to time interval from diagnosis to RP. Thus, equal-access includes equal timely access to the operating room. Given our previous finding of poorer outcomes among African Americans, treatment delays do not seem to explain these observations. Our findings need to be confirmed in patients electing other treatment modalities and in other practice settings.

UR - http://www.scopus.com/inward/record.url?scp=66649108505&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=66649108505&partnerID=8YFLogxK

U2 - 10.1158/1055-9965.EPI-08-0502

DO - 10.1158/1055-9965.EPI-08-0502

M3 - Article

C2 - 19336564

AN - SCOPUS:66649108505

VL - 18

SP - 1208

EP - 1212

JO - Cancer Epidemiology Biomarkers and Prevention

JF - Cancer Epidemiology Biomarkers and Prevention

SN - 1055-9965

IS - 4

ER -