SAN FRANCISCO—Many patients with metastatic prostate cancer (PCa) never receive anticancer treatment, and older age, lower income, and lack of private health insurance may be among the reasons, according to data presented here at the annual Genitourinary Cancers Symposium.
Alexander C. Small, a fourth-year medical student at Mount Sinai School of Medicine in New York, and collaborators used the National Cancer Database to identify patients diagnosed with stage IV PCa between 2000 and 2008. Of 1,201,732 patients with PCa diagnosed during this period, 59,074 (4.8%) had metastatic disease. Among these, 6,582 (11.1%) received no anticancer treatment.
With each 10-year increment in age, the prevalence of untreated metastatic PCa increased by 43%. Blacks and Hispanics were, respectively, 32% and 41% more likely than whites to have untreated metastatic PCa. Each $10,000 increase in income was associated with a 7% decrease in the prevalence. Medicaid patients, Medicare patients, and uninsured patients were, respectively, 57%, 82%, and 96% more likely to be untreated compared with privately insured patients.
“This is an important observation because these patients are basically falling through the cracks,” Small said.
The symposium is cosponsored by the American Society of Clinical Oncology, the American Society of Radiation Oncology, and the Society of Urologic Oncology.