Men with localized prostate cancer who live in highly populated areas are more likely to receive surgery or radiation compared to men living in less densely populated areas, according to a new study published in the journal Prostate Cancer and Prostatic Diseases, titled “Variation in prostate cancer treatment associated with population density of the county of residence.”
“This study highlights the importance of newly diagnosed prostate cancer patients seeking treatment in regions where it is best available, which happens to be locations that are more densely populated such as within large cities,” Dr. David Samadi, of the David Samadi Prostate Cancer Center in New York, said in a news release. “In less populated regions, there is less access to the most advanced medical care and especially to doctors who specialize in certain diseases such as prostate cancer. In order to get the best care for a disease like prostate cancer, it is highly recommended that patients find a specialist at a top hospital where they will have access to the most appropriate and necessary treatment.”
Researchers assessed the effect of population density of the county of residence on treatment for clinically localized prostate cancer, quantifying the variation in treatment attributable to the county and state level. Data from 138,226 men with clinically localized prostate cancer was retrieved from the Surveillance, Epidemiology and End Result (SEER) database between 2005 and 2008.
Results revealed that men with localized prostate cancer in metropolitan counties were 23 percent more likely to be treated with surgery or radiation compared to men in rural counties. These results remained stable even after the researchers controlled for the number of urologists per county, demographics, and clinical characteristics.
The results further showed that 3 percent of the total variation in treatment was attributable to the SEER site, while 6 percent of variation was attributable to the county of residence. These results remained stable after the researchers controlled for demographics and clinical characteristics.
The team concluded that the variation in the type of prostate cancer treatment received is associated with population density, as men living in more densely populated counties receive aggressive treatment more often than those in less-populated counties.
The study findings support the need for comparative effectiveness research and health policy initiatives to advance prostate cancer research and reduce unwarranted healthcare disparities in current clinical practice.
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