Lower socioeconomic groups less likely to get prostatectomy, radiotherapy for prostate cancer

Men from lower socioeconomic groups in the United Kingdom were less likely to undergo radiotherapy or prostatectomy to treat prostate cancer. This trend persisted even after factors such as hospital of diagnosis and disease stage were considered.

“Decision making for treatment of prostate cancer is known to be complex and at least in part patterned by the patient’s lifestyle, educational and demographic factors,” researchers wrote. “Given these uncertainties, the observed differences in treatment patterns cannot a priori be assumed to indicate differences in treatment quality.”

Data from 35,171 patients aged 51 years or older in the U.K. regional cancer registry were examined. All men had been diagnosed with prostate cancer between 1995 and 2006.

Between 1995 to 1997 and 2004 to 2006, the proportion of men who chose treatment with surgery increased from 2.9% to 8.4% (P<.001). However, the proportion of men who chose to be treated with radiotherapy remained stagnant at about 25% of the population.

Patients were classified into one of five groups based on level of deprivation: group 1 (least deprived), group 5 (most deprived). Both radiotherapy and prostatectomy were more commonly used among those patients classified as the least deprived.

About 29% of the least deprived men were treated with radiotherapy vs. 21% for the most deprived; for surgery it was 8.4% of the least deprived men vs. 4% of the most deprived.

This trend continued in the researchers multivariable analysis, which found that men who were the most deprived had a lower odds of being treated with radiotherapy (OR=0.92; 95% CI, 0.90-0.94) or surgery (OR=0.91; 95% CI, 0.87-0.94).

Lyratzopoulos G. BMJ. 2010;doi:10.1136/bmj.c1928.