Source
Northern and Yorkshire Cancer Registry and Information Service, Level 6, Bexley Wing, St James's Institute of Oncology, St James's Hospital, Beckett Street, Leeds, LS9 7TF, UK. lesley.fairley@bradfordhospitals.nhs.uk
Abstract
BACKGROUND:
Our objective was to analyse variation in non-metastatic prostate cancer management in the Northern and Yorkshire region of England.
METHODS:
We included 21,334 men aged > or = 55, diagnosed between 2000 and 2006. Principal treatment received was categorised into radical prostatectomy (11%), brachytherapy (2%), external beam radiotherapy (16%), hormone therapy (42%) and no treatment (29%).
RESULTS:
The odds ratio (OR) for receiving a radical prostatectomy was 1.53 in 2006 compared with 2000 (95% CI 1.26-1.86), whereas the OR for receiving hormone therapy was 0.57 (0.51-0.64). Age was strongly associated with treatment received; radical treatments were significantly less likely in men aged > or = 75 compared with men aged 55-64 years, whereas the odds of receiving hormone therapy or no treatment were significantly higher in the older age group. The OR for receiving radical prostatectomy, brachytherapy or external beam radiotherapy were all significantly lower in the most deprived areas when compared with the most affluent (0.64 (0.55-0.75), 0.32 (0.22-0.47) and 0.83 (0.74-0.94), respectively) whereas the OR for receiving hormone therapy was 1.56 (1.42-1.71).
CONCLUSIONS:
This study highlights the variation and inequalities that exist in the management of non-metastatic prostate cancer in the Northern and Yorkshire region of England.