Comparison of the treatment of men with prostate cancer between the US and England: an international population-based study
AuthorsParry, M. G.
Skolarus, T. A.
van der Meulen, J.
Trinh, Q. D.
Clarke, N. W.
AffiliationDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
MetadataShow full item record
AbstractIntroduction The treatment of prostate cancer varies between the United States (US) and England, however this has not been well characterised using recent data. We therefore investigated the extent of the differences between US and English patients with respect to initial treatment. Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to identify men diagnosed with prostate cancer in the US and the treatments they received. We also used the National Prostate Cancer Audit (NPCA) database for the same purposes among men diagnosed with prostate cancer in England. Next, we used multivariable regression to estimate the adjusted risk ratio (aRR) of receiving radical local treatment for men with non-metastatic prostate cancer according to the country of diagnosis (US vs. England). The five-tiered Cambridge Prognostic Group (CPG) classification was included as an interaction term. Results We identified 109,697 patients from the SEER database, and 74,393 patients from the NPCA database, who were newly diagnosed with non-metastatic prostate cancer between April 1st 2014 and December 31st 2016 with sufficient information for risk stratification according to the CPG classification. Men in the US were more likely to receive radical local treatment across all prognostic groups compared to men in England (% radical treatment US vs. England, CPG1: 38.1% vs. 14.3% – aRR 2.57, 95% CI 2.47–2.68; CPG2: 68.6% vs. 52.6% – aRR 1.27, 95% CI 1.25–1.29; CPG3: 76.7% vs. 67.1% – aRR 1.12, 95% CI 1.10–1.13; CPG4: 82.6% vs. 72.4% – aRR 1.09, 95% CI 1.08–1.10; CPG5: 78.2% vs. 71.7% – aRR 1.06, 95% CI 1.04–1.07) Conclusions Treatment rates were higher in the US compared to England raising potential over-treatment concerns for low-risk disease (CPG1) in the US and under-treatment of clinically significant disease (CPG3-5) in England.
CitationParry MG, Nossiter J, Morris M, Sujenthiran A, Skolarus TA, Berry B, et al. Comparison of the treatment of men with prostate cancer between the US and England: an international population-based study. Prostate Cancer Prostatic Dis. 2022.
JournalProstate Cancer Prostatic Dis
- Risk stratification for prostate cancer management: value of the Cambridge Prognostic Group classification for assessing treatment allocation.
- Authors: Parry MG, Cowling TE, Sujenthiran A, Nossiter J, Berry B, Cathcart P, Aggarwal A, Payne H, van der Meulen J, Clarke NW, Gnanapragasam VJ
- Issue date: 2020 May 28
- The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer: a validation study.
- Authors: Gnanapragasam VJ, Bratt O, Muir K, Lee LS, Huang HH, Stattin P, Lophatananon A
- Issue date: 2018 Feb 28
- Using prognosis to guide inclusion criteria, define standardised endpoints and stratify follow-up in active surveillance for prostate cancer.
- Authors: Gnanapragasam VJ, Barrett T, Thankapannair V, Thurtle D, Rubio-Briones J, Domínguez-Escrig J, Bratt O, Statin P, Muir K, Lophatananon A
- Issue date: 2019 Nov
- The Effects of O<sup>6</sup>-methyl Guanine DNA-methyl Transferase Promotor Methylation and CpG1, CpG2, CpG3 and CpG4 Methylation on Treatment Response and their Prognostic Significance in Patients with Glioblastoma.
- Authors: Yildiz OG, Aslan D, Akalin H, Erdem Y, Canoz O, Aytekin A, Ozoner S, Dundar M
- Issue date: 2020 Jun