Do Rural Patients with Early Stage Prostate Cancer Gain Access to All Treatment Choices?

Research center:
Lead researcher:
Project funded:
September 2008
Project completed:
June 2013

Optimal care for early stage prostate cancer includes multiple treatment options active surveillance, surgery, or radiation. Yet rural prostate cancer patients may have to choose treatments based on travel barriers or limited healthcare capacity rather than on preferences after consideration of treatment sequelae.

This study will examine whether rural residents with early stage prostate cancer access the full range of treatment options by comparing treatment rates of rural prostate cancer patients and their urban counterparts. Using 2004 data from 303 rural and 165 urban counties in 10 states with Surveillance, Epidemiology, and End Results cancer registries, we will compare use of active surveillance, radical prostatectomy, external beam radiation therapy, and brachytherapy between urban and rural patients with early disease.

We will determine how characteristics of patients (e.g. age), tumors (e.g. likelihood of organ-confined disease, and rural places (e.g. size, remoteness) influence prostate cancer treatment use. We will conduct unadjusted analyses and hierarchical logistic regression modeling that accounts for clustering of patients by county. Findings will inform cancer centers, advocacy groups, program planners, and policymakers about services and programs needed to ensure rural prostate cancer patients access to all treatment options. Products will include a Final Report and Policy Brief on the WWAMI RHRC website, a manuscript submitted to a refereed journal, and presentations to policy and research audiences at local, regional, and national conferences.