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Prostate cancer differs between county and private hospitals

Kathleen Blanchard's picture

New findings show differences in how prostate cancer is treated, depending on whether the facility is a county hospital or a private hospital. Treatments for localized prostate cancer include surgery or hormone therapy and radiation.

A study conducted by Moores Cancer Center at the University of California, San Diego shows that men whose prostate cancer is treated at a county hospital are more likely to undergo surgery. Men at private hospitals are more frequently receive radiation and hormone therapy for prostate cancer.

"The study examined the factors that drive treatment choices for patients with prostate cancer" said J. Kellogg Parsons, MD, MHS, principal investigator and urologic oncologist at Moores UCSD Cancer Center. "We found that decisions are significantly influenced by the type of health care facility where they receive care."

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Because prostate cancer is the leading cause of cancer death among men in the US, the researchers say the type of prostate cancer treatment men receive have public policy implications, especially because public hospitals are funded by city and state governments. As far as outcomes go, there is no consensus as to whether surgery or hormone therapy and radiation is superior. Each prostate cancer treatment has different risks and benefits. Pre-existing illnesses, life expectancy and the severity of prostate cancer could be driving choice of treatment accounting for the differences between county and private hospitals.

Data for the study was extracted from the records of 559 men with prostate cancer who were part of the Improving Access, Counseling and Treatment for Californians with Prostate Cancer (IMPACT) program between 2001 and 2006. Even though prostate cancer tumors were similar in both groups, the study found that prostate cancer patients treated in private hospitals were more likely to be white and less likely to receive surgery. Men in private hospitals were 2 ½ times more likely to receive radiation and 4 ½ times more likely to receive hormone therapy for prostate cancer, compared to men in county hospitals.

The reason for the difference in prostate cancer treatment between county and private hospitals is not clear. Private hospitals represented urologists, radiation oncologists, and medical oncologists, while county hospital patients with prostate cancer were more likely to be under the care of a urologist.

"The fact that prostate cancer patients are treated differently based on the type of hospital has implications for health policy, quality of care and equality of care - particularly because public hospitals are funded by city and state governments to provide health care for underserved, poor populations," said Parsons. The study is published January 25 in the journal Cancer.