Racial disparities in advanced prostate cancer care: An analysis of treatment patterns and patient experience

晚期前列腺癌护理中的种族差异：治疗模式和患者体验分析

• 批准号: 10581500
• 负责人: Emily Mae Rencsok
• 金额: $ 5.27万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10581500
• 关键词: Acceleration; Affect; Area; Australia; Black race; Cancer Control; Cancer Patient; Caring; Clinical; Communication; Confidence Intervals; Data; Diagnosis; Disease; Disease Progression; Disparity; Enrollment; Ensure; Equation; Equity; Ethnic Origin; European Organization for Research and Treatment of Cancer; Failure; Goals; Guidelines; Health; Health Personnel; Health Services Accessibility; Healthcare Systems; Heterogeneity; Incidence; Individual; International; Intervention; Investigation; Linear Regressions; Link; Logistic Regressions; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Medical Records; Modeling; Morbidity - disease rate; Newly Diagnosed; Not Hispanic or Latino; Odds Ratio; Outcome; Outcome Measure; Patient Care; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Pattern; Physicians; Population; Prospective cohort; Public Health; Quality of life; Questionnaires; Race; Registries; Regression Analysis; Reporting; Research; Surveys; Symptoms; Time; Toxic effect; Training; Translating; United Kingdom; United States; Visual; Work; access disparities; advanced prostate cancer; black men; black patient; cancer care; career; disparity reduction; experience; functional status; high risk; improved; men; mortality; mortality risk; novel; novel therapeutics; participant enrollment; prostate cancer survivors; racial difference; racial disparity; study population; survivorship; treatment disparity; treatment pattern; uptake

PROJECT SUMMARY/ABSTRACT Prostate cancer is a significant public health burden with substantial heterogeneity in clinical outcomes and large racial disparities: Black men in the United States are 1.6 times more likely to be diagnosed with prostate cancer and two times more likely to die from prostate cancer compared to white men. Patients with advanced prostate cancer (APC) experience the highest risk of death and the most severely impacted quality of life due to the disease itself as well as its associated therapies. Despite this, advanced prostate cancer is understudied. The treatment landscape for APC has changed rapidly over the past 10 years with the FDA approval of 11 new therapies in the US, yet the real-world uptake of these therapies and experience of men using these therapies is unknown. Additionally, though disparities in access to treatment and quality of life have been shown in patients with localized prostate cancer, these outcomes have not been studied in patients with APC; this is concerning as limited access to treatment and poorer quality of life have been linked to higher mortality in cancer broadly. Little is known about the treatment patterns for or experience of patients with APC, and most studies to date in this population have enrolled primarily non-Hispanic white men. There is an urgent need to expand the investigation of prostate cancer racial disparities into patients with APC, and with a specific focus on patient-centric outcomes, to highlight potential areas for intervention to decrease mortality from APC. The overarching goal of the proposed work is to quantify racial differences in the treatment patterns, experience with the health care system, and quality of life for patients with APC in the United States and United Kingdom. I will investigate these domains of the patient experience using data from approximately 1500 patients enrolled in the International Registry for Men with Advanced Prostate Cancer (IRONMAN), a global prospective cohort of men newly diagnosed with APC. Specifically, I will compare the self-identified races of Black and white men in the US and UK. In Aim 1, I will use medical record and physician questionnaire data to characterize differences in observed treatment patterns and reasons for discontinuing treatments. In Aim 2, I will use Australia’s National Cancer Control Indicators to assess differences in baseline patient experience with the health care system, emphasizing communication and integration into care. In Aim 3, I will use patient-reported outcome measures data from the EORTC QLQ-C30 Quality of Life Survey to assess racial differences in baseline and longitudinal domains of quality of life, including overall quality of life, functional status, and symptom status. This project will provide real-world information that can be directly translated by identifying and quantifying racial disparities across the spectrum of care received by patients with APC, suggesting potential areas for intervention by healthcare providers to ensure equitable care for all patients with APC.

项目摘要/摘要 前列腺癌是一种重要的公共卫生伯恩，在临床结果和 大种族差异：美国的黑人被诊断为前列腺的1.6倍 与白人相比，癌症死于前列腺癌的可能性高两倍。患者患者 前列腺癌（APC）的死亡风险最高，到期最严重影响的生活质量 疾病本身及其相关疗法。尽管如此，晚期前列腺癌是 研究了。在过去的10年中，APC的治疗景观随着FDA而发生了迅速变化 在美国批准了11种新疗法，但这些疗法和男性经验的现实吸收 使用这些疗法是未知的。此外，尽管获得治疗和生活质量的分布 已经在患有局部前列腺癌的患者中显示出来，这些结果尚未研究 与APC；这是因为获得治疗的机会有限，生活质量较差已与更高 癌症的死亡率广泛。关于APC患者的治疗模式或经验知之甚少 迄今为止，大多数研究中的大多数研究主要是非西班牙裔白人。有紧急 需要将前列腺癌种族分布的投资扩展到患有APC的患者，并具有特定 专注于以患者为中心的结果，以强调干预措施的潜在领域，以降低APC的死亡率。 拟议工作的总体目标是量化治疗方式中的种族差异， 美国APC患者的医疗保健系统和生活质量的经验 和英国。我将使用来自大约的数据调查患者体验的这些领域 1500名患有晚期前列腺癌国际注册处（Ironman）的患者，A 全球预期的男性队列新诊断为APC。具体来说，我将比较自我识别 美国和英国的黑白男子种族。在AIM 1中，我将使用病历和医生 问卷数据以表征观察到的治疗模式的差异和中断的原因 治疗。在AIM 2中，我将使用澳大利亚的国家癌症控制指标来评估基线的差异 患者在医疗保健系统方面的经验，强调沟通并融入护理。目标 3，我将使用EORTC QLQ-C30生活质量调查的患者报告的结果指标 评估基线和纵向生活质量领域的种族差异，包括整体生活质量， 功能状态和症状状态。该项目将提供可以直接的现实信息 通过识别和量化在患者接受的各种护理范围内的种族分布来翻译 APC，建议医疗保健提供者干预的潜在领域，以确保所有人的公平护理 APC患者。