Study
PLCO
(Learn more about this study)
Project ID
2008-0008
Initial CDAS Request Approval
Mar 20, 2008
Title
Prostate cancer treatment choices in PLCO
Summary
Patients diagnosed with prostate cancer are faced with multiple treatment choices including radical prostatectomy, radiation treatment, active surveillance, hormonal therapy and cryosurgery. Because of the lack of quality trials regarding the most efficacious treatments for various disease states, there is a strong subjective component to patient choices for treating prostate cancer, especially among men with localized prostate cancer. Identifying these factors may be important when linked to outcomes data so that clinicians can understand which patients may be best suited for particular treatments. The aim of the current study is to try to identify socioeconomic, demographic, and clinical factors associated with treatment choices among men with prostate cancer. The hypotheses to be tested are: 1. Initial treatment choices for localized prostate cancer diagnosed in PLCO vary according to prostate cancer risk stratification and age 2. Use of radical prostatectomy among PLCO subjects diagnosed with clinically localized cancer will be affected by age, tumor characteristics and comorbid conditions. 3. Scoiodemographic factors, such as race, education, marital status and income will affect the initial treatment choices for PLCO subjects diagnosed with clinically localized prostate cancer. Variables will include Gleason grade, TNM stage and pretreatment PSA level, socioeconomic data such as employment category and educational status and demographic characteristics such as age and race. Comparisons will be made between groups of men seeking each primary treatment with the goal of identifying the most important factors involved in these treatment decisions. Many other studies seeking to answer these questions have used resources such as the SEER and Medicare claims databases, which require linking to tumor registries or other databases, which can diminish the accuracy and detail of available data. In summary, the current proposal is to study the socioeconomic, demographic and clinical factors associated with initial treatment choices in men diagnosed with clinically localized prostate cancer in the PLCO trial. The PLCO study, by combining all of this information in a single dataset provides the ideal study dataset to examine these questions.
Aims
Specific Aim #1: Data suggest that optimal patterns of care for men diagnosed with prostate cancer while undergoing screening may vary based on patient age and/or clinical measures of cancer severity. Therefore we propose to study the degree to which primary treatment choices differ among PLCO participants in various age and cancer risk strata.. Specific Aim #2: The use of radical prostatectomy (RP) should be determined by age, cancer severity and competing mortality risks. There are limited data evaluating the degree to which these criteria guide utilization of RP among men who are screened for prostate cancer. Accordingly, we propose to study the tumor characteristics, clinical characteristics, including comorbid conditions and sociodemographic factors which determine the use of RP among men diagnosed with clinically localized prostate cancer in PLCO. Specific Aim #3: Sociodemographic factors such as race, martial status, socioeconomic status and education have previously been shown to affect initial treatment choices in clinically localized prostate cancer. We are collecting data on specific data on income level. We propose to use this data to study socioeconomic factors associated with the use of RP in the PLCO trial.
Collaborators
David Miller (UCLA)
Jerome Mabie (IMS)
Lawrence Ragard (Westat)
Paul Pinsky (NCI)
Robert Greenlee (Marshfield Clinic)
Tom Hickey (IMS)
Gerald Andriole (Washington University)
Robert Grubb (Washington University)
Grant Izmirlian
Tom Riley (IMS)
