ArticleProstate cancer and prostatic diseases2016
Variation in prostate cancer treatment associated with population density of the county of residence.
Article in Prostate cancer and prostatic diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence.Frontiers in oncology · 2019Pooled it
- Cancer Treatment Patterns Among Yukon Residents Referred to British Columbia for Care: A 13-Year Retrospective Study.Current oncology (Toronto, Ont.) · 2025Article
- Review
- Geographic and socioeconomic variation in treatment of elderly prostate cancer patients in Norway - a national register-based study.Research in health services & regions · 2024Article
- Identification and classification of principal features for analyzing unwarranted clinical variation.Journal of evaluation in clinical practice · 2024Review
- A Nationwide Study of Differences in Surgical Treatment Rates and Oncological Outcomes for Prostate Cancer according to Economic Status and Region.Cancer research and treatment · 2023Article
- Rural-urban differences in health-related quality of life: patterns for cancer survivors compared to other older adults.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2021Article
- Regional Variation in Active Surveillance for Low-Risk Prostate Cancer in the US.JAMA network open · 2020Article
- Prostate Cancer Incidence and Aggressiveness in Appalachia versus Non-Appalachia Populations in Pennsylvania by Urban-Rural Regions, 2004-2014.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- Article
- The association between neighborhood greenness and incidence of lethal prostate cancer: A prospective cohort study.Environmental epidemiology (Philadelphia, Pa.) · 2020Article
- Balancing Confounding and Generalizability Using Observational, Real-world Data: 17-gene Genomic Prostate Score Assay Effect on Active Surveillance.Reviews in urology · 2018Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe sought to assess variation in the primary treatment of prostate cancer by examining the effect of population density of the county of residence on treatment for clinically localized prostate cancer and quantify variation in primary treatment attributable to the county and state level.
methodsA total 138 226 men with clinically localized prostate cancer in the Surveillance, Epidemiology and End Result (SEER) database in 2005 through 2008 were analyzed. The main association of interest was between prostate cancer treatment and population density using multilevel hierarchical logit models while accounting for the random effects of counties nested within SEER regions. To quantify the effect of county and SEER region on individual treatment, the percent of total variance in treatment attributable to county of residence and SEER site was estimated with residual intraclass correlation coefficients.
resultsMen with localized prostate cancer in metropolitan counties had 23% higher odds of being treated with surgery or radiation compared with men in rural counties, controlling for number of urologists per county as well as clinical and sociodemographic characteristics. Three percent (95% confidence interval (CI): 1.2-6.2%) of the total variation in treatment was attributable to SEER site, while 6% (95% CI: 4.3-9.0%) of variation was attributable to county of residence, adjusting for clinical and sociodemographic characteristics.
conclusionsVariation in treatment for localized prostate cancer exists for men living in different population-dense counties of the country. These findings highlight the importance of comparative effectiveness research to improve understanding of this variation and lead to a reduction in unwarranted variation.
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