Variation in Locoregional Prostate Cancer Care and Treatment Trends at Commission on Cancer Designated Facilities: A National Cancer Data Base Analysis 2004 to 2013

Abstract

Micro-Abstract Within the National Cancer Data Base we evaluated whether differences in treatment patterns for prostate cancer exist at Commission on Cancer facilities. Overall, 825,707 men were included in the retrospective analyses. We found substantial variation in treatment patterns between different facility types and individual institutions, as well. Our findings indicate a necessity for policy makers to harmonize prostate cancer treatment. Background Contemporary treatment trends for prostate cancer show increased rates of active surveillance. However, nationwide applicability of these reports is limited. Additionally, the effect of Commission on Cancer facility type on prostate cancer treatment patterns is unknown. Patients and Methods We used the National Cancer Data Base to identify men diagnosed with prostate cancer, between 2004 and 2013. Our cohort was stratified on the basis of the National Comprehensive Cancer Network prostate cancer risk classes. Cochran–Armitage tests were used to evaluate temporal trends. Random effects hierarchical logit models were used to assess treatment variation at Commission on Cancer facility and institution level. Results In 825,707 men, utilization of radiation therapy declined and utilization of radical prostatectomy increased for all prostate cancer risk groups between 2004 and 2013 (P