Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Disparities in Prostate Cancer Treatment Suggest Ways to Improve Care

Quality of care varies greatly for the treatment of men with early-stage prostate cancer by region of the country and category of health care facility, suggesting the potential for improved patient outcomes with more standard treatment protocols, according to a new study that was published in the Aug. 1 issue of the Journal of Clinical Oncology (2008: Vol. 26, Issue 22).

The inconsistencies in care also suggest that there is much to do before quality improvement initiatives, such as pay-for-performance, can be instituted nationwide, according to Benjamin A. Spencer, M.D., M.P.H., the lead author of the study. Dr. Spencer is a urologic oncologist at NewYork-Presbyterian Hospital/Columbia University Medical Center and an assistant professor of urology at the Columbia University College of Physicians and Surgeons.

"We found significant variations for early-stage prostate cancer quality indicators. There were differences in care from community hospitals to cancer centers to teaching hospitals. There were also disparities in care from one region of the country to another. But there were no racial disparities, suggesting equity in care once a patient initiates treatment," says Dr. Spencer. "If these variations in care can be eliminated, thereby providing uniform quality, it may lead to improved outcomes for patients."

The study reviewed national databases and individual patient charts to identify gaps in care for prostate cancer using comprehensive quality measures developed by RAND.

All therapies for localized prostate cancer can significantly impact the patient's quality of life. Improving the quality of care throughout the health care system could greatly improve quality-of-life issues for men treated for the disease.

Compliance with structural measures, such as having more than one board-certified urologist and board-certified radiation oncologist on staff, was high at near or greater than 90 percent. In contrast, compliance with standards for pre-therapy assessments of sexual and bowel function was low, at less than 52 percent.

Comprehensive cancer centers and teaching/research hospitals had higher compliance rates than community cancer centers across the board on nearly all compliance measures. Compliance rates varied greatly throughout the country on several measures, including board-certified urologists and radiation oncologists, communication with primary care physician and conformal total radiation dose.

High-quality care is possible, as evidenced by the near or greater than 80 percent compliance with pre-therapy disease severity assessment and counseling indicators. However, compliance was substantially lower for pre-therapy functional assessment and post-treatment follow-up indicators.

Using the National Cancer Data Base, the study sampled early-state prostate cancer cases diagnosed in 2000 through 2001 and explicitly reviewed medical records from 2,775 men treated with radical prostatectomy or external-beam radiation therapy. The researchers determined compliance with 29 quality-of-care disease-specific structure and process indicators developed by RAND, stratified by race, geographic region and hospital type.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments -- more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service.

It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital's mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Jennifer Homa | Newswise Science News
Further information:

More articles from Health and Medicine:

nachricht Inflammation Triggers Unsustainable Immune Response to Chronic Viral Infection
24.10.2016 | Universität Basel

nachricht Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Oasis of life in the ice-covered central Arctic

24.10.2016 | Earth Sciences

‘Farming’ bacteria to boost growth in the oceans

24.10.2016 | Life Sciences

Light-driven atomic rotations excite magnetic waves

24.10.2016 | Physics and Astronomy

More VideoLinks >>>