Page 29 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer
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Insurance Type
Two multivariable analyses reported that having Medicare insurance increased the
probability of receiving WW/AS compared with private or Veterans Administration insurance.
One analysis reported that having preferred provider organization or health maintenance
organization coverage decreased the probability of receiving observational management
strategies versus RP. It also reported that Medicare supplemented with fee-for-service, health
maintenance organization, or preferred provider organization coverage decreased the probability
of receiving observational management strategies versus RP. One multivariable analysis reported
that insurance status was not a significant factor in predicting interruption of observational
management strategies.
Availability of Technology
No study addressed this factor.
Small Area Variation
No study addressed this factor.
Regional Variation
One multivariable analysis comparing the registries in the National Cancer Institute’s
Patterns of Care study claimed that men who resided in New Jersey had an increased probability
of receiving observational management strategies compared with men in California (excluding
three major cities). Comparisons among other registries were nonsignificant. Another
multivariable analysis reported that men in Northeast had a decreased probability of selecting
observational management strategies (versus active treatments) compared with men in California
(excluding three major cities).
Urban Versus Rural
One survey of men with prostate cancer in North Carolina reported that there was no
significant difference between urban and rural residents in North Carolina as to whether the
option of observational management strategies was discussed with their physicians. One
multivariable analysis reported that men who resided in urban areas (vs. rural areas) had a
decreased probability of receiving observational management strategies versus RP or RT. The
survey in North Carolina reported that there was a difference in whether physician
recommendation was the most influential factor in the treatment decision between urban and
rural residents (62 percent vs. 44 percent, respectively).
Academic Centers Versus Private Practice
One multivariable analysis reported that treatment facility status (academic vs. community
practice) was not a significant factor in predicting receiving observational management strategies
versus active treatment.
Risk Assessment, Predictive Models
No study addressed this factor.
ES-19
