INTRODUCTION: Initial observation (IO) is a strategy to minimize @entity263 overtreatment. We sought to evaluate contemporary trends in IO utilization for @entity263 in the United States and to identify factors associated with its uptake. METHODS: Using the National @entity5 Database, we identified @entity1 with @entity263 diagnosed between 2004 and 2011. IO utilization was plotted over time. Multivariate logistic regression was performed to determine the influence of diagnosis year and other factors on IO selection. RESULTS: Of the 219 971 @entity1 with @entity263 , 21 231 (9.7%) underwent IO. Beginning in 2008, IO use increased significantly with time (range: 7.5%-14.3%). Compared to 2004, @entity1 diagnosed in 2011 had 2.5 times the odds of choosing IO (odds ratio [OR] 2.5, confidence interval [CI] 2.3-2.6, p < 0.01). Aside from diagnosis year, age, race, Charlson score, clinical T stage, and PSA level predicted IO use (p < 0.01). Other predictors of IO included hospital type, insurance provider, and household income. Specifically, comprehensive @entity5 centres, private insurance, and higher income predicted decreased IO usage (OR 0.5, CI 0.5-0.5, p < 0.01; OR 0.4, CI 0.4-0.4, p < 0.01; and OR 0.8, CI 0.8-0.9, p < 0.01, respectively). Less educated @entity1 were also less likely to undergo observation (OR 0.8, CI 0.8-0.9, p < 0.01). Treatment within the western United States was significantly, but weakly, associated with increased use of IO (p < 0.01). CONCLUSIONS: In recent years, @entity263 has been increasingly managed with IO, appropriately driven by @entity1 and disease factors. Unexpectedly, observation usage also varies by race, hospital, insurance, income, and geography, suggesting that non-clinical factors may affect treatment selection.

A hospital-based study of initial observation for XXXX and its predictors in the United States.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'Cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'men'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer', 'low-risk prostate cancer']
@entity263 :: (MESH:D011471,Disease) :: ['low-risk prostate cancer']
