340 WHO MAKES THE DECISION REGARDING TREATMENT FOR LOCALIZED PROSTATE CANCER, PATIENT OR PHYSICIAN? RESULTS FROM A POPULATION-BASED STUDY (2012)

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History II1 Apr 2012340 WHO MAKES THE DECISION REGARDING TREATMENT FOR LOCALIZED PROSTATE CANCER, PATIENT OR PHYSICIAN? RESULTS FROM A POPULATION-BASED STUDY Lixin Song, Raj Kurpad, Ian Udell, Jeannette Bensen, Angela Smith, Matthew Nielsen, Eric Wallen, Michael Woods, Raj Pruthi, and James Mohler Lixin SongLixin Song Chapel Hill, NC More articles by this author , Raj KurpadRaj Kurpad Chapel Hill, NC More articles by this author , Ian UdellIan Udell Chapel Hill, NC More articles by this author , Jeannette BensenJeannette Bensen Chapel Hill, NC More articles by this author , Angela SmithAngela Smith Chapel Hill, NC More articles by this author , Matthew NielsenMatthew Nielsen Chapel Hill, NC More articles by this author , Eric WallenEric Wallen Chapel Hill, NC More articles by this author , Michael WoodsMichael Woods Chapel Hill, NC More articles by this author , Raj PruthiRaj Pruthi Chapel Hill, NC More articles by this author , and James MohlerJames Mohler Chapel Hill, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.401AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This study examines how patients' personal, cancer-related, and subjective-affective factors affect their role in decision-making regarding treatment for localized prostate cancer. METHODS The sample (N=788) is from the HCaP-NC, a multidisciplinary prospective study of a population-based cohort. Participants include 343 African-American and 445 Caucasian-American patients with localized prostate cancer. The HCaP-NC project performed annual telephone interviews to examine whether racial differences in prostate cancer treatment quality and health-related quality of life are a consequence of racial differences in healthcare access, healthcare availability, and treatment quality. The outcome variable “decision-maker” was obtained from participants' response to the question “Who was mostly responsible for deciding what to do about prostate cancer when you were first diagnosed?” The response has 3 categories: patient-only (Patient), patient-doctor shared (Shared), and doctor-only (Doctor) decision-making. Patient personal factors, including socio-demographics and cancer characteristics. Multinomial logistic regression is used to investigate the relationship between the explanatory variables and the nominal 3-level decision-making variable: patient-only, patient-doctor shared, and doctor-only. RESULTS The odds of patient-only over doctor-only decision-making were 1.68 times higher (95% CI=1.03-2.74) for men <65 yo vs. >=65 yo – i.e. younger men were more likely to report being the decision maker in their treatment. Also, odds of patient-only over doctor-only decision-making were 0.29 times lower (95% CI=0.15-0.55) for men with high cancer aggressiveness than those with low aggressiveness – i.e. patients with more aggressive cancers were more likely to report that the doctor was the main decision-maker. Greater odds of patient-only and patient-doctor shared decision-making were also associated with higher scores of concerns about physical impacts and having enough time for decision-making and lower scores in advice from others. CONCLUSIONS Evidence from this population-based study indicates that, to facilitate decision-making regarding treatment for localized prostate cancer, clinicians need to tailor interventions according to a patient's age and cancer aggressiveness; help reduce concerns and misconceptions about the physical impacts of treatments; allow sufficient time for patients to consider treatment options, and balance the advice and information from different sources. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e138-e139 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lixin Song Chapel Hill, NC More articles by this author Raj Kurpad Chapel Hill, NC More articles by this author Ian Udell Chapel Hill, NC More articles by this author Jeannette Bensen Chapel Hill, NC More articles by this author Angela Smith Chapel Hill, NC More articles by this author Matthew Nielsen Chapel Hill, NC More articles by this author Eric Wallen Chapel Hill, NC More articles by this author Michael Woods Chapel Hill, NC More articles by this author Raj Pruthi Chapel Hill, NC More articles by this author James Mohler Chapel Hill, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...