EURURO Vol. 71 No. 5

734 844

ratio [AOR] for RP: 0.873, 95% confidence interval [CI]:
0.872–0.874, per yr). Increasing Charlson comorbidity score
was associated with a higher likelihood of receiving RP
(AOR: 1.65, 95% CI: 1.62–1.68, for score 1 and AOR: 1.42,
95%CI: 1.37–1.48, for score 2, p < 0.001). Race was
independently associated with treatment modality, with
[25_TD$DIFF]non-White patients significantly less likely to receive RP
(AOR: 0.49, 95% CI: 0.48–0.50, for Blacks and AOR: 0.92, 95%
CI: 0.89–0.95, for Hispanics, p both < 0.001). Uninsured
patients and those with Medicaid were less likely to receive
RP (AOR: 0.61, 95% CI: 0.57–0.64, for the uninsured and
AOR: 0.50, 95% CI: 0.48–0.52, for Medicaid patients vs those
with private insurance, p both < 0.001) while patients aged
65 yr or older with Medicare were slightly more likely to
Table 2 – Multivariate logistic regression model of factors
associated with treatment received for those receiving radical
prostatectomy versus radiation therapy (external beam
radiotherapy or brachytherapy). A higher adjusted odds ratio (AOR)
indicates a higher likelihood of receiving radical prostatectomy
Variable AOR (95% CI) p value
Age (yr) 0.87 (0.87–0.87) <0.001
Race
Non-Hispanic White 1
Hispanic 0.92 (0.89–0.95) <0.001
Black 0.49 (0.48–0.50) <0.001
Other 0.89 (0.85–0.92) <0.001
Insurance typ
Private 1
Uninsured 0.61(0.57–0.64) <0.001
Medicaid 0.50 (0.48–0.52) <0.001
Younger Medicare 0.58 (0.56–0.60) <0.001
Older Medicare 1.03 (1.01–1.05) 0.003
Government 0.14 (0.13–0.15) <0.001
Diagnosis year
2004 1
2005 1.06 (1.03–1.09) <0.001
2006 1.20 (1.16–1.23) <0.001
2007 1.45 (1.41–1.49) <0.001
2008 1.92 (1.87–1.98) <0.001
2009 2.10 (2.04–2.16) <0.001
2010 2.41 (2.34–2.48) <0.001
2011 2.56 (2.49–2.64) <0.001
2012 2.56 (2.49–2.64) <0.001
Modified Charlson comorbidity score
0 1
1 1.65 (1.62–1.68) <0.001
2 1.42 (1.37–1.48) <0.001
Clinical T stage
T3/T4 1
T2 1.21 (1.16–1.26) <0.001
T1 1.15 (1.10–1.20) <0.001
Combined Gleason score
8–10 1
7 1.46 (1.43–1.50) <0.001
2–6 0.86 (0.84–0.88) <0.001
Prostate specific antigen level
>20 ng/ml 1
10–20 ng/ml 1.32 (1.28–1.36) <0.001
<10 ng/ml 1.84 (1.80–1.89) <0.001
Income level
$46 000 1
$35 000–45 999 0.97 (0.96–0.99) <0.001
$30 000–34 999 0.92 (0.90–0.94) <0.001
<$30 000 0.84 (0.83–0.86) <0.001
Treatment facility type
NCI network cancer center 1
Teaching/research hospital 0.36 (0.35–0.37) <0.001
Comprehensive community
cancer program
0.27 (0.27–0.28) <0.001
Community cancer program 0.19 (0.18–0.19) <0.001
Other 0.29 (0.29–0.30) <0.001
US census region
Northeast 1
Midwest 1.42 (1.39–1.44) <0.001
South 1.38 (1.36–1.41) <0.001
West 1.64 (1.60–1.67) <0.001
CI = confidence interval; NCI = National Cancer Institute.
a Younger Medicare refers to patients aged 18–64 yr receiving Medicare
coverage while Older Medicare refers to those aged 65 yr or older.
Table 3 – Multivariate logistic regression model of factors
associated with receiving observation versus definitive local
treatment (radical prostatectomy, radiation therapy, cryotherapy)
for patients with low-risk prostate cancer. A higher adjusted odds
ratio (AOR) indicates a higher likelihood of receiving observation
Variable AOR (95% CI) p value
Age (yr) 1.08 (1.08–1.08) <0.001
Race
Non–Hispanic White 1
Hispanic 1.08 (1.00–1.15) 0.04
Black 1.26 (1.21–1.31) <0.001
Other 1.02 (0.94–1.11) 0.6
Insurance type
Private 1
Uninsured 2.87 (2.61–3.15) <0.001
Medicaid 1.88 (1.72–2.06) <0.001
Younger Medicare 1.50 (1.41–1.60) <0.001
Older Medicare 0.96 (0.93–1.00) 0.03
Government 0.55 (0.45–0.67) <0.001
Diagnosis year
2004 1
2005 1.08 (1.01–1.15) 0.03
2006 1.06 (0.99–1.13) 0.1
2007 1.05 (0.98–1.11) 0.2
2008 1.29 (1.21–1.37) <0.001
2009 1.88 (1.77–1.99) <0.001
2010 1.84 (1.73–1.95) <0.001
2011 2.33 (2.20–2.46) <0.001
2012 3.17 (2.99–3.37) <0.001
Modified Charlson comorbidity score
0 1
1 0.87 (0.84–0.91) <0.001
2 1.30 (1.21–1.40) <0.001
Clinical T stage
T1 1
T2 0.71 (0.68–0.74) <0.001
Income level
$46 000 1
$35 000–45 999 1.02 (0.99–1.06) 0.2
$30 000–34 999 1.03 (0.99–1.07) 0.1
<$30 000 [8_TD$DIFF]1.06 ([9_TD$DIFF]1.01– [10_TD$DIFF]1.11) [11_TD$DIFF]0.02
Treatment facility type
NCI network cancer center 1
Teaching/research hospital [12_TD$DIFF]0.55 ([13_TD$DIFF]0.52– [14_TD$DIFF]0.57) <0.001
Comprehensive community
cancer program
0.36 (0.35–0.37) <0.001
Community cancer program [15_TD$DIFF]0.59 ([16_TD$DIFF]0.56– [17_TD$DIFF]0.62) <0.001
Other 0.36 (0.34–0.38) <0.001
US census region
Northeast 1
Midwest 0.85 (0.82–0.88) <0.001
South 0.86 (0.83–0.89) <0.001
West 1.19 (1.14–1.24) <0.001
CI = confidence interval; NCI = National Cancer Institute.
a Younger Medicare refers to patients aged 18–64 yr receiving Medicare
coverage while Older Medicare refers to those aged 65 yr or older.
E U R O P E A N U R O L O G Y 7 1 ( 2 0 1 7 ) 7 2 9 – 7 3 7 734