PURPOSE: National attention has focused on whether urology-radiation oncology practice integration, known as integrated prostate cancer centers, contributes to the use of intensity modulated radiation therapy, a common and expensive prostate cancer treatment. MATERIALS AND METHODS: We examined prostate cancer treatment patterns before and after conversion of a urology practice to an integrated prostate cancer center in July 2006. Using the SEER (Statistics, Epidemiology and End Results)-Medicare database, we identified patients 65 years old or older in 1 statewide registry diagnosed with nonmetastatic prostate cancer between 2004 and 2007. We classified patients into 3 groups, including 1--those seen by integrated prostate cancer center physicians (exposure group), 2--those living in the same hospital referral region who were not seen by integrated prostate cancer center physicians (hospital referral region control group) and 3--those living elsewhere in the state (state control group). We compared changes in treatment among the 3 groups, adjusting for patient, clinical and socioeconomic factors. RESULTS: Compared with the 8.1 ppt increase in adjusted intensity modulated radiation therapy use in the state control group, the use of this therapy increased 20.3 ppts (95% CI 13.4, 27.1) in the integrated prostate cancer center group and 19.2 ppts (95% CI 9.6, 28.9) in the hospital referral region control group. Androgen deprivation therapy, for which Medicare reimbursement decreased sharply, similarly decreased in integrated prostate cancer center and hospital referral region controls. Prostatectomy decreased significantly in the integrated prostate cancer center group. CONCLUSIONS: Coincident with the conversion of a urology group practice to an integrated prostate cancer center, we observed an increase in intensity modulated radiation therapy and a decrease in androgen deprivation therapy in patients seen by integrated prostate cancer center physicians and those seen in the surrounding health care market that were not observed in the remainder of the state.
PURPOSE: National attention has focused on whether urology-radiation oncology practice integration, known as integrated prostate cancer centers, contributes to the use of intensity modulated radiation therapy, a common and expensive prostate cancer treatment. MATERIALS AND METHODS: We examined prostate cancer treatment patterns before and after conversion of a urology practice to an integrated prostate cancer center in July 2006. Using the SEER (Statistics, Epidemiology and End Results)-Medicare database, we identified patients 65 years old or older in 1 statewide registry diagnosed with nonmetastatic prostate cancer between 2004 and 2007. We classified patients into 3 groups, including 1--those seen by integrated prostate cancer center physicians (exposure group), 2--those living in the same hospital referral region who were not seen by integrated prostate cancer center physicians (hospital referral region control group) and 3--those living elsewhere in the state (state control group). We compared changes in treatment among the 3 groups, adjusting for patient, clinical and socioeconomic factors. RESULTS: Compared with the 8.1 ppt increase in adjusted intensity modulated radiation therapy use in the state control group, the use of this therapy increased 20.3 ppts (95% CI 13.4, 27.1) in the integrated prostate cancer center group and 19.2 ppts (95% CI 9.6, 28.9) in the hospital referral region control group. Androgen deprivation therapy, for which Medicare reimbursement decreased sharply, similarly decreased in integrated prostate cancer center and hospital referral region controls. Prostatectomy decreased significantly in the integrated prostate cancer center group. CONCLUSIONS: Coincident with the conversion of a urology group practice to an integrated prostate cancer center, we observed an increase in intensity modulated radiation therapy and a decrease in androgen deprivation therapy in patients seen by integrated prostate cancer center physicians and those seen in the surrounding health care market that were not observed in the remainder of the state.
Authors: Samuel Swisher-McClure; Craig E Pollack; John P Christodouleas; Thomas J Guzzo; Naomi B Haas; Neha Vapiwala; Justin E Bekelman Journal: Int J Radiat Oncol Biol Phys Date: 2011-11-11 Impact factor: 7.038
Authors: Christian Bolenz; Amit Gupta; Timothy Hotze; Richard Ho; Jeffrey A Cadeddu; Claus G Roehrborn; Yair Lotan Journal: Eur Urol Date: 2009-11-11 Impact factor: 20.096
Authors: K Robin Yabroff; Elizabeth B Lamont; Angela Mariotto; Joan L Warren; Marie Topor; Angela Meekins; Martin L Brown Journal: J Natl Cancer Inst Date: 2008-04-29 Impact factor: 13.506
Authors: Shi-Yi Wang; Rong Wang; James B Yu; Xiaomei Ma; Xiao Xu; Simon P Kim; Pamela R Soulos; Avantika Saraf; Cary P Gross Journal: Med Care Date: 2014-08 Impact factor: 2.983
Authors: Brent K Hollenbeck; Samuel R Kaufman; Phyllis Yan; Lindsey A Herrel; Tudor Borza; Florian R Schroeck; Bruce L Jacobs; Ted A Skolarus; Vahakn B Shahinian Journal: Eur Urol Date: 2017-08-18 Impact factor: 20.096
Authors: Parth K Modi; Lindsey A Herrel; Samuel R Kaufman; Phyllis Yan; Tudor Borza; Ted A Skolarus; Florian R Schroeck; Brent K Hollenbeck; Vahakn B Shahinian Journal: Urology Date: 2019-04-25 Impact factor: 2.649
Authors: Huei-Ting Tsai; Nancy L Keating; Stephen K Van Den Eeden; Reina Haque; Andrea E Cassidy-Bushrow; Marianne Ulcickas Yood; Matthew R Smith; Arnold L Potosky Journal: J Urol Date: 2014-12-15 Impact factor: 7.450
Authors: Charlotte A Bolch; Haitao Chu; Stephanie Jarosek; Stephen R Cole; Sean Elliott; Beth Virnig Journal: BMC Med Res Methodol Date: 2017-07-10 Impact factor: 4.615
Authors: Kathryn A Marchetti; Mary Oerline; Brent K Hollenbeck; Samuel R Kaufman; Ted A Skolarus; Vahakn B Shahinian; Megan E V Caram; Parth K Modi Journal: Urology Date: 2021-02-19 Impact factor: 2.633