TABLE 2.
Adjusted multinomial logistic regression results for odds of receiving treatment modality
| Surgery only (vs no definitive treatment) | Radiation only (vs no definitive treatment) | Surgery and radiation only (vs no definitive treatment) | Radiation and/or surgery with adjuvant therapy (hormonal therapy and/or chemo) (vs no definitive treatment) | |
|---|---|---|---|---|
| Age at Dx (y) | ||||
| 40‐54 (REF) | — | — | — | — |
| 55‐64 | 0.55 (0.49, 0.60)** | 1.34 (1.19, 1.52)** | 0.52 (0.43, 0.62)** | 1.10 (0.96, 1.26) |
| 65‐74 | 0.20 (0.18, 0.22)** | 1.59 (1.40, 1.81)** | 0.17 (0.14, 0.22)** | 1.47 (1.28, 1.69)** |
| 75+ | 0.01 (0.01, 0.01) a , ** | 0.80 (0.70, 0.91)** | 0.01 (0.01, 0.02) a , ** | 0.83 (0.72, 0.96)* |
| Aggressiveness | ||||
| Less aggressive (REF) | — | — | — | — |
| More aggressive | 2.39 (2.24, 2.54)** | 0.67 (0.62, 0.71)** | 14.55 (12.57, 16.83)** | 4.15 (3.90, 4.41)** |
| Race/Ethnicity | ||||
| Non‐Hispanic White (REF) | — | — | — | — |
| Hispanic | 0.87 (0.70, 1.08) | 1.16 (0.93, 1.43) | 0.87 (0.53, 1.43) | 0.94 (0.74, 1.19) |
| Non‐Hispanic Black | 0.53 (0.48, 0.57)** | 0.91 (0.83, 0.99)* | 0.63 (0.51, 0.77)** | 0.78 (0.71, 0.86)* |
| Other | 0.75 (0.60, 0.94)* | 0.94 (0.75, 1.17) | 0.76 (0.44, 1.30) | 0.66 (0.51, 0.85)* |
| Insurance status | ||||
| Uninsured (REF) | — | — | — | — |
| Any private insurance/VA/Tricare | 1.94 (1.40, 2.68)** | 1.93 (1.31, 2.84)** | 2.14 (1.00, 4.59)* | 1.73 (1.18, 2.53)* |
| Medicaid | 0.91 (0.64, 1.30) | 1.66 (1.10, 2.51)* | 1.49 (0.66, 3.38) | 1.43 (0.95, 2.16) |
| Medicare only/Medicare plus private insurance | 1.39 (1.00, 1.93)* | 1.67 (1.14, 2.47)* | 1.47 (0.68, 3.19) | 1.54 (1.05, 2.26)* |
| Medicare with Medicaid eligibility | 0.62 (0.42, 0.92)* | 1.22 (0.79, 1.89) | 0.91 (0.35, 2.40) | 1.01 (0.65, 1.56) |
| Other | 1.52 (1.09, 2.12)* | 2.20 (1.48, 3.27)** | 1.68 (0.76, 3.67) | 1.59 (1.07, 2.35)* |
| Lymph node status | ||||
| Negative (REF) | — | — | — | — |
| Positive (1 or more) | 0.31 (0.25, 0.38)** | 0.10 (0.06, 0.15) a , ** | 0.60 (0.43, 0.83)* | 1.07 (0.89, 1.28) |
| ln(serum PSA)b | 0.68 (0.66, 0.70)** | 0.81 (0.79, 0.84)** | 0.87 (0.81, 0.94)** | 1.13 (1.09, 1.16)** |
| Rurality | ||||
| Urban cluster (REF) | — | — | — | — |
| Rural | 1.28 (1.16, 1.42)** | 1.03 (0.93, 1.15) | 1.16 (0.89, 1.52) | 1.07 (0.96, 1.19) |
| Urbanized area | 1.46 (1.32, 1.62)** | 1.42 (1.29, 1.57)** | 1.06 (0.81, 1.38) | 1.11 (1.00, 1.24)* |
| Smoking | 0.95 (0.94, 0.96)** | 0.96 (0.95, 0.97)** | 0.95 (0.93, 0.98)** | 0.93 (0.92, 0.94)** |
| Obesity | 0.96 (0.96, 0.97)** | 0.96 (0.95, 0.97)** | 0.92 (0.90, 0.94) a , ** | 0.97 (0.96, 0.98)** |
| Physical inactivity | 1.02 (1.01, 1.04)** | 1.02 (1.00, 1.03)* | 1.04 (1.01, 1.08)* | 1.07 (1.05, 1.08)** |
| Chronic drinking | 1.00 (0.98, 1.02) | 0.98 (0.96, 1.00) | 0.98 (0.93, 1.03) | 0.95 (0.93, 0.97)** |
| Daily fruits/vegetables | 1.03 (1.02, 1.04)** | 1.00 (0.99, 1.01) | 1.04 (1.02, 1.07)** | 1.02 (1.01, 1.03)** |
Cases with ‘Unknown’ or missing values for any of the covariates or the response were removed (n = 29 616 removed).
County‐level (BRFSS region) risk factors were assigned to PCR prostate cancer cases by county at the time of diagnosis, where counties within the same BRFSS region were linked with the same prevalence estimates as the region.
Odds ratio (95% confidence interval).
Abbreviation: BRFSS, behavioral risk factor surveillance system; PCR, Pennsylvania Cancer Registry; PSA, prostate‐specific antigen; REF, referent group.
Hauck‐Donner effect detected.
A natural‐log transformation was applied to serum PSA to remedy the right‐skewed distribution of the biomarker.
Significant at P < .001.
Significant at P < .05.