Distance to Treatment With Radical Cystectomy in a Rural State: Long Car Rides, Equivalent Outcomes.

Introduction: Radical cystectomy is a complex surgery with better outcomes reported when performed at high-volume centers. This may lead to patients traveling farther for care. We examined the impact of travel distance on clinical outcomes.

Racial Disparities in Prostate Cancer Screening: The Role of Shared Decision Making.

Introduction: The 2018 U.S. Preventive Services Task Force recommendations endorsed shared decision making for men aged 55-69 years, encouraging consideration of patient race/ethnicity for prostate-specific antigen screening.

PRState: Incorporating genetic ancestry in prostate cancer risk scores for men of African ancestry.

Background: Prostate cancer (PrCa) is one of the most genetically driven solid cancers with heritability estimates as high as 57%. Men of African ancestry are at an increased risk of PrCa; however, current polygenic risk score (PRS) models are based on European ancestry groups and may not be broadly applicable. The objective of this study was to construct an African ancestry-specific PrCa PRS (PRState) and evaluate its performance.

Prostate Specific Antigen Testing Behaviors for Prostate Cancer Screening Among U.S. Immigrants: A Cross-sectional Analysis Using the National Health Interview Survey.

Purpose: Immigrants constitute 14% of the U.S. population, and this group is especially vulnerable to poor health care access.

National Recommendations against Prostate Specific Antigen Screening versus Statewide Medicaid Expansion Initiatives: A Battle of the Titans.

Purpose: Medicaid expansion under the Patient Protection and Affordable Care Act occurred almost concurrently with 2012 U.S. Preventive Services Task Force recommendations against prostate specific antigen screening.

Meditative and mind-body practice among patients with genitourinary malignancy.

Introduction And Objective: Research on the utility of meditative and mind-body (MB) practices has increased dramatically in the last two decades and both have been suggested as useful adjuncts in coping with stressors associated with cancer survivorship. There exists little data on use among genitourinary (GU) cancer survivors. This study seeks to describe meditative and MB utilization among GU cancer survivors.

The Relationship Between Health Literacy and Nonrecommended Cancer Screening.

Introduction: Health literacy affects how patients behave within the healthcare system. Overutilization of screening procedures inconsistent with the U.S.

Impact of geography and travel distance on outcomes in epithelial ovarian cancer: a national cancer database analysis.

Background: As ovarian cancer treatment shifts to provide more complex aspects of care at high-volume centers, almost a quarter of patients, many of whom reside in rural counties, will not have access to those centers or receive guideline-based care.

Objective: To explore the association between proximity of residential zip code to a high-volume cancer center with mortality and survival for patients with ovarian cancer.

Methods: The National Cancer Database was queried for cases of newly diagnosed ovarian cancer between January 2004 and December 2015.

Impact of health literacy on shared decision making for prostate-specific antigen screening in the United States.

Background: Current guidelines endorse shared decision making (SDM) for prostate-specific antigen (PSA) screening. The relationship between a patient's health literacy (HL) and SDM remains unclear. In the current study, the authors sought to identify the impact of HL on the rates of PSA screening and on the relationship between HL and SDM following the 2012 US Preventive Services Task Force recommendations against PSA screening.

Pathologic nodal downstaging in men with clinically involved lymph nodes undergoing radical prostatectomy: Implications for definitive locoregional therapy.

A prostate cancer (CaP) patient with nonmetastatic but clinical positive lymph nodes (cN+) represents a difficult clinical scenario. We compare overall survival (OS) between cN+ men that underwent radical prostatectomy (RP) and were found to have negative node status (pN) with those found to have positive nodal status (pN+), and assess predictors of discordant nodal status. We queried the National Cancer Data Base between 2004 and 2015 for patients that were cT1-3 cN+ cM0 CaP treated with RP.

Receipt of Survivorship Care Plans and Self-Reported Health Status among Patients with Genitourinary Malignancy.

Purpose: Implementation of survivorship care plans has been emphasized as a key component to improving care for cancer survivors. Our objective was to determine the prevalence of survivorship care plan receipt for survivors of genitourinary malignancy including kidney, prostate and bladder cancer, and evaluate whether receipt was associated with a measurable health benefit.

Materials And Methods: Data from the Behavioral Risk Factor Surveillance System Cancer Survivorship modules in 2012, 2014, 2016 and 2017 were analyzed.

Delayed nephrectomy has comparable long-term overall survival to immediate nephrectomy for cT1a renal cell carcinoma: A population-based analysis.

Objectives: Early surgical resection remains the recommended treatment option for most small renal mass (≤4 cm). We examined the long-term overall survival (OS) of patients managed with delayed and immediate nephrectomy of cT1a renal cancer.

Patient And Methods: We utilized the National Cancer Database (2005-2010) to identify 14,677 patients (immediate nephrectomy: 14,050 patients vs.

Comparing Long-Term Outcomes Following Radical and Partial Nephrectomy for cT1 Renal Cell Carcinoma in Young and Healthy Individuals.

Background: Despite randomized data demonstrating better overall survival favoring radical nephrectomy, partial nephrectomy continues to be the treatment of choice for low-stage renal cell carcinoma.

Methods: We utilized the National Cancer Database to identify patients younger than 50 years diagnosed with low-stage renal cell carcinoma (cT1) treated with radical nephrectomy or partial nephrectomy (2004-2007). Inverse probability of treatment weighting adjustment was performed for all preoperative factors to account for confounding factors.

Effectiveness of Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer in the Current Real World Setting in the USA.

Background: The use of neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) is supported by results from several randomized control trials, including SWOG-8710.

Objective: To look at the effectiveness of NAC before RC in current real world practice in the USA.

Design, Setting, And Participants: We used the National Cancer Data Base (NCDB) to identify patients with nonmetastatic muscle-invasive urothelial carcinoma of the bladder who underwent RC between 2004 and 2012.

Impact of Accountable Care Organizations on Prostate Cancer Screening and Biopsies in the United States.

Introduction: Accountable care organizations are designed to financially incentivize efficiency and reduce low value care. To determine if accountable care organizations have impacted prostate cancer screening patterns, we analyzed trends in prostate specific antigen screening and prostate biopsies by accountable care organization and nonaccountable care organization providers.

Methods: Using a random 20% sample of Medicare claims, we selected men 66 years old or older.

Factors Influencing Prostate Specific Antigen Testing in the United States.

Introduction: Given the ongoing controversies regarding its benefit, prostate specific antigen based prostate cancer screening should be offered with patient preferences in mind. Understanding subsets of men who may or may not choose prostate specific antigen screening and their associated characteristics may allow more efficient care and may identify subsets of patients for whom additional counseling is warranted.

Methods: We analyzed male participants from the 2001 to 2010 cycles of the NHANES (National Health and Nutrition Examination Survey) who were 40 years old or older, and without a history of prostate cancer, recent prostate manipulation or hormone therapy use (8,133).

Prostate cancer navigation: initial experience and association with time to care.

Objective: To evaluate factors associated with use of patient navigation in a prostate cancer population and identify whether navigation is associated with prolonged time to care. Cancer patient navigation has been shown to improve access to cancer screening, diagnosis, and treatment, but little is known about patient navigation in prostate cancer care.

Methods: All men diagnosed with localized prostate cancer between 2009 and 2015 were abstracted from the MaineHealth multi-specialty tumor registry.