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Racial Differences in Diffusion of Intensity-Modulated Radiation Therapy for Localized Prostate Cancer
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    Intensity-modulated radiation therapy (IMRT), an innovative treatment option for prostate cancer, has rapidly diffused over the past decade. To inform our understanding of racial disparities in prostate cancer treatment and outcomes, this study compared diffusion of IMRT in African American (AA) and Caucasian American (CA) prostate cancer patients during the early years of IMRT diffusion using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. A retrospective cohort of 947 AA and 10,028 CA patients diagnosed with localized prostate cancer from 2002 through 2006, who were treated with either IMRT or non-IMRT as primary treatment within 1 year of diagnoses was constructed. Logistic regression was used to examine potential differences in diffusion of IMRT in AA and CA patients, while adjusting for socioeconomic and clinical covariates. A significantly smaller proportion of AA compared with CA patients received IMRT for localized prostate cancer (45% vs. 53%, p < .0001). Racial differences were apparent in multivariable analysis though did not achieve statistical significance, as time and factors associated with race (socioeconomic, geographic, and tumor related factors) explained the preponderance of variance in use of IMRT. Further research examining improved access to innovative cancer treatment and technologies is essential to reducing racial disparities in cancer care.

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    T32 CA128590/CA/NCI NIH HHS/United States
    HHSN261201000140C/CA/NCI NIH HHS/United States
    U54 CA153602/CA/NCI NIH HHS/United States
    HHSN261201000035C/CA/NCI NIH HHS/United States
    HHSN261200800726P/CO/NCI NIH HHS/United States
    HHSN261201000035I/CA/NCI NIH HHS/United States
    HHSN261201000034C/CA/NCI NIH HHS/United States
    U01 CA114629/CA/NCI NIH HHS/United States
    UL1 TR000083/TR/NCATS NIH HHS/United States
    U58 DP003862/DP/NCCDPHP CDC HHS/United States
    T32 CA106209/CA/NCI NIH HHS/United States
    P01 CA142538/CA/NCI NIH HHS/United States
    R01 CA124402/CA/NCI NIH HHS/United States
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