Prostate cancer treatment less likely for deprived men

Men from deprived areas are less likely to be treated for prostate cancer with common treatments than affluent patients, research suggests.

Prostate cancer treatments vary between socioeconomic groups (Photograph: SPL)
Prostate cancer treatments vary between socioeconomic groups (Photograph: SPL)

Researchers from Cambridge University found men with prostate cancer from the most deprived areas were 26% less likely to receive radiotherapy and 52% less likely to have surgery.

The research coincided with a survey by Opinion Health that showed 72% of prostate cancer patients in the UK and France did not want treatment for their condition to impact their lives.

In the 1990s and early 2000s, incidence of prostate cancer was 20-40% greater among more affluent individuals.

Previous studies had suggested that the higher uptake of PSA tests among more affluent men might be responsible for increased detection and survival rates. But testing this hypothesis proved difficult due to the numerous settings in which the test could be taken.

Instead, researchers analysed the likelihood of using common treatments such as radiotherapy and surgery between socioeconomic groups.

Georgios Lyratzopoulos and colleagues assessed the treatment of 35,171 patients with prostate cancer in the UK aged 51 or over.

Whereas 28.5% of the least deprived patients were treated with radiotherapy, just 21% of the most deprived were given the same treatment.

Similarly, surgery was used for 8.4% of the least deprived patients but in just 4% of the most deprived patients.

The authors suggest that socioeconomic status may affect attitudes to the risks associated with the more radical treatments.

They noted that the observed differences may confer a survival advantage on more affluent groups because the use of such treatments can improve prognosis.

However, an increased tendency for affluent groups to use these treatments for less aggressive tumours in may dampen any survival advantage, they added.

In an editorial in the BMJ, researchers in Finland suggested that, when discussing treatment decisions, ‘better educated patients may process information more easily and doctor-patient communication may be more effective or fluent when doctor and patient have similar social backgrounds'.

Further research is needed to explore the causes of these differences and impact on survival, the authors concluded.

Stephen Robinson

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