Sociodemographic factors associated with postprostatectomy radiotherapy

Purpose: To determine if nonclinical factors affect the use of adjuvant radiation therapy after surgical resection of the prostate gland. Methods: Using the National Cancer Institute's Surveillance Epidemiology and End Results ( SEER) public use data files, we identified men with localized/ regional prostate cancer who underwent postprostatectomy radiotherapy within 4 months of surgery. We used 2000 Census information to ascribe a median education and income level to these men based on the county of residence and ethnicity. Results: Of 34 763 men who underwent surgical resection, 1549 received postprostatectomy radiotherapy. Those with higher tumor grade and from certain geographic regions ( Seattle and Hawaii) had significantly higher rates of radiotherapy while being older and from other geographic regions ( Detroit, Utah, and New Mexico) was protective. The use of additional radiation therapy was not affected by ethnicity, income level, or educational attainment. Conclusions: We found no socioeconomic or demographic disparities in the receipt of postprostatectomy radiotherapy. Geographic variation in postprostatectomy radiotherapy may be explained by limited evidence supporting its use in clinical practice.