Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil
PURPOSEWe investigated the impact of the funding source (public v private) on the overall survival (OS) of men with prostate cancer in Brazil.METHODSWe retrospectively analyzed patients with prostate cancer from a large hospital registry from the state of São Paulo, Brazil. Patients age 50-99 years...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
American Society of Clinical Oncology
2025-02-01
|
| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-24-00271 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825208827272757248 |
|---|---|
| author | Fernando C. Maluf Cintia S.K.S. de Oliveira Patrícia K. Ziegelmann |
| author_facet | Fernando C. Maluf Cintia S.K.S. de Oliveira Patrícia K. Ziegelmann |
| author_sort | Fernando C. Maluf |
| collection | DOAJ |
| description | PURPOSEWe investigated the impact of the funding source (public v private) on the overall survival (OS) of men with prostate cancer in Brazil.METHODSWe retrospectively analyzed patients with prostate cancer from a large hospital registry from the state of São Paulo, Brazil. Patients age 50-99 years diagnosed with prostate acinar adenocarcinoma or adenocarcinoma not otherwise specified (NOS) between January 2014 and December 2017 were eligible. Demographic and clinical features were analyzed alongside the funding source. On the basis of clinical characteristics at diagnosis (lymph node status, distant metastasis, prostate-specific antigen [PSA], and Gleason score), patients were categorized into low-risk, intermediate-risk, high-risk, and metastatic groups.RESULTSOf 25,009 patients analyzed, 85% had a public funding source. These patients were slightly older, had greater proportion of adenocarcinoma NOS, and higher PSA levels and risk category. There was a significant difference in OS favoring patients with a private funding source (P < .0001). The estimated OS rates at 5 years were 76.2% (95% CI, 75.6 to 76.9) and 86.9% (95% CI, 85 to 88.7) for the public and private groups, respectively (P < .0001). The funding source was significantly associated with OS independent of age, educational level, and receipt of any treatment in the intermediate-risk (hazard ratio [HR], 2.28 [95% CI, 1.58 to 3.30]; P < .001) and high-risk (HR, 1.36 [95% CI, 1.02 to 1.80]; P = .04) groups, but not in the low-risk (HR, 0.85 [95% CI, 0.60 to 1.21]; P = .38) or metastatic groups (HR, 0.84 [95% CI, 0.64 to 1.11]; P = .23).CONCLUSIONThe worse OS observed for patients with prostate cancer with a public source of funding underscores the need for actions directed to improve the standards of public health care in Brazil. |
| format | Article |
| id | doaj-art-eae6a40cc0ef4193ab37f56cf5a4c9ea |
| institution | Kabale University |
| issn | 2687-8941 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-eae6a40cc0ef4193ab37f56cf5a4c9ea2025-02-06T20:59:10ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-02-011110.1200/GO-24-00271Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, BrazilFernando C. Maluf0Cintia S.K.S. de Oliveira1Patrícia K. Ziegelmann2Hospital Israelita Albert Einstein, São Paulo, BrazilProdutos Roche Quimicos e Farmaceuticos, São Paulo, BrazilFederal University of Rio Grande do Sul, Porto Alegre, BrazilPURPOSEWe investigated the impact of the funding source (public v private) on the overall survival (OS) of men with prostate cancer in Brazil.METHODSWe retrospectively analyzed patients with prostate cancer from a large hospital registry from the state of São Paulo, Brazil. Patients age 50-99 years diagnosed with prostate acinar adenocarcinoma or adenocarcinoma not otherwise specified (NOS) between January 2014 and December 2017 were eligible. Demographic and clinical features were analyzed alongside the funding source. On the basis of clinical characteristics at diagnosis (lymph node status, distant metastasis, prostate-specific antigen [PSA], and Gleason score), patients were categorized into low-risk, intermediate-risk, high-risk, and metastatic groups.RESULTSOf 25,009 patients analyzed, 85% had a public funding source. These patients were slightly older, had greater proportion of adenocarcinoma NOS, and higher PSA levels and risk category. There was a significant difference in OS favoring patients with a private funding source (P < .0001). The estimated OS rates at 5 years were 76.2% (95% CI, 75.6 to 76.9) and 86.9% (95% CI, 85 to 88.7) for the public and private groups, respectively (P < .0001). The funding source was significantly associated with OS independent of age, educational level, and receipt of any treatment in the intermediate-risk (hazard ratio [HR], 2.28 [95% CI, 1.58 to 3.30]; P < .001) and high-risk (HR, 1.36 [95% CI, 1.02 to 1.80]; P = .04) groups, but not in the low-risk (HR, 0.85 [95% CI, 0.60 to 1.21]; P = .38) or metastatic groups (HR, 0.84 [95% CI, 0.64 to 1.11]; P = .23).CONCLUSIONThe worse OS observed for patients with prostate cancer with a public source of funding underscores the need for actions directed to improve the standards of public health care in Brazil.https://ascopubs.org/doi/10.1200/GO-24-00271 |
| spellingShingle | Fernando C. Maluf Cintia S.K.S. de Oliveira Patrícia K. Ziegelmann Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil JCO Global Oncology |
| title | Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil |
| title_full | Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil |
| title_fullStr | Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil |
| title_full_unstemmed | Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil |
| title_short | Impact of Funding Source on Long-Term Outcomes in Prostate Cancer: Analysis of a Large Public Database From Sao Paulo, Brazil |
| title_sort | impact of funding source on long term outcomes in prostate cancer analysis of a large public database from sao paulo brazil |
| url | https://ascopubs.org/doi/10.1200/GO-24-00271 |
| work_keys_str_mv | AT fernandocmaluf impactoffundingsourceonlongtermoutcomesinprostatecanceranalysisofalargepublicdatabasefromsaopaulobrazil AT cintiasksdeoliveira impactoffundingsourceonlongtermoutcomesinprostatecanceranalysisofalargepublicdatabasefromsaopaulobrazil AT patriciakziegelmann impactoffundingsourceonlongtermoutcomesinprostatecanceranalysisofalargepublicdatabasefromsaopaulobrazil |