Our study sought to review and summarize the reported health disparities and inequities in the utilization of proton beam therapy (PBT) for prostate cancer. We queried the PubMed search engine through 12/2023 for original publications examining disparate utilization of PBT for prostate cancer. The query terms included the following: prostate cancer AND proton AND (disparities OR IMRT OR race OR insurance OR socioeconomic OR inequities)”. Studies were included if they involved United States patients, examined PBT in prostate cancer, and addressed health inequities. From this query, 22 studies met the inclusion criteria, comprising 13 population-based analyses, 5 single-institutional analyses, 3 cost/modeling investigations, and 1 survey-based study. The analyses revealed that in addition to age-related and insurance-related disparities, race and socioeconomic status played significant roles in the receipt of PBT. The likelihood of receiving PBT was lower for non-White patients in population-based and single-institution analyses. Socioeconomic metrics, such as higher median income and higher education level, portended an increased likelihood of receiving PBT. Conclusively, substantial age-based, racial, socioeconomic/insurance-related, and facility-associated disparities and inequities existed for PBT utilization in prostate cancer. The identification of these disparities provides a framework to better address these as the utility of PBT continues to expand across the US and globally.
本研究旨在回顾并总结已报道的前列腺癌质子束治疗（PBT）应用中的健康差异与不平等现象。我们通过PubMed搜索引擎检索截至2023年12月的相关原始文献，检索词包括：“前列腺癌 AND 质子 AND（差异 OR 调强放疗 OR 种族 OR 保险 OR 社会经济 OR 不平等）”。纳入标准为：涉及美国患者、探讨前列腺癌PBT应用且关注健康不平等问题的研究。经筛选，共22项研究符合纳入标准，包括13项基于人群的分析、5项单机构分析、3项成本/模型研究及1项调查研究。分析显示，除年龄和保险相关差异外，种族与社会经济地位对接受PBT治疗具有显著影响。基于人群及单机构分析均表明，非白人患者接受PBT的可能性较低。而较高收入中位数与教育水平等社会经济指标则预示接受PBT的可能性增加。综上所述，前列腺癌PBT应用存在显著的年龄、种族、社会经济/保险及医疗机构相关差异与不平等。识别这些差异为在美国及全球范围内持续扩大PBT应用时，系统解决相关问题提供了理论框架。
Health Disparities and Inequities in the Utilization of Proton Therapy for Prostate Cancer
肿瘤(癌症)患者之家