Adult urologyCystectomy for muscle-invasive bladder cancer: Patterns and outcomes of care in the medicare population
Section snippets
Data sources
Linkage of the Surveillance, Epidemiology and End Results (SEER) population-based cancer registries with the Centers for Medicare Services’ Medicare database containing healthcare claims for its enrollees enabled us to identify a cohort of patients with muscle-invasive bladder cancer. The SEER registries, sponsored by the National Cancer Institute, ascertain all incident cancer cases diagnosed in five states and six U.S. metropolitan areas, representing approximately 14% of the U.S. population.
Results
We identified 4664 patients with muscle-invasive bladder cancer, 1991 (43%) with Stage II, 1096 (23%) with Stage III, and 1577 (34%) with Stage IV disease at diagnosis. The patients’ clinical and demographic attributes are shown in Table I, which underscored that our cohort was composed of elderly white men. The pie charts in Figure 1 characterized the patients according to the treatments received within 6 months of diagnosis and showed that the practice patterns for management of
Comment
Using the SEER-Medicare linked data, we found a marked heterogeneity in the management of muscle-invasive bladder cancer in the United States in the 1990s. This analysis represents a first step toward the benchmarking of practice patterns recommended by the National Cancer Institute’s Bladder Cancer Progress review group. 23 Given that all cohort members were Medicare beneficiaries, the variation we found could not be attributed to insurance status.
Patients who underwent cystectomy achieved
Acknowledgment
To the staff of the Applied Research Program, National Cancer Institute for their efforts and Dr. Joan Warren, coordinator of the SEER-Medicare program; the Office of Information Services, and the Office of Strategic Planning, HCFA; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.
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Overcoming the Chasm Between Evidence and Routine Practice for Bladder Cancer; Just a Quixotic Notion?
2021, Clinical OncologyCitation Excerpt :The introduction of operational delivery networks for radiotherapy across England should help to drive the implementation of bladder CRS as standard in the future using the available state of the art radiotherapy techniques [81]. It has repeatedly been shown that a marked heterogeneity exists in the strategies used to treat non-metastatic MIBC, and there is mounting evidence that the potentially curative treatments for non-metastatic bladder cancer are persistently underutilised [14,29,56,80,82]. There is also evidence of bladder cancer recommendations being influenced by patient age and geographic region [14,20,82] (Table 2).
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D. Schrag supported by a career development award in preventive oncology (K07) from the National Cancer Institute.
This study used the linked SEER-Medicare Database. The interpretation and reporting of these data are the sole responsibility of the authors.