Compliance With American Urological Association Guidelines for Nonmuscle Invasive Bladder Cancer Remains Poor: Assessing Factors Associated With Noncompliance and Survival in a Rural State
Compliance With American Urological Association Guidelines for Nonmuscle Invasive Bladder Cancer Remains Poor: Assessing Factors Associated With Noncompliance and Survival in a Rural State
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DOI：
10.1016/j.urology.2019.06.021
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发表时间：
2019-10-01
期刊：
影响因子：
2.1
通讯作者：
Erickson, Bradley A.
中科院分区：
文献类型：
--
作者：
Tobert, Conrad M.;Nepple, Kenneth G.;Erickson, Bradley A.
目的：确定农村地区非肌肉浸润性膀胱癌（NMIBC）美国泌尿外科协会（AUA）指南依从性的相关因素，评估随时间推移的依从率，并评估患者和提供者农村性对NMIBC护理交付的影响。方法：我们在1992年至2009年的监测、流行病学和最终结果医疗保险中确定了847名爱荷华州患者，这些患者患有高度NMIBC，存活2年，在此期间未接受膀胱切除术或放疗。随着时间的推移，对AUA指南的依从性进行评估，并与患者人口统计学、肿瘤和治疗机构变量进行比较。利用监测、流行病学和最终结果的邮政编码数据分析农村性的影响，患者到最近的泌尿科医生诊所的旅行距离。结果患者对AUA指南的总体依从性较低(
OBJECTIVE To identify factors associated with nonmuscle invasive bladder cancer (NMIBC) American Urological Association (AUA) guideline compliance in a rural state, to evaluate compliance rates over time, and to assess the impact of patient and provider rurality on delivery of NMIBC care.METHODS We identified 847 Iowans in Surveillance, Epidemiology, and End Results-Medicare from 1992 to 2009 with high-grade NMIBC who survived 2 years and were not treated with cystectomy or radiation during this period. Compliance with AUA guidelines was assessed over time and compared to patient demographic, tumor, and treatment institution variables. Impact of rurality was analyzed using Surveillance, Epidemiology, and End Results ZIP code data travel distance of patient to nearest urologist practice location.RESULTS Overall compliance with AUA guidelines was low (