Journal article
Unplanned hospitalization among advanced prostate cancer patients by diabetes status-a population-based study
JNCI cancer spectrum, v 9(5), pkaf070
Oct 2025
PMID: 40668753
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Older adults with advanced prostate cancer (PCa) and type 2 diabetes mellitus (T2DM) are under-represented in trials of androgen receptor pathway inhibitors (ARPIs). This study examined changes in unplanned hospitalization rates in patients receiving ARPIs by T2DM status and assessed if unplanned hospitalization varies according to ARPI.
This population-based study of PCa patients over age 66 utilized SEER-Medicare data. Pre-post ARPI initiation changes and ARPI differences in unplanned hospitalization rates were estimated by adjusted incidence rate ratios (aIRR) with considerations for interactions between period, ARPI, and T2DM status. Linear contrasts were used to estimate and test conditional aIRRs. Tests were two-sided and p < .05 was considered statistically significant.
The study included 12,240 patients: 3,160 with T2DM (25.8%), 7,191 (58.8%) received AAP and 5,049 (41.2%) ENZA. Unplanned hospitalization rates increased after ARPI initiation by 65% among patients with T2DM complications (aIRR 1.65; 95% CI 1.37, 1.98) and 109% in non-diabetics (aIRR 2.09; 95% CI 1.94, 2.26). Among patients with T2DM without complications, the increase in unplanned hospitalization rates depended on the ARPI initiated: 103% after AAP (aIRR 2.03; 95% CI 1.70, 2.43) and 47% after ENZA (aIRR 1.47; 95% CI 1.21, 1.80), a 38% greater increase in unplanned hospitalization rates after AAP than ENZA (ratio of aIRRAAP/aIRRENZA 1.38; 95% CI 1.06, 1.80).
All patients had higher unplanned hospitalization rates after ARPI. Our findings highlight the importance of using real-world data to better understand the interplay between pre-existing health conditions and treatment outcomes, a critical step toward precision medicine.
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Details
- Title
- Unplanned hospitalization among advanced prostate cancer patients by diabetes status-a population-based study
- Creators
- Amy L Shaver - Thomas Jefferson UniversityKrupa Gandhi - Thomas Jefferson UniversityScott W Keith - Sidney Kimmel Cancer CenterNikita Nikita - Thomas Jefferson UniversityChristopher C Yang - Drexel UniversityFelix J Kim - Thomas Jefferson UniversityHushan Yang - Thomas Jefferson UniversityWilliam Kevin Kelly - Thomas Jefferson UniversityStephen J Freedland - Cedars-Sinai Medical CenterGrace Lu-Yao (Corresponding Author) - Sidney Kimmel Cancer Center
- Publication Details
- JNCI cancer spectrum, v 9(5), pkaf070
- Publisher
- Oxford University Press
- Number of pages
- 10
- Grant note
- California Department of Public Health: 103885 Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries: 1NU58DP007156 National Cancer Institute's Surveillance, Epidemiology and End Results Program: HHSN261201800032I, HHSN261201800015I, HHSN261201800009I National Cancer Institute
The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries, under cooperative agreement 1NU58DP007156; the National Cancer Institute's Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:001561857700001
- Scopus ID
- 2-s2.0-105015195901
- Other Identifier
- 991022065141804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology