Patterns of XXXX Care in the United States: 1990-2010.

@entity1 @entity694 @entity5 @entity14
BACKGROUND: @entity14 ( @entity14 ) mortality has declined in the United States, in part because of advances in treatment. Few studies have evaluated the adoption of therapies and temporal changes in patterns of care. METHODS: @entity1 age 20 years and older diagnosed with stages II/III @entity14 were randomly sampled from the population-based Surveillance, Epidemiology, and End Results (SEER) program in 1990-1991, 1995, 2000, 2005, and 2010 (n = 7057). Therapy was obtained from medical records and physician verification. We described the receipt of chemotherapy and radiation therapy. Log-binomial regression was used to examine factors associated with therapy. All statistical tests were two-sided. RESULTS: Chemotherapy receipt among @entity694 @entity1 increased from 1990 (stage II: 22.5%; stage III: 56.3%) to 2005 (stage II: 32.1%; stage III: 72.4%) and declined slightly in 2010 (stage II: 29.3%; stage III: 66.4%). Stage III @entity694 @entity1 who were older (vs <55 years, 75-79 years: risk ratio [RR] 0.81, 95% confidence interval [CI] = 0.71 to 0.91; >= 80 years: RR = 0.37, 95% CI = 0.28 to 0.47) or had a comorbidity score of 2 or higher (vs 0, RR = 0.56, 95% CI = 0.35 to 0.87) received chemotherapy less often. Receipt of radiation therapy by @entity5 @entity1 increased across all years from 45.5% to 66.1%. Increasing age (vs <55 years, 75-79 years: RR = 0.59, 95% CI = 0.47 to 0.74; >= 80 years: RR = 0.33, 95% CI = 0.25 to 0.45) was associated with lower chemoradiation use among stage II/III @entity5 @entity1 . CONCLUSION: Our findings demonstrate increased adoption of chemotherapy and radiation therapy for @entity694 @entity1 and differences in therapy by age, comorbidity, and diagnosis year. Increased receipt of these therapies in the community may further reduce @entity14 mortality.
