Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug;14(15):e71135.
doi: 10.1002/cam4.71135.

Socioeconomic and Geographic Disparities in Anorectal and Urinary Procedures Following Radiotherapy for Prostate Cancer

Tenaw Tiruye  1   2 , Braden Higgs  3 , Michael O'Callaghan  4   5   6   7 , Liesel M FitzGerald  8 , David Roder  1 , Kerri Beckmann  1
Affiliations

Socioeconomic and Geographic Disparities in Anorectal and Urinary Procedures Following Radiotherapy for Prostate Cancer

Tenaw Tiruye et al. Cancer Med. 2025 Aug.

Abstract

Background and purpose: Evidence on how treatment outcomes vary by patient characteristics helps to inform clinical practice. In this study, we measured socioeconomic and geographic disparity in post-radiotherapy procedures, as an indication of short-term radiotherapy adverse effects, among men with prostate cancer.

Materials and methods: We studied 8344 South Australian diagnosed men with prostate cancer (2002-2020) who received external beam radiotherapy. The outcomes were anorectal and urinary procedures, identified using hospital admission procedure codes and Medicare Benefits Schedule item codes. Crude rates per 1000 person-time were estimated at two years post-radiotherapy. Socioeconomic and geographic disparities were identified through multivariable adjusted zero-inflated Poisson regression.

Results: Fifteen percent of men underwent at least one post-radiotherapy procedure within two years. The rates of anorectal, urinary and overall (both anorectal and urinary) procedures were 18, 66 and 81 per 1000 person-years, respectively. Men in the highest socioeconomic quintile had lower rates of overall (incidence rate ratio [IRR] 0.70, 95% CI: 0.61-0.81), anorectal (IRR 0.32, 95% CI: 0.20-0.52) and urinary (IRR 0.69, 95% CI: 0.56-0.86) procedures than men in the lowest socioeconomic quintile. Men from non-metropolitan areas had higher rates of anorectal procedures (IRR 1.36, 95% CI: 1.05-1.77) than men from metropolitan areas, which was further compounded by low socioeconomic advantage. Receiving radiotherapy in more recent years was associated with lower rates of post-radiotherapy procedures.

Conclusion: Anorectal and urinary procedures following radiotherapy significantly vary across different population subgroups. Observed differences in procedure rates may suggest socioeconomic and geographic disparities in radiotherapy adverse effects for prostate cancer. This underscores the importance of follow-up care for at-risk population subgroups.

Keywords: disparity; prostate cancer; radiotherapy; treatment outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Predicted probability of post‐radiotherapy anorectal and urinary procedures, stratified by socioeconomic advantage and place of residence.
See this image and copyright information in PMC

References

    1. Cancer Council SA , “Prostate Cancer,” Adelaide (2022), https://www.cancersa.org.au/cancer‐a‐z/prostate‐cancer/the‐prostate.
    1. Tiruye T., O'Callaghan M., Moretti K., et al., “Patient‐Reported Functional Outcome Measures and Treatment Choice for Prostate Cancer,” BMC Urology 22, no. 1 (2022): 169. - PMC - PubMed
    1. Tiruye T., O'Callaghan M., Ettridge K., et al., “Clinical and Functional Outcomes for Risk‐Appropriate Treatments for Prostate Cancer,” BJUI Compass 5, no. 1 (2024): 109–120. - PMC - PubMed
    1. Hamdy F. C., Donovan J. L., Lane J. A., et al., “10‐Year Outcomes After Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer,” New England Journal of Medicine 375, no. 15 (2016): 1415–1424. - PubMed
    1. Tiruye T., Jay A., Higgs B., et al., “Comparing Post‐Treatment Urinary and Colorectal Procedures in Prostate Cancer Patients Using Population‐Based Linked Data,” International Urology and Nephrology 57, no. 4 (2025): 1189–1198. - PubMed

LinkOut - more resources