Implications of Regionalizing Care in the Developing World: Impact of Distance to Referral Center on Compliance to Biopsy Recommendations in a Brazilian Prostate Cancer Screening Cohort
Table 3
The association between distance and risk of PC and PC grade (n = 850).
Association between distance and risk of PC
Model: logistic regression
Distance variable format
Distance (km)
OR
95% CI
value
Unadjusted
Continuous
—
1.05
0.92–1.20
0.45
Categorical relative to 0–249 km
250–499
1.05
0.76–1.46
0.37
500–999
0.87
0.54–1.40
≥1000
1.45
0.91–2.30
Multivariable
Continuous
—
0.98
0.85–1.14
0.80
Categorical relative to 0–249 km
250–499
0.96
0.67–1.37
0.39
500–999
0.69
0.41–1.17
≥1000
1.22
0.74–2.03
Association between distance and PC grade (relative to no PC)
Model: multinomial logistic regression
Distance variable format
Distance (km)
OR
95% CI
P value
Cancer outcome: low-grade PC (Grade Group I)
Unadjusted
Continuous
—
1.04
0.91–1.20
0.56
Categorical relative to 0–249 km
250–499
0.97
0.69–1.36
0.27
500–999
0.86
0.53–1.40
≥1000
1.38
0.86–2.22
Multivariable
Continuous
—
0.98
0.84–1.14
0.79
Categorical relative to 0–249 km
250–499
0.90
0.62–1.30
0.32
500–999
0.69
0.40–1.17
≥1000
1.20
0.72–2.00
Cancer outcome: high-grade PC (Grade Group ≥2)
Unadjusted
Continuous
—
1.13
0.79–1.64
0.50
Categorical relative to 0–249 km
250–499
2.44
1.03–5.79
0.27
500–999
0.96
0.20–4.48
≥1000
2.39
0.72–7.93
Multivariable
Continuous
—
0.98
0.65–1.49
0.94
Categorical relative to 0–249 km
250–499
2.15
0.83–5.57
0.32
500–999
0.63
0.12–3.33
≥1000
1.47
0.34–6.41
Multivariable analysis adjusted for age, log PSA, education, family history of cancer, family history of PC, DRE, and screening year. CI: confidence interval; km: kilometers; OR: odds ratio; PC: prostate cancer; RRR: relative risk ratio.
