Hormonal Therapy Patterns in Older Men with Prostate Cancer in the United States, 2010–2019
Abstract
Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Data Sources
2.2. Study Subjects
2.3. Indications for HT
2.4. Definitions
2.5. Statistical Analyses
2.6. Data Availability
3. Results
3.1. Patient and Cancer Characteristics
3.2. Multivariable Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A

Appendix B
- HT (NDC and HCPCS) Codes
| Drug Name | NDC Code | HCPCS Code |
| Agonists | ||
| Leuprolide (Lupron, Eligard) | 00074-3642, 00074-3473, 00074-3683, 00185-7400, 00781-4003, 47335-0936, 55150-0478, 62935-0223, 62935-0303, 62935-0453, 62935-0753, 69448-0014, 72664-0611 | J1950, J1952, J9217, J9218, J9219 |
| Goserelin (Zoladex) | 50090-2027, 50090-3466, 70720-0950, 70720-0951 | J9202 |
| Triptorelin (Trelstar) | 00023-5902, 00023-5904, 00023-5906 | J3315 |
| Histrelin | 67979-0501, 67979-0401 | J1675, J9225, J9226 |
| Antagonists | ||
| Degarelix | 55566-8303, 55566-8403 | J9155 |
| Relugolix | 72974-0120 | |
| Antiandrogens | ||
| Old generation drugs | ||
| Flutamide | 69097-0915 | |
| Nilutamide | 59212-0111, 62559-0173, 66993-0212, 82454-0212 | |
| Bicalutamide | 00904-6019, 16714-0571, 16714-0816, 16729-0023, 47335-0485, 54868-4503, 54868-6133, 60429-0177, 60505-2642, 62559-0680, 62559-0890, 63629-5321, 63672-0005, 65841-0613, 67253-0191, 68382-0224 | |
| New generation drugs | ||
| Enzalutamide | 00469-0125 | |
| Apalutamide | 59676-0600 | |
| Darolutamide | 50419-0395 | |
| Abiraterone (CYP17 inhibitor) | 00093-1125, 00143-9597, 00378-6920, 00904-6948, 16714-0963, 42291-0024, 42291-0073, 57894-0150, 57894-0184 |
- ICD 9 and ICD 10 Codes
| Treatment | ICD-9, ICD-10 or HCPCS/CPT Code |
| Orchiectomy | (CPT codes 54520) ICD-9: 62.4, V45.77 ICD-10: Z90.79 |
| Radiation Therapy | External beam radiotherapy (CPT codes 77400–77416, 77420, 77425, 77430), Brachytherapy (CPT codes 77776–77778), ICD-9: 92.21–92.27, 92.3 ICD-10: Z51.0 DVY07ZZ HCPCS/CPT: 77401–77416, 77418, 77520, 77522–77525, 55875, 77373 |
| prostatectomy | ICD-9: 60.3, 60.4, 60.5, V45.77 ICD-10: Z90.79 HCPCS/CPT: 55801, 55810, 55812, 55815, 55840, 55842, 55845, 55860, 55862, 55865, 55866, 52601, 52612, 52614 |
| Demographic characteristics and comorbidities | |
| Age | NAACCR Item Number 230 |
| Race/Ethnicity | Non-Hispanics white, Non-Hispanics Black, Hispanics, others |
| Congestive heart failure | ICD-9 398.91, 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0–428.9 ICD-10 (I50) |
| Valvular disease | ICD-9 093.20–093.24, 394.0–397.1, 397.9, 424.0–424.99, 746.3–746.6, V42.2, V43.3 ICD-10 (I35) |
| Pulmonary circulation disorders | ICD-9 415.11–415.19, 416.0–416.9, 417.9 (491–496) ICD-10 (I26–I27) |
| Peripheral vascular disorders | ICD-9 440–440.9, 441.00–441.9, 442.0–442.9, 443.1–443.9, 444.21–444.22, 447.1,449, 557.1, 557.9, V43.4 (443) ICD-10 (I73) |
| Lymphoma | ICD-9 200.00–202.38, 202.50–203.01, 203.02–203.82, 203.8–203.81, 238.6, 273.3 ICD-10 (C85) |
| Diabetes mellitus | ICD-9 249.00–249.31, 250.00–250.33, 648.00–648.04, 249.40–249.91, 250.40–250.93, 775.1 (250) ICD-10 (E08–E13) |
| Hypertension | ICD-9 401.1, 401.9, 642.00–642.04, 401.0, 402.00–405.99, 437.2, 642.10–642.24, 642.70–642.94 (401–405) ICD-10 (I10) |
| Hypothyroidism | ICD-9 243–244.2, 244.8, 244.9 ICD-10 E03 |
| Hyperlipidemia | ICD-9 (272) ICD-10 (E78) |
| Chronic kidney disease | ICD-9 403.01, 403.11, 403.91, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 585.3, 585.4, 585.5, 585.6, 585.9, 586, V42.0, V45.1, V45.11, V45.12, V56.0-V56.32, V56.8 ICD-10 N18, N17, N19 |
| Chronic liver disease | ICD-9 070.22, 070.23, 070.32, 070.33, 070.44, 070.54, 456.0, 456.1, 456.20, 456.21, 571.0, 571.2, 571.3, 571.40–571.49, 571.5, 571.6, 571.8, 571.9, 572.3, 572.8, 573.5, V42.7 ICD-10 (K76, K75) |
| Chronic pulmonary disease | ICD-9 490–492.8, 493.00–493.92, 494–494.1, 495.0–505, 506.4, ICD-10 (J41–J44, I28) |
| Chronic peptic ulcer | ICD-9 531.41, 531.51, 531.61, 531.70, 531.71, 531.91, 532.41, 532.51, 532.61, 532.70, 532.71, 532.91, 533.41, 533.51, 533.61, 533.70, 533.71, 533.91, 534.41, 534.51, 534.61, 534.70, 534.71, 534.91 ICD-10 K27 |
| Cerebral vascular accident | ICD-9 (430–438) ICD-10 (I60–I67) |
| Neurological disorders | ICD-9 330.1–331.9, 332.0, 333.4, 333.5, 333.71, 333.72, 333.79, 333.85, 333.94, 334.0–335.9, 338.0, 340, 341.1–341.9, 345.00–345.11, 345.2–345.3, 345.40–345.91, 347.00–347.01, 347.10–347.11, 649.40–649.44, 768.7, 768.70, 768.71, 768.72, 780.3, 780.31, 780.32, 780.33, 780.39, 780.97, 784.3 ICD-10 G20, G35, G40–G41, G60–G64, G80–G83 |
| HIV and Aids | ICD-9 042–044.9 ICD-10 B20, Z21, Z83 |
| Metastatic cancer | ICD-9 196.0–199.1, 209.70, 209.71, 209.72, 209.73, 209.74, 209.75, 209.79, 789.51 ICD-10 C77, C80, C7B |
| Solid tumor without metastasis | ICD-9 140.0–172.9, 174.0–175.9, 179–195.8, 209.00–209.24, 209.25–209.3, 209.30–209.36, 258.01–258.03 ICD-10 C00, C43, C50, C55, C76 |
| Rheumatoid arthritis/collagen vascular diseases | ICD-9 701.0, 710.0–710.9, 714.0–714.9, 720.0–720.9, 725 ICD-10 M05–M06, M32, M34, M35.3 |
| Coagulation deficiency | ICD-9 286.0–286.9, 287.1, 287.3–287.5, 289.84, 649.30–649.34 ICD-10 D68 |
| Obesity | ICD-9 278.0, 278.00, 278.01, 278.03, 649.10–649.14, 793.91, V85.30-V85.39, V85.41-V85.45, V85.54 ICD-10 E66 |
| Weight loss | ICD-9 260–263.9, 783.21, 783.22 ICD-10 R63 |
| Fluid and electrolyte disorders | ICD-9 276.0–276.9 ICD-10 E87 |
| Blood loss anemia | ICD-9 280.0, 648.20–648.24 ICD-10 D50 |
| Deficiency anemias | ICD-9 280.1–281.9, 285.21–285.29, 285.9 ICD-10 D51, D52, D55, D53 |
| Alcohol abuse | ICD-9 291.0–291.3, 291.5, 291.8, 291.81, 291.82, 291.89, 291.9, 303.00–303.93, 305.00–305.03 ICD-10 F10 |
| Drug abuse | ICD-9 292.0, 292.82–292.89, 292.9, 304.00–304.93, 305.20–305.93, 648.30–648.34 ICD-10 Z71, F19, F11, F55, F15 |
| Psychoses | ICD-9 295.00–298.9, 299.10, 299.11 ICD-10 F29, F23, F53 |
| Depression | ICD-9 300.4, 301.12, 309.0, 309.1, 311 ICD-10 F32 |
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| Variable | No. of Subjects | Any HT † | Primary HT in Patients with Lower-Risk PCa † n = 73,840 | Adjuvant HT in Patients with Higher-Risk PCa † n = 6769 | p Value |
|---|---|---|---|---|---|
| Men receiving HT | 35.1% | 27.3% | 58.6% | ||
| Year of diagnosis | <0.0001 | ||||
| 2010 | 12,931 | 31.6% | 4261 (25%) | 511 (53.6%) | |
| 2011 | 13,227 | 31.7% | 4382 (22.6%) | 462 (52.8%) | |
| 2012 | 11,648 | 31.7% | 3852 (19.9%) | 438 (50.5%) | |
| 2013 | 12,576 | 31.6% | 4187 (16.9%) | 620 (55.2%) | |
| 2014 | 14,311 | 32.4% | 5028 (22.3%) | 520 (52.9%) | |
| 2015 | 15,517 | 34.5% | 6372 (28.2%) | 443 (54.2%) | |
| 2016 | 16,860 | 36.2% | 6272 (25.2%) | 729 (53.8%) | |
| 2017 | 17,592 | 38.0% | 6683 (26.4%) | 664 (59.0%) | |
| 2018 | 17,520 | 39.5% | 6428 (26.6%) | 710 (64.4%) | |
| 2019 | 17,333 | 40.2% | 6496 (25.9%) | 720 (68.1%) | |
| Age | <0.0001 | ||||
| 66–70 | 45,654 | 28.0% | 15,572 (16.8%) | 1455 (54.6%) | |
| 71–75 | 45,817 | 33.8% | 16,398 (22.2%) | 1758 (59.4%) | |
| 76–80 | 30,747 | 40.6% | 11,965 (29.6%) | 1434 (57.8%) | |
| >80 | 27,297 | 43.4% | 10,026 (33.8%) | 1170 (56.2%) | |
| Race/Ethnicity § | <0.0001 | ||||
| White | 118,613 | 40.5% | 43,136 (23.0%) | 4490 (56.7%) | |
| Black | 11,663 | 34.2% | 4426 (30.4%) | 418 (55.3%) | |
| Hispanic | 10,876 | 38.2% | 3379 (31.6%) | 494 (58.1%) | |
| Other | 8363 | 37.9% | 3020 (27.6%) | 415 (63.4%) | |
| Marital status | 0.7538 | ||||
| Married | 61,040 | 35.0% | 21,008 (24.5%) | 1975 (56.6%) | |
| Not Married | 88,475 | 35.3% | 32,953 (24.4%) | 3842 (58.4%) | |
| Clinical stage | <0.0001 | ||||
| Stage I | 5877 | 11.5% | 5272 (6.0%) | - | |
| Stage II | 96,066 | 32.8% | 48,689 (26.4%) | - | |
| Stage III | 18,244 | 39.2% | - | 2298 (59.1%) | |
| Stage IV | 29,328 | 45.0% | - | 3519 (55.9%) | |
| Tumor grade | <0.0001 | ||||
| Well differentiated | 21,078 | 8.8% | 12,684 (4.9%) | - | |
| Moderately differentiated | 43,856 | 26.4% | 17,212 (23.0%) | - | |
| Poorly differentiated/undifferentiated | 48,264 | 55.5% | - | 2301 (73.8%) | |
| Comorbidity Score | <0.0001 | ||||
| 0 | 45,406 | 31.4% | 16,782 (20.4%) | 1492 (61.7%) | |
| 1 | 42,793 | 35.3% | 15,476 (24.4%) | 1641 (59.4%) | |
| 2 | 27,812 | 37.1% | 10,182 (26.4%) | 1155 (57.8%) | |
| ≥3 | 33,504 | 38.5% | 11,521 (28.6%) | 1529 (49.9%) | |
| Radiation | <0.0001 | ||||
| Yes | 34,872 | 51.3% | - | 5817 (57.2%) | |
| No | 114,643 | 30.3% | 53,961 (24.4%) | - |
| Year of Diagnosis | Adjuvant HT in Patients with Higher-Risk PCa | Primary HT in Patients with Lower-Risk PCa § | ||||
|---|---|---|---|---|---|---|
| GnRH Agonist | GnRH Antagonist | Anti-Androgen | GnRH Agonist | GnRH Antagonist | Anti-Androgen | |
| 2010 | 281 (8.9%) | 13 (2.5%) | 173 (8.0%) | 1084 (8.6%) | 66 (3.6%) | 569 (7.9%) |
| 2011 | 243 (7.8%) | 22 (4.2%) | 151 (7.0%) | 1026 (8.2%) | 90 (4.9%) | 552 (7.7%) |
| 2012 | 223 (7.1%) | 22 (4.2%) | 125 (5.8%) | 785 (6.3%) | 68 (3.7%) | 445 (6.2%) |
| 2013 | 319 (10.1%) | 44 (8.5%) | 184 (8.5%) | 702 (5.6%) | 90 (4.9%) | 427 (5.9%) |
| 2014 | 256 (8.2%) | 47 (9.0%) | 175 (8.1%) | 1095 (8.7%) | 179 (9.8%) | 655 (9.2%) |
| 2015 | 240 (7.7%) | 38 (7.3%) | 175 (8.1%) | 1664 (13.3%) | 288 (15.8%) | 942 (13.2%) |
| 2016 | 368 (11.8%) | 65 (12.5%) | 284 (13.1%) | 1446 (11.5%) | 248 (13.6%) | 785 (10.9%) |
| 2017 | 365 (11.7%) | 80 (15.4%) | 272 (12.6%) | 1600 (12.8%) | 282 (15.5%) | 908 (12.7%) |
| 2018 | 411 (13.1%) | 85 (16.3%) | 285 (13.2%) | 1596 (12.7%) | 254 (13.9%) | 931 (13.0%) |
| 2019 | 424 (13.6%) | 105 (20.2%) | 330 (15.3%) | 1555 (12.4%) | 259 (14.2%) | 933 (13.1%) |
| Variables | Any HT n = 149,925 Odds Ratio | Adjuvant HT in Patients with Higher-Risk PCa (n = 6769) * Odds Ratio | Primary HT in Patients with Lower-Risk (n = 73,840) Odds Ratio | ||||||
|---|---|---|---|---|---|---|---|---|---|
| % | 95% CI | % | 95% CI | % | 95% CI | ||||
| Year of Diagnosis | |||||||||
| 2011 | 31.7% | 1.01 | 0.95–1.05 | 52.8% | 0.87 (990) | 0.79–0.96 | 22.6% | 0.97 (244) | 0.75–1.25 |
| 2012 | 31.7% | 1.00 | 0.95–1.06 | 0.74 (768) | 0.67–0.82 | 0.88 (221) | 0.68–1.14 | ||
| 2013 | 31.6% | 0.99 | 0.94–1.05 | 50.5% | 0.61 (706) | 0.54–0.67 | 19.9% | 1.06 (342) | 0.84–1.35 |
| 2014 | 32.4% | 1.04 | 0.98–1.08 | 0.86 (1119) | 0.77–0.94 | 0.97 (275) | 0.76–1.24 | ||
| 2015 | 34.5% | 1.14 | 1.08–1.20 | 55.2% | 1.17 (1799) | 1.08–1.28 | 16.9% | 1.02 (240) | 0.79–1.32 |
| 2016 | 36.2% | 1.23 | 1.16–1.28 | 1.01 (1583) | 0.92–1.11 | 1.01 (392) | 0.80–1.26 | ||
| 2017 | 38.0% | 1.33 | 1.26–1.39 | 52.9% | 1.07 (1763) | 0.98–1.17 | 22.3% | 1.25 (392) | 0.98–1.57 |
| 2018 | 39.5% | 1.41 | 1.34–1.48 | 1.08 (1707) | 0.99–1.18 | 1.56 (457) | 1.24–1.97 | ||
| 2019 | 40.2% | 1.45 | 1.38–1.52 | 54.2% | 1.05 (1684) | 0.96–1.15 | 28.2% | 1.84 (490) | 1.46–2.33 |
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Share and Cite
Albayyaa, M.; Kuo, Y.-F.; Shahinian, V.; Lopez, D.S.; Digbeu, B.; Urban, R.; Baillargeon, J. Hormonal Therapy Patterns in Older Men with Prostate Cancer in the United States, 2010–2019. Cancers 2025, 17, 3231. https://doi.org/10.3390/cancers17193231
Albayyaa M, Kuo Y-F, Shahinian V, Lopez DS, Digbeu B, Urban R, Baillargeon J. Hormonal Therapy Patterns in Older Men with Prostate Cancer in the United States, 2010–2019. Cancers. 2025; 17(19):3231. https://doi.org/10.3390/cancers17193231
Chicago/Turabian StyleAlbayyaa, Mohanad, Yong-Fang Kuo, Vahakn Shahinian, David S. Lopez, Biai Digbeu, Randall Urban, and Jacques Baillargeon. 2025. "Hormonal Therapy Patterns in Older Men with Prostate Cancer in the United States, 2010–2019" Cancers 17, no. 19: 3231. https://doi.org/10.3390/cancers17193231
APA StyleAlbayyaa, M., Kuo, Y.-F., Shahinian, V., Lopez, D. S., Digbeu, B., Urban, R., & Baillargeon, J. (2025). Hormonal Therapy Patterns in Older Men with Prostate Cancer in the United States, 2010–2019. Cancers, 17(19), 3231. https://doi.org/10.3390/cancers17193231

