Patterns of care and outcomes for men diagnosed with prostate cancer in Victoria: an update

ANZ J Surg. 2018 Oct;88(10):1037-1042. doi: 10.1111/ans.14722. Epub 2018 Jul 25.

Abstract

Background: To update patterns of care for men diagnosed with prostate cancer in Victoria, Australia between 2008 and 2015.

Methods: From August 2008 to December 2015, 14 025 men diagnosed with prostate cancer were included. These data were obtained from the Prostate Cancer Outcome Registry - Victoria (PCOR-Vic). Frequencies were used to describe hospital and patient characteristics and treatment types. Comparisons were made between previous period of analysis (2008-2011) to the most recent period (2011-2015). Survival analysis using a stepwise Cox proportional hazards regression model was performed.

Results: Mean age of diagnosis was 66.5 years and 44% of patients were diagnosed with Gleason 7 prostate cancer. Majority of notifications (63.6%) were received from a private institution and 70.2% of patients were diagnosed at a metropolitan institution. Most patients (95.3%) were diagnosed with clinically localized disease. Within 12 months of diagnosis, 55.9% of patients with low-risk disease received no active treatment. Radical prostatectomy was the most common primary treatment with curative intent (47%). When comparing of patterns of care between 2008-2011 and 2011-2015, the proportion of patients diagnosed with Gleason 9-10 disease increased, as has the proportion of patients diagnosed with metastatic disease.

Conclusion: With the PCOR-Vic, we were able to identify that increasing number of patients were diagnosed with high-risk and metastatic disease. There has been an overall decrease in radical treatment rates, likely due to active surveillance playing a significant role especially in patients with low-risk prostate cancer.

Keywords: health services research; patterns of care; prostate cancer; registry.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Disease Progression
  • Humans
  • Kallikreins / blood
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends*
  • Prostate / pathology
  • Prostate-Specific Antigen / blood
  • Prostatectomy / methods*
  • Prostatectomy / standards
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • Registries
  • Survival Analysis
  • Victoria / epidemiology

Substances

  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen