A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease
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Date
2016Author
Ruseckaite, Rasa
Beckmann, Kerri R
O'Callaghan, Michael
Roder, David
Moretti, Kim
Millar, Jeremy
Evans, Sue
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Abstract
Background: Prostate cancer (PCa) is the most commonly diagnosed malignancy reported to Australian
cancer registries with numerous studies from individual registries summarizing diagnostic and treatment
characteristics. The aim of this study was to describe annual trends in clinical and treatment characteristics,
and changes in surveillance practice within a large combined cohort of men with PCa in South Australia (SA)
and Victoria, Australia in 2008–2013.
Methods: Common data items from clinical registries in SA and Victoria were merged to develop a crossjurisdictional
dataset consisting of 13,598 men with PCa. Frequencies were used to describe these variables
using the National Comprehensive Cancer Network risk of disease progression categories in 10 year age
groups. A logistic regression analysis was performed to assess the impact of a number of factors (both
individually and together) on the likelihood of men receiving no active treatment within twelve months of
the diagnosis (i.e. managed with active surveillance/watchful waiting).
Results: Trend analysis showed that over time: (1) men in SA and Victoria are being diagnosed at older age in 2013,
66.1 (SD = 9.7) years compared to 2009 (64.5 (SD = 9.7)); (2) diagnostic methods and characteristics have changed with
time; and (3) types of the treatments have changed, with more men having no active treatment. The majority of men
were diagnosed with Prostate-Specific Antigen (PSA) <10 ng/mL (66 %) and Grade Group < 4 (65 %). Nearly seventy
percent received radical treatment within 12 months of diagnosis, while ~20 % had no active treatment. In 14 % of
cases treatment was not recorded or had not commenced. Having no active treatment was strongly associated older
age, lower PSA and lower Grade Group at diagnosis, and in 2013 it was offered more frequently (more than 3 times)
than in 2009 (OR = 2.63, 95 % CI: 2.16–3.22).
Conclusions: Findings of this study provide the first cross-jurisdictional description of PCa characteristics and
management in Australia. These findings will provide benchmarking for ongoing monitoring and feedback of disease
management and outcomes of PCa through the Prostate Cancer Outcomes Registry–Australia New Zealand to
improve evidence-based practice.
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