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. 2016 Aug 5:16:607.
doi: 10.1186/s12885-016-2655-9.

A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease

Rasa Ruseckaite  1 , Kerri Beckmann  2 , Michael O'Callaghan  3   4   5 , David Roder  2 , Kim Moretti  2   3   4   5 , Jeremy Millar  6   7 , Sue Evans  6
Affiliations

A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease

Rasa Ruseckaite et al. BMC Cancer. .

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 cross-jurisdictional 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.

Keywords: Clinical registry; Prostate cancer; Treatments; Trends.

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Figures

Fig. 1
Fig. 1
Age trends among men diagnosed with PCa from clinical registries in SA and Victoria
Fig. 2
Fig. 2
Trends in method of diagnosis (a), PSA levels (b), Grade Groups (c) and NCCN risk (d) among men diagnosed with PCa from clinical registries SA and Victoria. p < 0.05 for all trends, TURP, Transurethral Resection of the Prostate; TRUS, Transrectal Ultrasonography of the Prostate
Fig. 3
Fig. 3
Treatment types (a) and time to treatment (b) among men diagnosed with PCa from clinical registries in SA and Victoria. p < 0.05 for all trends. RP – Radical Prostatectomy; RT – Radiotherapy; ADT – Androgen Deprivation Therapy
See this image and copyright information in PMC

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