Background
Men diagnosed with prostate cancer in specific regional areas in Victoria, Australia have a poorer five-year survival rate compared to men living elsewhere in Victoria.
Aim
To describe patterns-of-care for men diagnosed with prostate cancer in a specific Victorian region, between 2008-2013, and compare the outcomes with other Victorian regions.
Methods
Series of 7,204 men diagnosed in metropolitan and regional Victoria were included in the analysis. Descriptive analyses describe diagnostic and treatment patterns in regional and metropolitan regions to compare risk factors, treatment type and time-taken-to-treatment.
Results
Compared with men living in other Victorian regions, men diagnosed with prostate cancer in the study region were more likely to be diagnosed at older age with more advanced disease, and incidentally rather than through case-finding PSA blood tests. In risk groups where immediate treatment is often indicated, they were less likely to have this immediate treatment. They were more likely to have a longer time from diagnosis to active treatment.
Conclusion
Multiple factors explain the higher mortality rate post-diagnosis in the study regional area. This range of explanatory factors, occurring at multiple points along the pathway of diagnosis and detection, suggests that interventions to improve outcomes for prostate cancer in regional areas such as this need to be systematic. Interventions specifically addressing any one factor in isolation are unlikely to have much effect.