Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/21585
Title: Trends in Conservative Management for Low-risk Prostate Cancer in a Population-based Cohort of Australian Men Diagnosed Between 2009 and 2016.
Authors: Ong, Wee Loon;Evans, Sue M;Evans, Melanie;Tacey, Mark;Dodds, Lachlan;Kearns, Paul;Milne, Roger L;Foroudi, Farshad;Millar, Jeremy
Affiliation: Precision Medicine, School of Clinical Sciences, Monash Health, Monash University, Melbourne, Australia
Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia
Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Barwon Health, Geelong, Australia
Ballarat Health Services, Ballarat, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Alfred Health Radiation Oncology Services, Melbourne, Australia
Central Clinical School, Monash University, Melbourne, Australia
School of Clinical Medicine, University of Cambridge, Cambridge, UK; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Australia
Department of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Australia
Issue Date: 6-May-2019
EDate: 2019-05-06
Citation: European urology oncology 2019; online first: 6 May
Abstract: Conservative management, specifically with active surveillance (AS), has emerged as the preferred approach for low-risk prostate cancer (LRPC). We evaluated the trend for conservative management (ie, no active treatment within 12mo of diagnosis) for LRPC in an Australian population-based cohort of men captured in the Prostate Cancer Outcomes Registry Victoria (PCOR-Vic). Of the 3201 men diagnosed with LRPC between January 2009 and December 2016, 60% (1928/3201) had conservative management, and 52% (1664/3201) were documented to be on AS. There was an increase in conservative management from 52% in 2009 to 73% in 2016 (p<0.001), largely attributable to an increase in AS from 33% in 2009 to 67% in 2016 (p<0.001). When stratified by age group, the increase in conservative management was more pronounced among younger patients: from 37% to 66% for men aged <60yr versus from 72% to 86% for men aged ≥70yr. In multivariable analyses, increasing age, lower prostate-specific antigen and clinical category, lower socioeconomic status, and being diagnosed in public metropolitan institutions were all independently associated with a greater likelihood of conservative management. Identification of sociodemographic and institutional variations in practice allows for targeted strategies to improve management for men with LRPC. PATIENT SUMMARY: We looked at the uptake of conservative management (no active treatment within 12 mo of diagnosis) over time in an Australian population-based cohort of men with low-risk prostate cancer. The proportion of men with low-risk prostate cancer managed conservatively increased from 52% in 2009 to 73% in 2016. The increase in the uptake of conservative management for low-risk prostate cancer in Australia is concordant with international guidelines and other international population-based studies.
URI: http://ahro.austin.org.au/austinjspui/handle/1/21585
DOI: 10.1016/j.euo.2019.04.006
ORCID: 0000-0001-8387-0965
PubMed URL: 31411964
Type: Journal Article
Subjects: Active surveillance
Patterns of care
Prostate cancer
Appears in Collections:Journal articles

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