Treatment variations in localised prostate cancer in Australia and New Zealand: a registry study.

Abstract

To describe the patterns of care and factors associated with treatment uptake of localised prostate cancer, using the bi-national Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ) database. Data for 36 504 patients, diagnosed between 2015 and 2018, from New Zealand and seven Australian jurisdictions were evaluated. Multinomial logistic regression was performed to identify factors associated with the likelihood of receiving no active treatment, radiotherapy (RT), androgen deprivation therapy (ADT) and combined ADT + RT, compared to radical prostatectomy (RP). The most common disease risk group and treatment were intermediate-risk disease (49.2%) and RP (40.3%). Men with low-risk disease were mostly managed by no active treatment (81.5%). Compared to men treated with RP, the likelihood of receiving other treatments was higher in residents from regional areas, those from lower socio-economic status (SES) areas and those diagnosed at regional or public hospitals. Being in the lowest SES group was associated with an odds ratio (OR) of 1.84, (95% confidence interval [CI] 1.67-2.02) of having no active treatment, an OR of 1.53 (95% CI 1.32-1.78) for RT, an OR of 2.66 (95% CI 2.10-3.36) for ADT and an OR of 2.56 (95% CI 2.23-2.93) for ADT + RT. Factors related to SES and hospital provider were associated with treatment choices in localised prostate cancer patients, independent of their age or disease risk classification.