Prostate cancer in Victoria in 1993: patterns of reported management

Frydenberg M, Giles GG, Mameghan H, Thursfield VJ, Millar J, Wheelahan JB, Bolton DM, Syme RR (2000) Prostate cancer in Victoria in 1993: patterns of reported management. Med J Aust 172:270-274

OBJECTIVE: To describe the management of newly diagnosed prostate cancer in 1993 during the early prostate specific antigen (PSA) era. DESIGN: Survey of medical practitioners involved in the management of a total sample of incident prostate cancer cases selected from a population-based cancer registry. The survey was conducted in 1996, and the sample was followed up until 1998, to obtain five-year survival data on all patients. SETTING: The State of Victoria, including both public and private health sectors. PATIENTS: All men who were newly diagnosed with prostate cancer in the six months January-June 1993. MAIN OUTCOME MEASURES: Reported management by method of diagnosis; staging investigations; and treatment by observation, hormonal therapy, radical radiotherapy or radical prostatectomy. RESULTS: 1048 of 1117 (94%) cases diagnosed were surveyed. Most of the men (858 [82%]) were older than 65 years: 117 (11%) cancers were detected by screening asymptomatic men, and a further 269 (26%) were found by testing of men with symptoms ("case-found"). The 259 (25%) men treated with definitive local therapies (prostatectomy and curative radiotherapy) were younger (< 75="" years),="" and="" their="" disease="" was="" clinically="" more="" localised="" (clinical="" stage,="" t1-2)="" and="" they="" were="" often="" found="" by="" screening="" or="" case-finding.="" men="" given="" hormonal="" therapy="" (407;="" 39%)="" or="" managed="" without="" treatment="" (373;="" 36%)="" tended="" to="" be="" older="" and="" more="" likely="" to="" have="" been="" diagnosed="" by="" transurethral="" resection="" of="" the="" prostate="" (turp).="" the="" overall="" relative="" survival="" at="" five="" years="" was="" 86%="" and="" was="" decreased="" in="" men="" with="" cancers="" of="" higher="" histological="" grade="" or="" more="" advanced="" clinical="" stage,="" or="" who="" had="" higher="" psa="" levels.="" conclusions:="" although="" a="" third="" of="" patients="" were="" detected="" by="" screening="" or="" case-finding="" early="" in="" the="" psa="" era,="" definitive="" local="" therapies="" were="" used="" infrequently="" (25%="" of="" the="" total="" sample).="" most="" received="" appropriate="">