Urban-rural differences in prostate cancer mortality, radical prostatectomy and prostate-specific antigen testing in Australia

Coory, Michael D. and Baade, Peter D. (2005) Urban-rural differences in prostate cancer mortality, radical prostatectomy and prostate-specific antigen testing in Australia. Medical Journal of Australia, 182 3: 112-115.

Author Coory, Michael D.
Baade, Peter D.
Title Urban-rural differences in prostate cancer mortality, radical prostatectomy and prostate-specific antigen testing in Australia
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
1326-5377
Publication date 2005-02-07
Sub-type Article (original research)
Volume 182
Issue 3
Start page 112
End page 115
Total pages 4
Editor Martin B. Van Der Weyden
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing
Language eng
Subject 321200 Public Health and Health Services
321202 Epidemiology
11 Medical and Health Sciences
Abstract OBJECTIVE: To assess differences in trends for prostate cancer mortality, radical prostatectomy and prostate-specific antigen (PSA) testing for Australian men aged 50-79 years living in capital cities compared with regional and rural areas. DESIGN: Descriptive, population-based study based on data from official sources from 1985 to the 2002/03 financial year (depending on data availability). MAIN OUTCOME MEASURES: Age-standardised rates per 100,000 men aged 50-79 years of mortality from prostate cancer, incidence of prostate cancer, PSA tests and radical prostatectomy. RESULTS: We found a statistically significant and increasing (age-standardised) mortality excess for prostate cancer in regional and rural areas. In 2000-2002 the excess (compared with capital cities) was 21% (95% CI, 14%-29%). Rates of radical prostatectomy in rural and regional Australia were 29% lower (95% CI, 23% lower to 35% lower) than in capital cities. Although PSA testing is common across the whole of Australia, age-standardised rates in 2002/03 were 16% lower (95% CI, 15% lower to 17% lower) in regional and rural areas than in capital cities. CONCLUSIONS: Our results show that the probability of a man having a PSA test and the management of his prostate cancer depend on where he lives. The cause or causes of the prostate cancer mortality excess in regional/rural areas cannot be established in a descriptive study, but fewer radical prostatectomies in regional and rural areas, perhaps associated with less PSA screening, remain among the several competing hypotheses. Other possibilities are related to other differences in management, perhaps associated with access to urologists. Governments and other budget holders need good evidence about the effectiveness of prostate cancer screening and early treatment, but also about the best strategies for providing equitable access to cancer services in both urban and rural areas.
Keyword Aged
Australia/ep [Epidemiology]
Humans
Incidence
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Public Health Publications
 
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Created: Fri, 21 Sep 2007, 10:50:33 EST