Prostate cancer - rural Australian men less likely to survive

The study by Associate Professor Peter Baade, from Cancer Council Queensland, and colleagues, showed an overall increase in rates of prostate specific antigen (PSA) screening and radical prostatectomy, reductions in mortality and improvements in survival throughout Australia.

Although incidence rates for prostate cancer in both urban and rural parts of Australia are similar, the study found that the gap between prostate cancer survival rates for rural and urban men had widened, with rural men experiencing lower survival.

A/Prof Baade said that rates of radical prostatectomy and PSA screening were lower among rural men, suggesting that rural men were more likely to be diagnosed after experiencing symptoms, when stage of disease can be more advanced, with less favourable survival prospects.

“This study suggests that PSA screening has not had an equivalent impact on the diagnosis of prostate cancer in urban and rural areas, and points to the need for further studies to investigate any differences in access to treatment options and follow-up care for men living in regional and rural areas and those living in urban areas,” A/Prof Baade said.

“Similar incidence trends, lower rates of PSA screening and lower rates of radical prostatectomy (a procedure specific to the treatment of localised prostate cancer) are consistent with the hypothesis that a greater proportion of men diagnosed with prostate cancer in rural areas of Australia are diagnosed because they show symptoms, more so than men living in urban areas.”

A/Prof Baade said that men living in regional and rural areas of Australia have been shown to use diagnostic and treatment services less than their urban counterparts, which could in part explain why their survival and mortality outcomes are consistently poorer.

“Further research is required to quantify the associations between prostate cancer diagnostic and treatment outcomes and key area-level characteristics and individual-level demographic, clinical and psychosocial factors, so that health services policy and planning strategies to manage this disease can be guided by evidence.

“It is urgent that we further explore the reasons for lower survival among regional and rural men so that we can identify strategies that will counter this alarming trend,” A/ Prof Baade said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACT:     Anne Savage                                        07 3634 5241 / 0417 709 869

                    Director of Public Affairs, Cancer Council Queensland