Prostate cancer in Victoria in 1993: patterns of reported management.
OBJECTIVE
To describe the management of newly diagnosed prostate cancer in 1993 during the early prostate specific antigen (PSA) era.


METHODS
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.


METHODS
The State of Victoria, including both public and private health sectors.


METHODS
All men who were newly diagnosed with prostate cancer in the six months January-June 1993.


METHODS
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 treatment.
Frydenberg
M
M
Department of Surgery, Monash University, Melbourne, VIC.
Giles
G G
GG
Mameghan
H
H
Thursfield
V J
VJ
Millar
J
J
Wheelahan
J B
JB
Bolton
D M
DM
Syme
R R
RR
D000367:Age Factors; D000368:Aged; D001706:Biopsy; D003625:Data Collection; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D014739:Victoria
D017430:Prostate-Specific Antigen