title: Patterns of care for men diagnosed with prostate cancer in Victoria from 2008 to 2011.
abstract: OBJECTIVE
  To describe patterns of care for men diagnosed with prostate cancer in Victoria, Australia, between 2008 and 2011.
  
  
  METHODS
  Men who were diagnosed with prostate cancer at 11 public and six private hospitals in Victoria from August 2008 to February 2011, and for whom prostate cancer notifications were received by the Prostate Cancer Registry.
  
  
  METHODS
  Characteristics of men diagnosed with prostate cancer; details of treatment provided within 12 months of diagnosis, according to National Comprehensive Cancer Network risk categories; and characteristics of men who did not receive active treatment within 12 months of diagnosis.
  
  
  RESULTS
  Treatment details were collected for 98.1% of men who were assessed as eligible to participate in the study (2724/2776) and were confirmed by telephone 12 months after diagnosis for 74.4% of them (2027/2724). Most patients (2531/2724 [92.9%]) were diagnosed with clinically localised disease, of whom 1201 (47.5%) were at intermediate risk of disease progression. Within 12 months of diagnosis, 299 of the 736 patients (40.6%) who had been diagnosed as having disease that was at low risk of progression had received no active treatment, and 72 of 594 patients (12.1%) who had been diagnosed as having disease that was at high risk of progression had received no active treatment. Of those diagnosed as having intermediate risk of disease progression, 54.5% (655/1201) had undergone radical prostatectomy. Those who received no active treatment were more likely than those who received active treatment to be older (odds ratio [95% CI], 2.96 [2.01-4.38], 10.94 [6.96-17.21] and 32.76 [15.84-67.89], respectively, for age 65-74 2013s, 75-84 2013s and ≥ 85 2013s, compared with < 55 2013s), to have less advanced disease (odds ratio [95% CI], 0.20 [0.16-0.26], 0.09 [0.06-0.12] and 0.05 [0.02-0.90], respectively, for intermediate, high and very high-risk [locally advanced] or metastatic disease, compared with low-risk disease) and to have had their prostate cancer notified by a private hospital (odds ratio [95% CI], 1.35 [1.10-1.66], compared with public hospital).
  
  
  CONCLUSIONS
  Our data reveal a considerable "stage migration" towards earlier diagnosis of prostate cancer in Victoria and a large increase in the use of radical prostatectomy among men with clinically localised disease.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. sue.evans@monash.edu.
authors.forename: Sue M
authors.initials: SM
authors.lastname: Evans
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Millar
authors.forename: Ian D
authors.initials: ID
authors.lastname: Davis
authors.forename: Declan G
authors.initials: DG
authors.lastname: Murphy
authors.forename: Damien M
authors.initials: DM
authors.lastname: Bolton
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Mark
authors.initials: M
authors.lastname: Frydenberg
authors.forename: Nick
authors.initials: N
authors.lastname: Andrianopoulos
authors.forename: Julie M
authors.initials: JM
authors.lastname: Wood
authors.forename: Albert G
authors.initials: AG
authors.lastname: Frauman
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
authors.forename: John J
authors.initials: JJ
authors.lastname: McNeil
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001918:Brachytherapy / Q000706:statistics & numerical data* / Q000639:trends; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data / Q000639:trends; D055088:Early Detection of Cancer / Q000706:statistics & numerical data / Q000639:trends; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011468:Prostatectomy / Q000706:statistics & numerical data* / Q000639:trends; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data / Q000639:trends; D012042:Registries; D014739:Victoria; D057832:Watchful Waiting / Q000706:statistics & numerical data* / Q000639:trends
chemical_list: D000970:Antineoplastic Agents