Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Factors associated with treatment type for prostate cancer patients in the 45 and Up Study, NSW (#28)

Mei Ling Yap 1 2 3 4 5 , Dianne O'Connell 4 5 6 , David Goldsbury 4 , Marianne Weber 4 5 , David P Smith 4 5 , Michael Barton 2 7
  1. Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute for Applied Medical Research, UNSW Sydney, Liverpool, NSW, Australia
  2. Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW
  3. School of Medicine, Western Sydney University, Campbelltown, NSW
  4. Cancer Research Division, Cancer Council NSW, Kings Cross, NSW
  5. School of Public Health, the University of Sydney, Camperdown, NSW
  6. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW
  7. Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Campbelltown, NSW, Australia

 

Aims

We aimed to describe the patterns of care for prostate cancer patients in the 45 and Up Study and ascertain factors associated with type of treatment received.


Methods 

There were 267,153 individuals aged ≥45 years in the Sax Institute’s 45 and Up Study, a population-based cohort study in New South Wales (NSW). Participants completed a baseline questionnaire during 2006-2009, which included items on socio-demographic factors and was linked to administrative health datasets by the Centre for Health Record Linkage. Incident prostate cancer cases were identified from the NSW Cancer Registry to December 2010. Receipt of radical prostatectomy (RP), external beam radiotherapy (EBRT) and/or androgen deprivation therapy (ADT), were identified in the NSW Admitted Patient Data Collection (to June 2014) and/or the Medicare Benefits Schedule and/or the Pharmaceutical Benefits Scheme (both provided by the Department of Human Services to December 2014). Multivariable logistic regression was used to examine variation in treatment types by sociodemographic characteristics.

 

Results

2432 men had a new diagnosis of prostate cancer (median age: 69, range: 45-98; median follow-up 5.5 years, range: 4.0-8.9). The first treatment received was 40% RP (n=979), 22% EBRT (n=537) and 10% (n=232) ADT alone. Of RP patients, 124 (13%) had a radiation oncology consultation recorded prior to surgery. From multivariable analysis, RP was associated with younger age (p<0.001), regional stage (p<0.001), being partnered (p=0.023), having better performance status (p=0.003) and having private health insurance (p<0.001). EBRT receipt was associated with older age (p=<0.001), higher stage (p<0.001), living <100km from a radiotherapy centre (p=0.007), fewer co-morbidities (p=0.047) and not having private health insurance (p<0.001).

Conclusions

Prostate cancer patients were twice more likely to receive RP than EBRT. Very few RP patients saw a radiation oncologist prior to surgery. Type of treatment received varied by both health factors and sociodemographic characteristics.