Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Prostate Cancer Extent of Disease, Treatment Utilisation and Survival: The impact of Culturally and Linguistically Diverse (CALD) Status, in South West Sydney Local Health District (SWSLHD) (#178)

Angela Berthelsen 1 2 , Sarah Bowers 1 2 , Kirsten J Duggan 1 2 , Kristy Jemison 1 2 , Mahbuba Sharmin 1 2 , Nasreen Kaadan 1 2 , Joseph Descallar 2 , Viet Do 3 , Mark Sidhom 3
  1. SWSLHD Clinical Cancer Registry, Liverpool, NSW, Australia
  2. Ingham Institute, Liverpool, NSW, Australia
  3. Cancer Therapy Centre, Liverpool Hospital, NSW, Australia

Background:

Prostate cancer awareness, and acceptance of screening and diagnostic tests vary between CALD communities. These factors may impact on patient management and outcome. We aim to investigate prostate cancer patients diagnosed and/or treated in SWSLHD, to identify any disparity in diagnosis, management and survival in relation to CALD status.

Method:

A retrospective cohort of prostate cancer cases, diagnosed 2006-2012, residing in SWS suburbs were identified from the SWSLHD Clinical Cancer Registry. Birthplace and Preferred Language determined CALD Status: Non-CALD, CALD–English, and CALD–Non-English speaking. Univariate and multiple multivariate models were used to identify associations for extent of disease, first course treatment utilisation and survival outcomes.

Results:

1499 cases were identified. 39% were from CALD backgrounds and 52% preferred languages other than English. Analysis groups were Non-CALD (61%), CALD-English (19%) and CALD-Non-English (20%). CALD-Non-English patients were older, with a mean age of 71 years, compared to 69 years in the other groups (p=0.015). Socioeconomic disadvantage varied between CALD groups (p<0.001). 8% had distant metastases at diagnosis, however this was not associated with CALD Status. 26% of Non-CALD patients received Surgery, compared to just 19% and 17% of CALD-English and CALD-Non-English respectively (p<0.001). Hormones were received in 46% of CALD-Non-English patients, 42% in CALD-English, and 40% Non-CALD groups (p=0.005). Radiotherapy utilisation was 49% in both CALD groups, compared to 44% in Non-CALD patients, though not significant. Other treatments received were Active surveillance (5%), Chemotherapy (1%) and no treatment in SWSLHD (14%). No statistical difference in overall survival was found between CALD groups.

Conclusion:

Our data suggests that men from CALD Groups are diagnosed at an older age, and receive Surgery less often, and Hormone therapy more often than their Non-CALD counterparts. These differences may be a result of cultural barriers, warranting further research into causes and ways to overcome.