Aim: To compare prostate cancer treatment for Victorian men diagnosed with prostate cancer in public versus private Victorian health care facilities.
Design: Retrospective study utilising statewide Victorian Cancer Registry data linked to various administrative datasets.
Setting/participants: Victorian men diagnosed with prostate cancer between 2011 and 2017 eligible for inclusion (n=29,813).
Main outcome measures: Utilization of prostatectomy (±radiation therapy) and radiation therapy alone within the first year following cancer diagnosis.
Results: Compared with men diagnosed in public health services, those diagnosed in private health services were younger, had fewer comorbidities, lived in areas of higher socio-economic position and were more likely to live in major cities. They were also more likely to be diagnosed with lower risk prostate cancer. After adjusting age and the presence of comorbidities, men diagnosed in private hospitals were more likely to receive a radical prostatectomy than those diagnosed in public hospitals (44% vs 28%; odds ratio=2.29; 95%CI=2.15-2.45) and less likely to receive radiation therapy alone (11% vs. 20%; odds ratio=0.50; 95%CI=0.46-0.54). These differences were consistent across each of the Gleason score-defined subsets. Although patterns have changed over time, stark differences remain.
Conclusion: Prostate cancer treatment patterns differ substantially between men diagnosed in public health services compared with private health services in Victoria.