Background
Methods
Study population
Explanatory variables
Variable | NCCN |
---|---|
Low | Clinical T1–T2a stage AND GS 2–6 AND PSA level <10 ng/mL |
Intermediate | Clinical T2b–T2c stage OR GS = 7 OR PSA level 10–20 ng/mL |
High | Clinical T3a stage OR GS 8–10 OR PSA level >20 ng/mL |
Very high (locally advanced) | Clinical T3b–T4 |
Any T, N1 | |
Metastatic | Any T, Any N, M1 |
Statistical analysis
Results
Demographic and diagnostic characteristics
Patients, N | % | |
---|---|---|
Included into the study | 13,598 | 100 |
State | ||
SA | 3,526 | 25.9 |
Victoria | 10,072 | 74.1 |
Age groups | ||
< 55 | 2,059 | 15.1 |
56–65 | 4,851 | 35.7 |
65–75 | 4,711 | 34.6 |
> 75 | 1,977 | 14.5 |
Age (mean, SD) | 65.4 (9.6) | |
Residential area | ||
Metropolitan | 9,586 | 70.5 |
Regional/Rural | 3,250 | 23.9 |
Unknown | 762 | 5.6 |
SEIFA | ||
Lowest 10 % (0–20 %) | 1,751 | 12.9 |
Lowest 21–40 % | 2,245 | 16.5 |
Lowest 41–60 % | 2,075 | 15.3 |
Highest 61–80 % | 2,840 | 20.9 |
Highest 81–100 % | 4,334 | 31.9 |
Unknown | 353 | 2.6 |
Method of diagnosis | ||
TRUS | 11,518 | 84.7 |
TURP | 1,239 | 9.1 |
Other | 841 | 6.2 |
PSA (ng/mL) | ||
< 4 | 2,691 | 19.8 |
4.01–10 | 5,985 | 44.0 |
10.01–20 | 1,820 | 13.4 |
> 20.01 | 1,284 | 9.4 |
Unknown | 1,818 | 13.4 |
Grade Group | ||
Grade Group 1 (Gleason score ≤ 6) | 4,769 | 35.1 |
Grade Group 2 (Gleason score 3 + 4) | 3,771 | 27.7 |
Grade Group 3 (Gleason score 4 + 3) | 1,832 | 13.5 |
Grade Group 4 (Gleason score 8) | 1,264 | 9.3 |
Grade Group 5 (Gleason score >8) | 1,193 | 8.8 |
Unknown | 769 | 5.7 |
NCCN Risk | ||
Low | 3,352 | 24.7 |
Intermediate | 5,727 | 42.1 |
High | 2,943 | 21.6 |
Very high/Metastatic | 546 | 4.0 |
Unknown | 1,030 | 7.6 |
Treatment characteristics
NCCN Risk | Low* | Intermediate* | High* | V.high/Metastasis* | Total | |||||
---|---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | N | % | |
RP | 1,164 | 34.7 | 3,097 | 54.1 | 988 | 33.6 | 57 | 10.4 | 5,306 | 42.2 |
RT | 418 | 12.5 | 1,263 | 22.1 | 958 | 32.6 | 153 | 28.0 | 2,792 | 22.2 |
ADT | 18 | 0.5 | 114 | 2.0 | 469 | 15.9 | 219 | 40.1 | 820 | 6.5 |
No active treatment | 1,483 | 44.2 | 723 | 12.6 | 225 | 7.6 | 18 | 3.3 | 2,449 | 19.5 |
Other | 154 | 4.6 | 307 | 5.4 | 194 | 6.6 | 45 | 8.2 | 700 | 5.6 |
Unknown | 115 | 3.4 | 223 | 3.9 | 109 | 3.7 | 54 | 9.9 | 501 | 4.0 |
Total | 3,352 | 100 | 5,727 | 100 | 2,943 | 100 | 546 | 100 | 12,568 | 100 |
Median [IQR] days to treatment | 119 [63–222.5] | 80 [48–137] | 49 [29–96] | 31 [12–71.5] | 75 [41–142] |
Temporal trends in demographic, diagnosis and treatment characteristics
Regression analysis of factors determining surveillance of PCa
Univariate model | Multivariate model | |||
---|---|---|---|---|
Factors | Odds Ratio | CI at 95 % | Odds Ratio | CI at 95 % |
Year of Diagnosis | ||||
2009 (Ref) | 1 | 1 | ||
2010
| 1.16 | 0.98–1.37 |
1.26
|
1.02–1.55
|
2011
|
1.32
|
1.13–1.53
|
1.43
|
1.18–1.73
|
2012
|
1.37
|
1.18–1.59
|
1.82
|
1.51–2.21
|
2013
|
1.43
|
1.23–1.66
|
2.63
|
2.16–3.22
|
Age Group | ||||
< 55 (Ref) | 1 | 1 | ||
56–65
|
1.29
|
1.11–1.49
|
1.48
|
1.24–1.76
|
65–75
|
1.38
|
1.19–1.59
|
2.03
|
1.69–2.44
|
> 75
|
2.01
|
1.71–2.36
|
5.83
|
4.56–7.45
|
State | ||||
SA (Ref) | 1 | 1 | ||
Victoria
|
1.74
|
1.54–1.95
|
1.49
|
1.16–1.65
|
Residential area | ||||
Metropolitan (Ref) | 1 | 1 | ||
Regional/Rural | 1.07 | 0.97–1.18 | 1.02 | 0.88–1.19 |
SEIFA | ||||
Lowest 0–20 % (Ref) | 1 | 1 | ||
Lowest 21–40 % | 0.96 | 0.81–1.14 | 0.85 | 0.69–1.07 |
Lowest 41–60 % | 0.97 | 0.82–1.15 | 0.97 | 0.77–1.22 |
Highest 61–80 % | 1.04 | 0.88–1.22 | 0.98 | 0.79–1.21 |
Highest 81–100 %
|
1.28
|
1.11–1.48
|
1.32
|
1.07–1.63
|
Method of diagnosis | ||||
TRUS (Ref) | 1 | 1 | ||
TURP
|
5.23
|
4.61–5.93
|
6.19
|
5.08–7.54
|
Other | 0.80 | 0.65–0.98 | 1.27 | 0.93–1.74 |
PSA (ng/mL) | ||||
< 4 (Ref) | 1 | 1 | ||
4.01–10
|
0.81
|
0.73–0.91
| 1.15 | 0.89–1.34 |
10.01–20
|
0.62
|
0.53–0.72
|
1.65
|
0.92–2.07
|
> 20.01
|
0.36
|
0.29–0.44
| 1.31 | 0.89–1.91 |
Grade Group | ||||
Grade Group 1 (Gleason score ≤ 6) [Ref] | 1 | 1 | ||
Grade Group 2 (Gleason score 3 + 4) |
0.19
|
0.17–0.22
|
0.33
|
0.27–0.42
|
Grade Group 3 (Gleason score 4 + 3) |
0.09
|
0.07–0.12
|
0.13
|
0.09–0.17
|
Grade Group 4 (Gleason score 8) |
0.06
|
0.05–0.08
|
0.08
|
0.05–0.13
|
Grade Group 5 (Gleason score >8) |
0.07
|
0.06–0.09
|
0.07
|
0.05–0.12
|
NCCN Risk | ||||
Low (Ref) | 1 | 1 | ||
Intermediate
|
0.17
|
0.15–0.19
|
0.35
|
0.28–0.44
|
High
|
0.09
|
0.08–0.12
|
0.23
|
0.15–0.34
|
V.high/Metastatic
|
0.02
|
0.02–0.06
|
0.06
|
0.03–0.11
|