Prostate cancer is the most common tumour type diagnosed in Victoria, including the Loddon Mallee region (LMR). Clinical practice guidelines have been developed to guide prostate-specific antigen (PSA) testing in Australia across three risk categories: age 50-69 years, age 70+ years, and family history. There is little published information on the presenting characteristics of men diagnosed with prostate cancer in the LMR, with a particular gap existing for characteristics stratified by localised versus advanced disease. This study aimed to describe the characteristics of men presenting with localised and advanced prostate cancer in the LMR.
The Victorian Cancer Registry (VCR) was used to ascertain all patients diagnosed with prostate cancer (International Classification of Diseases and Related Health Problems [ICD]-10 diagnosis code C61) in 2016 across six public and private LMR hospitals. An audit of patient characteristics at presentation was conducted in local hospital systems. Categorical variables were presented as percentages while continuous variables were summarised in terms of the median, with stratification by localised versus advanced disease.
There were 167 prostate cancer patients (localised: 146; advanced: 21) with a median age of 70 years (localised: 70 years; advanced: 75 years). Family history of prostate cancer was evident in 8% of localised cases and no advanced cases. The median PSA scores in those with localised and advanced disease were 7.01 and 37, respectively. At presentation, 40% of localised cases were symptomatic whereas 57% of advanced cases were symptomatic. Thirty-eight percent of patients had 5+ comorbidities, with the corresponding proportions for localised and advanced cases being 37% and 48%, respectively.
The median age of LMR prostate cancer patients was 70 years – the age at which the harms of PSA testing may outweigh the benefits. Compared with localised cases, advanced cases had no family history and higher PSA scores.