PD65-06 THE EFFECT OF PROSTATE CANCER SCREENING GUIDELINE CHANGES ON STAGE MIGRATION OF PROSTATE CANCER IN AUSTRALIA

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII (PD65)1 Sep 2021PD65-06 THE EFFECT OF PROSTATE CANCER SCREENING GUIDELINE CHANGES ON STAGE MIGRATION OF PROSTATE CANCER IN AUSTRALIA Jonathan Kam, Venu Chalasani, Ahmed Goolam, Philip Bergersen, Melanie Edwards, Warwick Delprado, and Max Dias Jonathan KamJonathan Kam More articles by this author , Venu ChalasaniVenu Chalasani More articles by this author , Ahmed GoolamAhmed Goolam More articles by this author , Philip BergersenPhilip Bergersen More articles by this author , Melanie EdwardsMelanie Edwards More articles by this author , Warwick DelpradoWarwick Delprado More articles by this author , and Max DiasMax Dias More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002109.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A decrease in PSA testing and corresponding increase in diagnosis of advanced stage prostate cancer in the US has been linked to the USPSTF guidelines which recommended against prostate cancer screening in 2012. Screening guidelines by the Royal Australasian College of GPs recommended against prostate cancer screening in their 2009, 2012 and 2016 guidelines. There is no published data analysing the trends of prostate cancer testing and stage in Australia over this period. We aimed to determine if screening guidelines have resulted in decreasing PSA testing and a migration to more advanced stage prostate cancer in New South Wales (NSW), the largest state of Australia. METHODS: Patients undergoing radical prostatectomy in NSW between 2007-2018 were identified in our prospectively maintained database. PSA testing and radical prostatectomy rates were obtained from Medicare Statistics database. Population data was obtained from Australian Bureau of Statistics. Joinpoint regression analysis was performed to analyse trends. RESULTS: We identified 17,375 patients who underwent radical prostatectomy in our database, representing 69% of radical prostatectomies in NSW. The rates of non-organ confined disease (pT3) significantly increased from 31% to 55%, annual percentage change (APC) 5.36%, p<0.05. This was seen in both pT3a stage (extra-capsular extension), APC 5.41%, p<0.05 and pT3b stages (seminal vesicle invasion), APC 4.6%, p<0.05. There was a significant decrease in the rate of PSA testing being performed in NSW, APC -4.9%, p<0.05 with crude testing rates decreasing from 8342 to 4910 per 100,000 males. CONCLUSIONS: A significant decrease in PSA testing in NSW has been observed from 2007 to 2018 corresponding to a significant increase in more advanced disease being found at time of radical prostatectomy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1154-e1154 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Kam More articles by this author Venu Chalasani More articles by this author Ahmed Goolam More articles by this author Philip Bergersen More articles by this author Melanie Edwards More articles by this author Warwick Delprado More articles by this author Max Dias More articles by this author Expand All Advertisement Loading ...