Premium
Metastatic prostate cancer incidence in Australia after amendment to prostate‐specific antigen screening guidelines
Author(s) -
Smith Sabin,
Wolanski Philippe
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14275
Subject(s) - medicine , prostate cancer , incidence (geometry) , guideline , cancer , prostate , prostate specific antigen , prostate biopsy , disease , oncology , gynecology , pathology , physics , optics
Background To compare the incidence of newly diagnosed metastatic prostate cancer at an Australian facility pre‐ and post‐publication of the United States Preventive Services Task Force ( USPSTF ) guidelines and subsequent amendment of the Royal Australian College of General Practitioners Preventive Activities in General Practice guidelines. Methods A retrospective analysis was undertaken by patients with newly diagnosed prostate cancer following transrectal ultrasound‐guided biopsy between 2009 and 2014. Patients were divided into two even groups based on whether they had undergone their transrectal ultrasound biopsy pre‐ (2009–2011) or post‐ (2013–2014) publication of USPSTF guidelines. Metastatic disease was determined by computed tomography chest, abdomen, pelvis as well as nuclear medicine bone scan. A comparison in the incidence of newly diagnosed metastatic prostate cancer was made. Results A total of 130 patients were allocated into each group. In the pre‐ USPSTF group, 23 out of 130 patients had newly diagnosed metastatic prostatic cancer (17.7%). In the post‐ USPSTF group, 41 out of 130 (31.5%) had newly diagnosed metastatic prostate cancer ( P < 0.05). The mean and median prostate‐specific antigen was 15.9 and 9.4 (pre‐guideline group) and 33.0 and 9.8 (post‐guideline group), respectively ( P = 0.02). The post‐guidelines group had a higher incidence of low‐grade disease (Gleason <7), a decreased incidence of intermediate grade disease (Gleason 7) and a relatively unchanged incidence in high‐risk disease (Gleason >7). Conclusion The incidence of newly diagnosed metastatic prostate cancer nearly doubled in patients referred to our Urology Department post‐release of the USPSTF guidelines.