Rural & regional disparities - prostate cancer project
Project Details
Survival rates for regional men in Australia with prostate cancer are below their metropolitan counterparts. In Victoria, outcomes are worse for men diagnosed with Prostate cancer in regional areas, compared to their Metropolitan, state-wide and national counterparts. Treatment outcomes were examined to understand this disparity.
Patron ID: PAT1032_5
Project Lead: Dr Meena Rafiq
Research Outcomes
Across Victoria around one-third of residents live in rural areas. There are known inequalities in prostate cancer outcomes depending on where patients live when they are diagnosed, with poorer outcomes in rural areas compared with metropolitan areas. Some of these differences may be due to how early prostate cancer is diagnosed in different areas, particularly in the use of Prostate Specific Antigen (PSA) blood tests, which are commonly used in primary care to investigate patients with possible prostate cancer. This study led by the VCCC Data Connect team used Patron data linked to the Victorian Cancer Registry to explore variations in PSA test use and how abnormal results are followed up in rural and metropolitan areas of Victoria. We also compared demographic and tumour characteristics between patients diagnosed with prostate cancer in rural and metropolitan areas and the occurrence and timing of abnormal PSA results before diagnosis.
We found rural Victorians with prostate cancer have higher PSA levels and Gleason scores (advanced grade) at diagnosis and experience longer diagnostic intervals (the time between first abnormal PSA test and cancer diagnosis) compared to metropolitan patients. In both rural and metropolitan areas, abnormal PSA tests are frequently detected several months before prostate cancer diagnosis and there is low guideline concordance regarding repeat tests within three months. Targeted interventions to identify and action abnormal PSA blood tests results in primary care could expedite prostate cancer diagnosis and reduce rural-metropolitan disparities in prostate cancer outcomes.
This paper is currently under review at BMC Cancer.
Research Publications
- Rural variations in primary care prostate cancer diagnosis and survival: a cohort study using linked Australian primary care electronic medical record data -https://bmccancer.biomedcentral.com/articles/10.1186/s12885-025-15044-5
- Wawryk, O., Collins, I.M., Lee, A. et al. Rural variations in primary care prostate cancer diagnosis and survival: a cohort study using linked Australian primary care electronic medical record data. BMC Cancer 25, 1809 (2025). https://doi.org/10.1186/s12885-025-15044-5