A contemporary, nationwide analysis of surgery and radiotherapy treatment for prostate cancer

Objective: To characterize national clinical practice trends in the treatment of prostate cancer (PCa) in Australia. Patients and Methods: Population-level data were extracted from existing Medicare Benefits Schedule data for radical prostatectomy (RP) and brachytherapy (2002–2016), as well as external beam radiotherapy (EBRT; 2012–2016). Treatment rates were calculated relative to whole and PCa populations among privately treated patients. Overall age-related and geographical trends were analysed. Results: The use of RP and low-dose-rate (LDR) brachytherapy increased between 2002 and 2009, but subsequently decreased to 124 and 6.9 per 100 000 men, respectively, in 2016. More dramatic decreases were observed for men aged <65 years. From 2012, rates of RP (15% drop) and LDR brachytherapy (58% drop) decreased, while the use of EBRT remained steady, falling by 5% to 42 per 100 000 men in 2016. Overall treatment increased in the age group 75–84 years, with the rate of RP increasing by 108%. Conclusion: National claims data indicate there has been a reduction in PCa treatment since 2009, which is mostly attributable to a reduction in the treatment of younger patients and reduced use of brachytherapy. RP is most commonly used and its use is rising in men aged >65 years.Special Issue: Urological Society of Australia and New Zealand