Rural men in Australia have less chance of surviving prostate cancer than urban men, according to a study in the Medical Journal of Australia.
The study by Associate Professor Peter Baade, from Cancer
Council Queensland, and colleagues, showed an overall increase in rates of
prostate specific antigen (PSA) screening and radical prostatectomy, reductions
in mortality and improvements in survival throughout Australia.
Although incidence rates for prostate cancer in both urban
and rural parts of Australia
are similar, the study found that the gap between prostate cancer survival
rates for rural and urban men had widened, with rural men experiencing lower
A/Prof Baade said that rates of radical prostatectomy and
PSA screening were lower among rural men, suggesting that rural men were more
likely to be diagnosed after experiencing symptoms, when stage of disease can
be more advanced, with less favourable survival prospects.
"This study suggests that PSA screening has not had an
equivalent impact on the diagnosis of prostate cancer in urban and rural areas,
and points to the need for further studies to investigate any differences in
access to treatment options and follow-up care for men living in regional and
rural areas and those living in urban areas," A/Prof Baade said.
"Similar incidence trends, lower rates of PSA screening and
lower rates of radical prostatectomy (a procedure specific to the treatment of
localised prostate cancer) are consistent with the hypothesis that a greater
proportion of men diagnosed with prostate cancer in rural areas of Australia
are diagnosed because they show symptoms, more so than men living in urban
A/Prof Baade said that men living in regional and rural
areas of Australia
have been shown to use diagnostic and treatment services less than their urban
counterparts, which could in part explain why their survival and mortality
outcomes are consistently poorer.
"Further research is required to quantify the associations
between prostate cancer diagnostic and treatment outcomes and key area-level
characteristics and individual-level demographic, clinical and psychosocial
factors, so that health services policy and planning strategies to manage this
disease can be guided by evidence.
"It is urgent that we further explore the reasons for lower
survival among regional and rural men so that we can identify strategies that
will counter this alarming trend," A/ Prof Baade said.
The Medical Journal of Australia
publication of the Australian Medical Association.