Australian ultrasound-guided biopsy trends: a 17-year analysis of national data.
Cancer screening
Population health
Prostate cancer
Public health
Journal
Prostate international
ISSN: 2287-8882
Titre abrégé: Prostate Int
Pays: Korea (South)
ID NLM: 101605566
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
01
05
2019
accepted:
24
09
2019
entrez:
24
1
2020
pubmed:
24
1
2020
medline:
24
1
2020
Statut:
ppublish
Résumé
Prostate cancer diagnosis is primarily performed through ultrasound-guided biopsy. Australia has a Stage 4 aging population and as prostate cancer is a disease of middle aged to elderly patients, it would be expected that there would be an increase in the diagnosis of prostate cancer. However, several key events have occurred in the last 10 years including the introduction of multiparametric magnetic resonance imaging (mpMRI) of the prostate and publication of major prostate cancer screening trials and guidelines. We aimed to characterize the trends in prostate biopsy in Australia in the context of these changes. Population and prostate biopsy data were obtained from the Australian Government Bureau of Statistics Census data and the Australian Department of Health Medicare Benefits Schedule between 2000 and 2017. A meta narrative review of publications, guidelines, and policy announcements regarding prostate cancer screening and diagnosis in Australia was performed. Prostate biopsy trends were analyzed from 2000 to 2017 by age-group and year. The 2016 Census data showed the male population of Australia was 11,546,638. Between 2000 and 2017, a total of 373,158 ultrasound-guided biopsies were performed in Australia. A general decline in the total number of prostate biopsies performed was observed from 2009 onwards. There was a transition of the highest prostate biopsy age-group from 55-64 to 65-74 years with the transition occurring in 2012. Biopsy numbers in the age-group 75-84 years also slowly increased from 2000 to 2009 and declined for a short period of time till 2013 and is on the rise again.The decrease in 2010 coincides with the increased uptake of mpMRI in Australia as a new tool in the screening for prostate cancer. Furthermore, this decrease also coincides with the release of the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) prostate cancer screening trials in 2009 and the policy statements developed as a result of these by Royal Australian College of General Practitioners and Urological Society of Australia and New Zealand. Interesting trends have been identified through this population study. With an aging population, it would be expected that the number of prostate biopsies would be increasing. It is likely that the introduction of mpMRI in Australia and the release of prostate cancer screening guidelines have decreased the number of patients being screened for prostate cancer. Furthermore, increasing use of active surveillance may be responsible for the increase in the prostate biopsies occurring in the older age-groups.
Sections du résumé
BACKGROUND
BACKGROUND
Prostate cancer diagnosis is primarily performed through ultrasound-guided biopsy. Australia has a Stage 4 aging population and as prostate cancer is a disease of middle aged to elderly patients, it would be expected that there would be an increase in the diagnosis of prostate cancer. However, several key events have occurred in the last 10 years including the introduction of multiparametric magnetic resonance imaging (mpMRI) of the prostate and publication of major prostate cancer screening trials and guidelines. We aimed to characterize the trends in prostate biopsy in Australia in the context of these changes.
METHODS
METHODS
Population and prostate biopsy data were obtained from the Australian Government Bureau of Statistics Census data and the Australian Department of Health Medicare Benefits Schedule between 2000 and 2017. A meta narrative review of publications, guidelines, and policy announcements regarding prostate cancer screening and diagnosis in Australia was performed. Prostate biopsy trends were analyzed from 2000 to 2017 by age-group and year.
RESULTS
RESULTS
The 2016 Census data showed the male population of Australia was 11,546,638. Between 2000 and 2017, a total of 373,158 ultrasound-guided biopsies were performed in Australia. A general decline in the total number of prostate biopsies performed was observed from 2009 onwards. There was a transition of the highest prostate biopsy age-group from 55-64 to 65-74 years with the transition occurring in 2012. Biopsy numbers in the age-group 75-84 years also slowly increased from 2000 to 2009 and declined for a short period of time till 2013 and is on the rise again.The decrease in 2010 coincides with the increased uptake of mpMRI in Australia as a new tool in the screening for prostate cancer. Furthermore, this decrease also coincides with the release of the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) prostate cancer screening trials in 2009 and the policy statements developed as a result of these by Royal Australian College of General Practitioners and Urological Society of Australia and New Zealand.
CONCLUSION
CONCLUSIONS
Interesting trends have been identified through this population study. With an aging population, it would be expected that the number of prostate biopsies would be increasing. It is likely that the introduction of mpMRI in Australia and the release of prostate cancer screening guidelines have decreased the number of patients being screened for prostate cancer. Furthermore, increasing use of active surveillance may be responsible for the increase in the prostate biopsies occurring in the older age-groups.
Identifiants
pubmed: 31970140
doi: 10.1016/j.prnil.2019.09.002
pii: S2287-8882(19)30028-5
pmc: PMC6962731
doi:
Types de publication
Journal Article
Langues
eng
Pagination
150-155Informations de copyright
© 2019 Asian Pacific Prostate Society, Published by Elsevier Korea LLC.
Déclaration de conflit d'intérêts
The authors have no conflict of interest.
Références
Appl Health Econ Health Policy. 2017 Feb;15(1):95-111
pubmed: 27757918
N Engl J Med. 2009 Mar 26;360(13):1310-9
pubmed: 19297565
BJU Int. 2019 Jul;124(1):9-26
pubmed: 31206997
Lancet Oncol. 2014 Oct;15(11):e484-92
pubmed: 25281467
N Engl J Med. 2009 Mar 26;360(13):1320-8
pubmed: 19297566
Eur Radiol. 2012 Apr;22(4):746-57
pubmed: 22322308
Adv Nutr. 2016 Mar 15;7(2):418-9
pubmed: 26980827
BMC Med. 2013 Jan 29;11:20
pubmed: 23360661
Eur Urol. 2014 Jul;66(1):22-9
pubmed: 24666839
Ann Intern Med. 2012 Jul 17;157(2):120-34
pubmed: 22801674
Eur Urol. 2016 Jan;69(1):16-40
pubmed: 26427566
J Urol. 2014 Jul;192(1):67-74
pubmed: 24518762
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593