Disease mapping: Geographic differences in population rates of interventional treatment for prostate cancer in Australia.

Abstract

BackgroundTreatment decisions for men diagnosed with prostate cancer depend on a range of clinical and patient characteristics such as disease stage, age, general health, risk of side effects and access. Associations between treatment patterns and area-level factors such as remoteness and socioeconomic disadvantage have been observed in many countries.ObjectiveTo model spatial differences in interventional treatment rates for prostate cancer at high spatial resolution to inform policy and decision-making.MethodsHospital separations data for interventional treatments for prostate cancer (radical prostatectomy, low dose rate and high dose rate brachytherapy) for men aged 40 years and over were modelled using spatial models, generalised linear mixed models, maximised excess events tests and k-means statistical clustering.ResultsGeographic differences in population rates of interventional treatments were found (pConclusionsThe geographic differences in treatment rates may partly reflect differences in patients' physical and financial access to treatments. Treatment rates also depend on diagnosis rates and thus reflect variation in investigation rates for prostate cancer and presentation of disease. Spatial variation in interventional treatments may aid identification of areas of under-treatment or over-treatment.