Hayen Andrew, Smith David P, Patel Manish I, O'Connell Dianne L
NSW Injury Risk Management Research Centre, University of New South Wales, Australia.
Aust N Z J Public Health. 2008 Oct;32(5):417-20. doi: 10.1111/j.1753-6405.2008.00272.x.
Prostate cancer is the most commonly registered cancer in Australian men, yet there is a lack of information about its management. We described the patterns and trends in the surgical treatment of men with prostate cancer in New South Wales (NSW).
We used probabilistic record linkage to link cancer registry data with hospital admissions. All NSW men diagnosed with prostate cancer between 1993 and 2002 were eligible for the study. Rates of radical prostatectomy, bilateral orchidectomy and transurethral resection of the prostate were calculated. Factors affecting the probability of undergoing these procedures were examined using log-binomial regression.
Between January 1993 and December 2002, 38,712 men were diagnosed with prostate cancer in NSW. Of these, 33,200 (85.8%) cancer registry records were linked to at least one hospital admission record. Men resident in rural areas at diagnosis (RR = 0.69, 95% Cl 0.65-0.73) and men resident in more socio-economically disadvantaged areas (RR =0.83, 95% Cl 0.78-0.89 for most disadvantaged) were significantly less likely to undergo a radical prostatectomy after adjusting for age and disease stage. While orchidectomy rates fell significantly during the period, rates were significantly higher in rural and lower socio-economic areas after adjusting for age and stage.
Further investigation is needed to understand the reasons for the variation in the surgical patterns of care for prostate cancer so that interventions can be implemented to ensure appropriate access for all men.
前列腺癌是澳大利亚男性中登记最常见的癌症，但关于其治疗的信息却很缺乏。我们描述了新南威尔士州（NSW）前列腺癌男性患者手术治疗的模式和趋势。
我们使用概率记录链接将癌症登记数据与医院入院记录相链接。所有在1993年至2002年期间被诊断为前列腺癌的新南威尔士州男性均符合该研究条件。计算了根治性前列腺切除术、双侧睾丸切除术和经尿道前列腺切除术的发生率。使用对数二项回归分析了影响接受这些手术可能性的因素。
在1993年1月至2002年12月期间，新南威尔士州有38712名男性被诊断为前列腺癌。其中，33200份（85.8%）癌症登记记录与至少一份医院入院记录相链接。在调整年龄和疾病分期后，诊断时居住在农村地区的男性（相对风险[RR]=0.69，95%可信区间[Cl]0.65 - 0.73）和居住在社会经济地位较低地区的男性（最贫困地区RR = 0.83，95% Cl 0.78 - 0.89）接受根治性前列腺切除术的可能性显著降低。虽然在此期间睾丸切除术的发生率显著下降，但在调整年龄和分期后，农村和社会经济地位较低地区的发生率仍然显著较高。
需要进一步调查以了解前列腺癌手术治疗模式差异的原因，以便能够实施干预措施，确保所有男性都能获得适当的治疗。
