Aims: To explore treatment patterns among men with prostate cancer (PCa) from culturally- and linguistically-diverse (CALD) backgrounds in Victoria, Australia compared with their non-CALD counterparts.
Methods: We used data from men with an index diagnosis of PCa in Victoria, Australia between 2014 and 2022 in the Victorian Prostate Cancer Outcomes Registry (PCOR-Vic). We defined CALD background as at least one of two indicators: born in a non-English-speaking country and preferring to speak a language other than English. We staged PCa using National Comprehensive Cancer Network risk of disease progression and defined treatment as the first PCa treatment type received after diagnosis. Descriptive statistics were produced.
Results: There were 29,556 men with PCa overall; 23,584 and 5,972 men were from non-CALD and CALD backgrounds, respectively. Median (interquartile range) age at diagnosis was 68 (62-74) years overall, and 67 (61-73) and 70 (64-75) years for men from non-CALD and CALD backgrounds, respectively. At diagnosis, 21%, 46%, 21%, and 11% of men from non-CALD and 20%, 39%, 24%, and 15% of men from CALD backgrounds had low-risk, intermediate-risk, high-risk, and metastatic PCa, respectively. Among those diagnosed with low-risk PCa, the rate of active surveillance and watchful waiting (ASWW) for men from CALD and non-CALD backgrounds increased from 58% and 55%, respectively, in 2014-2016 to 76% and 72%, respectively, in 2020-2022. Among those diagnosed with intermediate and high-risk PCa, CALD men received less surgical management (59% vs 64% and 39% vs 51%) and more radiation therapy (22% vs 19% and 37% vs 30%) than non-CALD men.
Conclusion: Among participants with low-risk PCa, rates of ASWW increased over 2014-2022 but were comparable between CALD and non-CALD men. Among participants with intermediate and high-risk PCa, CALD men had more non-surgical management than non-CALD men. We will continue to investigate potential underlying reasons for this variation.