Decade-long trends in prostate cancer biopsy and treatment within a population-based registry

What is it about?

The study analyzed changes in prostate cancer (PCa) grade diagnosis, biopsy, and treatment approach from 2011 to 2020 in a population-level registry in Australia. Over the decade, there was a substantial decrease in the proportion of low-grade PCa diagnosed, particularly in younger men. The percentage of interventional management performed in low-grade disease has fallen to very low levels. The decline in biopsy Grade Group 1 (GG1) disease was observed in both transrectal ultrasonography (TRUS) biopsy and transperineal biopsy (TPB) patients, although the increase in GG2 was more marked in TPB. The study found that there has been a substantial reduction in the proportion of low-grade prostate cancer being diagnosed over the last decade at the population level. Several factors could explain this result, including changes in PSA testing recommendations and the increasing availability of mpMRI within the jurisdiction. The study suggests that the reduction in GG1 disease is likely to be due to changes in PSA testing and the increasing availability of newer techniques such as mpMRI and TPB, which have improved prostate cancer detection and accuracy.

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Why is it important?

This research is important because it provides population-level data on changes in diagnosis, biopsy, and treatment approaches for prostate cancer over a decade in a clinical quality cancer registry. This information can help inform future allocation of treatment methods and contribute to the ongoing improvement of diagnostic and treatment guidelines. Key Takeaways: 1. From 2011 to 2020, there was a substantial decrease in the proportion of Grade Group 1 (GG 1) prostate cancer diagnosed, particularly in younger men. 2. The percentage of interventional management performed in GG 1 disease has fallen to very low levels. 3. The decline in GG 1 disease was observed in both transrectal ultrasonography (TRUS) biopsy and transperineal biopsy (TPB) patients, although the increase in GG 2 was more marked in TPB. 4. The increase in GG 5 disease was particularly noticeable in TPB from 2017 onward compared to 2013-2016.