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Patterns of prostate‐specific antigen testing by remoteness of residence and socio‐economic status: An Australian population‐based study
- Calopedos, Ross J. S., Bang, Albert, Baade, Peter, Yu, Xue Q., Ruthven, Stephen, Patel, Manish I., Smith, David P.
- TheAustralian journal of rural health 2019 v.27 no.3 pp. 216-223
- Australians, antigen detection, cities, descriptive studies, humans, men, prostate-specific antigen, prostatic neoplasms, regression analysis, rural health, screening, socioeconomic status, Australia
- OBJECTIVE: Describes the variation in prostate cancer testing by the remoteness of residence and socio‐economic status groups in Australia. DESIGN: A national population‐based descriptive study using Medicare data extracted by the Department of Health (formerly the Department of Health and Ageing). SETTING: Australia. PARTICIPANTS: All men, with a Medicare‐reimbursed prostate‐specific antigen test conducted in Australia between 2002 and 2017, were included. We focused on “screening and case finding” tests (Medicare Benefits Schedule item number 66655) from 1 April 2005 to 31 December 2009, to describe testing differences in subgroups. Groups were categorised into State and Territory, socio‐economic status and region of residence. A negative binomial regression model was fitted to measure the incidence rate ratios of those who had a screening prostate‐specific antigen test by group. MAIN OUTCOME MEASURES: Age‐standardised testing rates and incidence rate ratios. RESULTS: Between 2002 and 2017, 11 588 775 screening prostate‐specific antigen tests were reimbursed by the Department of Human Services. During 2005‐2009, 52% of all Australian men, aged 40 years and over, had a screening test. The incidence rate ratios differed by State and Territory. Men aged 40 years and over, living in very remote areas, were 43% less likely to have had a screening test than residents of major cities. Prostate‐specific antigen testing rates fell in all age groups between 2007 and 2009 and 2017. CONCLUSIONS: The prostate‐specific antigen testing behaviour differs between community groups in Australia. Men were less likely to have had a screening prostate‐specific antigen test the farther they lived from the major cities. This highlights the need for a more targeted approach to achieve an equitable and evidence‐based prostate cancer care across all sectors of the community.