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| Professor Mark Frydenberg |
The quality of prostate cancer care is improving according
to new Monash University research published yesterday in The Medical Journal of
Australia.
The five-year collaborative study between Monash University
and 33 health institutions across Victoria, capturing 75 per cent of men
diagnosed with prostate cancer in Victoria, found that processes of care were
markedly improved, suggesting that the feedback from quality indicators was
clinically valuable.
“We know that quality indicators are valuable tools to
enable benchmarking performance of hospitals and clinicians. Where there is
confidence in the quality of the data, providing these indicators back to
health services and doctors has been shown to drive quality improvement.
“It’s terrific to see through quality indicators that the
outcomes for men with prostate cancer are good and becoming even better,” said
Professor Sue Evans, Head of the Clinical Registry Unit at Monash’s School of
Public Health and Preventive Medicine, which houses the Movember-funded Australian
Prostate Cancer Clinical Registry.
Prostate cancer continues to be the most commonly diagnosed
cancer among Australian males. More than 18,000 Australian men are diagnosed
with prostate cancer each year.
For men living with prostate cancer, there are a variety of
treatment options now available which vary according to the stage of disease at
diagnosis, but can include: active surveillance; hormone therapy; surgery;
radiotherapy; or a combination of therapies.
“The Prostate Cancer Research International Active
Surveillance (PRIAS) protocol guideline suggests men with low risk disease
should be under active surveillance rather than receive immediate invasive
treatment. Our Victorian research found the proportion of men with low risk
disease who underwent active treatment declined over the five year period,”
said Associate Professor Evans.
“As a practicing
urologist it is satisfying to see such a high percentage of urologists
committed measuring outcomes and improving quality of care,” said Professor
Mark Frydenberg from the Department of Surgery at Monash University and Monash
Health.
Professor
Frydenberg said it can highlight areas of improvement such as clinical T stage
documentation in histories, ensuring men with low risk cancer are ideally managed
with surveillance, and ensuring that specialists can track potency and
continence outcomes and measure for improvement with time.
“It is also
gratifying to see a reduction in the pT2 margin rates suggesting better patient
selection and better surgery to cure the disease.”
The mean percentage of PRIAS non-compliance had increased
non-significantly from 45 per cent in 2009 to 55 per cent in 2010 and 50 per
cent in 2011, but a downward trend was evident in 2012 (40 per cent) and 2013
(34 per cent); this achieved statistical significance in 2013 (P = 0.024).
The study also found that men diagnosed with high risk or
locally advanced prostate cancer received treatment at a quicker rate across
the duration of the study.
“This has the real
potential to substantially improve quality of care, and also identify gaps in
care such as in regional or rural areas that could be explored and inequities
addressed,” said Professor Frydenberg.
“I would suggest
that patients are also encouraged to ask if their surgeon participates in the
registry as a sign of the urologists’ commitment to quality care of men with
prostate cancer in Victoria.”
