Introduction

1. No. 005 Comparison of prostate cancer diagnosis and tumour characteristics between urban and rural patients in Western Australia Ooi WL1,2, Brown A3,, Ramakrishnan S2, Cohen R4,5, Hayne D1,2. 1Fremantle Hospital, Urology Department, Fremantle, Western Australia. 2University of Western Australia, School of Surgery, Western Australia. 3Tissugen Pty Ltd, Perth, Western Australia. 4Uropath Pty Ltd, Perth, Western Australia. 5University of Western Australia, School of Pathology and Laboratory Medicine, Western Australia Introduction Prostate cancer services in Australia are generally located in the major centres. As a result, it has been postulated that the 15-30% of West Australian men living in rural locations may be diagnosed later and subsequently have worse disease profiles. Results Aim We quantified thedifferences in the rates of prostate cancer diagnosis and disease profile in urban and rural men undergoing prostate needle biopsy in Western Australia. • Methods • Between 1998 and 2006, 7561 West Australian (WA) men underwent an initial prostate needle biopsy for the diagnosis of prostate cancer. All histopathology was performed at Uropath by a single pathologist. • Based on the Australian Bureau of Statistics remoteness area (RA) classification, these patients were segregated into urban (RA 1 & 2, 6525 men) or rural (RA 3-5, 1036 men) locality based on their corresponding postcode. • Comparison of prostate cancer in urban versus rural populations was made; including analysis of patient demographics and tumour characteristics at time of prostate needle biopsy, as well as rates of progression to radical prostatectomy. • Higher incidence of WA rural men who underwent TRUS prostate biopsy were diagnosed with prostate cancer than urban counterparts, 62.6% vs 58.4%. Both groups had high rates of prostate cancer diagnosis. • Rural patients had higher PSA, 37.5% men with PSA>10ng/ml compared to 31.9% urban men. Median age 65 years for both. • In 649 cases of prostate cancer in rural men, 22.5% of these tumours were Gleason Grade 8-10 compared with 18.7% in the 3811 urban patients. • Lower incidence of rural men diagnosed with prostate cancer underwent radical prostatectomy than urban men(27.1% versus 31.2% respectively). Conclusions West Australian prostate needle biopsy patients from rural locations had a higher rate of cancer diagnosis and higher grade tumours than men from urban centres. This may be a result of suboptimal or delayed access to healthcare. A lower incidence of rural patients underwent radical prostatectomy, possibly reflecting higher grade disease at diagnosis. References Baade PD, Youden DR, Coory MD, Gardiner RA, Chambers SK. Urban-rural differences in prostate cancer outcomes in Australia: what has changed? MJA 2011. 194(6);293-296. Coory MD, Baade PD. Urban-rural differences in prostate cancer mortality, radical prostatectomy and prostate-specific antigen testing in Australia. Med J Aust 2005; 182(3):112-115. Acknowledgements Proudly supported by WAURO Poster presentation sponsor