Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Bridging the Gap: Understanding the Sociodemographic Disparities in Access to Early Prostate Cancer Detection in Australia (#278)

Rani R Chand 1 , Karen KC Chiam 1 , Visalini VNS Nair-Shalliker 1 , Jeff JD Dunn 2 , Peter PH Heathcote 2 , David DS Smith 1
  1. Daffodil Centre, Sydney, NSW, Australia
  2. Prostate Cancer Foundation of Australia, NSW, Australia

Aims:

In Australia, while prostate cancer (PC) diagnosis and treatment are influenced by demographic, cultural, and geographic factors, the impact of sociodemographic factors on access to early detection is not well explored. This study aims to describe how inequalities affect access to PSA testing across various priority populations in Australia, highlighting gaps and barriers that may impact understanding and access to early detection.

Methods:

A narrative review was conducted to identify equity issues in accessing PSA testing among Australian priority populations, including Aboriginal and Torres Strait Islander people, individuals with African ancestry, Culturally and Linguistically Diverse (CALD) populations, and rural and regional/remote areas. Relevant sources, including peer-reviewed publications, websites, and reports, were retrieved from January 2010 to July 2024 using databases and search engines such as PubMed and Google. Outcome measures included incidence, mortality, PSA testing, patterns of care, and attitudes toward testing.

Results:

Over 100 sources were reviewed. In Australia, individuals in major cities, aged 50-59, with higher education and private health insurance are more likely to participate in PC screening via PSA testing1,2. Data revealed that PC incidence and mortality rates were higher in regional and rural areas compared to major cities3. Between 2017–2021, the age-standardised PC mortality rate in NSW was higher in remote areas (34.9 per 100,000) compared to major cities (18.7 per 100,000). These disparities may stem from variations in patient management practices, healthcare access, and socioeconomic factors4.

Equity issues affecting healthcare access were identified, including inadequate community awareness, low health literacy, and travel-related barriers. There is a notable lack of comprehensive evidence on PC outcomes, early detection, or healthcare uses for individuals with African ancestry and CALD populations.

Conclusions:

Our review highlights the need for strategies that ensure equitable access to culturally appropriate information and services to improve PC outcomes across Australian priority populations.

  1. 1. Kohar A, Cramb SM, Pickles K, et al. Changes in prostate specific antigen (PSA) "screening" patterns by geographic region and socio-economic status in Australia: Analysis of medicare data in 50-69 year old men. Cancer epidemiology. 2023;83: 102338. https://doi.org/10.1016/j.canep.2023.102338
  2. 2. Nair-Shalliker V, Bang A, Weber M, et al. Factors associated with prostate specific antigen testing in Australians: Analysis of the New South Wales 45 and Up Study. Scientific reports. 2018;8(1), 4261. https://doi.org/10.1038/s41598-018-22589-y
  3. 3. Yu XQ, Luo Q, Smith DP, et al. Geographic variation in prostate cancer survival in New South Wales. Med J Aust. 2014;200(10):586-590. https://doi.org/10.5694/mja13.11134
  4. 4. Cancer Institute NSW. Detailed cancer incidence, mortality and survival statistics. Retrieved August 7, 2024, from https://www.cancer.nsw.gov.au/research-and-data/cancer-data-and-statistics/data-available-now/cancer-statistics-nsw/cancer-incidence-mortality-survival/detailed-cancer-incidence-mortality