Differences in treatment choices for localised prostate cancer diagnosed in private and public health services

To the Editor: Te Marvelde and colleagues1 report that patients with prostate cancer diagnosed in the private health system in Victoria are more likely to undergo radical treatment than patients in the public system. In particular, they report that patients in the private system undergo surgery more often than those in the public system (44% v 28%; odds ratio, 2.28; 95% CI, 2.13–2.44). The authors do not provide an explanation for this, but the inference is that private patients may be more likely to be overtreated in private hospitals. We respectfully point out two more plausible explanations.