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

Luc te Marvelde, Roger L Milne and Ian E Haines
Med J Aust 2021; 214 (10): . || doi: 10.5694/mja2.51073
Published online: 7 June 2021

In reply: We thank Mark and colleagues and Woo and Murphy for their comments. We agree that the lack of information on prostate‐specific antigen (PSA) and T stage of the tumours is a weakness of our study, which was acknowledged in the article. The International Society of Urological Pathology (ISUP) grade of the tumour is a reliable predictor of prognosis by itself and unarguably one of the key determinants for making treatment recommendations. The fact remains that there were stark differences between the private and public health systems in the type of treatment men with similar grade tumours chose, even when corrected for a number of possible variables. This choice depends largely on how a patient’s prognosis is assessed by his treating specialist using any one of many available and differing prognostic tools.

  • Luc te Marvelde1
  • Roger L Milne2,3
  • Ian E Haines4

  • 1 Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC
  • 2 Cancer Council Victoria, Melbourne, VIC
  • 3 Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC
  • 4 Cabrini Health, Melbourne, VIC


Competing interests:

No relevant disclosures.

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