Geographical and Temporal Distribution of Prostate Specific Antigen Testing Across Australia

Prostate cancer is the most diagnosed cancer and the second-leading cause of cancer death in Australian men. The Prostate Specific Antigen (PSA) test is the most frequently used test to indicate possible prostate cancer in ‘average-risk’ men without symptoms. However, there remain many unanswered questions and uncertainties about the population wide use of this test in helping reduce the burden of prostate cancer in Australia. One of the large gaps in knowledge is the limited information regarding the prevalence of PSA testing in small areas across the country.

To address this gap, Australian Rotary Health/Rotary Club of Blacktown City, Rotary Districts 9790 and 9830 PhD Scholarship recipient, Ankur Kohar1, aimed to better understand how, where a man resides is related to his use of the PSA test.

The PhD used comprehensive Medicare data provided by the Department of Health and Aged Care, Australia, to analyse PSA testing patterns among men aged 50 to 79 from 2002 to 2018.

The findings2 revealed a peak in PSA testing in Australia during 2008, followed by a gradual decline until 2018. Generally, the PSA testing trends remained consistent across all states and territories. Whereas men living in remote regions of Australia had considerably lower testing rates compared to their urban counterparts.

While examining small geographical areas3, the study identified significant variation in PSA testing rates across Australia, as well as within broader regions including socioeconomic groups, remoteness categories, and states and territories.

The small area geographical pattern varied substantially over time with densely populated areas, such as major cities, witnessed the most significant changes compared to many remote regions.

While lower testing rates in large urban centres were associated with reduced incidence rates, there were mixed results and no clear patterns in smaller, remote regions. The study also notably found a weak correlation between PSA testing and prostate cancer incidence rates across small areas in Australia.  This unexpected result requires further study.

Australian guidelines relating to prostate cancer testing using the PSA test are currently being reviewed. This research project offers valuable information to inform the development and implementation of evidence-based strategies aimed at addressing disparities in prostate cancer outcomes across Australia.


Ankur’s thesis titled ‘Geographical and Temporal Distribution of Prostate Specific Antigen Testing Across Australia’ and was undertaken at the Daffodil Centre, a joint venture between Cancer Council NSW and the University of Sydney.




Media contact:       First published 19th September 2023

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