Dataset Information

Prostate cancer awareness, case-finding, and early diagnosis: Interviews with undiagnosed men in Australia.

ABSTRACT: Previous research in Victoria, Australia, found differences in prostate cancer outcomes in regional and metropolitan areas. This investigation of undiagnosed men in regional areas and a metropolitan area of South Australia sought their perspectives on prostate cancer. Our aim was to learn whether men who had not been diagnosed could shed light on why men outside metropolitan areas tended to have poorer outcomes than metropolitan men. Our goal was to build on evidence contributing to improving outcomes in prostate cancer care. Semi-structured interviews were designed to elicit explanation and meaning. 15 men (10 metropolitan, 5 regional) not diagnosed with prostate cancer were recruited through widely-distributed flyers in medical and community settings. Interviews were recorded and transcribed; transcripts were analysed thematically. Five main themes were identified, four of which were prompted by the questions: Addressing prostate health, Experiences with and expectations of GPs, Differences in care between regional and metropolitan areas, and Achieving early diagnosis. The fifth theme arose spontaneously: Australian masculinity. Men identified as problematic the limited availability of GPs in regional areas, the lack of consistency in approaches to prostate cancer detection, and men's reluctance to seek medical care. Community-level strategies appear to be valued to encourage men to address prostate health. Maintaining and extending a systemic approach to prostate care may improve outcomes for men in Australia.

SUBMITTER: Kannan A

PROVIDER: S-EPMC6405086 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Prostate cancer awareness, case-finding, and early diagnosis: Interviews with undiagnosed men in Australia.

Kannan Ashwini A Kirkman Maggie M Ruseckaite Rasa R Evans Sue M SM

PloS one 20190307 3

Previous research in Victoria, Australia, found differences in prostate cancer outcomes in regional and metropolitan areas. This investigation of undiagnosed men in regional areas and a metropolitan area of South Australia sought their perspectives on prostate cancer. Our aim was to learn whether men who had not been diagnosed could shed light on why men outside metropolitan areas tended to have poorer outcomes than metropolitan men. Our goal was to build on evidence contributing to improving ou ...[more]

PMID: 30845152

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Project description:IntroductionWe determined the contribution of undiagnosed HIV to new infections among gay and bisexual men (GBM) over a 12-year period in Australia where there has been increasing focus on improving testing and HIV treatment coverage.MethodsWe generated annual estimates for each step of the HIV cascade and the number of new HIV infections for GBM in Australia over 2004 to 2015 using relevant national data. Using Bayesian melding we then fitted a quantitative model to the cascade and incidence estimates to infer relative transmission coefficients associated with being undiagnosed, diagnosed and not on ART, on ART with unsuppressed virus, or on ART with suppressed virus.ResultsBetween 2004 and 2015, we estimated the percentage of GBM with HIV in Australia who were unaware of their status to have decreased from 14.5% to 7.5%. During the same period, there was a substantial increase in the number and proportion of GBM living with HIV on treatment and with suppressed virus, with the number of virally suppressed GBM increasing from around 3900 (30.2% of all GBM living with HIV) in 2004 to around 14,000 (73.7% of all GBM living with HIV) in 2015. Despite the increase in viral suppression, the annual number of new infections rose from around 660 to around 760 over this period. Our results have a wide range due to the uncertainty in the cascade estimates and transmission coefficients. Nevertheless, undiagnosed GBM increasingly appear to contribute to new infections. The proportion of new infections attributable to undiagnosed GBM almost doubled from 33% in 2004 to 59% in 2015. Only a small proportion (<7%) originated from GBM with suppressed virus.DiscussionOur study suggests that an increase in HIV treatment coverage in Australia has reduced the overall risk of HIV transmission from people living with HIV. However, the proportion of infections and the rate of transmission from undiagnosed GBM has increased substantially. These findings highlight the importance of HIV testing and intensified prevention for Australian GBM at high risk of HIV.

Dataset Information

Prostate cancer awareness, case-finding, and early diagnosis: Interviews with undiagnosed men in Australia.

Publications

Prostate cancer awareness, case-finding, and early diagnosis: Interviews with undiagnosed men in Australia.

Similar Datasets

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