This study aimed to observe trends in PSA tests, biopsies, and radical prostatectomies for prostate cancer in Australia during the first 24 months of the COVID-19 pandemic, comparing these to the previous decade.
Data from the Medicare Benefits Schedule was analyzed for PSA tests, biopsies, and radical prostatectomies from January 2010 to June 2021. Trends for the pandemic years (2020-2021) were compared with five previous two-year periods. The study also considered COVID-19 case data per state.
Key findings include:
- A significant drop in PSA tests across all states in April 2020 coinciding with the first wave of COVID-19 and lockdown measures. Another decline was observed during subsequent COVID-19 waves.
- Biopsy procedures saw a decline starting in March/April 2020, remaining below trend for the rest of the year but rebounding in 2021, especially in Western Australia.
- Radical prostatectomies showed a similar pattern with a two- to three-month delay following the drop in biopsies.
From January 2020 to December 2021, Australia saw 14% fewer PSA tests, 12% fewer biopsies, and 16% fewer prostatectomies compared to the long-term trend. The declines were more pronounced in states with higher COVID-19 cases (Victoria, New South Wales) and associated restrictions, while Western Australia experienced a rise in biopsies and prostatectomies and a smaller decline in PSA tests.
The reduction in PSA testing is likely due to reduced primary care visits and engagement in non-critical health measures. Decreased biopsy and prostatectomy rates are likely due to reduced elective surgeries and the downstream effect of fewer PSA tests.
By June 2021, the numbers largely returned to the long-term trend, though subsequent COVID-19 waves caused similar reductions. The impact on stage at presentation and oncological outcomes remains uncertain and should be monitored, especially in disadvantaged communities.
The study suggests that future high vaccination levels may prevent strict COVID-19 measures, potentially limiting impacts on prostate cancer management.
