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Recent trends in the use of radical prostatectomy in England: the epidemiology of diffusion

Oliver, S.E., Donovan, J.L., Peters, T.J., Frankel, S., Hamdy, F.C. and Neal, D.E. (2003) Recent trends in the use of radical prostatectomy in England: the epidemiology of diffusion. BJU International, 91 (4). pp. 331-336. ISSN 1464-4096

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To describe recent trends in the use of radical prostatectomy (RP) in England, as there is currently no consensus on the most effective treatment for localized prostate cancer, although RP is the treatment of choice among urological surgeons for men aged < 70 years.


Routine data were assessed to establish the number of RPs performed in England in 1991–99. Age-standardized operation rates were compared by region and socio-economic group, and the geographical spread of use mapped.


The number of RPs performed annually increased nearly 20-fold between 1991 and 1999. Rates of surgery were greatest in the London National Health Service (NHS) regions and lowest in the Trent region. Outside London, the risk of surgery in a NHS hospital was significantly greater for men living in the least deprived areas; in London this trend was reversed.


Rapid increases in the use of RP showed marked regional variations, most likely related to access to prostate-specific antigen testing and the location of surgeons able to carry out radical surgery. By 1999, a third of procedures were still being undertaken in 'low-volume' hospitals, with implications for the quality of care and outcomes. Crucially, these developments occurred in the absence of robust information about the effectiveness of RP. Recent funding of a randomized trial of treatment options in this area is welcome, but wider questions remain about the timing of the evaluation of surgical technologies.

Item Type: Article
Copyright, Publisher and Additional Information: Open access copy available from the journal web site.
Keywords: prostate cancer, radical prostatectomy, demography, frequency, screening
Institution: The University of Sheffield, The University of York
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield)
The University of York > Health Sciences (York)
Depositing User: Open Access From Journal
Date Deposited: 22 Dec 2008 19:33
Last Modified: 22 Dec 2008 19:33
Published Version: http://dx.doi.org/10.1046/j.1464-410X.2003.04083.x
Status: Published
Publisher: Wiley-Blackwell
Refereed: Yes
Identification Number: 10.1046/j.1464-410X.2003.04083.x
URI: http://eprints.whiterose.ac.uk/id/eprint/5093

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