Introduction
Prostate cancer (PCa) is the most commonly diagnosed cancer among males in the ACT. Incorporating pre‑biopsy magnetic resonance imaging (MRI) into diagnostic pathways has been shown to improve the detection of clinically significant disease and support more targeted biopsy approaches.
Objectives
To assess trends in pre‑biopsy MRI uptake across National Comprehensive Cancer Network (NCCN) risk groups among individuals diagnosed with PCa and enrolled in the ACT Prostate Cancer Outcomes Registry (PCOR‑ACT).
Methods
Demographic and diagnosis data were extracted for PCOR‑ACT participants diagnosed between 2015 and 2023. Pre‑biopsy MRI use was recorded, and participants were assigned to low, intermediate, high/very high, or metastatic risk groups using the NCCN risk group guidelines.
Results
A total of 3,121 participants were distributed across intermediate‑risk (41%), high/very high‑risk (22%), low‑risk (17%), metastatic (13%), and unclassified (6%) disease groups. Median age at diagnosis was 69 years. Overall, 69% underwent pre‑biopsy MRI. Uptake rose from 4% in 2015 to 86% in 2019 and remained consistently high until 2023 (83%). MRI use varied by risk category: 74% of those with intermediate‑risk disease, 73% with high/very high‑risk disease, 68% with low‑risk disease, 55% with metastatic disease, and 46% of unclassified cases received MRI prior to biopsy.
Conclusion
PCOR-ACT data shows increase in the use of pre-biopsy MRI for PCa diagnosis over time. The introduction of Medicare Benefits Schedule funding for multiparametric MRI in July 2018 may have contributed to this shift in diagnostic practice in the ACT.