Individuals from culturally and linguistically diverse backgrounds have more advanced prostate cancer at diagnosis in Victoria, Australia

Introduction: The Australian Cancer Plan prioritises individuals from culturally and linguistically diverse (CALD) backgrounds as a focus of interventions aimed at improving cancer care experiences and outcomes. We aimed to investigate differences in the National Comprehensive Cancer Network (NCCN) risk category classification at prostate cancer (PCa) diagnosis between CALD and non-CALD populations. Methods: We included Victorian Prostate Cancer Outcomes Registry registrants with a PCa diagnosis (February 2009-August 2022) and country-of-birth data. CALD status was defined as birth in a mainly non-English-speaking country (CALD) versus Australia or a mainly English-speaking country (MESC). CALD individuals were further sub-grouped by preferred spoken language: English-speaking and non-English-speaking. We estimated the effect of CALD status on NCCN risk categories using partial proportional ordinal logistic regression. Results: There were 25,951 individuals: 18,392 (71 %) Australian-born, 5046 (19 %) CALD and 2513 (10 %) MESC-born. Of 4872 CALD individuals with preferred-language data, 498 (10 %) preferred speaking a language other than English. Compared to Australian-born individuals, non-English-speaking CALD individuals presented with less low-risk (15 % vs 22 %) but more high-risk (32 % vs 21 %) and metastatic (18 % vs 8 %) disease. CALD individuals had significantly more advanced (regional or metastatic) disease than Australian-born individuals (adjusted odds ratio [aOR]=1.17, 95 % confidence interval [CI]=1.06–1.29). Non-English-speaking CALD individuals had significantly more advanced PCa (aOR=1.54, 95 % CI=1.23–1.94). Conclusions: Individuals from CALD backgrounds had greater odds of presenting with high-risk or advanced PCa. Improving early detection of PCa for CALD individuals requires investigation of underlying factors to plan effective interventions.