{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:49:30Z","timestamp":1777009770807,"version":"3.51.4"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aims to investigate survival outcomes among individuals with high\u2010risk, regional, and metastatic prostate cancer (PCa) by culturally and linguistically diverse (CALD) status in Victoria, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individuals with high\u2010risk, regional, and metastatic PCa (February 2009\u2013February 2024) registered in the Victorian Prostate Cancer Outcomes Registry (PCOR\u2010Vic), with last follow\u2010up on 31 July 2024. CALD status was derived from study participants' country of birth and subgrouped into: mainly non\u2010English\u2010speaking countries (NESC) (CALD backgrounds), mainly English\u2010speaking countries (MESC) outside Australia (MESC\u2010born), and Australia\u00a0(reference group). The primary outcomes, all\u2010cause mortality (ACM) and PCa\u2010specific mortality (PCSM), were determined through linkage of PCOR\u2010Vic to Victorian Cancer Registry death data. ACM and PCa\u2010specific survival were estimated using Kaplan\u2013Meier curves and the cumulative incidence function. Weibull parametric survival and Fine\u2010Gray competing\u2010risks regression models, adjusted for sociodemographic and clinical variables, assessed the association of CALD status with ACM and PCSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 10,024 eligible participants, 32% died. The median survival time (death) was 116\u2009months, and median follow\u2010up time (censoring) was 66\u2009months. CALD individuals had lower 5\u2010year overall survival compared to Australian\u2010born individuals (66% vs. 71%). While unadjusted models suggested higher ACM among CALD individuals (adjusted hazard ratio [aHR]\u2009=\u20091.20, 95% confidence interval [CI]\u2009=\u20091.11\u20131.30), adjusted models showed lower ACM (aHR\u2009=\u20090.89, 95% CI\u2009=\u20090.82\u20130.97) and PCSM (adjusted subdistribution hazard [asHR]\u2009=\u20090.86, 95% CI\u2009=\u20090.76\u20130.96) than Australian\u2010born individuals. There were significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt;\u20090.05) interactions between CALD and age (older CALD individuals had higher hazard of ACM and PCSM) and CALD and PCa risk category (CALD individuals with regional PCa had higher hazard of ACM).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While CALD individuals had lower overall survival and higher ACM than Australian\u2010born individuals, CALD individuals exhibited lower ACM and PCSM following adjustments. Interactions of age and PCa risk category with CALD influenced mortality. Contributing factors (e.g., late diagnosis) should be addressed to reduce disparities by CALD status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71779","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T04:17:36Z","timestamp":1776226656000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survival of Individuals Diagnosed With High\u2010Risk, Regional, and Metastatic Prostate Cancer by Culturally and Linguistically Diverse Status: A Retrospective Cohort Study Set in Victoria, Australia"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6495-1882","authenticated-orcid":false,"given":"Koku Sisay","family":"Tamirat","sequence":"first","affiliation":[{"name":"School of Rural Health Monash University  Warragul Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Papa","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-8602","authenticated-orcid":false,"given":"Jeremy","family":"Millar","sequence":"additional","affiliation":[{"name":"School of Translational Medicine Monash University  Melbourne Australia"},{"name":"Radiation Oncology Alfred Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-8398","authenticated-orcid":false,"given":"Eli","family":"Ristevski","sequence":"additional","affiliation":[{"name":"School of Rural Health Monash University  Warragul Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael James","family":"Leach","sequence":"additional","affiliation":[{"name":"School of Rural Health Monash University  Bendigo Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Australia's Health 2022: In Brief, in Australia's Health Series Number 18","author":"Australian Institute of Health and Welfare","year":"2022","journal-title":"AIHW"},{"key":"e_1_2_11_3_1","unstructured":"Australian Institute of Health Welfare \u201cCancer data in Australia \u201d(2024) https:\/\/www.aihw.gov.au\/reports\/cancer\/cancer\u2010data\u2010in\u2010australia."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33326-3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-021-01474-6"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14722"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb02977.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.11134"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12134-014-0340-x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13256-z"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckx001"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY10065"},{"key":"e_1_2_11_13_1","volume-title":"Australian Cancer Plan","author":"Cancer Australia","year":"2023"},{"key":"e_1_2_11_14_1","unstructured":"Cancer Council Victoria and Department of Health Victoria \u201cOptimal Care Pathway for Men With Prostate Cancer \u201d(2021)."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-021-06125-9"},{"key":"e_1_2_11_16_1","volume-title":"An Evidence Check Review Brokered by the Sax Institute for the Cancer Institute NSW","author":"Phillipson L.","year":"2012"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-144"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-025-01660-8"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2025.102827"},{"key":"e_1_2_11_20_1","unstructured":"Australian Bureau of Statistics \u201cAustralia's Population by Country of Birth \u201d(2022) https:\/\/www.abs.gov.au\/statistics\/people\/population\/australias\u2010population\u2010country\u2010birth\/2021."},{"key":"e_1_2_11_21_1","unstructured":"F.SampurnoandS.Evans \u201cVictorian Prostate Cancer Clinical Registry Five Year Report \u201d(2015)http:\/\/pcr.registry.org.au."},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.09.002"},{"issue":"5","key":"e_1_2_11_23_1","first-page":"583","article-title":"NCCN Guidelines Updates: Management of Prostate Cancer","volume":"17","author":"Mohler J. 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