在一个临床质量癌症登记处的人群水平上，评估2011年至2020年一个十年内（2011-2020）诊断前列腺癌（PCa）等级、活检和治疗方法的变化。从澳大利亚维多利亚前列腺癌结局登记处中检索2011年至2020年间通过前列腺活检诊断的患者，该登记处是一个前瞻性、覆盖全州的临床质量登记处。按照活检技术、年龄组和随后的治疗方法分别对每个等级组（GG）的比例随时间进行模拟。在该登记处中，从2011年至2020年，共有24,308名男性被诊断为患有PCa。GG 1疾病的比例从36%下降到23%，而GG 2（31-36%）、GG 3（14-17%）和GG 5（9.3-14%）疾病的比例相应增加。对于通过经直肠超声检查或经会阴穿刺活检诊断的男性，这种趋势类似。年龄＜55岁的患者中，GG 1 PCa的绝对减少最大，从56％下降到35％，而相比之下，年龄分别为55-64岁（41％-31％）、65-74岁（31％-21％）和≥75岁（12％-10％）的患者GG 1 PCa的比例减少要小得多。GG 1疾病患者接受前列腺切除术的比例从28%下降到7.1%，而接受原发性放射治疗的比例从22%下降到3.5%。从2011年至2020年，GG 1 PCa的诊断比例显著下降，尤其是在年轻男性中。对GG 1疾病进行干预性治疗的比例已降至非常低的水平。这些结果反映了诊断和治疗指南的重大变化，并有助于未来治疗方法的分配。 © 2023 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

To assess changes in diagnosis prostate cancer (PCa) grade, biopsy and treatment approach over a decade (2011-2020) at a population level within a clinical quality cancer registry.Patients diagnosed by prostate biopsy between 2011 and 2020 were retrieved from the Victorian Prostate Cancer Outcomes Registry, a prospective, state-wide clinical quality registry in Australia. Distributions of each grade group (GG) proportion over time were modelled with restricted cubic splines, separately by biopsy technique, age group and subsequent treatment method.From 2011 to 2020, 24 308 men were diagnosed with PCa in the registry. The proportion of GG 1 disease declined from 36-23%, with commensurate rises in GG 2 (31-36%), GG 3 (14-17%) and GG 5 (9.3-14%) disease. This pattern was similar for men diagnosed by transrectal ultrasonography or transperineal biopsy. Patients aged <55 years had the largest absolute reduction in GG 1 PCa, from 56-35%, compared to patients aged 55-64 (41-31%), 65-74 (31-21%), and ≥75 years (12-10%). The proportion of prostatectomies performed for patients with GG 1 disease fell from 28% to 7.1% and, for primary radiation therapy, the proportion fell from 22% to 3.5%.From 2011 to 2020, there has been a substantial decrease in the proportion of GG 1 PCa diagnosed, particularly in younger men. The percentage of interventional management performed in GG 1 disease has fallen to very low levels. These results reflect the implementation of major changes to diagnostic and treatment guidelines and inform the future allocation of treatment methods.© 2023 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.