LATP biopsies not only offer diagnostic benefits but are cost-effective as well. Health system leadership is needed to lift uptake by clinicians and patients.
Prostate cancer is the most diagnosed cancer in Australian men, yet despite major advances in diagnostic methods globally, our local clinical practice hasn’t kept pace.
One key example is the underutilisation of local anaesthetic transperineal (LATP) prostate biopsies—an approach that is already standard in countries like New Zealand and the UK.
While transperineal (TP) biopsies now account for around 70% of prostate cancer biopsies in Australia, the majority are still performed under general anaesthesia. LATP offers the same diagnostic benefits, but with significant added advantages: no need for hospital admission or sedation, lower costs, and shorter procedure time.
The clinical evidence supporting the safety, accuracy, and tolerability of LATP is robust (here, here, and here). For patients, the shift to LATP means avoiding unnecessary hospitalisation, recovering faster, and often returning to work the same day. For the health system, it opens the door to outpatient models of care and substantial cost savings.
A recent cost-effectiveness analysis shows that LATP offers equivalent diagnostic accuracy to GA but at far lower cost. The study found average savings of nearly AU$1000 per case from a hospital perspective and over AU$1600 when including societal costs like time off work.
These findings reinforce what many clinicians already know: LATP is safer, quicker and more sustainable. It is time to adopt this modern approach, especially as prostate cancer cases are set to double by 2040.
So why are we still slow to embrace it?
Despite the evidence, the uptake of LATP remains inconsistent. Structural and policy barriers persist—many hospitals still default to general anaesthetic approaches, and outpatient LATP services are not universally available. In some regions, clinical pathways remain outdated. These gaps are not just logistical—they reflect a broader inertia in adapting to more efficient, patient-centred care models.
This inertia comes at a cost. Prostate cancer is projected to place increasing pressure on the health system as Australia’s population ages. LATP provides a scalable, efficient way to meet rising demand without overburdening surgical theatres or hospital beds. It also aligns with modern healthcare priorities: safety, accessibility, and sustainability.
To change course, we need national leadership. Investment in clinician training, hospital infrastructure, and revised diagnostic pathways are essential. Public funding models should reflect the cost-effectiveness of outpatient LATP. Awareness among referring GPs must also improve, as early diagnosis hinges on access to appropriate biopsy options.
The tools are available. The evidence is clear. LATP biopsies are not just good medicine—they’re good policy. What’s missing is coordinated action to embed them into routine care across Australia.
Let’s not allow outdated systems to hold back better outcomes for patients.
Associate Professor Matt Brown is a urologist in Perth and the University of Western Australia.
