Researchers are baffled as to why the mortality rate for prostate cancer in Australia is declining at a slower rate than other developed countries, despite the availability of similar tests and treatments.
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Australian men are among the most likely to develop prostate cancer in the developed world, and although the mortality rate has declined, it has not reduced as dramatically as it has in similar countries.
Between 1994 and 2010, the mortality rate from prostate cancer dropped by 50 per cent in the United States, compared with 25 per cent in Australia, research published in the World Journal of Urology shows.
 
Conversely, Australians were less likely to die of lung or colourectal cancer and equally likely to die of breast cancer.
"Importantly, these results show that, had Australia experienced mortality rates similar to those of the USA, almost 11,000 deaths from prostate cancer might have been averted," the article said.
The disparity could not be attributed to better testing in the US because the drop in mortality occurred too soon to be a result of prostate-specific antigen [PSA] testing.
The affect of such testing takes 10 years to be felt, whereas the drop in mortality occurred six years after PSA testing was introduced in Australia.
Neither could it be attributed to the higher use of radical prostatectomy in the US because such treatment has been shown to be no more effective than watchful waiting.
"There weren't any clear areas where we could say, 'We don't do that and the Americans do'," study author David Smith of the NSW Cancer Council said.
But he said previous studies showing that men in rural and regional areas were more likely to die of prostate cancer than those living in metropolitan areas suggested those who had good access to follow-up treatment and monitoring were more likely to survive.
"What we suspect is that it's the men who have got high-risk disease after their initial treatment who are falling through the gaps, and this is where we're not performing."
Urological Society of Australia and New Zealand vice-president Mark Frydenberg said there could be innate geographical differences that made prostate cancer more aggressive in Australia than the US.
PSA testing would have saved some lives in the US, as well as more equitable access to GPs and services, he said.
"Australia has a fairly large regional and remote population that's not always as well serviced by GPs and specialists as they could be and I think what's happening is those men are really only turning up to their doctors with very advanced symptoms," Professor Frydenberg said.
Phil Burge, 67, was diagnosed with prostate cancer in 2009 after having annual PSA testing.
His father had died of prostate cancer 10 years earlier, and he was determined not to go the same way.
"I think men in his day didn't go to the doctor too often," Mr Burge said.
"When he did, it had already spread. It was a terrible way to die."
Mr Burge's cancer was aggressive but it had not yet spread, and was able to be removed with surgery.
More than 3000 men died from prostate cancer in 2011, Australian Institute of Health and Welfare figures show.
About 92 per cent of men diagnosed survived five years from diagnosis in 2006-2010.
