OBJECTIVE: To examine temporal trends and current survival differences between Māori and non-Māori men with prostate cancer in New Zealand.
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SUBJECTS/PATIENTS AND METHODS: A cohort of 37,529 men aged 40+ years diagnosed with prostate cancer between 1996 and 2010 was identified from the New Zealand Cancer Registry and followed until 25 May 2011. Cause of death was obtained from the Mortality Collection by data linkage. Survival for Māori compared with non-Māori men was estimated using the Kaplan-Meier method, and Cox proportional hazard regression models, adjusted for age, year of diagnosis, socioeconomic deprivation and rural/urban residence.
RESULTS: The probability of surviving was significantly lower for Māori compared with non-Māori men at one, five and 10 years post-diagnosis. Māori men were more likely to die of any cause (adjusted hazard ratio (HR), 1.84 (95% CI, 1.72, 1.97)) and of prostate cancer (adjusted HR, 1.94 (95% CI, 1.76, 2.14)). The adjusted HR of prostate cancer death for Māori men diagnosed with regional extent was 2.62-fold (95% CI; 1.60, 4.31)) compared with non-Māori men. The survival gap between Māori and non-Māori men has not changed throughout the study period.
CONCLUSION: Significantly poorer survival was observed for Māori men compared with non-Māori, particularly when diagnosed with regional prostate cancer. Despite improvements in survival for all men diagnosed after 2000, the survival gap between Māori and non-Māori men has not been reduced with time. Differences in prostate cancer detection and management, partly driven by higher socio-economic deprivation in Māori men, were identified as the most likely contributors to ethnic survival disparities in New Zealand.
Obertová Z, Scott N, Brown C, Stewart A, Lawrenson R. Are you the author?
Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
Reference: BJU Int. 2014 Aug 14. Epub ahead of print.