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Treatment modalities for Māori and New Zealand European men with localised prostate cancer

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Abstract

Objectives

To examine diagnostic and treatment pathways for Māori (the indigenous people of New Zealand [NZ]) and NZ European men with prostate cancer in order to identify causes of higher mortality rates for Māori men.

Methods

All Māori men (150) diagnosed with prostate cancer in the Midland Cancer Network region between 2007 and 2010 were identified from the NZ Cancer Registry and frequency age-matched with three randomly sampled NZ European men. Clinical records of these men were searched for information on clinical stage at diagnosis, comorbidities, and type of treatment for localised disease.

Results

The final cohort included 136 Māori and 400 NZ European men, of whom 97 Māori and 311 NZ European were diagnosed with localised prostate cancer. Māori men were twice as likely to be diagnosed with distant metastases compared with NZ European men (19.1 vs 9.8 %). Māori men with localised disease were less likely to be treated with radical prostatectomy compared with NZ European men [RR 0.66 (95 % CI 0.48, 0.90)]. Multivariate regression analysis adjusted for age, D’Amico risk strata, comorbidities, and socioeconomic deprivation showed that Māori men were more likely to be managed expectantly [RR 1.74 (95 % CI 1.06, 2.57)].

Conclusion

Differences between Māori and NZ European men observed in the management of localised prostate cancer cannot be readily explained by patient characteristics, such as comorbidities or risk assessment at diagnosis. Poorer outcomes for Māori men may not only be related to later stage at diagnosis but differences in treatment modalities may also be a factor.

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Acknowledgments

This study was supported by Health Research Council of New Zealand (HRC Partnership Programme grant number 11/082, entitled ‘The costs and complications of screening for prostate cancer’). We are very grateful to all contributing specialists, their departments and practices and to the regional community laboratory Pathlab.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Waikato Clinical School, Peter Rothwell Academic Centre, University of Auckland, Private Bag 3200, Hamilton, 3240, New Zealand

    Zuzana Obertová, Ross Lawrenson, Charis Brown & Chunhuan Lao

  2. Te Puna Oranga, Waikato District Health Board, Hamilton, New Zealand

    Nina Scott

  3. Urology Department, Waikato Hospital, Hamilton, New Zealand

    Michael Holmes

  4. Radiation Oncology, Waikato Hospital, Hamilton, New Zealand

    Leanne Tyrie

  5. Department of Surgery, University of Auckland, Auckland, New Zealand

    Peter Gilling

Authors
  1. Zuzana Obertová
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  2. Ross Lawrenson
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  3. Nina Scott
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  4. Michael Holmes
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  5. Charis Brown
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  6. Chunhuan Lao
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  7. Leanne Tyrie
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  8. Peter Gilling
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Corresponding author

Correspondence to Zuzana Obertová.

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Obertová, Z., Lawrenson, R., Scott, N. et al. Treatment modalities for Māori and New Zealand European men with localised prostate cancer. Int J Clin Oncol 20, 814–820 (2015). https://doi.org/10.1007/s10147-014-0781-4

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  • DOI: https://doi.org/10.1007/s10147-014-0781-4

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