Abstract
Prostate cancer (PCa) incidence is similar between Māori and non-Māori, but the survival rate is significantly lower among Māori. This study examined the differences in clinical assessment, clinical management, and patient-reported outcome measures between Māori and non-Māori in Aotearoa New Zealand (NZ).
8,344 NZ men aged 40 years old and over (7.3% were Māori [n = 611]; 92.6% were non-Māori [n = 7,733]) with PCa diagnosed between 2017 and 2020 were recruited from the Prostate Cancer Outcome Registry – Australia and New Zealand, an international registry that collects information on the care provided and outcomes of men with PCa in Australasia. Data linkage was used to gather subjects’ socioeconomic and comorbidity data from the NZ Ministry of Health National Minimum Dataset. Multivariate regression analyses assessed differences in PCa care provided and outcomes between Māori and non-Māori while adjusting for demographics and PCa characteristics.
The effect of ethnicity on the receipt of transrectal ultrasound-guided biopsy became apparent but weakened for diagnostic and staging CT scans after adjusting for clinical and demographic factors. For PCa management, non-Māori were found to be 61% more likely to receive surgery (p≤0.001) but 29% less likely than Māori to receive radiotherapy (p≤0.001) after adjusting for various factors. Māori reported lower scores on patient-reported outcome measures compared to non-Māori at baseline and 12 months post-treatment but both groups showed a similar decline in scores post-treatment.
Ethnic disparities in PCa management could be an important factor in differences in PCa survival between Māori and non-Māori in NZ. Further studies are warranted to examine the underlying factors contributing to differences in PCa management.