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Prostate cancer mortality outcomes and patterns of primary treatment for A boriginal men in N ew S outh W ales, A ustralia
Author(s) -
Rodger Jennifer C.,
Supramaniam Rajah,
Gibberd Alison J.,
Smith David P.,
Armstrong Bruce K.,
Dillon Anthony,
O'Connell Dianne L.
Publication year - 2015
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12899
Subject(s) - medicine , prostate cancer , hazard ratio , prostatectomy , androgen deprivation therapy , odds ratio , confidence interval , cancer , proportional hazards model , logistic regression , gynecology , radiation therapy , cancer registry , oncology
Objective To compare prostate cancer mortality for A boriginal and non‐ A boriginal men and to describe prostate cancer treatments received by A boriginal men. Patients and methods We analysed cancer registry records for all men diagnosed with prostate cancer in N ew S outh W ales ( NSW ) in 2001–2007 linked to hospital inpatient episodes and deaths. More detailed information on androgen‐deprivation therapy and radiotherapy was obtained from medical records for 87 NSW Aboriginal men diagnosed in 2000–2011. The main outcomes were primary treatment for, and death from, prostate cancer. Analysis included Cox proportional hazards regression and logistic regression. Results There were 259 A boriginal men among 35 214 prostate cancer cases diagnosed in 2001–2007. Age and spread of disease at diagnosis were similar for A boriginal and non‐ A boriginal men. Prostate cancer mortality 5 years after diagnosis was higher for Aboriginal men (17.5%, 95% confidence interval ( CI ) 12.4–23.3) than non‐ A boriginal men (11.4%, 95% CI 11.0–11.8). A boriginal men were 49% more likely to die from prostate cancer (hazard ratio 1.49, 95% CI 1.07–1.99) after adjusting for differences in demographic factors, stage at diagnosis, health access and comorbidities. A boriginal men were less likely to have a prostatectomy for localised or regional cancer than non‐ A boriginal men (adjusted odds ratio 0.60, 95% CI 0.40–0.91). Of 87 A boriginal men with full staging and treatment information, 60% were diagnosed with localised disease. Of these, 38% had a prostatectomy (± radiotherapy), 29% had radiotherapy only and 33% had neither. Conclusion More research is required to explain differences in treatment and mortality for A boriginal men with prostate cancer compared with non‐ A boriginal men. In the meantime, ongoing monitoring and efforts are needed to ensure A boriginal men have equitable access to best care.