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Survival disparities between M āori and non‐ M āori men with prostate cancer in N ew Z ealand
Author(s) -
Obertová Zuzana,
Scott Nina,
Brown Charis,
Stewart Alistair,
Lawrenson Ross
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.12900
Subject(s) - prostate cancer , hazard ratio , medicine , proportional hazards model , cancer , demography , confidence interval , cohort , cancer registry , oncology , gerontology , gynecology , sociology
Objective To examine temporal trends and current survival differences between M āori and non‐ M āori men with prostate cancer in N ew Z ealand ( NZ ). Patients and Methods A cohort of 37 529 men aged ≥40 years diagnosed with prostate cancer between 1996 and 2010 was identified from the N ew Z ealand Cancer Registry and followed until 25 M ay 2011. Cause of death was obtained from the M ortality C ollection by data linkage. Survival for M āori compared with non‐ M āori men was estimated using the K aplan– M eier 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 M āori compared with non‐ M āori men at 1, 5 and 10 years after diagnosis. M āori men were more likely to die from any cause [adjusted hazard ratio ( aHR ) 1.84, 95% confidence interval ( CI ) 1.72–1.97] and from prostate cancer ( aHR 1.94, 95% CI 1.76– 2.14). The aHR of prostate cancer death for M āori men diagnosed with regional extent was 2.62‐fold (95% CI 1.60–4.31) compared with non‐ M āori men. The survival gap between M āori and non‐ M āori men has not changed throughout the study period. Conclusion M āori men had significantly poorer survival than non‐ M āori, particularly when diagnosed with regional prostate cancer. Despite improvements in survival for all men diagnosed after 2000, the survival gap between M āori and non‐ M āori men has not been reduced with time. Differences in prostate cancer detection and management, partly driven by higher socioeconomic deprivation in M āori men, were identified as the most likely contributors to ethnic survival disparities in NZ .