Prostate cancer – are ethnic minorities disadvantaged?

Making Education Easy

Authors:

Lamb DS et al

August 17, 2009

Summary:

These researchers analysed the ethnic mix of a database including men from the greater Wellington region presenting with clinically localised prostate cancer between 1996 and 2007, in an attempt to clarify whether fewer Māori men receive treatment than non-Māori men. The database included 271 men with lowrisk prostate cancer treated with brachytherapy (permanent iodine seed implantation), and 188 men with intermediate- or high-risk prostate cancer treated with radical external beam radiotherapy. Each man was allocated to a major ethnic group according to ethnic categories defined in the 2006 New Zealand Census. The observed ethnic mixes of men in the low- and intermediate/high-risk groups were compared with the expected percentages derived from Census and Cancer Registry data. Ten Māori men were on the database, compared to 44 expected, and one Pacific man, compared to 37 expected. The same pattern of underrepresentation of these ethnic minorities was seen for both low-risk and intermediate/high-risk localised prostate cancer.

Comment:

Māori men are less likely to receive a diagnosis of prostate cancer yet significantly more likely to die of the disease than non-Māori men. This study shows that Māori men are under-represented among those presenting with localised prostate cancer. What this suggests is that by the time Māori men come into contact with the health system they are more likely to have cancer that has spread beyond the prostate. While we’re on the topic, let’s dispel a common myth: Māori do not have “a cultural reluctance to present for health care until forced to by disabling symptoms”. The real question we should ask is what is wrong with health services that makes Māori men, in particular, delay or avoid seeking care. At the Tāne Ora conference cardiovascular risk screening was available on site and men flocked to it. This shows that if care is accessible and provided in a culturally safe way Māori men will go.

Reference: Anticancer Res. 2008;28(6B):3891-5.

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

Prostate cancer – are ethnic minorities disadvantaged?

Independent commentary by Dr. Matire Hardwood

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Prostate cancer – are ethnic minorities disadvantaged?

Independent commentary by Dr. Matire Hardwood

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