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The use of androgen deprivation therapy (ADT) and chemotherapeutic agents in New Zealand men with prostate cancer

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Authors:
Summary:

This paper reports data from a nationwide audit of androgen deprivation therapy (ADT) and chemotherapy treatment for prostate cancer undertaken in New Zealand men within the first year after prostate cancer diagnosis. The study population included 15,947 men diagnosed with prostate cancer between 2006 and 2011; 4978 (31%) were prescribed ADT or chemotherapeutic agents. ADT was dispensed for 72% of men with metastatic disease, while only 24 men (0.2%) received chemotherapeutic agents. Age-adjusted analyses revealed that compared with younger men, older men (>70 years) with advanced (regional or metastatic) disease were more likely to receive anti-androgens only and to be treated with orchidectomy. Māori and Pacific men (compared with non-Māori/ non-Pacific men) were more likely to receive pharmacological ADT; Māori men were also more likely to be treated with orchidectomy

Comment:
Although this audit focused on treatment for prostate cancer (and showed clear under-utilisation of medical treatments for men with advanced disease and higher rates of orchidectomy for Māori), the study has also highlighted issues in the quality of data, with 72% of men registered with prostate cancer having “unknown” extent of disease. This has major implications for equity.
Reference: J Cancer 2013;5(3):214-20
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.

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