Māori men in New Zealand at greater risk than ethnic Europeans

A new study from a research group on New Zealand has again raised questions about risks from prostate cancer among men from different ethnic backgrounds, and whether these differences in risk are inherent (genetic) or related to lifestyle and other socio-economic issues.

Loa et al., in their article in the European Journal of Cancer Care, have  shown that, in New Zealand, Māori men are twice as likely to die of prostate cancer once diagnosed than are men of European ethnicity.

Their study was based on a careful analysis of data from men of 40+ years of age, all diagnosed with prostate cancer in the Midland Cancer Network region of New Zealand and registered with prostate cancer in 2007-2010 in the New Zealand Cancer Registry.

Lao et al. report that:

  • They identified 535 men with prostate cancer (inclusive of all all Māori men and a sample of European New Zealanders).
    • 135 were Māoris
    • 400 were ethnic Europeans
  • Māori men were at greater risk for diagnosis with more advanced disease than the ethnic Europeans.
  • 5-year prostate cancer-specific survival rates were
    • 98.6 percent for men diagnosed with localized prostate cancer
    • 88.8 percent for men diagnosed with locally advanced disease
    • 19.1 percent for men diagnosed with metastatic prostate cancer
  • Survival rates were significantly poorer for Māori men than for ethnic Europeans.
    • P = 0.004 for all-cause (overall) survival.
    • P = 0.006 for prostate cancer-specific survival.
  • Compared to ethnic Europeans, the hazard ratio for prostate cancer-specific survival for Māori men was 2.01.

The authors also state that the fact that Māori men were at risk of having more advanced disease at diagnosis explains most of the survival inequity between Māori men and the ethnic Europeans.

Clearly this raises all sorts of questions (just as it does with African Americans here in the USA) about whether Māori men have the same level of access to healthcare services as otherwise comparable ethnic Europeans in New Zealand; whether lifestyle factors may be affecting their risk for prostate cancer; or whether they have a greater genetic risk for diagnosis with more aggressive forms of prostate cancer (perhaps at younger ages).

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