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Title: Prostate cancer mortality outcomes and patterns of primary treatment for Aboriginal men in New South Wales, Australia
Authors: Rodger JC; Supramaniam R; Gibberd AJ; Smith DP; Armstrong BK; Dillon A; O'Connell DL
Categories: Cancer Type - Prostate Cancer
Treatment - Resources and Infrastructure
Year: 2015
Journal Title: BJU International
Volume: 115
Issue: 5
Page number start: 16
Page number end: 23
Citation: 115 Suppl 5:16-23
Abstract: OBJECTIVE: To compare prostate cancer mortality for Aboriginal and non-Aboriginal men and to describe prostate cancer treatments received by Aboriginal men. PATIENTS AND METHODS: We analysed cancer registry records for all men diagnosed with prostate cancer in New South Wales (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 Aboriginal men among 35,214 prostate cancer cases diagnosed in 2001-2007. Age and spread of disease at diagnosis were similar for Aboriginal and non-Aboriginal 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-Aboriginal men (11.4%, 95% CI 11.0-11.8). Aboriginal 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. Aboriginal men were less likely to have a prostatectomy for localised or regional cancer than non-Aboriginal men (adjusted odds ratio 0.60, 95% CI 0.40-0.91). Of 87 Aboriginal 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 Aboriginal men with prostate cancer compared with non-Aboriginal men. In the meantime, ongoing monitoring and efforts are needed to ensure Aboriginal men have equitable access to best care.
Division: Cancer Research Division
Funding Body: (1) National Health and MRC Health Services grant (440202) (2) Cancer Institute NSW Epidemiology Linkage Grant (10/EPI/2‐05)
DOI: 10.1111/bju.12899
Appears in Collections:Research Articles

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