title: Elevated serum prostate-specific antigen levels and public health implications in three New Zealand ethnic groups: European, Maori, and Pacific Island men.
abstract: OBJECTIVE
  To predict differences in prostate cancer rates between New Zealand's major ethnic groups using community-based levels of elevated serum prostate-specific antigen (PSA).
  
  
  METHODS
  This study was undertaken in the Wellington region of New Zealand. 1425 subjects with no clinical history of prostate cancer had serum PSA levels measured--728 New Zealand European, 353 Maori, and 344 Pacific Island men. Age-standardised elevated PSA prevalences were calculated by standardising for population proportions. Prostate cancer prevalence ratios were predicted using a previously published method.
  
  
  RESULTS
  There was no significant difference between New Zealand's ethnic groups in the prevalence of elevated PSA (p>0.05). The overall age-standardised elevated PSA prevalence (3.9%) was lower than for all other community-based studies that were compared. Predicted cancer prevalence ratios were 1.1 across all New Zealand ethnic comparisons.
  
  
  CONCLUSIONS
  The prevalence of elevated PSA in New Zealand men is lower than found in other community-based studies, and not significantly different between the three New Zealand ethnic groups. However, levels of elevated PSA may be useful for predicting prostate cancer incidence rates in ethnic groups. Available incidence data show New Zealand European men to have a higher prostate cancer incidence rate than both Maori and Pacific Islands men; however, this study found that prostate cancer incidence ratios between these groups are more likely to be closer to 1. Findings may indicate cultural barriers in the health system for Maori and Pacific Islands men; highlighting the need for clinicians to further consider cultural appropriateness in practice, and to target prostate health promotion for these groups.
authors.affiliation: Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. marion.gray@afip.osd.mil
authors.forename: Marion
authors.initials: M
authors.lastname: Gray
authors.forename: Barry
authors.initials: B
authors.lastname: Borman
authors.forename: Peter
authors.initials: P
authors.lastname: Crampton
authors.forename: Philip
authors.initials: P
authors.lastname: Weinstein
authors.forename: Craig
authors.initials: C
authors.lastname: Wright
authors.forename: John
authors.initials: J
authors.lastname: Nacey
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010139:Pacific Islands / Q000208:ethnology; D015995:Prevalence; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D012016:Reference Values; D011795:Surveys and Questionnaires; D044465:White People
chemical_list: D017430:Prostate-Specific Antigen