title: Treatment modalities for Māori and New Zealand European men with localised prostate cancer.
abstract: OBJECTIVE
  To examine diagnostic and treatment pathways for Māori (the indigenous people of New Zealand [NZ]) and NZ European men with prostate cancer in order to identify causes of higher mortality rates for Māori men.
  
  
  METHODS
  All Māori men (150) diagnosed with prostate cancer in the Midland Cancer Network region between 2007 and 2010 were identified from the NZ Cancer Registry and frequency age-matched with three randomly sampled NZ European men. Clinical records of these men were searched for information on clinical stage at diagnosis, comorbidities, and type of treatment for localised disease.
  
  
  RESULTS
  The final cohort included 136 Māori and 400 NZ European men, of whom 97 Māori and 311 NZ European were diagnosed with localised prostate cancer. Māori men were twice as likely to be diagnosed with distant metastases compared with NZ European men (19.1 vs 9.8 %). Māori men with localised disease were less likely to be treated with radical prostatectomy compared with NZ European men [RR 0.66 (95 % CI 0.48, 0.90)]. Multivariate regression analysis adjusted for age, D'Amico risk strata, comorbidities, and socioeconomic deprivation showed that Māori men were more likely to be managed expectantly [RR 1.74 (95 % CI 1.06, 2.57)].
  
  
  CONCLUSIONS
  Differences between Māori and NZ European men observed in the management of localised prostate cancer cannot be readily explained by patient characteristics, such as comorbidities or risk assessment at diagnosis. Poorer outcomes for Māori men may not only be related to later stage at diagnosis but differences in treatment modalities may also be a factor.
authors.affiliation: Waikato Clinical School, Peter Rothwell Academic Centre, University of Auckland, Private Bag 3200, Hamilton, 3240, New Zealand, obertovazuzana@yahoo.co.nz.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Obertová
authors.forename: Ross
authors.initials: R
authors.lastname: Lawrenson
authors.forename: Nina
authors.initials: N
authors.lastname: Scott
authors.forename: Michael
authors.initials: M
authors.lastname: Holmes
authors.forename: Charis
authors.initials: C
authors.lastname: Brown
authors.forename: Chunhuan
authors.initials: C
authors.lastname: Lao
authors.forename: Leanne
authors.initials: L
authors.lastname: Tyrie
authors.forename: Peter
authors.initials: P
authors.lastname: Gilling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D011897:Random Allocation; D012042:Registries; D012189:Retrospective Studies; D044465:White People