Do Maori and Pacific Island men present with more advanced prostate cancer than European New Zealand men? An analysis of 486 men undergoing biopsy in Auckland

Abstract

Objective • To address the question of whether Maori and Pacific Islander men in Auckland present with more advanced prostate cancer at diagnosis than New Zealand European or European men. Patients and methods • A retrospective database audit was undertaken of all men presenting for a first prostate biopsy under the Auckland Hospital Urology Service in 2005 and 2006. • Ethnicity was coded from self-identification codes on hospital databases. • Population numbers were obtained from the 2006 Census figures from Statistics New Zealand. • Primary outcome measures used as surrogates for advanced disease were PSA level at biopsy, Gleason Score and palpable abnormality on digital rectal examination and rates of metastatic disease as determined by nuclear medicine bone scan. Results • There was no appreciable difference when Maori and Pacific Islander men were compared with European men for median PSA level (13.30 vs 12.55 ng/ml, P = 0.264); median Gleason score (7 and 7), mean Gleason score (7.0 vs 6.9, P = 0.196) or the proportion of Gleason Score 7 or 8–10 (P = 0.431) • There was no difference between the rates of metastatic disease at presentation (11.5% vs 7.8%, P = 0.376). • There appeared to be a significant difference in the proportion of Maori and Pacific Islanders presenting with palpable disease (67.2%) compared with European men (53.3%, P = 0.042). • The crude population biopsy rate per 100 000 was similar for Maori and Pacific Islander and European men (560 vs 547). Conclusions • Maori and Pacific Islander men present with similar prostate cancer characteristics to European men at diagnosis but there appears to be a real discrepancy in the rates of palpable disease.