Indigenous men with prostate cancer more likely to have metastasis, worse survival

Reviewed by Megan Craig, M.Sc.Jul 10 2023

Indigenous Peoples in Canada have higher illness rates and lower life expectancies than non-Indigenous Canadians. A new study reveals that Indigenous men in the country who have prostate cancer are being diagnosed with more advanced and more aggressive tumors than their non-Indigenous counterparts. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

To identify disparities in prostate cancer screening, diagnoses, management, and outcomes between Indigenous and non-Indigenous men in Canada, a team led by Adam Kinnaird, MD, PhD, of the University of Alberta, examined data on 1,444,974 men who were screened for prostate cancer in 2014–2022 and were enrolled in the Alberta Prostate Cancer Research Initiative.

When they examined testing rates by postal code, the investigators found that men in Indigenous communities were less likely to have prostate-specific antigen (PSA) tests to detect prostate cancer than men outside of Indigenous communities (32 versus 46 PSA tests per 100 men aged 50–70 years within 1 year).

Also, among 6,049 men diagnosed with prostate cancer, Indigenous men were more likely to have PSA levels ≥10 ng/mL (48% versus 30%), stage II or higher cancer (65% versus 47%), and high-grade tumors (79% versus 64%) than non-Indigenous men. In addition, over a median follow-up of 3.3 years, Indigenous patients were 2.3-times more likely to experience cancer spread, or metastasis, than non-Indigenous patients.

What is critical about this is that these results come from within a publicly funded universal health care system in which all peoples should have equal access to care. The findings are significant because they identify Indigenous men as a population at risk for more aggressive prostate cancer and potentially worse survival. Key infrastructure changes, including better access to primary care physicians, may help improve prostate cancer screening and identify men at earlier, and curable, stages of the disease."

Dr. Adam Kinnaird, MD, PhD, University of Alberta