Ethnic Differences in Response Rate and Patient-Reported Outcomes at Baseline and 12 Months Post-Treatment Among New...

Patient-reported outcomes (PRO) can be influenced by patient- and health system-related factors. This study examined the effect of contemporary prostate cancer (PCa) treatments (watchful waiting/active surveillance, surgery, external beam radiotherapy and androgen deprivation therapy) on PRO among Māori and non-Māori in New Zealand (NZ).

A total of 13 893 men (1155 Māori; 12 828 non-Māori) with PCa were recruited from the NZ Prostate Cancer Outcome Registry, a national registry for PCa care and PRO. The Expanded Prostate Cancer Index Composite-26 was used as the patient-reported outcomes measure (PROM) to assess five disease-specific functions (urinary incontinence, urinary obstructive/irritative, bowel, sexual and hormonal function) at baseline and 12 months post-treatment. Multivariable regression analyses were performed to assess between-group differences and post-treatment PRO changes with adjustments for confounders.

The PROM response rate in Māori was 1.87 to 2.04 times lower than non-Māori at baseline and 12 months post-treatment. Māori reported significantly worse (p ≤ 0.002) PRO than non-Māori in urinary incontinence, sexual and hormonal function at baseline but not sexual function (p = 0.9) at 12 months post-treatment after adjustments. Both groups demonstrated a similar magnitude of PRO changes 12 months post-treatment after adjustments, except for surgery and androgen deprivation therapy, where Māori had a significantly lesser decline in hormonal function (p = 0.003) and sexual function (p = 0.046) post-treatment respectively.

Findings from this study can better inform clinicians and patients in choosing a more patient-tailored PCa treatment in NZ. More work is needed to understand the possible causes for response rate and PRO differences at baseline and 12 months post-treatment between Māori and non-Māori.