Indigenous men have more serious and later-stage prostate cancer when theySA国际影视传媒檙e diagnosed than non-Indigenous men, a new Canadian study says.

SA国际影视传媒淚t is very clear from this data that Indigenous men are at higher risk of developing aggressive prostate cancer than non-Indigenous men,SA国际影视传媒� said Dr. Adam Kinnaird, senior author of the study and the Frank and Carla Sojonky Chair in Prostate Cancer Research at the University of Alberta.

The study, published Monday in the journal Cancer, looked at prostate cancer screening data among almost 1.5 million men in Alberta between 2014 and 2022. They were all between 50 and 70 years old.

Using postal codes, the researchers found that men in First Nations and Metis communities were much less likely to have had a prostate-specific antigen (PSA) test SA国际影视传媒� the method used to screen for prostate cancer SA国际影视传媒� than men living outside of Indigenous communities.

SA国际影视传媒淣on-Indigenous men are having their PSA test done 50 per cent more often than Indigenous men are. And thatSA国际影视传媒檚 a pretty big difference,SA国际影视传媒� Kinnaird said.

The lack of screening, he said, could be a contributing factor to the studySA国际影视传媒檚 other major finding SA国际影视传媒� that at the time of diagnosis, prostate cancer in Indigenous men was more advanced and more aggressive than in non-Indigenous men.

That finding was based on the tumour characteristics of 6,049 men diagnosed with prostate cancer who were seen at urology referral centres at the University of Alberta in Edmonton and at the University of Calgary.

Dr. Jason Pennington, a surgeon at the Scarborough Health Network and the Indigenous lead for the Central East Regional Cancer Program in Ontario, said the results are SA国际影视传媒渘ot surprising.SA国际影视传媒�

SA国际影视传媒�(They are) actually supporting findings that weSA国际影视传媒檝e been getting from Ontario,SA国际影视传媒� said Pennington, who was not involved in the study and is a member of the Huron-Wendat Nation.

SA国际影视传媒淭his is what we see across Canada and across Indigenous populations around the world.SA国际影视传媒�

One weakness of the study, Kinnaird said, is that because it relied on postal codes, it couldnSA国际影视传媒檛 compare the rate of PSA testing between Indigenous and non-Indigenous men living in cities.

About half of the Indigenous population lives in cities, he said, and researchers will be looking at data in another Alberta study to try to find testing rates for urban Indigenous men.

KinnairdSA国际影视传媒檚 team also plans additional research to determine whether or not there might be a genetic factor that could make Indigenous men more prone to aggressive prostate cancer, he said.

ThatSA国际影视传媒檚 something that occurs in the Ashkenazi Jewish population, he said.

The study did not look at whether prostate cancer was more or less prevalent overall among Indigenous men SA国际影视传媒� just at screening rates and severity at diagnosis.

There are many possible reasons Indigenous men are both tested less and suffer more advanced prostate cancer, Pennington said.

Lack of access to a primary-care provider to get screened is a likely factor, he said, along with social determinants of health, such as poverty, which could make it difficult for someone to take time off work to get a PSA test.

Kinnaird said itSA国际影视传媒檚 critical that health-care providers are aware of the inequity of prostate cancer screening.

SA国际影视传媒淚tSA国际影视传媒檚 something thatSA国际影视传媒檚 important for Indigenous men, for family physicians, for nurse practitioners and for urologists to bear in mind that when you are seeing an Indigenous man in your clinic that you are really thinking about whether you need to screen for prostate cancer,SA国际影视传媒� he said.

Indigenous distrust of the health-care system is another potential factor behind lower screening rates, Pennington said.

SA国际影视传媒淓very Indigenous person I know, every Indigenous family I know, has had negative experiences in our health-care system,SA国际影视传媒� he said.

One promising solution is holding community screening days, Pennington said, where Indigenous SA国际影视传媒減atient navigatorsSA国际影视传媒� and Indigenous nursing staff are present to answer questions and provide a culturally safe environment. Families can go together to help them feel more comfortable, he said.

That approach also works in remote Indigenous communities with mobile screening buses, he said.

Pennington said the time has come to implement more of these types of culturally safe Indigenous strategies and measure their success.

SA国际影视传媒淲eSA国际影视传媒檙e starting to have quite a bit of evidence now regarding the lower screening, the higher stages (of cancer), the poor outcomes,SA国际影视传媒� he said.

SA国际影视传媒淚tSA国际影视传媒檚 about time we start doing something about it.SA国际影视传媒�

SA国际影视传媒擝y Nicole Ireland, The Canadian Press