{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:13:39Z","timestamp":1785899619095,"version":"3.56.0"},"reference-count":13,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Indigenous Peoples have higher morbidity rates and lower life expectancies than non\u2010Indigenous Canadians. Identification of disparities between Indigenous and non\u2010Indigenous men regarding prostate cancer (PCa) screening, diagnoses, management, and outcomes was sought.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An observational cohort of men diagnosed with PCa between June 2014 and October 2022 was studied. Men were prospectively enrolled in the province\u2010wide Alberta Prostate Cancer Research Initiative. The primary outcomes were tumor characteristics (stage, grade, and prostate\u2010specific antigen [PSA]) at diagnosis. Secondary outcomes were PSA testing rates, time from diagnosis to treatment, treatment modality, and metastasis\u2010free, cancer\u2010specific, and overall survivals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Examination of 1,444,974 men for whom aggregate PSA testing data were available was performed. Men in Indigenous communities were less likely to have PSA testing performed than men outside of Indigenous communities (32 vs. 46 PSA tests per 100 men [aged 50\u201370 years] within 1 year; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Among 6049 men diagnosed with PCa, Indigenous men had higher risk disease characteristics: a higher proportion of Indigenous men had PSA \u2265 10\u00a0ng\/mL (48% vs. 30%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01), TNM stage\u00a0\u2265\u00a0T2 (65% vs. 47%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01), and Gleason grade group \u2265 2 (79% vs. 64%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) compared to non\u2010Indigenous men. With a median follow\u2010up of 40 months (interquartile range, 25\u201365 months), Indigenous men were at higher risk of developing PCa metastases (hazard ratio, 2.3; 95% CI, 1.2\u20134.2; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) than non\u2010Indigenous men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite receiving care in a universal health care system, Indigenous men were less likely to receive PSA testing and more likely to be diagnosed with aggressive tumors and develop PCa metastases than non\u2010Indigenous men.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34812","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T03:01:14Z","timestamp":1688958074000},"page":"2864-2870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Disparities in prostate cancer screening, diagnoses, management, and outcomes between Indigenous and non\u2010Indigenous men in a universal health care system"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3923-3042","authenticated-orcid":false,"given":"Alex","family":"Kiciak","sequence":"first","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Clark","sequence":"additional","affiliation":[{"name":"Indigenous Health Initiatives University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell","family":"Uhlich","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeline","family":"Letendre","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Screening Innovations Alberta Health Services  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy","family":"Littlechild","sequence":"additional","affiliation":[{"name":"Maskwacis Health Services  Maskwacis Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Lightning","sequence":"additional","affiliation":[{"name":"Indigenous Health Initiatives University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina","family":"Vasquez","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Singh","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Broomfield","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anais Medina","family":"Martin","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guocheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Fairey","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta  Edmonton Alberta Canada"},{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Alberta Centre for Urologic Research and Excellence  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kolinsky","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Department of Oncology University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5990-4026","authenticated-orcid":false,"given":"Christopher J. D.","family":"Wallis","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery Mount Sinai Hospital and University Health Network University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7516-8631","authenticated-orcid":false,"given":"Christopher","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Radiology and Diagnostic Imaging University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Hyndman","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Department of Surgery Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Yip","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Department of Oncology Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek A.","family":"Bismar","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Department of Oncology Cumming School of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Department of Pathology Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7734-1204","authenticated-orcid":false,"given":"John","family":"Lewis","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Department of Oncology University of Alberta  Edmonton Alberta Canada"},{"name":"Cancer Research Institute of Northern Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Department of Oncology University of Alberta  Edmonton Alberta Canada"},{"name":"Department of Mathematical and Statistical Sciences University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kinnaird","sequence":"additional","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta  Edmonton Alberta Canada"},{"name":"Alberta Prostate Cancer Research Initiative  Edmonton Alberta Canada"},{"name":"Alberta Centre for Urologic Research and Excellence  Edmonton Alberta Canada"},{"name":"Department of Oncology University of Alberta  Edmonton Alberta Canada"},{"name":"Cancer Research Institute of Northern Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Prostate Cancer Statistics.Canadian Cancer Statistics Advisory Committee Canadian Cancer Society. Accessed December 18 2021.https:\/\/cancer.ca\/en\/cancer\u2010information\/cancer\u2010types\/prostate\/statistics"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.4185"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.epi\u201016\u20100706"},{"issue":"1","key":"e_1_2_8_5_1","article-title":"Chronic diseases and mortality in Canadian Aboriginal peoples: learning from the knowledge","volume":"8","author":"King M","year":"2011","journal-title":"Prev Chronic Dis"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ans.0000000000000039"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.09.017"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010037222"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.4888"},{"key":"e_1_2_8_10_1","unstructured":"Addressing Guidelines. Canada Post. Accessed July 26 2022.https:\/\/www.canadapost\u2010postescanada.ca\/cpc\/en\/support\/articles\/addressing\u2010guidelines\/postal\u2010codes.page#:~:text=code%20searching%20tools\u2010 The%20structure%20of%20the%20postal%20code Local%20Delivery%20Unit%20(LDU)"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.0826"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.36364"},{"key":"e_1_2_8_13_1","volume-title":"Focus on Geography Series, 2016 Census. Catalog number 98\u2010404\u2010X2016001","year":"2017"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7248"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34812","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T10:38:09Z","timestamp":1760265489000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.34812"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,10]]},"references-count":13,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2023,9,15]]}},"alternative-id":["10.1002\/cncr.34812"],"URL":"https:\/\/doi.org\/10.1002\/cncr.34812","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,10]]},"assertion":[{"value":"2023-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}