Disparities in prostate cancer screening, diagnoses, management, and outcomes between Indigenous and non‐Indigenous men in a universal health care system

Background Indigenous Peoples have higher morbidity rates and lower life expectancies than non‐Indigenous Canadians. Identification of disparities between Indigenous and non‐Indigenous men regarding prostate cancer (PCa) screening, diagnoses, management, and outcomes was sought. Methods An observational cohort of men diagnosed with PCa between June 2014 and October 2022 was studied. Men were prospectively enrolled in the province‐wide Alberta Prostate Cancer Research Initiative. The primary outcomes were tumor characteristics (stage, grade, and prostate‐specific antigen [PSA]) at diagnosis. Secondary outcomes were PSA testing rates, time from diagnosis to treatment, treatment modality, and metastasis‐free, cancer‐specific, and overall survivals. Results 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 50–70 years] within 1 year; p