Thesis Format

Integrated Article

The Impact of Ethnicity and Immigration on Prostate Cancer Mortality in Canada

Noah Stern, The University of Western OntarioFollow

Degree

Master of Science

Program

Surgery

Supervisor

Power, Nicholas

2nd Supervisor

Haan, Michael

Co-Supervisor

Abstract

Despite the prevalence of prostate cancer its pathogenesis remains unclear. Marked differences in mortality rates have been observed between countries, however, it is unclear whether the source of the observed differences is driven by underlying genetics, geographic, or social factors. This thesis investigated the impact of ethnicity and immigration on prostate cancer mortality in Canada using the Canadian Census Health and Environment Cohort. South Asian and East Asian men were seen to be at decreased risk of prostate cancer mortality, while no increased risk was observed in black men. These results affirm studies showing lower risks in Asian men; however, they contradict the previously held notion that black men are at increased risk of aggressive disease. Attempts to study the impact of immigration on prostate cancer mortality were limited by small sample sizes and missing data. Efforts to improve linkages and a longer timespan may allow for future analysis.

Summary for Lay Audience

Prostate cancer is one of the most commonly diagnosed and most deadly male cancers. Despite its prevalence, surprisingly little is known about what causes prostate cancer and who is at an increased risk. This study used a Statistics Canada dataset with detailed demographic and health data to track a cohort of the Canadian population over an 18-year period to determine the impact of ethnicity and immigration on the risk of dying from prostate cancer. In our cohort, Asian-Canadians had lower rates of prostate cancer mortality, while Black-Canadians had equivalent mortality rates to non-visible minority Canadians. This is contradictory to previous studies that showed increased rates of early and aggressive prostate cancer in African Americans. Our study looking at the impact of immigration on prostate cancer mortality showed the dataset to be currently too immature to contribute meaningful data, however this may improve with time.

Our studies demonstrate the importance of considering confounding variables – most importantly socioeconomic factors and access to care when interpreting studies from large datasets. Additionally, they identified potential future avenues of research, specifically trying to understand the underlying cause of the improved mortality rates in Asian Canadians and working to strengthen the dataset to allow more detailed analysis.

Recommended Citation

Stern, Noah, "The Impact of Ethnicity and Immigration on Prostate Cancer Mortality in Canada" (2020). Electronic Thesis and Dissertation Repository. 7328.
https://ir.lib.uwo.ca/etd/7328