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Holistic approach to testicular cancer

Dr Jason Gurney

Gurney 2

Internationally, Pākehā males suffer the highest rates of testicular cancer; so why is it that New Zealand bucks that trend, with Māori men more likely to present with this illness?

University of Otago, Wellington’s Dr Jason Gurney (Ngāpuhi) has received a Health Research Council Eru Pomare Post-Doctoral Fellowship to run a three-stage programme of in-depth research into the circumstances surrounding this pronounced ethnic disparity.

Jason says, “In 2012-13 I led a study into New Zealand rates of undescended testes to see if the same disparity existed, and found that they did. That led directly to this new programme of work. The main factors that lead to undescended testicles occur prenatally, so that may be where we need to look to learn more about the causes of testicular cancer in Māori and non-Māori men.”

Jason’s programme begins with an examination of the epidemiology of testicular cancer in New Zealand, particularly focusing on points of difference between Māori and non-Māori men. The study will examine differences in characteristics, such as stage of disease and tumour type. It will also investigate whether survival disparities exist between ethnic groups.

Jason - profileThe Fellowship’s second stage involves a systematic academic literature review and meta-analysis – a research technique which will allow Jason to estimate the importance of a number of exposures that may influence the incidence of testicular cancer.

“There are a couple of key exposures that haven’t been looked at using this technique before,” Jason says.

The third stage involves a full case control study.

“The last of my Fellowship objectives is to pilot the case control study and then get funding to do a full study. We’ll ask a whole bunch of questions about pre- and post-natal exposures. We’ll also be investigating the role that genetics has to play, since testicular cancer is the third most-heritable cancer. The studies are intended to break down the key exposures, explaining why testicular cancer is relatively higher in Māori men.”

Jason’s research time isn’t solely devoted to testicular cancer. He also manages a couple of large HRC rheumatic fever studies. One looks into the illness’s key causes and the other at the benefits and harms of screening for rheumatic heart disease.

“In New Zealand, rheumatic fever is almost exclusively a disease of Māori and Pacific Islanders,” Jason says.