Reducing cancer inequalities in Māori a priority

Dr Lis Ellison-Loschmann, senior research officer, Massey University Centre for Public Health Research.

Underlying factors that drive cancer inequalities in Māori, such as poverty, must be addressed immediately, according to Dr Lis Ellison-Loschmann, from Massey University’s Centre for Public Health Research.

An international study published in The Lancet Oncology highlights the gap in cancer incidence between Māori and other New Zealanders is much higher than for other indigenous populations in western nations.

Led by the International Agency for Research on Cancer, the study investigated the scale and nature of cancer among indigenous peoples in the United States, Canada, Australia and New Zealand.

Dr Ellison-Loschmann is the only New Zealand author on the paper, which shows high rates of a number of cancers in Māori, from data taken between 2002 and 2006. She says those rates are even higher now.

“The disparity is particularly serious for Māori women, where breast, lung and colorectal cancer rates continue to rise. We need to learn from what has and hasn’t worked in terms of cancer prevention and screening for Māori, particularly as we look to the possible introduction of a bowel screening programme.

“Overall cervical screening and tobacco control strategies have been less successful for Māori than non- Māori. However breast screening targets are now beginning to be met for Māori which shows that achieving equity in the prevention stage is absolutely possible.”

She says the study highlights the need for reducing inequalities to remain a government priority. “A strategic focus on Māori cancer priorities is needed immediately, including addressing underlying factors that drive cancer inequalities, such as poverty. Higher risks of chronic infections from household crowding in childhood largely increase the risk of development of stomach and liver cancers in adulthood.”

Dr Ellison-Loschmann says a noted and justified criticism of the study was the way ethnicity status was identified in the other countries making cross-country comparisons difficult. “We are confident in the quality of the New Zealand data. Māori and non- Māori researchers and policy people have put a lot of work into the measurement and collection of ethnicity data, and I think we are in a position to teach the US, Australia and Canada about how this is done. We also need to support indigenous peoples in these other countries to ensure a high standard of monitoring is achieved for them.”

Key findings:

-        Lung cancer rates were four times higher among Māori woman and 2.5 times higher among Māori men

-        Stomach and liver cancer rates were more than double among Māori

-        Smoking was the biggest determinant of lung cancer

-        Smoking rates among Māori women were the highest in the study

-        Overall Māori die eight years earlier than non- Māori

-        Childhood poverty increased the likelihood of cancer in adult Māori

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