A further analysis of the national lung cancer registration dataset for 2007 to 2019 has found that Māori patients need to travel longer than European patients to access surgery and radiation therapy. The median travel distances for Māori vs European patients were 57 vs 34 km to access surgery and 75 vs 35 km to access radiation therapy. The adjusted odds of living more than 200 km away for Māori patients was 1.83 (95% CI 1.49–2.25) for surgery and 1.41 (95% CI 1.25–1.60) for radiation therapy compared with European patients. The study authors commented that while centralisation of care may improve treatment outcomes, it also makes accessing treatment more difficult for populations such as Māori who are more likely to live rurally and in deprivation.
As the authors say, lung cancer is the biggest cancer killer of Māori and so I am somewhat surprised that it has taken this long to evaluate the care pathway to the extent it has been in these papers. I’ve spoken before about the stigma of lung cancer (often associated with smoking) when we know about the differential exposure to other risk factors (i.e. occupational) between Māori and non-Māori. And now we have evidence for inequitable lung cancer treatment. The lung cancer screening programme, currently being tested for Māori and Pacific peoples, holds promise.
Independent commentary by Dr. Matire Hardwood
Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.
Research Review publications are intended for New Zealand health professionals.
Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.
