This paper discusses the evidence in support of the importance of bowel cancer screening in Māori New Zealanders. Currently, Māori have lower incidence of colorectal cancer compared with NZ Europeans, but the rates are increasing more rapidly among Māori. Moreover, despite this lower incidence, the colorectal cancer mortality burden is similar for Māori and NZ Europeans. Notably, colorectal cancer mortality rates have generally increased since the early 1980s among Māori, yet have remained stable or declined among NZ Europeans. In addition, survival among Māori with colorectal cancer is lower than that for non-Māori. There is evidence of poorer access and quality of care contributing to poorer colorectal cancer survival in Māori compared with non-Māori patients. A pilot bowel cancer screening programme is planned; the authors of this paper stress that attention must be paid to the effectiveness of this programme for Māori as well as European New Zealanders. Its introduction has the potential to reduce ethnic disparities in colorectal cancer survival, if screening is accompanied by investment in diagnostic and treatment services (such as colonoscopy).
