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The effect of Māori ethnicity misclassification on cervical screening coverage

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Summary:

These researchers examined data from Waitemata District Health Board’s two Primary Health Organisations (PHOs) to identify the population of Waitemata domiciled women aged 25–69 years eligible for cervical screening. Their cervical screening status was obtained from the National Cervical Screening Programme register (NCSP-R). Auckland and Waitemata DHB data were used to determine the women’s ethnicity in the National Health Index (NHI). Ethnicity codes from the three sources (PHO registers, NCSP-R and NHI) were compared to identify women classified as non-Māori in the NCSP-R but Māori in either of the other two data sources. Of a total of 6718 women identified as Māori on the NCSP, 5242 had been screened within the last 3 years and 1476 had not. An additional 2075 women who identified as Māori in either the PHO or NHI databases but not in the NCSP-R had been screened within the preceding 3 years, and a further 2094 had not been screened. Moreover, 797 women identified as Māori in the NHI or PHO datasets who were not on the NCSP-R (and therefore were not screened). After adjusting ethnicity data to include all screened women classified as Māori from any source, the Waitemata DHB Māori screening coverage rate increased from 49.3% to 68.8% (or to 61.0% and 63.2%, respectively, after adjusting for just PHO or NHI Māori).

Comment:
The findings are of particular importance for those PHOs and practices with large numbers of Māori women. Hopefully, the NCSP team overseeing the register will be able to address the problem.
Reference: N Z Med J 2013;126(1372):55-65
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.

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