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Indigenous inequities in the presentation and management of stomach cancer in New Zealand: a country with universal health care coverage

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Authors:
Summary:

These researchers investigated the presentation, management and survival of stomach cancer in a cohort of newly diagnosed Māori and non-Māori patients. They reviewed the clinical notes of all Māori from the North Island diagnosed between 2006 and 2008, and a random equivalent sample of non-Māori (final cohort n=335). Compared to non-Māori, Māori patients had a younger average age at diagnosis, a higher prevalence of congestive heart failure and renal disease, and were more likely to be diagnosed with distal disease (43% Māori vs 26% non-Māori; p=0.004). Stage and grade distributions were similar between ethnic groups. Two-thirds (66%) of stage I–III patients had definitive surgery; rates were similar rates between Māori and non-Māori (71% vs 68%). Māori were less likely to have surgery performed by a specialist upper gastrointestinal surgeon (38% Māori vs 79% non-Māori; p<0.01) and less likely to be treated in a main centre (44% Māori vs 87% non-Māori; p<0.01). In multivariate analyses adjusted for age, sex, stage, tumour site and comorbidity, survival was poorer among Māori (hazard ratio 1.27; 95% CI, 0.96 to 1.68).

Comment:
Another example of unequal treatment and inequities in cancer outcomes between Māori and non-Māori in Aotearoa. I liked that the authors have highlighted the fact that this is supposedly ‘a country with universal health care’!
Reference: Gastric Cancer. 2015;18(3):571-9
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.

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