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Thursday, August 26

Unequal Impact of Cancer Rates

For ten years to 2006, Māori mortality rates for cervical cancer fell by 11% per year. This is more than double the non-Māori drop in death rates over the same period (5% per year).

The conclusion from an Otago University report prepared for the Ministry of Health indicates that this success is not being replicated elsewhere.

The report is called Unequal Impact II: Māori and Non-Māori Cancer Statistics by Deprivation and Rural–Urban Status 2002–2006.

Funded by Te Kete Hauora and prepared by Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington, this publication follows on from the first cancer chart book Unequal Impact: Māori and Non-Māori Cancer Statistics 1996-2001, which provided specific information about the unequal distribution of cancer incidence and outcomes for Māori compared with Non-Māori.

Unequal Impact II: Māori and Non-Māori Cancer Statistics by Deprivation and Rural-Urban Status 2002-2006 builds on the first cancer chart book, investigating the role of area deprivation and rural-urban status on Māori and Non-Māori cancer incidence, stage at diagnosis, survival and mortality.

Area deprivation and/or rural-urban status have the potential to influence disparities in cancer incidence and outcomes through a range of avenues and mechanisms. Selected findings from the second chart book include:

 
50% of Māori cancer registrations during the period 2002–2006, compared to 18% of non-Māori, were among people living in the two most socio-economically deprived deciles (deciles 9 and 10) at the time of their diagnosis.

The deprivation gradient in incidence and mortality, which indicates cancer registration and death age-standardised rates by deprivation decile, shows a steeper gradient for Māori than non-Māori.

Cancer incidence is lowest in rural areas (for both Māori and non-Māori), and higher in small towns than main urban areas (among Māori only).

Rural residents and small town residents have poorer survival chances than main urban residents.

Findings such as these would indicate that while cancer incidence is lowest in rural areas, rural status also results in poorer access to cancer care for patients following diagnosis.
 
The impact of factors such as deprivation and rural-urban status on cancer require further study.

Deputy Director-General Māori Health Teresa Wall says in recent years, considerable work has taken place to enhance the aspects of the system that are doing well.

“There has been improvement, particularly in the area of cervical cancer. But overall, the burden of cancer continues to disproportionately impact on Māori.”

"We must continue in our drive for better services that deliver high quality, patient-centred health care. Early diagnosis and early treatment are two areas in particular, where we could enhance the effectiveness of services to ensure the needs of all patients are being met.”



“And we must continue to track our progress to ensure these improvements are making a difference where it really matters,” Ms Wall says.