Māori missing early cancer diagnoses

There is strong evidence that Māori cancer patients are more likely to die of their cancer than non-Māori cancer patients, and one of the possible drivers of this inequity is differential access to timely diagnosis.

Combining New Zealand Cancer Registry (NZCR) and available clinical audit data, we found that Maori are less likely to be diagnosed with localised disease and more likely to be diagnosed with advanced disease for several common cancers.

However, this is not the case for all cancers: both NZCR and clinical audit data agree that Maori patients are marginally less likely to be diagnosed with metastatic lung and liver cancers than European/Other patients, and differences for pancreatic and stomach cancers are negligible.

When compared to gold-standard clinical audit data, the NZCR underestimates the proportion of both Maori and European/Other patients with metastasised disease at diagnosis.

For several key cancers, NZCR staging data is inadequate for ascertaining the stage at diagnosis (particularly for Māori), and a review of clinical notes is required to gauge what is actually happening.
Summary

In this study, we combined the best available data on stage of cancer at diagnosis for Māori and European/Other New Zealanders. We compared the two ethnic groups and found that while Māori are less likely to be diagnosed with early stage at diagnosis for several commonly-diagnosed cancers, this is not the case for all cancers. In our paper we talk about the weaknesses of our national cancer registry in terms of allowing us to monitor stage at diagnosis for Māori (and non-Māori) patients.