Gov't sets aside $6.2mn to tackle inequities in cancer treatment

By Will Trafford

The government will fund $6.2 million of research tackling inequities in cancer care and survival for Māori and Pacific peoples, with lung cancer and endometrial or uterine cancer a major focus of the work.

The initiative led by The Health Research Council (HRC), Te Aho o Te Kahu, the Cancer Control Agency, and the Ministry of Health will address Māori mortality rates which when it comes to lung cancer are four times higher than non-Māori.

It's an “unacceptable disparity that has remained unchanged for at least the past 20 years," says HRC Chief Executive Professor Sunny Collings.

"If we are to eliminate the significant health inequities in cancer outcomes that exist in Aotearoa New Zealand and ensure that future public health initiatives don’t unintentionally exacerbate them, it is vital that we conduct equity-focused research from the get-go.”

Professor Diana Sarfati, Chief Executive of Te Aho o Te Kahu, says the research themes align with the greatest inequities identified in the New Zealand Cancer Action Plan unveiled in February 2019 and runs till February 2029.

“We are prioritising lung cancer research because lung cancer is our biggest cancer killer - over 1700 people die of lung cancer each year - and our most inequitable cancer. We are excited to enable research that has the potential to make a massive difference for whānau living with lung cancer in Aotearoa.”

Māori epidemiologist Associate Professor Jason Gurney (Ngāpuhi) of the University of Otago, Wellington and his team have received funding to draw together new and existing information to help improve lung cancer services for Māori, with a view to achieving equity in lung cancer survival for Māori by 2030.

“At 300 deaths per year, about the same number of Māori die from lung cancer as die from the six next most common causes of cancer death combined. Our own recent research shows strong survival disparities across all stages of lung cancer, suggesting that access to potentially curative treatment is not equal between Māori and non-Māori regardless of the stage,” says Associate Professor Gurney.

“This project will explicitly focus on understanding the role of cancer services in perpetuating inequities in lung cancer survival and identifying those factors that might be able to be modified in the short to medium-term.”

Also focused on achieving equity in lung cancer outcomes is University of Otago Associate Professor Aniruddha Chatterjee and his team who have received $1.2 million in funding to develop sensitive, cost-effective blood-based molecular tests to identify lung cancers in Aotearoa’s diverse population at an earlier stage.

“Although surgery and radiotherapy are effective treatments for early-stage lung cancer, 80 percent of patients are diagnosed with late-stage disease, when their tumours are no longer curative,” says Chatterjee.

“By developing a test that identifies the presence of tumours from plasma-derived DNA, our team aims to improve the diagnostic performance and accuracy of the proposed low-dose computed tomography (CT) national lung cancer screening programme and improve lung cancer outcomes. Because this test would only require a peripheral blood sample, sampling could be carried out within the community by rural nurses, marae-based clinics and general practices at any time, reducing geographic and ethnic inequities.”

In addition to lung cancer, gynaecologist Dr Georgina McPherson from Waitematā District Health Board has received funding to identify potential contributors to the delayed diagnosis of endometrial or uterine cancer, which is on the rise, particularly among young pre-menopausal Pacific women. Meanwhile, Maria Ngawati (Ngāti Hine) from Māori public health provider Hāpai te Hauora Tapui will pilot a new model of cancer care service for Māori that involves oncology services and Whānau Ora providers partnering together to localise cancer care within Māori community settings.

Ministry of Health Chief Science Advisor Ian Town says the research projects will promote equitable healthy futures for all New Zealanders.

“We want to support all New Zealanders to live longer and have the best possible quality of life, and are focused particularly on Māori, Pacific, disabled and rural communities. This is also a major priority of the health and disability sector reforms. Research such as this will help inform how clinical care will be planned and delivered to meet the needs of all people who use the health system,” he says.