Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Ethnic or racial disparities in cancer treatment have been documented in several countries and cancer types. We examined and compared treatment of Mâori (Indigenous) and non-Mâori New Zealanders with colon cancer.
From the New Zealand Cancer Registry we identified a population-based cohort of 629 patients diagnosed with colon cancer between 1996 and 2003. We reviewed medical notes and compared surgical and oncology treatment in Mâori and non-Mâori patients. We adjusted treatment differences for tumour characteristics, patient comorbidity and treatment facility type.
Mâori and non-Mâori patients received similar rates of surgical resection although Mâori patients were less likely to have extensive lymph node clearance (relative risk (RR) 0.25, 95% CI 0.13 to 0.50 for removal of 30 or more nodes) and were more likely to die in the post-operative period (RR 5.31, 95% CI 1.54 to 18.32 for death following elective surgery). In patients with stage III disease Mâori were significantly less likely to receive chemotherapy (RR 0.69, 95% CI 0.53 to 0.91) and more likely to experience delay of at least eight weeks to start chemotherapy (RR 1.98, 95% CI 1.23 to 3.16). Treatment disparities were not accounted for by patient comorbidity or treatment facility type (public cancer centre, public non-cancer centre and private facility) although differences within facility types remain a potential explanatory factor.
Mâori and non-Mâori patients with colon cancer receive similar surgical treatment but Mâori are less likely to receive adjuvant chemotherapy and may experience a lower quality of care. Attention to health-system factors is needed to ensure equal access and quality of cancer treatment.