Ethnicity and Management of Colon Cancer in New Zealand: Do Indigenous Patients Get a Worse Deal?

Sarah Hill, Diana Sarfati, Tony Blakely, Bridget Robson, Gordon Purdie, Elizabeth Dennett, Donna Cormack, Kevin Dew, John Z. Ayanian, Ichiro Kawachi

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: Racial and ethnic inequalities in colon cancer treatment have been reported in the United States but not elsewhere. The authors of this report compared cancer treatment in a nationally representative cohort of Maori (indigenous) and non-Maori New Zealanders with colon cancer. METHODS: On the basis of cancer registry data, 301 Maori patients and 329 randomly selected non-Maori patients were identified who were diagnosed with colon cancer between 1996 and 2003. Medical notes were reviewed, and surgical and oncology treatments were compared by indigenous status. RESULTS: Maori and non-Maori patients had similar rates of surgical resection, although Maori patients were less likely to undergo extensive lymph node clearance and were more likely to die during the postoperative period. Maori patients were significantly less likely to receive chemotherapy for stage III disease (relative risk [RR], 0.69; 95% confidence interval [CI], 0.53-0.91) and were more likely to experience a delay of at least 8 weeks before starting chemotherapy (RR, 1.98; 95%CI, 1.23-3.16). Treatment disparities were not explained by differences in tumor characteristics or patient comorbidity. CONCLUSIONS: Maori New Zealanders with colon cancer were less likely to receive adjuvant chemotherapy and experienced a lower quality of care compared with non-Maori patients. The authors concluded that attention to health system factors is needed to ensure equal access and quality of cancer treatment for indigenous and ethnic minority populations. Cancer 2010;116:3205-14. (C) 2010 American Cancer Society.
Original languageEnglish
Pages (from-to)3205-3214
Number of pages10
JournalCancer
Volume116
Issue number13
DOIs
Publication statusPublished - 1 Jul 2010

Keywords / Materials (for Non-textual outputs)

  • colonic neoplasms
  • delivery of healthcare
  • ethnic groups
  • indigenous populations
  • New Zealand

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