Eru Pōmare Māori Health Research Centre, Department of Public Health, University of Otago, Wellington, School of Medicine and Health Sciences, New Zealand.
Aust N Z J Public Health. 2010 Apr;34(2):193-9. doi: 10.1111/j.1753-6405.2010.00506.x.
Māori women in New Zealand have higher incidence of and mortality from cervical cancer than non-Māori women, however limited research has examined differences in treatment and survival between these groups. This study aims to determine if ethnic disparities in treatment and survival exist among a cohort of Māori and non-Māori women with cervical cancer.
A retrospective cohort study of 1911 women (344 Māori and 1567 non-Māori) identified from the New Zealand Cancer Register with cervical cancer (adenocarcinoma, adenosquamous or squamous cell carcinoma) between 1 January 1996 and 31 December 2006.
Māori women with cervical cancer had a higher receipt of total hysterectomies, and similar receipt of radical hysterectomies and brachytherapy as primary treatment, compared to non-Māori women (age and stage adjusted). Over the cohort period, Māori women had poorer cancer specific survival than non-Māori women (mortality hazard ratio (HR) 2.07, 95% confidence interval (CI): 1.63-2.62). From 1996 to 2005, the survival for Māori improved significantly relative to non-Māori.
Māori continue to have higher incidence and mortality than non-Māori from cervical cancer although disparities are improving. Survival disparities are also improving. Treatment (as measured) by ethnicity is similar.
Primary prevention and early detection remain key interventions for addressing Māori needs and reducing inequalities in cervical cancer in New Zealand.
新西兰毛利族女性宫颈癌的发病率和死亡率均高于非毛利族女性，但针对这两组人群在治疗和生存方面差异的研究有限。本研究旨在确定在一组毛利族和非毛利族宫颈癌女性患者中，是否存在治疗和生存方面的种族差异。
对 1911 名（344 名毛利族和 1567 名非毛利族）新西兰癌症登记处（1996 年 1 月 1 日至 2006 年 12 月 31 日）登记的宫颈癌（腺癌、腺鳞癌或鳞状细胞癌）女性患者进行回顾性队列研究。
与非毛利族女性相比，毛利族宫颈癌患者接受全子宫切除术的比例较高，而接受根治性子宫切除术和近距离放疗作为主要治疗方法的比例相似（年龄和分期调整后）。在整个队列期间，毛利族女性的癌症特异性生存率低于非毛利族女性（死亡风险比（HR）2.07，95%置信区间（CI）：1.63-2.62）。1996 年至 2005 年，毛利族女性的生存率相对于非毛利族女性显著提高。
尽管毛利族女性宫颈癌的发病率和死亡率仍高于非毛利族女性，但差距正在缩小。生存差距也在改善。种族差异对治疗（按测量）的影响不大。
初级预防和早期发现仍然是解决毛利族需求和减少新西兰宫颈癌不平等的关键干预措施。
