Medical Research Centre, University of Waikato, Hamilton, New Zealand.
Faculty of Medical and Health Sciences, University of Auckland and Te Whatu Ora Health New Zealand Te Toka Tumai, Auckland, New Zealand.
Intern Med J. 2024 Mar;54(3):421-429. doi: 10.1111/imj.16202. Epub 2023 Aug 16.
Māori have three times the mortality from lung cancer compared with non-Māori. The Te Manawa Taki region has a population of 900 000, of whom 30% are Māori. We have little understanding of the factors associated with developing and diagnosing lung cancer and ethnic differences in these characteristics.
To explore the differences in the incidence and characteristics of patients with newly diagnosed lung cancer between Māori and non-Māori.
Patients were identified from the regional register. Incidence rates were calculated based on population data from the 2013 and 2018 censuses. The patient and tumour characteristics of Māori and non-Māori were compared. The analysis used Χ tests and logistic models for categorical variables and Student t tests for continuous variables.
A total of 4933 patients were included, with 1575 Māori and 3358 non-Māori. The age-standardised incidence of Māori (236 per 100 000) was 3.3 times higher than that of non-Māori. Māori were 1.3 times more likely to have an advanced stage of disease and 1.97 times more likely to have small cell lung cancer. Māori were more likely to have comorbidities, chronic obstructive pulmonary disease, cardiovascular disease and diabetes. They also had higher levels of social deprivation and tended to be younger, female and current smokers.
The findings point to the need to address barriers to early diagnosis and the need for system change including the need to introduce a lung cancer screening focussing on Māori. There is also the need for preventive programmes to address comorbidities that impact lung cancer outcomes as well as a continued emphasis on creating a smoke-free New Zealand.
与非毛利人相比，毛利人因肺癌而死亡的风险高 3 倍。特马纳瓦·塔基地区有 90 万人口，其中 30%是毛利人。我们对导致肺癌的因素以及这些因素在毛利人和非毛利人之间的差异知之甚少。
探索毛利人和非毛利人新发肺癌患者的发病率和特征差异。
从区域登记处确定患者。根据 2013 年和 2018 年的人口普查数据，计算发病率。比较毛利人和非毛利人的患者和肿瘤特征。分析采用卡方检验和逻辑模型进行分类变量分析，采用学生 t 检验进行连续变量分析。
共纳入 4933 例患者，其中 1575 例为毛利人，3358 例为非毛利人。标准化发病率显示，毛利人（236/100000）是 3.3 倍，而非毛利人（78/100000）。毛利人患晚期疾病的可能性增加了 1.3 倍，患小细胞肺癌的可能性增加了 1.97 倍。毛利人更容易患合并症，如慢性阻塞性肺疾病、心血管疾病和糖尿病。他们的社会贫困程度也更高，且更倾向于年轻、女性和当前吸烟者。
这些发现表明，需要解决早期诊断的障碍，需要进行系统变革，包括需要引入针对毛利人的肺癌筛查。还需要制定预防计划来解决影响肺癌预后的合并症，同时继续强调创建一个无烟的新西兰。
