Department of Public Health, University of Otago, Wellington, New Zealand.
Te Ngira Institute for Population Research, University of Waikato, Hamilton, New Zealand.
N Z Med J. 2024 Nov 8;137(1605):40-58. doi: 10.26635/6965.6422.
Māori are less likely to survive their lung cancer once diagnosed, but it remains unclear whether this is partially driven by poorer access to best-practice diagnostic services.
We examined all lung cancer registrations in Aotearoa New Zealand between 2007-2019 (n=27,869) linked to national administrative health datasets and further stratified by ethnicity, tumour type and stage of disease. Using descriptive and regression analyses, we compared ethnic groups in terms of the basis of diagnosis (e.g., histology, cytology), receipt of bronchoscopy and travel distance and time to access bronchoscopy.
We found no differences in access to a pathological diagnosis between ethnic groups regardless of cancer type or stage. We found that Māori within the cohort were marginally more likely to access bronchoscopy than the majority European group; however, we also found that Māori had lower odds of living close to the location of their bronchoscopy, and correspondingly higher odds of living 100-200km (adjusted odds ratio [adj. OR] 1.46, 95% confidence interval [CI] 1.26-1.69) or more than 200km away (1.36, 95% CI 1.15-1.61) than Europeans.
Interventions that aim to further support Māori to overcome the systematic and cumulative disadvantages in access to cancer care should be broadly supported and resourced.
毛利人一旦被诊断出患有肺癌，其存活率就较低，但目前尚不清楚这是否部分归因于他们获得最佳诊断服务的机会较差。
我们检查了 2007-2019 年间在新西兰（n=27869）所有被诊断患有肺癌的患者，这些患者的信息与国家行政健康数据集相关联，并根据种族、肿瘤类型和疾病阶段进一步分层。我们使用描述性和回归分析，根据诊断依据（例如组织学、细胞学）、接受支气管镜检查的情况以及进行支气管镜检查的旅行距离和时间，比较了不同种族群体之间的差异。
无论癌症类型或阶段如何，我们发现不同种族群体之间在获得病理诊断方面没有差异。我们发现，与大多数欧洲群体相比，队列中的毛利人更有可能接受支气管镜检查；然而，我们还发现毛利人更不可能居住在接受支气管镜检查的地点附近，而居住在 100-200 公里（调整后的优势比 [adj. OR] 1.46，95%置信区间 [CI] 1.26-1.69）或 200 公里以上（1.36，95% CI 1.15-1.61）的可能性更高。
应广泛支持和为旨在进一步支持毛利人克服在获得癌症护理方面存在的系统性和累积劣势的干预措施提供资源。
