Improving survival disparities in cervical cancer between maori and non-Māori women in New Zealand: A national retrospective cohort study

Abstract

Objective: Maori 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 Maori and non-Māori women with cervical cancer. Methods: A retrospective cohort study of 1911 women (344 Maori and 1567 nonMāori) identified from the New Zealand Cancer Register with cervical cancer (adenocarcinoma, adenosquamous or squamous cell carcinoma) between 1 January 1996 and 31 December 2006. Results: Maori women with cervical cancer had a higher receipt of total hysterectomies, and similar receipt of radical hysterectomies and brachytherapy as primary treatment, compared to nonMāori women (age and stage adjusted). Over the cohort period, Maori women had poorer cancer specific survival than non-Māori women (mortality hazard ratio (HR) 2.07, 95% confidence interval (Cl): 1.63-2.62). From 1996 to 2005, the survival for Maori improved significantly relative to non-Māori. Conclusion: Maori continue to have higher incidence and mortality than non-Maori from cervical cancer although disparities are improving. Survival disparities are also improving. Treatment (as measured) by ethnicity is similar. Implications: Primary prevention and early detection remain key interventions for addressing Maori needs and reducing inequalities in cervical cancer In New Zealand. © 2010 The Authors.