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Keywords:

  • Cervix neoplasms;
  • cervical cancer;
  • survival;
  • survival analyses;
  • ethnicity;
  • treatment

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Implications: Primary prevention and early detection remain key interventions for addressing Māori needs and reducing inequalities in cervical cancer in New Zealand.