We all know someone with that dreaded cough.
The one that lingers for months. The one that gets brushed off as a smoker’s cough, winter bugs, getting older, or just part of life.
For too many Māori whānau, that cough becomes something far more serious.
As Radio Waatea continues its Men’s Health Week series examining the five biggest preventable killers of tāne Māori, today’s focus is on lung cancer — the deadliest cancer affecting Māori in Aotearoa.
Over years of reporting on Māori health, one statistic continues to stand out above almost every other cancer-related figure: more Māori die from lung cancer each year than from the next five most common cancer causes combined.
It is a staggering reality.
A Disease Hitting Māori Harder
Lung cancer remains one of the greatest health inequities facing Māori.
Research shows Māori men are more than three times more likely to be diagnosed with lung cancer than non-Māori men.
The outlook remains grim after diagnosis.
Even when diagnosed at similar stages of disease, Māori patients are around 30 percent more likely to die from lung cancer than non-Māori patients.
For rural Māori men, the challenge can be even greater.
Distance from specialist services, transport barriers, workforce shortages and delayed access to diagnostic testing continue to create obstacles to timely care.
Health advocates say geography should never determine survival, yet it remains a reality for many whānau living outside major centres.
The Problem of Late Diagnosis
One of the biggest challenges facing lung cancer treatment is timing.
Health experts estimate that up to 80 percent of lung cancer cases are diagnosed only after the disease has already advanced.
By then, treatment options become significantly more limited.
Early-stage lung cancer often produces few obvious symptoms.
A persistent cough, shortness of breath, chest pain, unexplained weight loss, recurring chest infections or coughing up blood may all be warning signs, but many people delay seeking medical advice.
Some simply put symptoms down to smoking, ageing or poor fitness.
Others struggle to access healthcare quickly.
The result is that many diagnoses occur too late.
Smoking Remains the Biggest Risk
Health professionals are united on one point: tobacco smoking remains the single largest cause of lung cancer.
While smoking rates among Māori have declined significantly over recent decades, the legacy effects remain visible across generations.
The damage caused by smoking accumulates over many years, which means today’s lung cancer statistics often reflect smoking patterns from decades ago.
The encouraging news is that quitting works.
Research consistently shows stopping smoking reduces lung cancer risk at any age.
The earlier someone quits, the greater the health benefit, but even people who have smoked for decades can significantly improve their health outcomes by stopping.
Avoiding second-hand smoke is equally important, particularly around tamariki and mokopuna.
Are Māori More Vulnerable?
Researchers are increasingly investigating why lung cancer affects Māori so severely.
Studies suggest Māori may experience smoking-related lung damage at younger ages and may have higher rates of chronic respiratory conditions such as Chronic Obstructive Pulmonary Disease (COPD).
There is also evidence that Māori are more likely to be diagnosed with particularly aggressive forms of lung cancer.
While more research is needed, experts say these findings reinforce the need for earlier intervention and stronger prevention programmes.
The Promise of Screening
One of the most exciting developments in lung cancer prevention is the growing focus on screening.
International studies have shown that low-dose CT scanning can identify lung cancer years before symptoms develop.
Finding cancer earlier dramatically improves survival rates.
In Aotearoa, initiatives such as the Māori-led Te Oranga Pūkahukahu programme are helping shape future screening models designed to work effectively for Māori communities.
Health leaders say equitable access must sit at the centre of any future national screening programme.
Historically, Māori have often missed out on the benefits of new health initiatives because systems were designed around the needs of the majority population rather than those at highest risk.
Advocates argue lung cancer screening provides an opportunity to do things differently.
Looking Beyond Smoking
While quitting smoking remains the most important step, experts say broader lifestyle factors also matter.
Regular physical activity has been linked to reduced cancer risk and improved lung health.
Eating a balanced diet rich in vegetables, fruit, legumes and whole grains helps support overall wellbeing and resilience.
Reducing exposure to environmental hazards is another important factor.
Workplace exposure to asbestos, diesel exhaust and airborne pollutants can increase lung cancer risk.
Experts also recommend testing homes for radon gas where appropriate, as it remains one of the leading causes of lung cancer worldwide after smoking.
The Conversation We Need to Have
One of the most powerful tools available is awareness.
Many Māori men are reluctant to visit a doctor until symptoms become severe.
Health providers continue to encourage men to have conversations with whānau, friends and healthcare professionals about persistent respiratory symptoms.
The message is simple: do not ignore that cough.
Getting checked early could save your life.
For Waatea’s Men’s Health Week series, lung cancer sits at number two on the list of the five biggest potentially preventable killers of tāne Māori.
The challenge facing Aotearoa is not simply reducing smoking rates but ensuring Māori receive the same opportunities for early diagnosis, treatment and survival as every other New Zealander.
Tomorrow, Radio Waatea turns its attention to another major killer of Māori men — gastrointestinal cancers, including bowel cancer, where early detection can make the difference between life and death.
Until then, if you know someone with that dreaded cough, encourage them to get it checked.
Their whānau may be depending on it.
