When most people think about bowel cancer, they imagine it as a disease that affects older people.
The latest research tells a different story for Māori men.
As Radio Waatea continues its Men’s Health Week series on the five biggest potentially preventable killers of tāne Māori, the spotlight turns to gastrointestinal cancers — particularly bowel cancer and stomach cancer — diseases that continue to claim far too many Māori lives.
What is alarming health experts is not only the number of Māori men developing these cancers, but how much earlier they are appearing compared with the rest of the population.
For many whānau, the first sign of trouble comes when it is already too late.
A Disease Affecting Māori at Younger Ages
Research shows around 52 percent of Māori men diagnosed with bowel cancer are under the age of 60.
That figure is significantly higher than for non-Māori.
Even more concerning, studies from the University of Otago have found bowel cancer rates among Māori under the age of 50 are increasing by approximately 36 percent every decade.
Health researchers say this trend should ring alarm bells throughout the health sector.
Traditionally, bowel cancer has been considered a disease of older adults.
The evidence now suggests Māori men are increasingly developing the disease much earlier in life.
Too Many Diagnosed Too Late
One of the most troubling findings is how bowel cancer is often discovered.
Research from projects such as PIPER has found that up to 39 percent of Māori patients first present with bowel cancer through Emergency Departments rather than through routine screening or primary healthcare services.
In practical terms, many men are not being diagnosed until symptoms become severe enough to require urgent medical attention.
By that stage, treatment options are often more complex and outcomes less favourable.
Māori are also more likely to be diagnosed with Stage 4 bowel cancer, the most advanced stage of the disease.
Health advocates say this highlights the importance of earlier screening, stronger primary healthcare engagement and greater awareness of warning signs.
A Hidden Inequity in Hospital Care
Recent research published in the British Journal of Surgery has revealed another concerning disparity.
While Māori experience surgical complications at rates similar to non-Māori patients, they are almost twice as likely to die from those complications.
Researchers suggest the difference is not the surgery itself but what happens afterwards.
The findings indicate Māori patients are less likely to have complications recognised and treated quickly enough, exposing ongoing inequities within hospital systems.
Health leaders say these findings reinforce long-standing concerns about institutional bias and unequal healthcare outcomes.
Stomach Cancer Remains a Major Threat
While bowel cancer receives increasing public attention, stomach cancer remains another major health challenge for Māori men.
Statistics show Māori men experience two to three times the incidence of stomach cancer compared with New Zealanders of European descent.
Death rates are even more alarming, with Māori experiencing three to four times the mortality rate.
Researchers have identified one major factor contributing to this inequity: Helicobacter pylori, commonly known as H. pylori.
This bacterial infection is responsible for more than half of the excess stomach cancer cases experienced by Māori men.
The infection is strongly associated with overcrowded housing and childhood poverty, creating a direct link between social conditions and cancer risk.
The encouraging news is that H. pylori can be identified through relatively simple medical testing and treated with antibiotics before cancer develops.
The Power of Early Detection
Health experts consistently describe screening as one of the most powerful tools available for reducing cancer deaths.
Bowel cancer is highly treatable when detected early.
The National Bowel Screening Programme currently provides free at-home testing kits for eligible New Zealanders.
However, many Māori health organisations continue to advocate for earlier screening eligibility for Māori because of the younger age at which bowel cancer develops.
Groups such as Bowel Cancer New Zealand have argued that screening should begin between ages 45 and 50 for Māori rather than waiting until later life.
Many clinicians believe this change could save lives.
Health professionals stress that men should never wait for an invitation if they experience symptoms.
Changes in bowel habits, blood in the stool, unexplained weight loss, ongoing abdominal pain or persistent fatigue should all be discussed with a healthcare provider.
Food Matters
Research continues to show a strong connection between diet and bowel health.
Health New Zealand and the Cancer Society recommend increasing fibre intake through whole grains, vegetables, fruit, legumes and beans.
Most New Zealanders consume significantly less fibre than recommended.
Experts say a fibre-rich diet helps maintain a healthy digestive system and reduces exposure to toxins within the bowel.
At the same time, reducing processed meats such as bacon, sausages, salami and ham is strongly advised.
Red meat consumption should also be moderated, with experts recommending no more than 700 grams of uncooked red meat each week.
Staying hydrated remains another simple but important strategy for maintaining gut health.
Lifestyle Changes Save Lives
As with many diseases affecting Māori men, lifestyle factors continue to play a major role.
Smoking remains one of the most preventable causes of gastrointestinal cancers.
Alcohol consumption also increases bowel cancer risk, even at moderate levels.
Regular exercise and maintaining a healthy body weight have been shown to reduce cancer risk and improve overall wellbeing.
For men with a family history of bowel cancer, the message is even more urgent.
Specialist surveillance programmes are available for those considered high-risk, allowing earlier monitoring and intervention.
A Conversation Every Whānau Needs
Health experts often describe bowel cancer as one of the cancers people are least comfortable talking about.
Many symptoms involve bodily functions that men can find embarrassing to discuss.
That reluctance can be deadly.
For Radio Waatea’s Men’s Health Week series, gastrointestinal cancers rank third among the five biggest potentially preventable killers of tāne Māori because they represent one of the clearest examples of where earlier diagnosis can dramatically improve outcomes.
The challenge for Māori communities, healthcare providers and policymakers is ensuring that screening, treatment and prevention programmes reach those most at risk.
The message is straightforward: don’t wait.
Talk to your doctor. Learn your whānau history. Get screened when eligible. Pay attention to symptoms.
Because when bowel or stomach cancer is found early, lives can be saved.
Tomorrow, Radio Waatea turns its attention to another growing health challenge facing Māori men — Type 2 diabetes, a disease affecting Māori at twice the rate of non-Māori and driving a range of serious health complications across Aotearoa.
