New research has exposed significant differences in access to cancer treatment across Aotearoa, with some rural patients — including Māori — less likely to receive radiotherapy than people living in urban centres.
The first nationwide study comparing rural and urban access to radiotherapy examined treatment for breast, prostate and lung cancers, comparing Māori and non-Māori patients across different parts of the country.
Led by researchers at the University of Otago – Ōtākou Whakaihu Waka, the study highlights the additional barriers faced by cancer patients who live far from major treatment centres.
Around one-third of New Zealanders with cancer receive radiation treatment, but radiotherapy centres and specialist oncology services are generally concentrated in major cities.
That means rural patients can face significant travel and accommodation requirements, as well as spending extended periods away from their whānau while receiving treatment.
The disparities were particularly concerning for some Māori patients.
Rural Māori aged 75 and over with lung cancer received curative radiotherapy at a rate 66 percent lower than Māori of the same age living in urban areas.
Women with breast cancer aged over 75 living in small towns and rural non-Māori women aged between 45 and 64 were also found to have lower rates of radiotherapy.
The research uncovered another significant disparity for younger wāhine Māori.
Māori women under 45 with breast cancer received radiotherapy at lower rates than non-Māori women of the same age living in the same geographical areas.
In the most remote parts of the country, radiotherapy rates for those younger Māori women were 50 percent lower.
Researchers say lower rates of radiotherapy for breast cancer are generally associated with higher rates of total mastectomy rather than breast-conserving surgery followed by radiation treatment.
However, the rural picture was not the same across every cancer.
Rural men with prostate cancer received radiotherapy at rates 47 percent higher than their urban counterparts, while rural men and women with lung cancer had rates about 90 percent higher.
Researchers say those differences could reflect factors including patient choice, higher cancer incidence or later diagnosis, but further research is needed.
The study points towards practical measures that could improve access, including better transport and accommodation support, stronger communication with local health teams and greater engagement with communities about the social and cultural needs of patients.
Researchers are also calling for targeted action to address ethnic inequities, including identifying barriers to diagnosis and treatment for Māori, improving cultural safety and increasing the Māori workforce across radiation therapy and other cancer services.
The findings add another dimension to the debate over healthcare equity in Aotearoa — showing that where someone lives, as well as whether they are Māori, can influence the cancer treatment they receive.
For rural whānau facing a cancer diagnosis, distance from a major city should not determine their chance of accessing potentially life-saving treatment.
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