Cancer research for Maori women

Two new separate studies aim to discover why Maori women are more likely to die from cancers of the breast and uterus than non-Maori, by looking at barriers to women getting treatment.

Dr Beverley Lawton of the University of Otago, and Dr Lis Ellison-Loschmann of Massey University hope to find out why Maori women are less likely to see a doctor soon after displaying cancer symptoms, like pain or post-menopausal bleeding.

Dr Lawton, of Ngati Porou, says her research into the life expectancy of Maori women with uterine cancer examines the journeys women are taking between noticing the first symptoms of ill health and seeking medical help.

“Our aim is to describe the particular journey for Maori and non-Maori women from the first instance of post-menopausal bleeding to their first specialist assessment.

“Uterine cancer has a pre-malignant phase and lends itself very well to preventive measures, so we want to find out why Maori women are stillmore likely to die from this disease.”

Dr Ellison-Loschmann, of Te Atiawa, Ngati Raukawa and Ngai Tahu, says her team is going to cast a wide net in their search for answers as to why Maori and Pacific women are less likely to survive breast cancer than non-Maori and non-Pacific women.

“There are all sorts of things that stop women from seeking help, whether it be that you can’t afford to pay the bill, or you can’t get a good appointment time or the kids are sick and you can’t make it.

“But we’re going to be analysing the differences in access to care and the barriers or facilitators to diagnosis in three areas: ethnicity, socio-economic factors and urban and rural residence.”

Dr Ellison-Loschmann’s study will be the first to fully explore the impact of urban and rural residence on Maori and Pacific women’s survival from cancer and will also look into ethnic differences in cancer screening uptake, which has had little work done.

A key factor that both studies will look into is the ways in which Maori women are treated by the New Zealand healthcare system.

Dr Denise Wilson, senior lecturer in nursing at Massey in Auckland, has been looking into the ways in which Maori women experience the healthcare system in New Zealand and explained her findings in the annual Oteha lecture to the university’s Te Mata o Te Tau Academy for Maori Research and Scholarship.

In her lecture, Dr Wilson of Ngati Tahinga, said Maori women often felt they weren’t treated with dignity and respect by mainstream health services.

Because of this, many do not get the treatment they need.

“There’s a real need for Maori women to be able to have effective access to health services – being able to get greeted in a pleasant way that’s going to make you feel welcome, to being able to understand the language being used, to having the time to digest what’s being said to them so they can ask questions,” Dr Wilson says.

Dr Ellison-Loschmann agrees that “physician factors” are key to the likelihood of Maori women seeking treatment for cancer.

“The perceptions and biases of health professionals are very relevant. It’s very easy to make someone feel not good in that situation.”

Dr Lawton also identifies treatment by health service staff as a potential barrier to treatment.

“Cultural confidence is definitely one of the factors we’ll be looking at, along with patient satisfaction with care, language skills and communication barriers.

“It’s about how we feel about those parts of our bodies.”

The results of both new studies are likely to have wide-reaching effects and Dr Lawton hopes that women suffering from a range of cancers will benefit from the outcomes.

“We’re hoping that results within our medical group may be able to be transposed to other cancers, like cervical cancer, to assess if the pathways to diagnosis are the same.”

Dr Lawton and Dr Ellison-Loschmann have had their work funded by the Health Research Council of New Zealand and will receive a combined total of $2.6 million over three years.