Health Disparities of Head and Neck Cancer in Māori and European in Mid Central New Zealand 2014-2020.

BACKGROUND

Māori face notable survival disparities for head and neck cancer (HNC). New studies on HNC disparities with a rural lens are limited. This study aims to assess differences in HNC survival and treatment between Māori and Europeans in the Mid Central region of New Zealand (NZ), identify survival-correlating factors, and highlight areas for health system improvement.

METHOD: This retrospective study examined Māori and European patients managed through the Mid Central Regional Head and Neck Meeting for HNC from 2014 to 2020. Data on mortality, treatment modalities, demographics, comorbidities, Eastern Cooperative Oncology Group (ECOG) status, smoking and disease characteristics were collected from electronic patient records. Statistical analysis included Fisher's exact test, Welch's t test, Wilcoxon rank-sum tests, Kaplan-Meier curves and Cox Proportional Hazard regression.

RESULTS

The study included 49 Māori and 318 European patients. Overall HNC 5-year survival was 76%, with no statistically significant difference between Māori and Europeans. Māori were diagnosed an average of 7 years younger and were more likely to present with stage 4 disease. No significant differences between the groups were observed in treatment goal, modality, or delay. One-quarter of all patients received treatment beyond the 62-day target set by the Ministry of Health (MOH).

CONCLUSION

Although no difference in 5-year survival was found, Māori continue to experience poorer outcomes in other ways. The identified disparities emphasise the need to improve social determinants of health, cultural safety of service, and primary care. Future research should identify specific barriers and assess the effectiveness of transitions from primary to secondary care.