Director of health outcomes Dr Karen Bartholomew, principal investigatoron the project. Photo / supplied
Director of health outcomes Dr Karen Bartholomew, principal investigatoron the project. Photo / supplied
A study hopes to better understand why more Māori women are dying of breast cancer than any other ethnicity across the country.
Māori women were 65 per cent more likely to die from breast cancer than non-Māori women.
"That number is pretty shocking and we want to use this as an opportunity to improve those health outcomes," Waitemata District Health Board director of health outcomes Dr Karen Bartholomew said.
Bartholomew - who was leading the research - said radiotherapy was an important step in reducing long-term mortality rates however some groups of women - particularly Māori - were less likely to take it up or complete the treatment.
"There are a number of factors that influence women's decision for treatment, whether that be the type of cancer they have or how far they have to travel or various other reasons.
"We want to understand those choices in detail and look at how we can make a difference in improving women's breast cancer outcomes."
The 12-month-research, funded by Waitemata and Auckland district health boards, Health Research Council of New Zealand and the Breast Cancer Foundation, started earlier this month.
The research was being divided into two parts. The first part was looking at the national Breast Cancer Register data around women who were eligible for surgery and numbers that start and complete radiotherapy.
The second part involved interviewing 180 patients across five DHB areas - Waitemata, Auckland, Northland, Counties Manukau and Waikato - to better understand their experiences.
Bartholomew said there was a lot of research done on this internationally but on a local level these inequalities hadn't been looked at in enough detail.
"This is a fantastic opportunity to work collaboratively with researchers, clinicians, patients, funding bodies and DHBs to generate insights that will lead to direct improvement in services."
Research manager Adèle Gautier from Breast Cancer Foundation NZ said Bartholomew's study would give practical insights into why people were turning down radiotherapy, not completing their course, or opting for a more radical treatment – mastectomy – so they could avoid radiotherapy.
"If it's because they can't afford the time or travel for radiation therapy on top of all the other treatments they've had, then that's a critical issue our health system needs to address.
"We know radiotherapy can help prevent breast cancer coming back, so it's worrying when people aren't having the full treatment recommended," Gautier said.
Waitemata DHB CEO Dr Dale Bramley said patients would have a strong voice throughout this research, ensuring it unearthed important new insights and identified barriers along the treatment pathway.
"In order to provide the very best standards of care to our community, we need a deep understanding of the issues that impact people's choices when it comes to health and wellbeing. Powered by these findings, we can better tailor services to meet current and future demand," Bramley said.
Facts and figures:
• The number of Māori diagnosed with breast cancer each year was about 35 per cent higher than non-Maori.
• Māori death rates from breast cancer were on average 65 per cent higher than non-Maori.
• Maori five-year survival after diagnosis of advanced breast cancer was 5 per cent compared with 15 per cent for non-Maori.
Case study:
Shona Kelway, 55, described herself as the perfect breast cancer statistic.
"I'm of that age, I'm Māori and I'm overweight."
She was diagnosed three years ago, yet against those odds she managed to beat it by opting for treatment as soon as it was detected.
Pukekohe woman Shona Kelway chose to be treated as soon as she was diagnosed three years ago. Photo / supplied
Kelway - who lives in Pukekohe - said, for her, it was about doing everything in her power to make sure that she was around to see her children and grandchildren grow up.
But she understood that for some it wasn't that black and white.
"I did a talk to some radiologists about a year ago and we tried to answer why some Māori weren't taking up treatment."
She said some women found it too time consuming - transport was an issue, poverty was an issue and some felt it was more important to look after the other people in their family.
"Others just felt that they didn't want to know, they weren't even getting mammograms and some just didn't feel like their lives were that important."
Kelway said it sounded clique but having breast cancer changed her outlook on life.
"I want to live life to the fullest and I try not to get too bogged down in what's not important. It's all about being happy and making others around you happy - don't sweat the small stuff.
