title: Improving survival disparities in cervical cancer between Māori and non-Māori women in New Zealand: a national retrospective cohort study.
abstract: OBJECTIVE
  Māori women in New Zealand have higher incidence of and mortality from cervical cancer than non-Māori women, however limited research has examined differences in treatment and survival between these groups. This study aims to determine if ethnic disparities in treatment and survival exist among a cohort of Māori and non-Māori women with cervical cancer.
  
  
  METHODS
  A retrospective cohort study of 1911 women (344 Māori and 1567 non-Māori) identified from the New Zealand Cancer Register with cervical cancer (adenocarcinoma, adenosquamous or squamous cell carcinoma) between 1 January 1996 and 31 December 2006.
  
  
  RESULTS
  Māori women with cervical cancer had a higher receipt of total hysterectomies, and similar receipt of radical hysterectomies and brachytherapy as primary treatment, compared to non-Māori women (age and stage adjusted). Over the cohort period, Māori women had poorer cancer specific survival than non-Māori women (mortality hazard ratio (HR) 2.07, 95% confidence interval (CI): 1.63-2.62). From 1996 to 2005, the survival for Māori improved significantly relative to non-Māori.
  
  
  CONCLUSIONS
  Māori continue to have higher incidence and mortality than non-Māori from cervical cancer although disparities are improving. Survival disparities are also improving. Treatment (as measured) by ethnicity is similar.
  
  
  CONCLUSIONS
  Primary prevention and early detection remain key interventions for addressing Māori needs and reducing inequalities in cervical cancer in New Zealand.
authors: Eru Pōmare Māori Health Research Centre, Department of Public Health, University of Otago, Wellington, School of Medicine and Health Sciences, New Zealand.
authors: Melissa
authors: M
authors: McLeod
authors: Ricci
authors: R
authors: Harris
authors: Gordon
authors: G
authors: Purdie
authors: Donna
authors: D
authors: Cormack
authors: Bridget
authors: B
authors: Robson
authors: Peter
authors: P
authors: Sykes
authors: Sue
authors: S
authors: Crengle
authors: Douglas
authors: D
authors: Iupati
authors: Nick
authors: N
authors: Walker
mesh_terms: D000328:Adult; D000367:Age Factors; D002277:Carcinoma / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D016001:Confidence Intervals; D005006:Ethnicity; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance; D011203:Poverty; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D044465:White People / Q000706:statistics & numerical data*