Abstract
Aim: Research shows survival disparities between Māori and non-Māori colon cancer patients, with comorbidity and cancer care being major contributing factors. We studied rectal cancer management and survival in a cohort of Māori and non-Māori patients with a newly diagnosed rectal cancer.
Methods: 194 Māori and non-Māori patients diagnosed with rectal cancer between 2006 and 2008 were identified from the New Zealand Cancer Registry. Medical records were reviewed and patients compared on presentation, patient and tumour characteristics, and receipt and timing of treatment. Cox regression models were fitted to compare cancer-specific survival.
Results: Compared to non-Māori patients, Māori patients were younger (mean age at diagnosis 63.5 and 69.2 for Māori and Non-Māori respectively; p<0.001) and had higher prevalence of comorbidity. Stage, grade and tumour size distributions were similar. Almost all stage I-III patients (97%) underwent definitive surgery, with no difference between Māori and non-Māori. Māori patients waited longer for referral to medical oncologists (40 days vs. 33 days; p=0.03). Results suggested Māori patients with stage IV disease may be less likely than non-Māori to be referred to palliative care (13% vs. 40%; p=0.07). The hazard ratio for cancer-specific death for Māori compared with non-Māori patients was 1.24 (95% CI 0.65-2.35).
Conclusion: The findings suggest both similarities and some differences in treatment and outcomes between Māori and non-Māori rectal cancer patients, but firm conclusions are limited by small sample size.