Rangahau
What the research shows
57 papers published by members of Hei Āhuru Mōwai, read and grouped into themes. This page sets out what each summary was built from, and what the collection does not reach.
How to read this page
Who wrote the summaries
Every summary here was written for this website by Redux, the team building it, from the paper itself. They are not the authors’ abstracts and they are not the authors’ words. Each paper is linked, so any summary can be checked against it.
Hei Āhuru Mōwai has not yet reviewed this page or the summaries on it.
What was actually read
37 of these summaries were written from the whole paper. 3 were written from part of one, where only some sections could be reached. 17 – 30% of the collection – were written from the abstract alone.
Where the assessment records a reason it differs from paper to paper: a paywall or a sign-in wall, a publisher page that refused an automated request, a file that could not be fetched. Some record no reason at all. Each paper below carries a badge saying how much of it was read, and the route taken to it is printed with the summary in the assessment’s own words.
A summary built from an abstract, or from part of a paper, deserves less weight than one built from the whole of it. Nothing on this page pretends otherwise.
Not all of it has results
4 of these are registered protocols: the design of a study, published before it has findings. A further 13 are viewpoints, commentaries, editorials, position letters or narrative reviews, which argue a case or draw together other people’s work rather than report a new dataset. Both kinds are worth reading and neither is evidence of an outcome.
The method line on each entry says which kind of document it is.
How the collection was gathered
These are papers Hei Āhuru Mōwai holds, gathered because its members wrote them. No systematic search was run, and no inclusion criteria were applied beyond that.
A subject missing from this page says nothing about the literature. It says this collection does not hold a paper on it.
6 of these papers are not cancer studies
This is the organisation’s own list of what its members have published, so what is on it is settled by who wrote a paper rather than by what the paper is about. These 6 are named here rather than dropped, each with the assessment’s own words on where it sits.
4 are about the system cancer care runs through
Each is about the system cancer care runs through rather than about a cancer. The assessment records each as not cancer-specific rather than as unrelated, and says what it bears on. 3 of them also sit under a theme below.
- What we do matters: Supporting anti-racism and decolonisation of public health teaching and practice through the development of Māori public health competenciesFrom the assessment: It is a workforce-training resource rather than a cancer-outcomes study, of most use to Hei Āhuru Mōwai if it is assessing or building training for people working with Māori across the cancer system, not only clinicians.
- Mortality outcomes and inequities experienced by rural Māori in Aotearoa New ZealandFrom the assessment: This paper is not cancer-specific - it covers all-cause and amenable mortality generally (amenable mortality means deaths that good healthcare could plausibly have prevented, a category that includes but is not limited to some cancers).
- Disparities in post-operative mortality between Māori and non-Indigenous ethnic groups in New ZealandFrom the assessment: This covers surgery generally, not cancer surgery specifically.
- Postoperative mortality in New Zealand following general anaesthetic: demographic patterns and temporal trendsFrom the assessment: This is not a cancer-specific paper, but cancer surgery happens under general anaesthetic, so a gap of this size in the wider surgical system is relevant background for anyone looking at Māori cancer treatment outcomes.
2 the assessment says are not about cancer
Each of these is here because a member of the organisation wrote it. What the assessment says about each, it says in the words below, on that paper’s own terms.
- Tū Kaha: He mōhio ki ngā Māori o te kōmaoa waewae (Stand Strong: A qualitative study of Māori with venous leg ulcers in Aotearoa New Zealand)From the assessment: This paper is not about cancer – it concerns venous leg ulcers, a vascular skin condition.
- Te Pepe Ao Uri Whāriki. The development of pūrākau analysis frameworkFrom the assessment: This paper is not about cancer.
The shape of the collection
| Subject | Papers |
|---|---|
| National figures on incidence, stage and survival | 7 |
| Lung cancer | 8 |
| Screening participation and design | 9 |
| Access to surgery and treatment | 10 |
| Time to diagnosis, and the route people take to it | 5 |
| Palliative and end-of-life care | 3 |
| Cancer policy and system design | 9 |
| Data, research governance and workforce | 8 |
| Prevention and co-occurring conditions | 5 |
| Services through COVID-19 | 3 |
| Subject | Papers |
|---|---|
| System and policy | 27 |
| Treatment | 21 |
| Screening | 16 |
| Diagnosis | 13 |
| Data | 12 |
| Prevention | 6 |
| Workforce | 4 |
| Palliative care | 3 |
| Living after treatment | 1 |
The dated papers run from 2016 to 2024. 9 carry no publication year in the assessment, so no date is shown for them rather than a guessed one.
The themes
10 groupings, made for this website so the collection can be read. They are a finding aid, and are not Hei Āhuru Mōwai’s statement of its research priorities.
10 papers in this theme
Show every themeAccess to surgery and treatment
What happens once a cancer has been found: whether an operation is offered, how long it takes to happen, how far someone travels for it, and what follows.
10 papers, 3 of them summarised from less than the whole paper.
Access to and Timeliness of Lung Cancer Surgery, Radiation Therapy, and Systemic Therapy in New Zealand: A Universal Health Care Context (opens in a new tab)
Summarised from the abstract· 2024
national registry cohort, 27,869 lung cancer registrations, 2007–2019
Our summary of what it found
Using the same national dataset of 27,869 New Zealand lung cancer registrations from 2007 to 2019, this study compared access to and timing of treatment between Māori and European patients. Māori patients were less likely to receive surgery than European patients (14% versus 20%), including curative surgery (10% versus 16%), and this gap was not explained by stage, tumour type or comorbidity. Once age was accounted for, there were no significant differences between Māori and European patients in access to radiation therapy or systemic therapy, nor in how quickly treatment started. The authors conclude that Māori patients who may be good candidates for surgery are missing out on it more often than European patients, for reasons the available data could not explain.
Why it matters: An unexplained gap in surgery access, in a universal health system, is a harder equity finding to argue away than a gap explained by geography or stage at diagnosis. It points at decision-making in the surgical pathway itself as a place to look.
Limits: Read at abstract level via a secondary aggregator, not the publisher page or the full PMC text directly, both of which were blocked. Shares its dataset with the Supportive Care in Cancer travel-equity paper above.
Read as: abstract, read via a Semantic Scholar record for the paper — the ASCO publisher page redirected to a sign-in wall (PMID 38301179, PMC10846779, also captcha-blocked directly)
Written for this website from the paper, not the authors’ abstract.
Equity of travel to access surgery and radiation therapy for lung cancer in New Zealand (opens in a new tab)
Summarised from the whole paperSupportive Care in Cancer· 2024· doi:10.1007/s00520-024-08375-9
Gurney J, Davies A, Stanley J, Whitehead J, Costello S, Dawkins P, Henare K, Jackson CGCA, Lawrenson R, Scott N, Koea J
national retrospective cohort, 27,869 people diagnosed with lung cancer 2007-2019 (5,601 Māori, 19,698 European), GIS road-network analysis of home-to-treatment travel
Our summary of what it found
Māori travelled further than Europeans to reach both treatments. For surgery, median distance was 57 km for Māori against 34 km for Europeans (median time 59 versus 40 minutes); Māori were more likely to live over 200 km from the surgical centre (24% versus 16%, adjusted odds ratio 1.83). For radiation therapy the gap was wider: median distance 75 km for Māori against 35 km for Europeans (69 versus 41 minutes), with 20% of Māori versus 15% of Europeans living over 200 km away (adjusted odds ratio 1.41). Māori patients were also more likely to have received surgery at a high-volume centre.
Why it matters: This travel burden falls on people who are also more likely to be diagnosed at a later stage, and it sits on top of the treatment itself rather than instead of it.
Limits: The cohort is limited to people who actually received treatment, so it cannot show whether travel distance kept anyone from being treated at all. Private hospital data was excluded, and radiation therapy type (curative versus palliative) could not be distinguished. I read the full text via PMC.
Read as: full text (PMC10879218, open access)
Written for this website from the paper, not the authors’ abstract.
Ethnic differences in time to surgery for women with early stage breast cancer in Aotearoa/New Zealand: a population-based study (opens in a new tab)
Summarised from the whole paperThe Lancet Regional Health – Western Pacific· 2024· doi:10.1016/j.lanwpc.2024.101091
Boyle L, Lawrenson R, Ronald M, Campbell I, Nosa V, Tin Tin S
population-based cohort, 16,365 women, four NZ urban regions, 2000–2020
Our summary of what it found
In a cohort of 16,365 women having surgery for early-stage (stage 1–3a) breast cancer across four NZ urban regions between 2000 and 2020, only 58.2% had surgery within the 31-day Faster Cancer Treatment target. Māori women had 18% higher adjusted odds of missing that target than NZ European women (OR 1.18, 95% CI 1.05–1.33), and Pacific women 42% higher odds (OR 1.42, 95% CI 1.22–1.65); there was no significant difference for Asian women. Deprivation and treatment in the public rather than private system explained most of the gap – women treated publicly had close to seven times the odds of a delay past 31 days. The gap did not close after the Faster Cancer Treatment policy was introduced in 2012.
Why it matters: Time to surgery is a direct, government-tracked equity measure, and this shows Māori and Pacific women are still waiting longer for it despite a policy meant to close that gap.
Limits: Confined to four urban regions using the Breast Cancer Foundation's clinical register, so may not generalise to rural areas or regions outside the four studied. Read the full open-access text via PubMed Central.
Read as: full text
Written for this website from the paper, not the authors’ abstract.
Receipt of mastectomy and adjuvant radiotherapy following breast conserving surgery (BCS) in New Zealand women with BCS-eligible breast cancer, 2010–2015: an observational study focusing on ethnic differences (opens in a new tab)
Summarised from the whole paperBMC Cancer· 2023· doi:10.1186/s12885-023-11248-9
Bartholomew K, Ghafel M, Tin Tin S, Aye PS, Elwood JM, Hardie C, Scott N, Kidd J, Ramsaroop R, Campbell I
retrospective observational study, New Zealand Breast Cancer Registry, 5,520 BCS-eligible women 2010-2015 (4,541 invasive, 979 DCIS)
Our summary of what it found
Among women eligible for breast-conserving surgery, 22% had a mastectomy instead and 91% of those who had breast-conserving surgery went on to radiotherapy. Asian women were around twice as likely as the reference group to have a mastectomy for invasive cancer. Pacific women had substantially lower odds of receiving radiotherapy after breast-conserving surgery, for both invasive cancer and DCIS. Māori women's rates did not differ significantly from the reference group on either measure. The most common reason radiotherapy was missed was that a clinician had not referred the woman for it.
Why it matters: It shows the treatment gap for BCS-eligible women sits mainly with Pacific and Asian ethnicity rather than with Māori in this cohort, which matters for where equity effort in breast cancer treatment pathways is targeted.
Limits: Registry-based observational study covering 2010-2015 only, so it cannot establish why the differences occurred and may not reflect current practice.
Read as: full text, read via PMC (PMC10436661)
Written for this website from the paper, not the authors’ abstract.
Equity of timely access to liver and stomach cancer surgery for Indigenous patients in New Zealand: A national cohort study (opens in a new tab)
Summarised from the whole paperBMJ Open· 2022· doi:10.1136/bmjopen-2021-058749
Jason Gurney, Diana Sarfati, James Stanley, Clarence Kerrison, Jonathan Koea
national cohort study using linked NZ Cancer Registry and National Minimum Dataset records, 2007-2019; 866 Maaori vs 2,460 European liver cancer patients, 953 Maaori vs 3,192 European stomach cancer patients
Our summary of what it found
Maaori and European patients had similar overall rates of curative surgery for both cancers, but access diverged on specific procedures. For liver cancer, Maaori patients were about 66% less likely than European patients to receive a transplant (adjusted OR 0.33, 95% CI 0.19-0.60). For stomach cancer, Maaori patients were around twice as likely to have a palliative bypass procedure (enteroenterostomy) rather than curative surgery (adjusted OR 1.98, 95% CI 1.31-2.99). Only around a third of all liver cancer patients, Maaori or European, had documented surgical treatment of any kind.
Why it matters: It shows the inequity for these two cancers sits inside specific treatment decisions - who gets a transplant, who gets a curative resection versus a palliative bypass - rather than in whether surgery happens at all.
Limits: Registry-based analysis; the paper cannot say why the transplant and bypass gaps exist, only that they exist. Read as full text.
Read as: full text (via BMJ Open, which is open access)
Written for this website from the paper, not the authors’ abstract.
Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand (opens in a new tab)
Summarised from the whole paperPLOS ONE· 2022· doi:10.1371/journal.pone.0269593
Jason Gurney, Jesse Whitehead, Clarence Kerrison, James Stanley, Diana Sarfati, Jonathan Koea
national registry analysis using GIS to calculate travel distance and time, 2007-2019; same cohort as the companion surgery-access paper - 866 Maaori vs 2,460 European liver cancer patients, 953 Maaori vs 3,192 European stomach cancer patients
Our summary of what it found
For liver cancer, Maaori patients travelled much further for surgery than European patients: a median 121km versus 56km, and a median 123 minutes versus 59 minutes. Maaori patients were more likely to travel over 200km (36% versus 29%, adjusted OR 1.48, 95% CI 1.09-2.01). For stomach cancer the paper found no significant difference in travel distance between the two groups, both travelling a median of around 21-22km.
Why it matters: Travel burden for liver cancer surgery falls unevenly on Maaori patients specifically, while stomach cancer - where surgery is more geographically distributed - shows no such gap, pointing to where centralised care creates an access cost.
Limits: Registry-based, distance calculated by GIS rather than reported by patients; does not capture cost, time off work or whether a patient travelled with whaanau. Read as full text.
Read as: full text (PLOS ONE is open access)
Written for this website from the paper, not the authors’ abstract.
Disparities in post-operative mortality between Māori and non-Indigenous ethnic groups in New Zealand (opens in a new tab)
Summarised from part of the paperNew Zealand Medical Journal, Vol 134 No 1542, pp 15-28· 2021
Jason Gurney, Melissa McLeod, James Stanley, Diana Sarfati, Doug Campbell, Cheryl Davies, Elizabeth Dennett, Peter Himona, Sarah Jackson, Dick Ongley, Bridget Robson, Juliet Rumball-Smith, Virginia Signal, Jeannine Stairmand, Courtney Thomas, Jonathan Koea
retrospective national cohort, nearly 3.9 million surgical procedures (876,976 acute, 2,990,726 elective/waiting list), Cox proportional hazards regression
Our summary of what it found
Māori had higher 30- and 90-day post-operative mortality than other ethnic groups across most procedure categories, with the gap against Europeans strongest for elective/waiting-list procedures (e.g. elective musculoskeletal procedures, 30-day mortality adjusted hazard ratio 1.93, 95% CI 1.56-2.39). This covers surgery generally, not cancer surgery specifically. The authors attribute the pattern to a combination of health-system, process and clinical-team factors rather than patient-level biology.
Why it matters: Documents a measurable survival gap for Māori after surgery nationally, which bears on how the cancer system should scrutinise its own surgical pathways for the same pattern.
Limits: I read the abstract and introduction/methods in full but not the discussion or limitations section, so I cannot report what caveats the authors themselves state there. No DOI exists for this article: Crossref shows the New Zealand Medical Journal only began registering DOIs from July 2022 (volume 135 onward); this September 2021 volume-134 article predates that and none has since been assigned.
Read as: full text (read the published PDF directly: title page, abstract and the opening of the methods section)
Written for this website from the paper, not the authors’ abstract.
Indigenous access to clinical services along the lung cancer treatment pathway: a review of current evidence (opens in a new tab)
Summarised from the whole paper
narrative literature review, 36 manuscripts and reports included from 1,459 screened, to July 2022
Our summary of what it found
Across the four countries reviewed, Indigenous peoples face disparities in access to lung cancer services at multiple points in the pathway. The clearest and most consistent disparities were in early detection and access to surgery. Evidence on other parts of the pathway, such as chemotherapy or radiotherapy access, was mixed or too thin to draw firm conclusions.
Why it matters: Because this pulls together evidence across four countries, including Aotearoa, it gives a wider frame for interpreting the New Zealand-specific lung cancer findings elsewhere in this set.
Limits: The authors themselves describe the underlying evidence as relatively scant globally, and call for better data collection and monitoring of Indigenous cancer outcomes.
Read as: full text, read via the PMC mirror (PMC11564377)
Written for this website from the paper, not the authors’ abstract.
Inequalities between Maori and non-Maori men with prostate cancer in Aotearoa New Zealand (opens in a new tab)
Summarised from the whole paper
narrative literature review, by Egan, Kidd, Lawrenson, Cassim, Black, Blundell, Bateman and Broughton, funded by the Movember Foundation
Our summary of what it found
This review asks why Māori men are less likely than non-Māori men to be diagnosed with prostate cancer, yet significantly more likely to die of it once diagnosed - a mortality rate around 1.5 times higher. Drawing on existing New Zealand studies, the authors found Māori men are screened for prostate cancer roughly half as often as non-Māori men, are more often diagnosed at a later or metastatic stage, and less often receive prostatectomy or low-dose brachytherapy. They link this to institutional racism, weaker continuity of care in general practice, and socioeconomic barriers such as travel and accommodation costs for treatment based in major centres.
Why it matters: It identifies specific, checkable points along the pathway - screening rates, staging data gaps, treatment choice - where the gap between Māori and non-Māori prostate cancer mortality opens up.
Limits: As a narrative review it draws together earlier NZ studies of varying size and region (some single-city, some Midland-region only) rather than presenting new data of its own. The authors themselves note that national registry data on prostate cancer stage at diagnosis is about 75% recorded as 'unknown', which limits what any of the underlying studies can show.
Read as: full text (read directly from the supplied PDF)
Written for this website from the paper, not the authors’ abstract.
Postoperative mortality in New Zealand following general anaesthetic: demographic patterns and temporal trends (opens in a new tab)
Summarised from the abstract
retrospective national cohort, 1,836,683 patients, 2005–2017
Our summary of what it found
A national cohort of everyone having a procedure under general anaesthetic in New Zealand between 2005 and 2017. Overall 30-day mortality was 0.5 per 100 procedures, far higher after acute admissions (1.6 per 100) than elective ones (0.2 per 100). After adjusting for other factors, Māori patients having an elective procedure were 30% more likely to die within 30 days than European patients. The authors attribute part of this gap to institutionalised racism in the health system.
Why it matters: This is not a cancer-specific paper, but cancer surgery happens under general anaesthetic, so a gap of this size in the wider surgical system is relevant background for anyone looking at Māori cancer treatment outcomes.
Limits: Covers all procedures under general anaesthetic, not cancer surgery specifically, and does not report cancer patients as a separate subgroup. Seen via a structured abstract on the journal landing page, not the full text.
Read as: abstract (structured abstract via landing page; PDF fetch returned only raw PDF code, so HTML landing page was used instead)
Written for this website from the paper, not the authors’ abstract.
What this collection does not cover
Each of these is a statement about the papers on this page, and about nothing else. Research may well exist on all of them. It is not held here.
No evaluation of a cancer navigator or Māori cancer support service
Nothing in this collection tests whether a navigator service or a Māori cancer support service works, for whom, or at what cost.
Several papers here argue that support of that kind is needed. The scoping review of palliative care for Māori reports that whānau-led care works better where it is free of the assumptions built into mainstream services. The Hā Ora work on lung cancer names thin health-literacy support and services that do not accommodate whānau involvement among the barriers people described. The integrative review of health service responses to Indigenous people with cancer found better access where services built culturally appropriate care around the population they served, and flags how few such studies have been published at all.
What none of them does is evaluate a service. That is the largest hole in this collection, and it sits directly under the navigator network this site already points people to.
Cancers with no paper here
This collection does not cover:
- Melanoma and skin cancer
- Head and neck cancer
- Bladder and testicular cancer
A further 3 cancers appear in a single paper each.
Life after treatment
One paper in this collection is tagged as being about living after treatment. This collection does not cover late effects, or returning to work after treatment.
Whose voice is in it
The qualitative work here reports what researchers found across groups of participants. This page summarises those papers at the level of their own findings, and carries no individual account.
Elsewhere on this site
Published rangahau is the full bibliography of members’ work, filterable by subject, year and researcher. It lists more than the papers assessed here.
Rauemi holds the organisation’s own reports and papers, alongside resources published by other organisations and linked to them.
If you are looking for a particular piece of rangahau, email communications@heiahurumowai.org.nz.