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.
9 papers in this theme
Show every themeScreening participation and design
Cervical, bowel and lung screening: what keeps people away from a screening programme, what changes when the test can be taken at home, and what Indigenous communities have said they want a screening service to be.
9 papers, 2 of them summarised from less than the whole paper.
Cancer Screening Services: What Do Indigenous Communities Want? A Systematic Review (opens in a new tab)
Summarised from the abstract· 2024
systematic review (PRISMA), 18 qualitative studies included
Our summary of what it found
This systematic review, conducted to PRISMA guidelines and searching MEDLINE, Scopus, PubMed and Google Scholar, identified 18 qualitative studies on what Indigenous communities want from cancer screening services. Four themes recurred across the included studies: culturally appropriate education, community participation in designing screening programmes, trusting relationships with healthcare providers, and respect for individual autonomy in screening decisions. The authors conclude that one-size-fits-all screening programmes are not well suited to reaching Indigenous communities, and argue for local consultation before new screening programmes are introduced.
Why it matters: It puts a citable evidence base behind community-led screening design rather than one-size-fits-all programmes, which is a useful reference point for arguing that case here.
Limits: Read at abstract/summary level, not the full text, so it was not possible to confirm which countries or Indigenous groups the 18 included studies covered, or whether any Māori-specific studies were among them.
Read as: abstract, read via a Semantic Scholar record for the paper — the ASCO publisher page redirected to a sign-in wall, and the PMC page (PMC10881110) was captcha-blocked directly
Written for this website from the paper, not the authors’ abstract.
Cervical Screening by HPV Self-Testing: A Game Changer for Māori (opens in a new tab)
Summarised from the whole paper· 2024
Bev Lawton, Anna Adcock, Kendall Stevenson, Tania Slater, Francesca Storey
book chapter drawing on the He Tapu Te Whare Tangata research programme: qualitative interviewing, clinical implementation and randomised controlled trials
Our summary of what it found
The chapter sets out why HPV self-testing changes cervical screening for wahine Maori. It reports that 41% of wahine Maori are underscreened or never screened against 21% of European and other women, and that HPV-based screening gives 60 to 70 per cent greater protection than cytology. From the He Tapu Te Whare Tangata studies, underscreened wahine Maori offered an HPV self-test were almost three times more likely to be screened, and those more than ten years from their last screen almost five times as likely. It records that in September 2023 Aotearoa New Zealand became the first high-income country to move straight to HPV self-testing as the primary screening method.
Why it matters: This is a documented case of Maori-led research changing a national screening programme, and it names the organisations whose advocacy contributed.
Limits: A chapter summarising a research programme rather than a single study, so the figures quoted rest on the underlying papers it cites, two of which are separately in this collection.
Read as: full text, supplied by Brooke from the publisher page (open access, CC BY-NC-ND 4.0)
Written for this website from the paper, not the authors’ abstract.
Perceived barriers to self-collected HPV testing for cervical cancer screening, and knowledge of HPV: a survey of primary healthcare smear-takers across Aotearoa New Zealand (opens in a new tab)
Summarised from part of the paper· 2024
cross-sectional web-based questionnaire, 73 respondents (67 completed in full), 57.8% completion rate
Our summary of what it found
The survey measured primary-care smear-takers' knowledge of HPV and their views on the shift to primary HPV testing, including home self-testing. Average knowledge score was 56.5%, with strong understanding of some areas (comparability of self- versus clinician-collected samples) and weak understanding of others, including the new recall guidelines. Respondents mostly rated the anticipated logistical barriers to home self-testing as minor, but 73.3% wanted further education on managing results under the new programme.
Why it matters: The paper's own introduction notes that 2022 national cervical screening coverage sat at 78% for non-Māori against 62% for Māori, so gaps in provider knowledge about the new HPV self-testing pathway land on a workforce already serving an unequal screening system.
Limits: This assessment covers only the first five pages of the PDF (abstract through early results); the paper's own stated limitations, further results and full discussion were not read and are not represented here. The study itself is a single-round survey with a 57.8% completion rate, self-reported knowledge, and predominantly NZ European respondents (72.6%), with only 12.3% identifying as Māori.
Read as: full text (first five pages of the PDF read directly: title, abstract, introduction, methods, and the start of results including demographic tables; the discussion and stated-limitations section further into the PDF was not read)
Written for this website from the paper, not the authors’ abstract.
A Model for Empowering Rural Solutions for Cervical Cancer Prevention (He Tapu Te Whare Tangata): Protocol for a Cluster Randomized Crossover Trial (opens in a new tab)
Summarised from the whole paperJMIR Research Protocols· 2023· doi:10.2196/51643
Lawton B, MacDonald EJ, Storey F, Stanton JA, Adcock A, Gibson M, Parag V, Sparkes NK, Kaimoana B, King F, Terry M, Watson H, Bennett M, Lambert CS, Geller S, Paasi I, Hibma M, Sykes P, Hawkes D, Saville M
trial protocol, cluster randomised crossover design, two rural primary care sites; interim uptake figures only (743 HPV self-tests over the first 15-month period)
Our summary of what it found
This is a protocol paper, not a results paper. It sets out a trial comparing two pathways after a positive HPV self-test: one giving a point-of-care result within an hour with immediate referral to colposcopy, run through community-controlled services, against standard laboratory-based testing and referral. The primary measure is the share of women who reach colposcopy within 20 working days. In the first 15-month period, 743 eligible self-tests were done, split roughly evenly between the two pathways, with 7.3% testing positive for high-risk HPV.
Why it matters: If the community-controlled, point-of-care pathway shortens the wait to colposcopy, it is a concrete model for closing a step in the cervical screening pathway where delay disproportionately affects rural Māori women.
Limits: Protocol and interim uptake data only; the primary outcome (colposcopy timeliness by pathway) was not yet reported at the point this paper was published.
Read as: full text, read via PMC (PMC10540018)
Written for this website from the paper, not the authors’ abstract.
Invitation methods for Indigenous New Zealand Māori in lung cancer screening: Protocol for a pragmatic cluster randomized controlled trial (opens in a new tab)
Summarised from the whole paper· 2023
protocol for a pragmatic cluster randomised controlled trial, up to 48 clinics paired and randomised 1:1, with a nested COPD-assessment cohort
Our summary of what it found
This is a trial protocol, not a results paper. It sets out a plan to compare two ways of inviting people to lung cancer screening, invitations sent from the person's own primary care clinic against invitations sent from a centralised hub, in Māori aged 55 to 74 who currently or formerly smoke and meet a calculated risk threshold. The protocol anticipates around 4,412 invitation letters, with roughly 500 to 550 people going on to a CT scan. The primary measures are the proportion completing a risk assessment and the proportion completing a CT scan in each arm.
Why it matters: Māori carry a substantially higher lung cancer burden, and this protocol treats the way people are invited, not just whether screening exists, as something worth testing properly before a national programme is built around one approach.
Limits: As a protocol, there are no screening-uptake results yet. The paper does not spell out its own limitations in the sections read; it does state the trial is designed and governed with Māori leadership throughout, including a Māori steering committee, dedicated engagement roles, and data sovereignty protections aligned with Te Mana Raraunga principles, and follows the CONSIDER reporting standard for Indigenous health research.
Read as: full text (via WebFetch of the PLOS ONE article page)
Written for this website from the paper, not the authors’ abstract.
Acceptability of human papillomavirus (HPV) self-sampling among never- and under-screened Indigenous and other minority women: a randomised three-arm community trial in Aotearoa New Zealand (opens in a new tab)
Summarised from the whole paper· 2021
Naomi Brewer, Karen Bartholomew, Jane Grant, Anna Maxwell, Georgina McPherson, Helen Wihongi, Collette Bromhead, Nina Scott, Sue Crengle, Sunia Foliaki, Chris Cunningham, Jeroen Douwes, John D Potter
open-label three-arm randomised community trial, 3,553 women, with a non-randomised follow-on substudy
Our summary of what it found
Never-screened and markedly under-screened Maori, Pacific and Asian women aged 30 to 69 were randomised to take an HPV self-sample at their clinic, to be mailed a kit to use at home, or to usual care by cytology. Participation was highest in the mailed-to-home group: 14.6% of Maori women against 2.0% under usual care. Adjusted for study group, screening history, deprivation and age, Maori women sent a kit were 9.7 times more likely to be screened than those offered usual care (95% CI 3.0 to 31.5), Pacific women 6.0 times and Asian women 5.1 times. Of those who self-sampled, 7.9% tested positive for a high-risk HPV type, and clinically appropriate follow-up was completed for 92% of them, needing a mean of 2.5 hours of nurse time each.
Why it matters: It shows the route that actually reaches the women the screening programme has never reached, and it puts a number on the follow-up workforce that route requires.
Limits: The authors note they could not tell whether non-responders ever received the invitation, so participation may be underestimated; recruitment was limited to two Auckland districts, so the findings may not carry to rural areas; and participants and staff could not be blinded.
Read as: full text, supplied by Brooke from the publisher page (open access)
Written for this website from the paper, not the authors’ abstract.
Bowel cancer screening age range for Māori: what is all the fuss about? (opens in a new tab)
Summarised from the whole paperNew Zealand Medical Journal, Vol 134 No 1535, pp 71-77· 2021
Melissa McLeod, Ricci Harris, Sarah-Jane Paine, Sue Crengle, Donna Cormack, Nina Scott, Bridget Robson
viewpoint/opinion article, not primary research, drawing on national bowel cancer incidence-by-age data
Our summary of what it found
The authors argue for extending bowel screening down to age 50 for Māori. Their reasoning: 58% of bowel cancers in Māori women and 52% in Māori men occur before age 60, against 27% and 29% in non-Māori respectively - a gap the article attributes to Māori having a younger population age structure, not to a higher age-specific cancer rate (rates were similar by age band in 2017). Even a start age of 50 would still miss roughly 30% of affected Māori women and 25% of affected Māori men.
Why it matters: Reframes the screening-age debate as a population-structure and equity question rather than a dispute about who gets cancer at what rate.
Limits: I read this through a page-rendering tool rather than the raw article myself, so treat the specific percentages as the article's own reported figures relayed through that extraction rather than something I visually verified character-by-character. This is the authors' argued position, not a systematic review.
Read as: full text (article page content, not merely an abstract)
Written for this website from the paper, not the authors’ abstract.
Recommendations for implementing HPV Self-testing in Aotearoa (opens in a new tab)
Summarised from the whole paper· 2021
editorial / expert recommendations, not a primary study
Our summary of what it found
Written after the 2021 Budget announcement of funding for a national HPV self-testing programme, this editorial by researchers and health board staff who ran New Zealand's HPV self-testing trials sets out recommendations for the Ministry of Health's rollout. These include making Māori health equity the organising principle of implementation rather than an add-on, reviewing the legislation governing the national cervical screening programme to strengthen Māori governance over screening data, building risk-stratified and culturally safe colposcopy and follow-up pathways, and offering an on-request mailed self-test alongside clinic-based testing.
Why it matters: It put Māori governance over cervical screening data on the table as part of the implementation design, ahead of the 2023 national rollout of HPV self-testing.
Limits: This is an editorial by the people who ran the underlying self-testing trials; several authors declare Health Research Council funding, pharmaceutical or diagnostics industry fees, or a seat on the National Screening Advisory Committee. It sets out recommendations rather than new data.
Read as: Full text, read directly from the NZMJ PDF (all pages, including author declarations and references)
Written for this website from the paper, not the authors’ abstract.
Impact of low-dose CT screening for lung cancer on ethnic health inequities in New Zealand: a cost-effectiveness analysis (opens in a new tab)
Summarised from the whole paperBMJ Open· 2020· doi:10.1136/bmjopen-2020-037145
McLeod M, Sandiford P, Kvizhinadze G, Bartholomew K, Crengle S
modelling study — Markov macrosimulation using linked New Zealand administrative and health data
Our summary of what it found
Modelled the cost-effectiveness of a national biennial low-dose CT screening programme for lung cancer in current and former heavy smokers aged 55-74. The programme was cost-effective overall at roughly NZ$34,400 per health-adjusted life-year (HALY) gained, and more cost-effective for Māori specifically (about NZ$27,400 per HALY) than for non-Māori (about NZ$36,300 per HALY). Per-person health gains were about twice as large for Māori women as for non-Māori women, and about 25% larger for Māori men than non-Māori men. The authors conclude the programme would narrow the absolute gap in health outcomes between Māori and non-Māori, though relative differences in survival by cancer stage at diagnosis would persist.
Why it matters: Gives a costed case that a national lung screening programme would narrow, not widen, the harm lung cancer does to Māori, which is directly useful for advocacy on programme design and funding.
Limits: A modelling study with wide uncertainty intervals reported alongside each ICER; results depend on assumptions about screening uptake, eligibility criteria and stage-shift, and are estimates rather than observed programme outcomes.
Read as: full text (open-access PMC copy, PMC7517554)
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.