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.
5 papers in this theme
Show every themeTime to diagnosis, and the route people take to it
How long the path from a first symptom to a diagnosis takes, what sits in the way of it, and how many people arrive at that diagnosis through an emergency department.
5 papers, 2 of them summarised from less than the whole paper.
Ethnic differences in the characteristics of patients with newly diagnosed lung cancer in the Te Manawa Taki region of New Zealand (opens in a new tab)
Summarised from the abstractInternal Medicine Journal· 2024· doi:10.1111/imj.16202
Nguyen H, Lao C, Keenan R, Laking G, Elwood M, McKeage M, Wong J, Aitken D, Chepulis L, Lawrenson R
retrospective regional cohort, 4,933 patients (1,575 Māori, 3,358 non-Māori) newly diagnosed with lung cancer
Our summary of what it found
Māori patients in this region had a markedly higher age-standardised incidence of lung cancer than non-Māori, were more likely to be diagnosed at an advanced stage, and were close to twice as likely to have small cell lung cancer, a subtype with a poorer outlook. Māori patients also had more coexisting health conditions and higher socioeconomic deprivation than non-Māori patients in the same cohort.
Why it matters: It quantifies, for one region, the scale of the stage-at-diagnosis gap behind Māori lung cancer mortality, which is the kind of figure that supports a case for targeted early-diagnosis or screening effort.
Limits: I read the PubMed abstract only, via NCBI eutils; the Wiley publisher page sits behind a cookie wall and I found no PMC or open-access copy. The task listed this as a 2023 paper; PubMed's indexed citation gives Intern Med J 2024 Mar;54(3):421-429, so it was likely available online in 2023 ahead of the 2024 print issue.
Read as: abstract, read via PubMed/NCBI eutils; publisher full text behind a cookie wall, not read
Written for this website from the paper, not the authors’ abstract.
Patient-reported diagnostic intervals to colorectal cancer diagnosis in the Midland region of New Zealand: a prospective cohort study (opens in a new tab)
Summarised from the whole paperFamily Practice· 2022· doi:10.1093/fampra/cmab155
Tania Blackmore, Lynne Chepulis, Keenan Rawiri, Jacquie Kidd, Tim Stokes, Melissa Firth, Mark Elwood, David Weller, Jon Emery, Ross Lawrenson
prospective cohort study, structured interviews using the Model of Pathways to Treatment framework; 176 patients analysed of 235 recruited, April 2018 to March 2020
Our summary of what it found
Over half of patients (96 of 176, 54.5%) had a total diagnostic interval longer than 120 days; median total interval was 142 days. A third (36.9%) had a GP diagnostic interval over 120 days. Reporting rectal bleeding was linked to a shorter interval (OR 0.34). Longer intervals were linked to being under 60 (OR 3.32 for the appraisal interval), being female (OR 2.19) and being Maaori (OR 3.18, 95% CI 1.04-9.78) for the GP diagnostic interval specifically.
Why it matters: It locates part of the delay to colorectal cancer diagnosis inside the GP diagnostic interval for Maaori patients specifically, rather than in how long patients themselves take to seek care.
Limits: Self-reported intervals depend on patient recall; the Maaori OR's confidence interval is wide (1.04-9.78), reflecting a small number of Maaori patients in the 176-patient sample - the paper does not give that subgroup count directly. Read as full text via PMC.
Read as: full text, read via the PubMed Central open-access copy (PMC9295611) rather than the Oxford Academic page, which shows only the abstract to a non-subscriber
Written for this website from the paper, not the authors’ abstract.
Hā Ora: secondary care barriers and enablers to early diagnosis of lung cancer for Māori communities (opens in a new tab)
Summarised from the whole paperBMC Cancer, Volume 21, Article 121· 2021· doi:10.1186/s12885-021-07862-0
Jacquie Kidd, Shemana Cassim, Anna Rolleston, Lynne Chepulis, Brendan Hokowhitu, Rawiri Keenan, Janice Wong, Melissa Firth, Karen Middleton, Denise Aitken, Ross Lawrenson
qualitative kaupapa Māori study: 9 community hui (108 participants - patients, whānau, community members) and 9 provider hui (27 primary-care staff), thematic analysis with independent double-coding
Our summary of what it found
Two broad themes emerged: barriers within specialist services/treatment, and the whānau journey. Reported barriers included long waits and delayed referral for diagnostic imaging, poor communication between hospital departments and district health boards, insensitive specialist interactions, thin health-literacy support, and services that did not accommodate tikanga or whānau involvement. Reported enablers included whānau advocacy and proactive engagement, and health literacy passed between generations within families.
Why it matters: Names specific, fixable points in the secondary-care pathway - referral delays, inter-agency communication, cultural fit of specialist services - where rural Māori lung cancer patients are currently losing time to diagnosis.
Limits: Confined to five rural Midland localities, so the specific barriers found may not generalise to urban Māori communities or other regions; I have not independently checked whether the paper's own limitations section states this or other caveats, since I read a structured summary of the full text rather than transcribing the discussion section myself.
Read as: full text (read via PMC's open-access copy)
Written for this website from the paper, not the authors’ abstract.
The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination (opens in a new tab)
Summarised from the whole paper· 2021
descriptive national service-data report, 2020 compared with 2018-2019, stratified by ethnicity
Our summary of what it found
Using national data on cancer registrations, diagnostic testing (including endoscopy) and treatment volumes, the authors compare 2020 against 2018-2019, split by ethnicity. Registrations dropped by around 40% during the March-April 2020 lockdown, then recovered to pre-lockdown levels by around August-September 2020. Surgery and medical oncology saw comparatively little disruption; radiation therapy volumes were down about 8% year-on-year, which the authors attribute partly to a shift toward shorter treatment courses rather than fewer patients treated. Outcome patterns were broadly similar across ethnic groups, though lung cancer diagnosis for Māori is again flagged as an area of concern.
Why it matters: It offers early evidence that a country pursuing COVID-19 elimination was able to protect its cancer diagnostic and treatment pathway through the pandemic's first year, in contrast to countries that saw sustained falls in cancer diagnosis during 2020.
Limits: This covers 2020 only and does not speak to later, more sustained periods of community transmission after New Zealand moved away from elimination.
Read as: Full text via PMC (thelancet.com itself returned a 403 error)
Written for this website from the paper, not the authors’ abstract.
Characteristics and outcomes of lung cancer patients presenting through the emergency department: a Waikato District Health Board study (opens in a new tab)
Summarised from the abstract
retrospective cohort, 2,397 lung cancer patients
Our summary of what it found
Just under 40% of patients attended the emergency department before their lung cancer diagnosis. Māori were 1.27 times more likely than non-Māori to be diagnosed this way rather than through a GP referral. Patients diagnosed via the emergency department had more advanced disease and lower 12-month survival than those who were not, and survival was worse again for patients with two or more ED visits.
Why it matters: An emergency department diagnosis is a marker of a system that did not catch the cancer earlier, and this paper shows Māori patients are more likely to be caught by it.
Limits: The authors note they could not classify why patients attended ED rather than a GP, and flag that more advanced disease at ED presentation may partly reflect reasons other than diagnostic delay.
Read as: abstract, read from the article's own page on the NZMJ website (the PDF link given was too large to fetch directly, so the journal's article 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.