Kim Webby

The stark facts are that Māori men are more likely to die from prostate cancer than non-Māori men, yet early screening for Māori is being axed.

Dr Elana Curtis, Associate Professor at Te Kupenga Hauora Māori, University of Auckland, told Radio New Zealand’s Māpuna programme on Saturday, that 50 percent of bowel cancers for Māori and Pasifika men occur between the ages of 50 and 60, with the peak around 55.  

For non-Māori, that peak is after the age of 60.

That seems to make a good case for early prostate cancer screening for Māori and that was being rolled out.  

Then, the Government scrapped the phased roll out of the Māori and Pacific age extension in the national bowel cancer screening programme.

That roll out, which began in mid-2023, screened Māori and Pasifika men from age 50 and non-Māori from age 60.

Now all men will be screened at age 58, regardless of risk.

Dr Curtis believes this effectively eliminates Māori from the benefits of a screening programme.

And it’s not only Māori doctors who are concerned.  

Te Aho o Te Kaho, the Cancer Care Agency, noted in January that the optimal cancer care pathway was to screen for prostate cancer from age 50-69 and for high-risk groups including Māori, to begin screening at 45.  

A literature review published in the New Zealand Medical Journal states, that most of the disparity in death rates between Māori and non-Māori, is due to the later stage at diagnosis for Māori men and ethnicity-based differences in treatment.  

Evidence-based research studies also show that  Māori men are 20 percent less likely to be diagnosed in the first place.  

New Minister of Health, Simeon Brown, received a briefing paper from the Ministry of Health this month.  

I’d like to know what it said about Māori Health Directives, but that part of the publicly available report, is blacked out.  

Why is this such a sensitive topic?

Meantime, Māori health advocate, Dr Rawiri Janssen is reported in E-Tangata as saying,

“We’re accepting an Aotearoa where, as a group, Māori, tangata whenua, will always die younger and be sicker than Pākehā.

“Where we’ll never be the best we can be. It’s just plain racist.”

He notes that he treats women differently from men and older people differently from younger people.  

So, I wonder, why the fuss when it comes to offering different health care to Māori or other groups, when it is clearly needed.

I’m familiar with the cries of, “why can’t we all be treated as equal”. That would be awesome indeed, but sadly in Aotearoa, not everyone is equal, and health is one of the areas where disparity is the greatest.

And prostate cancer matters, because it is the second most common cancer diagnosed in men in New Zealand, with around 4000 people diagnosed and 700 deaths from prostate cancer each year.

By lowering the screening age for all to 58, the Government expects to save 500 lives.

That is to be applauded, but it doesn’t mean that Māori lives will be saved equitably.