Screening and breast cancer equity in NZ
Screen-detected cancers were less common in Māori women, and crude survival was worse, but survival gaps narrowed among screen-detected cases.
Source
Impact of mammographic screening on ethnic and socioeconomic inequities in breast cancer stage at diagnosis and survival in New Zealand: a cohort study
What they did
A New Zealand cohort of screening-age women with first primary breast cancer compared screen-detected versus symptomatic cancers by ethnicity and deprivation, examining stage and cancer-specific survival.
What they found
Among 1846 women, NZ European cancers were more often screen-detected than Māori cancers (62.7% vs 49.2%). Māori women had worse crude five- and ten-year survival overall, but among screen-detected cancers survival was similar or numerically better for Māori.
The limits
What it doesn't show
Observational screening associations cannot fully separate selection effects from screening benefit. Residual confounding and regional coverage variation remain.
Key terms
- Screen-detected cancer
- Cancer found through organised or opportunistic mammography rather than symptoms.
- Interval cancer
- Cancer diagnosed between screening rounds after a prior negative screen.
- BreastScreen Aotearoa
- New Zealand’s national mammographic screening programme.
- Deprivation quintile
- Socioeconomic ranking used to compare outcomes by area disadvantage.
- Cancer-specific survival
- Survival treating death from breast cancer as the event.
- Stage at diagnosis
- How advanced the cancer is when first found.
Flashcards
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Quiz yourself
Māori screen-detection vs NZ European was roughly:
Common questions
How many women were included?
1846 screening-age women with first primary breast cancer.
Screen detection in Māori vs European?
49.2% vs 62.7%.
Did screen-detected survival still favour Europeans?
No significant disadvantage for Māori among screen-detected cancers.
Overall crude survival?
Lower for Māori at five and ten years.
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