Health equity
Screening and breast cancer equity in NZ
Open access · cc by · source: Europe PMC
Screen-detected cancers were less common in Māori women, and crude survival was worse, but survival gaps narrowed among screen-detected cases.
Study at a glance
- Design
- Cohort — New Zealand screening-age women with first primary breast cancer; screen-detected vs symptomatic
- N
- N=1846 · 1,548 invasive and 298 in-situ; 1,064 (57.6%) screen-detected
- Population
- Screening-age women in New Zealand with newly diagnosed first primary breast cancer
- Outcome
- Screen detection rates and cancer-specific survival by ethnicity
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
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.
Methodology
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.
Limitations
Observational screening associations cannot fully separate selection effects from screening benefit. Residual confounding and regional coverage variation remain.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
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.
Evidence for the claim as stated.
Logistic-style binary contrasts also describe coverage and access gaps without naming a causal lever. Among 1,846 New Zealand women with first primary breast cancer, screen-detection was 62.7% in NZ European versus 49.2% in Māori cancers. In a national sample of 18,215 middle-aged and older Chinese adults, only 6.5% had recent Internet access while 83% owned a mobile phone; Internet access tracked neighbourhood amenities and health disparities more than phones did.
Evidence for the claim as stated.
Among 1,846 New Zealand women with first primary breast cancer, screen-detection was 62.7% in NZ European versus 49.2% in Māori cancers. Māori women had worse crude five- and ten-year survival overall, but among screen-detected cancers survival was similar or numerically better for Māori. Observational screening–survival associations cannot fully separate selection, lead time and length bias from screening benefit.
Evidence for the claim as stated.
KM in a randomised anaesthetic trial, KM in a biomarker series, KM in a screening cohort, and an 8-week app RCT are not one method applied four times. Propofol versus sevoflurane can say assigned anaesthetic did not shift 5-year OS (~92%, HR near 1). ANXA1's HR 1.70 in HER2-positive overexpression is an observational 10-year BCSS association. NZ ethnic survival gaps change when the sample is restricted to screen-detected cancers. IntelliCare did not analyse cancer death at all.
Evidence for the claim as stated.
Crude and stratum-specific survival can tell opposite equity stories. Māori women had worse crude five- and ten-year survival overall, yet among screen-detected cancers survival was similar or numerically better for Māori, while screen-detection itself was 49.2% versus 62.7%. A KM curve that ignores detection route will not match a curve that conditions on it, and neither fully isolates screening's causal effect.
Evidence for the claim as stated.
Open questions
Tensions this paper is part of
From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.
KM in a randomised anaesthetic trial, KM in a biomarker series, KM in a screening cohort, and an 8-week app RCT are not one method applied four times. Propofol versus sevoflurane can say assigned anaesthetic did not shift 5-year OS (~92%, HR near 1). ANXA1's HR 1.70 in HER2-positive overexpression is an observational 10-year BCSS association. NZ ethnic survival gaps change when the sample is restricted to screen-detected cancers. IntelliCare did not analyse cancer death at all.
- Supports · Propofol vs sevoflurane and breast cancer survival
- Supports · ANXA1 in breast cancer prognosis
- Supports · Coaching vs recommendations in IntelliCare
Crude and stratum-specific survival can tell opposite equity stories. Māori women had worse crude five- and ten-year survival overall, yet among screen-detected cancers survival was similar or numerically better for Māori, while screen-detection itself was 49.2% versus 62.7%. A KM curve that ignores detection route will not match a curve that conditions on it, and neither fully isolates screening's causal effect.
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Same topic cluster — not a recommendation engine.