This national study offers a detailed look at how rural whānau experience access to radiation therapy for breast, prostate and lung cancer in Aotearoa. Its findings challenge some common assumptions and highlight important opportunities to strengthen equitable cancer care for rural communities

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ABSTRACT

Introduction

Accessing radiation therapy is a challenge for rural cancer patients. This study explored the rates of receiving radiation therapy for rural Māori and non-Māori New Zealanders with breast, prostate or lung cancer compared with their most urban counterparts.

Method

Rates of receipt of radiation therapy per 100,000 population were calculated using radiation treatment data from 2014 to 2020, obtained from the Radiation Oncology Collection and resident population estimates from StatsNZ. Rurality was assigned by the Geographical Classification for Health (GCH).

Results

For females with breast cancer, receipt of radiotherapy was lower for those over 75 living in smaller cities (U2) and for non-Māori aged 45–64 living rurally. For prostate cancer, there was higher receipt of radiotherapy by rurality in those under 65. For lung cancer, radiotherapy rates were higher in rural patients under 65, particularly females and non-Māori, but lower receipt of curative radiotherapy was observed for the most rural (R2/R3) Māori females and males over 75. Irrespective of rurality, Māori receipt of radiotherapy was lower than non-Māori in the youngest age groups for breast and prostate cancer, while Māori aged 45–74 with breast cancer, and Māori females and males with lung cancer in almost all age groups and GCH categories, had higher rates of radiotherapy than their non-Māori counterparts.

Conclusion

This study observed some rural–urban differences in receipt of radiation therapy for the three cancers studied, though with evidence of variability by age group and cancer type, and significant differences between Māori and non-Māori.