For the indigenous people of New Zealand, the Māori, cancer statistics are bleak, as they are 20% more likely to develop cancer, and twice as likely as non-Māori to die from it. But New Zealand-based Cancer Control Agency, Te Aho o Te Kahu, is trying to beat back against this inequity and close the gap in care for Māori people.

This story, and more, were among the many featured as part of World Cancer Day, a global initiative led by the Union for International Cancer Control (UICC) on 4 February. The theme for this year – ‘Close the Care Gap’ – addresses a need to address inequities in cancer care globally.

This inequity has been even more pronounced in recent years, with the COVID-19 pandemic setting back treatment services and progress in many parts of the world. 

“We see [inequities] on a day to day basis, and they impact the chances of someone developing cancer in their lifetime, and also someone surviving cancer,” said UICC CEO Cary Adams.  

Featured speakers and experts from around the world – from New Zealand, Switzerland, Kuwait, the Philippines, and others, discussed ways to close the cancer care gap, including in ageing and indigenous populations, and told stories of cancer survivors.

Engagement with indigenous groups necessary to address cancer care inequities in New Zealand

Engagement is key to addressing the inequities surrounding cancer care, said Michelle Mako, Equity Director of the Cancer Control Agency. 

While exposure to risk factors such as smoking, alcohol, poor nutrition, lack of physical activity, and more drives up cancer incidence in Māori people, lack of access and lower utilization of primary care has also impacted cancer prevention and treatment. 

“Like many other nations, we are also seeing late detection of cancers in emergency departments, and we’re also seeing higher cancer rates with lower survival,” said Mako. 

To understand the gaps in care and potential solutions, Mako and the Cancer Control Agency spoke to around 2800 Māori with lived experiences of cancer in their families, as well as providers in the community.

New Zealand is also going through a series of health reforms, one of which will incorporate a new agency for the Maori people – the Māori Health Authority, which will work with the NZ Ministry of Health and other local health agencies to ensure equitable access to care for the Maori. 

Looking forward, Mako hopes that equity is achieved with cancer care in New Zealand, especially with these initiatives and more.

“I’d like to think that equity stops being a vague promise to do better or a fancy job title. I really hope that delivery equity just becomes standard practice and part of normal cancer care in the future.” 

Translating cancer care to aging populations 

With the number of people 60 years and older to double in the next twenty years, and with cancer cases already impacting 37% of the elderly – a number that will also undoubtedly rise in the next twenty years, it is crucial that cancer care also address the needs of ageing populations. 

“The cancer workforce is not always prepared to meet the complex needs of patients with cancer,” said Nicolo Battisti, President-Elect of the International Society of Geriatric Oncology. 

Currently, in some parts of the world, there are few geriatric oncology clinics that are able to provide comprehensive care to these patients. Older people with cancer also tend to be excluded more frequently from innovative clinical trials.

But Rania Azmi, President of the Kuwait-based Fadia Survive and Thrive Cancer Association, has created an initiative centered around nine pillars that focus on meaningful discussion about elderly patients with cancer and patient-centered care in order to bring light to this issue.

One of the pillars considers the issue of functional age as opposed to chronological age for cancer patients, which makes all the difference for treatment.

“It’s not just the number – 60 or 70 or 80 that defines who’s at risk for cancer. It’s organ function,” said Azmi. 

Elderly patients also experience different cognitive changes and pain when it comes to cancer, so all knowledge and cancer control, including prevention, early detection, diagnosis, treatment, and even palliative care and quality of life, must be translated into actions to address their needs. 

“It’s really beyond oncology. To achieve [quality of care in elderly cancer patients] we need to hear the patient’s voice and have inclusion of patient decision in treatment,” Azmi noted.

Providing financial and psychosocial support to child cancer patients in the Philippines

Children and younger populations also have difficulties in accessing quality care, especially in the Philippines, according to Philippines-based Kythe Foundation co-founder and Executive Director Maria Fatima Garcia-Lorenzo. 

The Kythe Foundation provides both psychosocial support and family support to children and families with chronic illness. 

‘Adopted’ patients are also given full financial support – medicines, transportation, money for clean water – so that they can have a greater chance of surviving cancer. 

To celebrate their 30th anniversary, the foundation hosted a webinar in conversation with older cancer survivors and younger survivors, where they found striking differences in accessing treatment. 

“Our younger survivors had to really strive and line up to get financial help [for care]. They were not even diagnosed right away and had to go from one hospital to another to get proper diagnosis,” said Garcia-Lorenzo.

One survivor, according to Garcia-Lorenzo, did not even initially know what cancer was, causing him great fear and preventing him from complying with treatment.

“You could see the disparities, the inequities of the health system – the haves and the have-nots. Everyone should have access to treatment, medicine, and information.”  

The Kythe Foundation is already pushing for more funding from the Philippine government, health departments, and insurance agencies to provide for the needs of cancer patients.

Image Credits: einalem, World Cancer Day , Queen's University/Flickr, PTVph/Twitter .