Resisting ethnic inequities in advanced breast cancer: a call to action

Māori women with advanced breast cancer are less than half as likely as their Pākehā counterparts to reach the five-year survival mark. We argue that this inequity is unacceptable. We trace the inequity back to i) inadequate screening and risk assessment, ii) lack of support for patient navigation, iii) failure to offer accessible state-of-the-art treatments, and iv) delays in receiving life-prolonging care. We posit that each of these factors is a site of institutional racism and privilege as they cause Māori women to experience significantly worse outcomes than non-Māori. In the active pursuit of justice, cancer survivors, women living with cancer and their supporters across the country have been engaging in passionate advocacy to address inequities. As the Ministry of Health develops a new cancer control plan, in this viewpoint opinion piece, we seek to amplify these distressing inequities and offer evidence-based recommendations to improve the quality of care and ultimately survival rates. Breast cancer inequities are modifiable. We recommend prioritising breast cancer screening and risk assessments for Māori women, reducing treatment delays, providing Māori-centered patient navigation, increasing funding for treatments and drugs to align with the OECD standard of care, and holding health providers accountable for ethnic inequities. We call on policy makers drafting the new cancer control strategy, and those working across the cancer continuum, to take action to improve breast cancer outcomes so Māori women will gain valuable life-years.