The past, present and future of liver cancer control for Māori

Liver cancer is among the most commonly diagnosed and least-survivable cancers in New Zealand. There are stark disparities between the Indigenous Māori population in incidence of and mortality from liver cancer relative to non-Māori. In this review, we have summarised the key risk factors for liver cancer, and the key activities undertaken in New Zealand, over time, to control this disease, with a focus on how risk factors and interventions aimed at reducing them differentially impact Māori. We have conducted a narrative literature review. The disproportionate burden of liver cancer experienced by Māori is primarily driven by disparities in viral exposure to hepatitis B and C between ethnic groups. Efforts to control hepatitis-associated liver cancer in New Zealand have lacked national coordination, further driving disparities in liver cancer survival between Māori and NZ Europeans. A national primary care-based programme to detect and treat hepatitis B and C and to screen for liver cancer among high-risk patients, along with renewed effort to maximise hepatitis B vaccination rates, has the potential to substantially reduce the burden of hepatitis-associated liver cancer and address a significant health disparity between Māori and non-Māori.