For Pacific people in New Zealand, cancer is a major cause of mortality and morbidity, and there is evidence that the burden of cancer (especially lung and colo-rectal) is increasing in these ethnic groups and is making an increasing contribution to health inequalities [1]. The Central Cancer Network (CCN) has identified the importance of engaging with Pacific communities in its region, and working together to reduce the inequalities that exist.

Population

As per the 2006 census, 48,312 Pacific people reside in the Central Cancer Network Region. This comprises 18% of the total Pacific population of New Zealand.

The estimated national increase in the Pacific population is to 420,000 (from 265,974) by the year 2021 – an increase of around 58%. If the population growth in the Central region stays in line with national growth, then the total number of Pacific peoples will rise to around 76,000.

While 67% of New Zealand’s Pacific population reside in the Auckland regional DHBs, the next biggest populations reside in the Capital and Coast, Waikato, Hutt Valley and Canterbury regions.

In the Central region, 58% of Pacific people reside in the Capital and Coast, and Hutt Valley DHB areas, and the remaining 42% are spread across the other 6 DHBs .

Population of specific ethnic groups that make up Pacific communities

In the Central region the largest Pacific communities are Samoan people (27,180 - 56%) and Cook Islands Maori people (11,283 – 23%). This reflects the national population where Samoan and Cook Islands Maori are the largest Pacific communities.

The remaining 21% of Pacific people are Tongan, Tokelauan, Niuean, Fijian, Tuvaluan and from other smaller Pacific communities. The Tokelauan community (found mainly in the Capital and Coast and Hutt Valley areas) comprises 56% of the total Tokelauan population for New Zealand.

Age breakdown

In the Central region, 63% of Pacific people are aged 29 years and below. This also reflects the national trend of a young population. A further 32% are aged between 30 and 50 years, with the remaining 5% over the age of 50. It is reasonable to assume then at least 63% of Pacific people in this region are born here in New Zealand, as opposed to being born in other Pacific countries.

Cancer Registrations

The TAS report notes that between 1996 and 2005, there were 649 cancer registrations for Pacific peoples in this region (355 female, 294 male). The average number of registrations per year is 73 for the years 2001 – 2005; this is a 43% increase on the average of 51 for the years 1996 – 2000.

In line with the Pacific populations in each DHB area, the highest number of registrations are in the Capital and Coast DHB area, followed by Hutt Valley then Hawkes Bay. The remaining five DHBs have fairly similar, smaller numbers.

Also in line with the populations of specific Pacific ethnic groups, the highest number of registrations are from Samoan people (55%), Cook Islands Maori (17%) then Tokelauan people (7%).

As noted in the HNA, the leading female cancers for Pacific women 1996 – 2005 combined were:

  • Breast 30%
  • Uterus 10%
  • Colorectal 8%
  • Lung 7%
  • Ovary 5%
  • Other 39%

Breast cancer is the leading cancer for all females in the Central region and in New Zealand. Cancer of the uterus has a higher incidence in Pacific females than other groups of women in the Central region and New Zealand. Cancer of the ovary does not feature in the leading female cancers for groups of women other than Pacific in the Central region or in New Zealand.

The leading cancers for Pacific men for the same period were:

  • Prostate 22%
  • Lung 15%
  • Liver and intraheptic bile ducts 8%
  • Colorectal 7%
  • Stomach 6%
  • Other 43%

Prostate cancer is also the leading cancer for all non-Maori males in the Central region and New Zealand. Cancer of the liver is a leading cancer for Maori men in New Zealand but otherwise does not feature for groups of men in the Central region other than Pacific men.

For both Pacific women and men, there are number of specific Pacific ethnic groups whose registration numbers for certain types of cancer exceed the average for all Pacific peoples in the Central region by 3% or more (refer to Tables 3 and 4 in Appendix One). Examples of this are Samoan women with breast cancer, and Cook Islands Maori men with prostate cancer.

Summary comment

Pacific-specific information on health issues has not always been gathered in forms useful for planning, or for trying to determine the nature and extent of inequalities between Pacific peoples and other people in New Zealand. The level of detail provided in the TAS report (particularly the ethnic-specific data) is useful for beginning to determine the nature, extent and causes of inequalities that exist for Pacific peoples in the cancer control continuum.

At a basic level, the data highlights the following cancers which are particularly prevalent in Pacific people (and in some cases more prevalent than for other people in New Zealand), causing inequality:

  • Female - breast, uterus and ovary
  • Males - prostate, lung and liver

This information forms a basis for an initial conversation between cancer services and Pacific communities to highlight what types of cancers are more of an issue for Pacific people, and the key information that Pacific people could be made aware of to prevent, manage and treat such cancers. While there is already a strong focus on breastscreening for Pacific women, and some public awareness of prostate and lung cancers, it is fair to say that the other cancers are more unknown. Raising awareness of these types of cancer with Pacific peoples could contribute to a reduction in the inequality that exists in terms of higher numbers of registrations.

The data also highlights cancers for which specific Pacific ethnic groups have higher registrations than other Pacific and non-Pacific ethnic groups. While it is difficult to draw any particular conclusions in relation to specific Pacific ethnic groups, the data provides a basis for engagement between cancer services and those groups because the data is directly relevant to them (and not bundled in with all other Pacific ethnic groups).


[1] The New Zealand Cancer Control Strategy: Action Plan 2005-2010, page 5

Last updated 5th January 2012