Lung cancer is the greatest single cancer contributor to the life expectancy gap between Māori and non-Māori. A collaborative research programme between Health New Zealand | Te Whatu Ora and University of Otago is hoping to change that.

Since 2018, the collaborative programme, named Te Oranga Pūkahukahu, has focused on research that would inform the development of an effective, equitable lung cancer screening pathway that could be introduced in Aotearoa New Zealand.

Having already completed over 500 screenings through trials in Health NZ’s  Northern region, Te Oranga Pūkahukahu has just received a $5 million funding boost from the Health Research Council.

Health NZ continues to support the next phase of the research programme through the Service Improvement and Innovation directorate in Health NZ.  The programme includes undertaking a second round of scans for participants in earlier trials, and screening in a rural setting in the Manawatū with support from the local Iwi Māori Partnership Board.

Director Health Equity Dr Karen Bartholomew, says, “This programme grant is designed to directly inform planning for a national lung cancer screening programme. The work draws on high profile national and international expertise, and puts New Zealand at the forefront of innovative screening  focused on equitable outcomes.” 

Study lead Professor Sue Crengle (Kāi Tahu,Kāti Māmoe, Waitaha), Co-Director of Otago University’s Ngāi Tahu Māori Health Research Unit, says the team is “super-excited” to receive the funding.

“We are all really committed to this research and really want to design a lung cancer screening programme that works for those that most need it.

“Lung cancer is the leading cause of death for Māori women in Aotearoa New Zealand and the second leading cause of death for Māori and non-Māori men. Screening enables the disease to be diagnosed at an early stage, reducing lung cancer deaths by 20 to 26 per cent,” she says.

This funding will, among other things, enable researchers to investigate using a biomarker to improve lung cancer risk prediction, and the use of artificial intelligence (AI) in screening.

“We only offer lung cancer screening to people considered to be at high risk of developing lung cancer, but predicting this risk relies heavily on people’s recall of their personal tobacco use over their lifetime.

“The biomarker we are looking at is known to be an accurate marker for tobacco exposure – both personal tobacco use and second-hand smoke exposure – and is associated with cardiovascular disease outcomes. We are looking to see if it improves the accuracy of risk prediction for use in lung cancer screening,” Professor Crengle says.

The AI project will seek views of community members and health professionals on using the technology to read scans, alongside a human radiologist. Māori and European CT scans will also be compared to see if there are any differences in lung tissue which may bias AI models.