University of Otago Ngāi Tahu Māori Health Research Unit co-director Prof Sue Crengle received the funding boost in the latest round of Health Research Council (HRC) grants, to continue four research projects focused on developing an effective, equitable lung cancer screening pathway that could be introduced in New Zealand.
"I think that our current screening programmes are really designed to work for the majority, and they don’t think about our population groups and what they might do to meet those people’s needs," she said.
"The overall goal of all of our research work in this area is to develop a lung cancer screening pathway that works for everyone, but in particular, works for the people who are most in need of lung cancer screening.
"When you look at the incidence rates and the mortality rates, then that’s Māori.
"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%.
"So we’ve got to make sure that it works for Māori because all of the other national lung cancer screening programmes don’t deliver equally to Māori."
The researchers recently completed lung cancer screenings of more than 500 people, and the first project aimed to invite them to come back for a second screening using a low-dose CT scan to look for nodules in the lungs, Prof Crengle said.
"They are little areas of abnormality — some of those won’t be cancer, but some of them will be early cancers.
"What we want to do is find those early cancers when they’re really small and the person doesn’t have any symptoms of them, and then that means the ability to cure people will be really high.
"Those with very high-risk cancers will go straight for treatment, and for the people with low risk or moderate risk, they’ll go for 12-month and three-month repeat scans."
The research would also look at how many people agreed to do follow-up scans, and why they chose to do them or avoid them, she said.
The second research project aimed to create a simple blood test, to test for a biomarker that would show how much a person had been exposed to tobacco smoke during their lifetime.
Lung cancer screenings were only offered to people considered to be at high risk of developing lung cancer, but predicting this risk relied heavily on people’s recall of their personal tobacco use over their lifetime, she said.
The blood test would show how at risk a person was of developing lung cancer.
"I don’t know of anyone else around the world that’s looking at this at the moment."
The third project would look at using artificial intelligence to read CT scans, to reduce the number of people needed to read the scans and reduce the time it took to read them.
The AI project would seek views of community members and health professionals on using the technology, to read scans alongside a human radiologist, she said.
Māori and European CT scans would also be compared to see if there were any differences in lung tissue which may bias AI models.
And the fourth project was to work with Māori health providers in the Manawatu, to co-design a pathway for lung cancer screening.
"These projects could be the next best thing to finding a cure for cancer," she said.
"But ideally, what I want is tobacco control to be so successful that people no longer smoke. We’ve gone backwards recently on that.
"In the meantime, we need to do everything we can to identify lung cancer early and make sure that we have excellent investigation, diagnosis and treatment pathways for people."
