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• Why is there higher cancer mortality in indigenous Polynesian peoples? 

Native residents of Hawaii and New Zealand have much higher mortality rates for many cancers than the European peoples who live there. Education on screening programmes, diet, and smoking could help tackle this. The issues are discussed in the first of a series of Reviews on worldwide cancer disparities in the May issue of The Lancet Oncology. . . .

In terms of risk factors, Māori people are more than twice as likely to be smokers than European New Zealanders, 50% more likely to be obese, and almost three-times as likely to be obese smokers. Native Hawaiians have only a slightly higher smoking incidence than European Hawaiians, but a significantly higher risk of cancer for the same smoking history, suggesting they are more susceptible to the carcinogenic properties of cigarette smoke. Limited tobacco legislation in developing countries means that many Pacific islands are among tobacco companies’ new targets . . .

The authors conclude: "The extent of the differences in outcome due to different extrinsic risk factors, biological factors, or health behaviours is unclear….Advances such as adjuvant chemotherapy for breast, bowel, and lung cancer have improved survival, but data on treatment by ethnicity are lacking, and such treatment might be unequally applied between ethnicities. Evidence exists for a benefit of culturally appropriate education on screening programmes, diet, and smoking, all of which could lower the cancer burden in Polynesian communities."

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