Te Tumu input into international cancer research
Regular readers of this blog will know of Karyn Paringatai’s research work. Not only is she an award-winning teacher, an advanced te reo Māori practitioner, and kapa haka aficionado, but she is also undertaking Marsden-funded research on Māori and gastric cancer in collaboration with Professor Parry Guilford of the university’s Centre for Translation Cancer Research. What follows is an update of this research, and some media links for those wanting more information.
Hereditary diffuse gastric cancer (HDGC): updated clinical practice guidelines
Parry Guilford and Karyn Paringatai. Click to enlarge.
Māori are three times more likely to develop stomach cancer than people of European descent. Māori are one of the few populations worldwide where diffuse-type gastric cancer is more common than intestinal-type stomach cancer. Diffuse gastric cancer is an aggresive type of cancer that grows rapidly in the cells of the stomach wall – it does not form a mass or a tumour. These cancer cells spread widely and quickly and it makes it difficult to diagnose. The reasons for this high occurrence of diffuse stomach cancer are unclear but a relatively high frequency of the inherited CDH1 variants in the Māori population is one important reason. When working properly the CDH1 gene controls the growth of cells. But because it has mutated it allows cells to grow uncontrollably – including cancer cells. This genetic mutation is particularly prevalent amongst Māori, but many are unaware of the risk.
When Dr Karyn Paringatai was tested for a CDH1 variant 11 years there were only 3-4 Māori whānau with mutations in this particular gene. That number has since increased to between 12-15 Māori whānau. This prompted researchers and health professionals working in this area and affected whānau and families from all around the world to gather in Wānaka in March 2019 to update the previous management guidelines for HDGC published in 2015. A number of important new and revised recommendations are made in these updated guidelines, which was recently published by Lancet Oncology. However, most pertinent to Māori was that the whānau of any Māori person who has been diagnosed with diffuse stomach cancer be encouraged to have a genetic test, regardless of any other family history. Previously, the guidelines were largely based around the number of cases of this cancer in a family. 11 years ago Karyn had to fight to be tested and prove that she was at risk of HDGC, which was tough to do with her scant knowledge of her whānau’s medical history. That is no longer the case.
Professor Parry Guilford (Te Aho Matatu, Centre for Translation Cancer Research, University of Otago), the lead author of the article, states, “It is very uncommon in international guidelines to single out sub populations, so this is quite a significant move that we hope will reduce their risk as well as helping to reduce inequities in health for Māori.” Karyn, a co-author of these guidelines, is actively encouraging Māori to be tested and to make contact with her for any advice on how to do so. It is important to do so – for the future of our whakapapa.
This research is linked to Karyn’s Marsden funded project E kore au e ngaro – The enduring legacy of whakapapa.
Click here for a link to the updated guidelines in Lancet Oncology
Click on the links in the titles below to access media reports.
| Three, Newshub Live at 6pm, 10/08/2020, Samantha Hayes and Mike McRoberts |
| There are likely to be several hundred Maori unaware they are at high risk of an inherited form of stomach cancer, a New Zealand research team has suggested. The team from the University of Otago is hopeful updated international clinical practice guidelines they helped develop will encourage these people to be tested. |
| Radio NZ – National, Checkpoint, 10/08/2020, Lisa Owen |
| Report by Meriana Johnsen. A move to make it easier to get tested for stomach cancer is expected to save the lives of whanau Maori, and in particular, the several hundred Maori who are unaware they are at risk. New guidelines developed by the University of Otago and Kimihauora Research Clinic allow Maori to be tested for the genetic mutation CDH1 even if there is only one other family member with stomach cancer. |
| Radio NZ – National, 15:00 News, 10/08/2020 | |||||||
| A new testing criterion for identifying stomach cancer developed by Otago University and the Kimihauora Research Clinic is anticipated to save the lives of whanau Maori. Otago University’s Senior Lecturer at the School of Maori, Pacific, and Indigenous Studies Karyn Paringatai says Maori would have fewer holes to jump through.
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| Stomach cancer test to save whanau Maori lives | |||||||
| Radio New Zealand, Other, 10/08/2020 | |||||||
| A move to make it easier to get tested for stomach cancer is expected to save the lives of whānau Māori, and in particular, the several hundred Māori who are unaware they are at risk. New guidelines developed by the University of Otago and Kimihauora Research Clinic allow Maori to be tested for the genetic mutation, CDH1, even if there is only one other family member with stomach cancer. |
| Testing expected to save Maori from stomach cancer |
| Radio New Zealand, Other, 10/08/2020 |
| A research team hopes Maori lives will be saved with a new testing criteria for stomach cancer. The University of Otago and Kimihauora Reseach Clinic have developed the new criteria to make it easier for Maori to be tested for the genetic mutation that leads to the cancer. |
| Changing international guidelines to save Maori lives |
| Radio New Zealand, Other, 10/08/2020 |
| Researchers have managed to get a change to international clinical guidelines to ensure Maori are tested for a gene which causes stomach cancer. Otago University Professor Parry Guilford explains to Jesse why this gene is more prevalent in Maori and can be identified before a person gets cancer. |
| New clinical guidelines for stomach cancer testing aim to improve outcomes for Maori |
| Newshub, Other, 10/08/2020, Dave Goosselink |
| An Otago University team has developed new clinical guidelines for testing stomach cancer in New Zealand – especially in Maori. Maori have a higher risk of developing the disease, due to a cancer-causing gene passed down through some whakapapa. |
| Research team hopes Maori lives will be saved with new testing criteria for stomach cancer |
| New Zealand Doctor Online, Other, 10/08/2020 |
| There are likely to be several hundred Maori unaware they are at high risk of an inherited form of stomach cancer and a New Zealand research team is hopeful updated international clinical practice guidelines they helped develop will encourage these people to be tested. The University of Otago and the Kimihauora Health and Research Clinic’s (Mt Maunganui) work in understanding the role of variants (mutations) in the CDH1 gene in familial stomach cancer and the subsequent development of a genetic test, has dramatically reduced the number of deaths from this form of inherited cancer. |
| A research team hopes Maori lives will be saved by new testing criteria for stomach cancer |
| NZCity, Other, 11/08/2020 |
| Otago University Professor Parry Guilford was part of the research team which in 1997, discovered a gene mutation that makes people more likely to get stomach cancer. He’s now helped develop a new set of testing guidelines for it. |
| Research team hopes Maori lives will be saved with new testing criteria for stomach cancer |
| University of Otago, Other, 10/08/2020, Liane Topham-Kindley |
| There are likely to be several hundred Maori unaware they are at high risk of an inherited form of stomach cancer and a New Zealand research team is hopeful updated international clinical practice guidelines they helped develop will encourage these people to be tested. The University of Otago and the Kimihauora Health and Research Clinic’s (Mt Maunganui) work in understanding the role of variants (mutations) in the I gene in familial stomach cancer and the subsequent development of a genetic test, has dramatically reduced the number of deaths from this form of inherited cancer. |
| Newstalk ZB (Auckland), 10:00 News, 11/08/2020 |
| Otago University Prof Parry Guilford has helped develop new testing guidelines for his 1997 research, with the hope that it will make it easier for Māori to get tests to find out if they have stomach cancer-causing genes. |
| Newstalk ZB (Auckland), 10:00 News, 11/08/2020 |
| Otago University Prof Parry Guilford has helped develop new testing guidelines for his 1997 research, with the hope that it will make it easier for Māori to get tests to find out if they have stomach cancer-causing genes. |
