Te Tumu input into international cancer research

Posted on August 14, 2020 by Lachlan Paterson

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.

This entry was posted in Indigenous Development, Māori Studies, publication, research outreach, success story and tagged CDH1, gastric cancer, Karyn Paringatai, Māori health by Lachlan Paterson. Bookmark the permalink.