New Zealand is currently piloting the feasibility of a national population-based screening programme for colorectal cancer. Colorectal cancer is one of the most common forms of cancer worldwide, with New Zealand having one of the highest colorectal death rates in the world (Blakely et al., 2010; Shah, Sarfati, Blakely, Atkinson & Dennet, 2012). Considered the most preventable form of cancer, lives can be spared through early diagnosis and intervention. However, evidence of disparities continue to exist in access to healthcare within some population groups, which has an influence on uptake rates in screening programmes (Pitama et al., 2012). Despite improvement in decreased mortality rates in New Zealand’s breast and cervical screening, there continues to be a gap in New Zealand’s uptake in health screening initiatives, especially within the Māori population. In view of the proposed colorectal cancer screening programme, there is a need for specific guidelines that will guide healthcare services in providing robust strategies that will effectively contribute to equity of uptake for Māori. A critical literature review on the equity of uptake in population-based screening for New Zealand’s Māori population was undertaken using a critical social theory lens. The aim was to identify factors that influence equity in uptake of screening in order to recommend robust guidelines in assuring equity of uptake for Māori in the proposed colorectal cancer screening programme.
Sixteen articles from a large body of knowledge were selected and supporting articles and government publications were also used to enhance the review. A thematic analysis of the selected articles identified access to healthcare/screening as the main theme, with structural issues of socioeconomics, health literacy, structural racism, acceptability of service, appropriate services and geographical structures being sub-themes. Recommendations include on-going education to providers, healthcare professionals and the general public, on-going research into equitable access to screening and follow-up treatment, and consideration of Marae-based clinics and/or mobile endoscopy screening units.