New website launched Our new website is here. Find out more

About the project

There are significant inequalities in cancer survival between Māori and non-Māori, and evidence that comorbidity (the presence of other health problems) and service access play important roles. The C3 Qualitative Study aims to understand the independent and interacting influences of ethnicity and comorbidity on cancer survival and to develop interventions that will change health delivery to reduce these inequalities.

Methods of the C3 Qualitative Study include recording of multidisciplinary team meetings, 'digital diaries' of patient and clinician perceptions of consultations, and interviews with patients about their cancer journey. Māori Community and Clinical Oversight groups will provide research guidance.

Outcomes of the C3 Qualitative Study include improved understanding of ethnicity and comorbidity on clinical decision-making about cancer treatment, and cancer journeys, and the development, piloting and evaluation of at least three interventions to reduce these inequalities. This research has the potential to improve the management of cancer and comorbidity in Māori, and possibly the management of other chronic diseases.

The C3 Qualitative study is one of two interlinked studies within the Cancer, Comorbidity and Care (C3) programme.

This project is divided into four distinct phases;

  1. understanding the process of clinical decision-making in multidisciplinary team (MDT) meetings,
  2. understanding the process and content of specialist consultations where treatment options are discussed, and the perceptions of clinicians and patients/whānau to these consultations,
  3. patient understanding of their cancer journey, and
  4. development of interventions aimed at improving cancer survival and reducing inequalities in survival between Māori and non-Māori cancer patients.



This project is funded by the Health Research Council of New Zealand.

Our people

  • Louise Signal (PI); University of Otago, Wellington
  • Chris Cunningham (Co-PI); Massey University
  • Kevin Dew; Victoria University
  • Diana Sarfati; University of Otago, Wellington
  • Jeannine Stairmand; University of Otago, Wellington
  • Maureen Holdaway; Massey University
  • Lis Ellison-Loschmann; Massey University
  • Lesley Batten; Massey University
  • Jonathan Koea; Hepatobiliary surgeon, Auckland
  • Elizabeth Dennett; Colorectal surgeon, Wellington
  • Dr Andrew Simpson; Oncologist, Wellington


C3 (Qualitative) study: Update on Progress

Associate Professor Louise Signal updates progress on the C3 (Qualitative) study.


Dew K, Stairmand J, Signal L, Sarfati D. Cancer care decision-making and treatment consent: An observational study of patients' and clinicians' rights. Journal of Sociology 2018;1-18.

O'Brien I, Signal L, Sarfati D. Wide-ranging impacts reported by NZ cancer survivors: is supporting cancer survivor resilience a health sector role? Supportive Care in Cancer 2018; 16(4): 1207-13.

Stairmand, J., Signal, L., Sarfati, D., Jackson, C., Batten, L., Holdaway, M., & Cunningham, C. (2015). Consideration of comorbidity in treatment decision-making in multidisciplinary cancer team meetings: A systematic review. Annals of Oncology. Advance online publication. doi: 10.1093/annonc/mdv025

Dew, K., Stubbe, M., Signal, L., Stairmand, J., Dennett, E., Koea, J., Simpson, A., Sarfati, D., … Holdaway, M. (2015). Cancer care decision making in multidisciplinary meetings. Qualitative Health Research, 25(3), 397-407. doi: 10.1177/1049732314553010

Dew, K., Signal, L., Davies, C., Tavite, H., Hooper, C., Sarfati, D., Stairmand, J., Cunningham, C. (2015). Dissonant roles: The experience of Māori in cancer care. Social Science & Medicine, 138, 144-151. doi: 10.1016/j.socscimed.2015.06.008

C3 Qualitative Study
Department of Public Health
University of Otago, Wellington
PO Box 7343
Wellington South 6242
New Zealand
Tel: +64 4 918 6477
Fax: +64 4 389 5319

Back to top