The future of cancer research in Aotearoa New Zealand: a pathway for better cancer outcomes

Cancer research has never been more important to Aotearoa New Zealand. More than 30,000 New Zealanders are expected to be diagnosed with cancer in 2026, increasing to more than 45,000 annually by 2044. Five-year cancer survival has improved substantially over the past 25 years, but New Zealand continues to lag behind comparable high-income countries.¹ Cancer remains our leading cause of death. The challenge is not about providing more cancer treatment but to create a health system capable of generating and rapidly applying the evidence that will improve prevention, earlier diagnosis, treatment and survivorship.

The New Zealand Cancer Action Plan 2026–2029 (Cancer Action Plan) explicitly recognises that research, including clinical trials, underpins the entire cancer control continuum and identifies national co-ordination, improved clinical-trial capacity, research translation and stronger relationships between researchers, policymakers and service providers as priorities.¹ Action point 8.4 calls for cancer research and innovation to be “aligned and elevated”, including decentralised clinical trials, targeted research funding and national mechanisms for translating research findings into routine clinical care. While New Zealand may want to recognise the importance of cancer research in clinical practice and as a driver to improved cancer survival, the issue is whether we have the funding, infrastructure and institutional structures required to deliver these ambitions.

New Zealand already has considerable cancer-research capability. A recent analysis of the cancer research landscape from 2016 to 2026 identified 586 researchers, of whom 420 had held cancer-related funding, producing more than 20,000 publications with collaborations involving 145 countries.² It identified NZ$184.07 million of state funding across 272 projects and NZ$85.81 million from philanthropic and charitable organisations across 220 projects.² Cancer Society funding alone totalled NZ$52 million across 54 projects.²

These sums appear substantial, but spread across a decade and a population exceeding 5 million they are relatively modest. Approximately NZ$270 million of identifiable state and charitable funding equates, very approximately, to NZ$5 per person per year. This should not be regarded as a precise international comparison: funding definitions differ between countries, and the New Zealand analysis is unlikely to capture all expenditure. Nevertheless, the scale is informative. Cancer Research UK alone spent £403 million on research in 2024/2025—approximately £6 per United Kingdom resident from a single charitable organisation—before government, university and other charitable research expenditure is included.³ Canada similarly reports annual cancer-research investment of approximately CA$500 million.⁴ Australia continues to make substantial investments through the Medical Research Future Fund, including AU$750 million over 10 years through its Clinical Trials Activity initiative.⁵

The issue, however, is not simply asking for more money. It is important that the money and resources we have are best utilised and the people and infrastructure are organised. Cancer research in New Zealand is already concentrated. Eighty-five percent of researchers identified in the recent analysis were affiliated with the universities of Auckland and Otago.² Together, these universities held 358 of the 491 identified projects and NZ$146.74 million of the NZ$198.07 million in attributable project-level funding.² Such concentration is not necessarily undesirable. Contemporary cancer research requires critical mass, sophisticated laboratories, genomics, biobanking, data science, clinical-trial infrastructure and multidisciplinary expertise. New Zealand cannot efficiently reproduce all these capabilities everywhere.

Auckland has already begun to translate this principle into organisational change. In 2026, The University of Auckland established a Department of Cancer Sciences under its founding head, Associate Professor Ben Lawrence, a medical oncologist. The department brings together the Auckland Cancer Society Research Centre, the former Department of Oncology and Cancer Trials New Zealand, while seeking to connect researchers and clinicians across the university, Health New Zealand – Te Whatu Ora and other organisations.⁶ The university describes this as a major step towards a comprehensive cancer centre. Their longer-term vision is for the department to provide the foundation for New Zealand’s first such centre within the next decade, integrating prevention and screening, laboratory discovery, drug development, precision oncology, clinical trials and clinical care.⁷

Christchurch also has many of the components required for this model. While Otago is a multi-campus medical school, Christchurch is a major clinical and research campus with substantial cancer research, translational laboratory activity and tissue-banking capability, closely integrated with Christchurch Hospital. The combination of patients, clinicians, tissue, data and laboratory scientists provides precisely the environment required for translational cancer research. The existing Canterbury Comprehensive Cancer collaborative network provides an additional foundation on which a more integrated centre could be built. The integration across clinical practice and basic laboratory research is important. Clinical problems generate research questions; laboratory discoveries move into trials; patients are routinely considered for research participation; outcomes are measured; and evidence is rapidly translated back into practice. As Lawrence has argued in developing the Auckland model, research and clinical care strengthen each other when they occur within the same environment.⁷

Such centres could also provide an organisational mechanism for delivering many of the priorities already identified in the Cancer Action Plan. The plan separately calls for stronger national cancer data and intelligence, genomics capacity, artificial intelligence, clinical-trial infrastructure and research translation.¹ Comprehensive cancer centres could bring these together through shared biobanks, molecular pathology, genomics, clinical-trial units, research nurses, statisticians, bioinformaticians and linked national datasets.

This should not mean centralising cancer research or cancer care in Auckland and Christchurch, as Dunedin, Wellington, the Malaghan Institute of Medical Research and other centres have substantial research expertise, while regional hospitals are essential to equitable trial access. The objective should be to concentrate expensive infrastructure while distributing access nationally. The Cancer Action Plan itself calls for decentralised trials so that people living outside the major centres can participate in research. Comprehensive cancer centres should therefore function as hubs within a network, rather than institutions that draw research and patients away from the regions.

Equity is fundamental to cancer delivery and research. Māori and Pacific people continue to experience substantially poorer cancer outcomes. The Cancer Action Plan specifically includes growing and supporting the Māori cancer-research workforce. Research priorities, governance, workforce development and recruitment to clinical trials must therefore address inequity from the outset rather than as an afterthought.

There is also an important question about how we balance investment in today’s cancer treatment against investment in tomorrow’s care. Government has made substantial recent investments in medicines, infusion services, diagnostics and bowel screening.¹ These were often overdue and necessary. But genomics, precision oncology, artificial intelligence, new diagnostics and new treatments will not simply implement themselves. A modern cancer system must invest in the knowledge-generating infrastructure required to determine which innovations work, for whom they work and how they should be delivered in New Zealand.

New Zealand cannot, and should not, undertake every form of cancer research. We should identify areas in which our population, national health system, clinical expertise, research strengths and linked datasets provide international advantages, while participating strongly in international research elsewhere.

The Cancer Action Plan has established the direction. The next challenge is to fund and organise cancer research as essential health infrastructure. Auckland has begun developing one model under Ben Lawrence. Christchurch has the clinical, academic and translational foundations for a complementary centre. Connecting these centres with Dunedin, Wellington, regional cancer services, research institutes, registries, charities and patients could create something considerably more important than two institutions: a national cancer research system. Research is not an academic luxury added to cancer care. It is how cancer care improves.