Cancer study NZ's largest

Thousands of New Zealand bowel cancer cases will be examined to find out what influences survival, says study project clinical lead Dr Chris Jackson, of Dunedin.

The $1 million three-year study had been jointly funded by the Health Research Council and the Ministry of Health, it was announced on Monday. It would be the largest study of bowel cancer patient outcomes undertaken in New Zealand.

Dr Jackson, a Southern District Health Board medical oncologist and University of Otago senior lecturer, told the Otago Daily Times he suspected there were widely differing survival rates throughout New Zealand.

"[The study is] looking at why people get a different deal depending on where they live in the country.""Our hypothesis is if you are in a major metropolitan area you are more likely to have access to timely cancer treatment and more thorough investigation and follow-up and treatment.""My suspicion is there are very different outcomes depending on what sort of treatments you receive, and my suspicion is that there are a number of gaps in the services we provide," Dr Jackson said.

At present, there was no strong data on death rate by region.

Using treatment notes from 6500 bowel cancer patients mainly in 2007 and 2008 (with a wider time sample for Maori and Pacific Island patients), the study aimed to determine the role played by socioeconomic, geographic, ethnic and clinical factors.

Researchers did not need individual patient approval as the data collection was routine, although general ethics approval was being sought.

Maori and Pacific Island survival rates were significantly worse than those of Europeans, even though their rates of the disease were lower, suggesting "ethnic inequality".

The study was an important step to tackling New Zealand's high incidence and death rate from bowel cancer.

"Research often focuses on single elements of good cancer care, like choosing the best chemotherapy drug, or right radiation dose.

"Our project aims to join the dots, and look at how each of the components of care fits together to give us a holistic view of the treatments we deliver, with the patient at the centre of that."

Bowel cancer was unusual because, unlike other types, it required a clinical team approach, rather than a more straightforward "conveyor belt" of treatments.

It was also unusual because bowel was the only cancer type sufferers could survive once it had spread to another part of the body, so monitoring was especially crucial, Dr Jackson said.

The study's principal investigator was Cancer Trials New Zealand director Prof Michael Findlay, of Auckland University. Other oncology and medical clinical leaders from around New Zealand were also contributing.

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Bowel cancer
• Also called colon, rectal, or colorectal cancer.
• Kills about 1200 New Zealanders each year, more than breast and prostate cancer combined.
• Each year, more than 2800 cases diagnosed.
• New Zealand has one of the world's highest incidences and death rates.
• Otago-Southland has the highest incidence rate in New Zealand.

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- eileen.goodwin@odt.co.nz