Te Aho o Te Kahu Cancer Control Agency’s report on cancer in New Zealand over the past five years showed cancer numbers are burgeoning and, while we are surviving longer after cancer diagnoses, we lag behind other high-income countries.
The report said the chance of dying from cancer has been declining for decades in New Zealand, mostly due to improvements in screening and cancer treatment.
Survival rates five years after diagnosis have improved, translating to nearly 3000 more people with cancer being alive each year.
Other "wins" outlined in the report were the increased spending on cancer medicines and expanding radiation treatment capacity.
Smoking rates had declined across all ethnicities and national screening programmes were becoming more effective and accessible.
But the rate of smoking decline seems to have stalled. Public health advocates have linked that to the rolling back of Labour’s planned wide-ranging and ground-breaking anti-smoking measures.
While the report said there had been substantial investment in and improvement to the country’s breast, bowel and cervical cancer programmes in the past five years, and they were close to meeting their coverage targets, ongoing focus was needed to ensure targets were met and, ideally, exceeded.
There were significant inequities for Māori and Asian populations across all screening programmes and for Pasifika in some. International evidence also showed disabled people were under-screened.
Too many people in New Zealand had their cancer diagnosed following an emergency department admission, rather than early through primary care, when their cancer was more likely to be at an earlier stage and more treatment options were possible.
Where people live can affect access to treatment and the report drew attention to the need for more improvement to the National Travel Assistance scheme, which can help those who need to travel away from home for treatment.
Recruiting and retaining cancer health professionals was a continuing challenge with workforce shortages contributing to reduced access and increased wait times for many patients.
The number of people diagnosed with cancer each year is expected to rise from about 30,000 this year to more than 45,000 by 2044.
As the control agency’s chief executive, Rami Rahal, says, doing more of the same cannot be the response to this big increase in demand. New and innovating ways of delivering care and preventing cancers would be needed.
Improved prevention could mean between 8000 and 14,000 fewer cancer diagnoses each year.
The report said there had been minimal change to cancer incidence rates, as improvements due to the steady reduction in smoking rates have been offset by increases in other cancer risk factors like poor nutrition, physical inactivity and excess body weight.
People’s risk of developing cancer often depended on where they lived, and their levels of power, money and resources, and "access to culturally safe care".
In many socioeconomically deprived areas, where more Māori and Pasifika lived, there was a higher density of fast-food and alcohol outlets, making healthy choices harder to access.
Māori and Pasifika are more likely to die from cancer than other ethnicities and inequity for them was evident in both prevention and treatment.
The report’s publication must raise questions, again, about whether we are doing enough on prevention.
For instance, the report points out only one in five adults surveyed in 2023 were aware of the link between drinking alcohol and cancer.
It said there was no large-scale public awareness campaign addressing that, with the only mandatory health warnings on alcohol in New Zealand against drinking during pregnancy and they were only required in 2023.
The current government has shown no appetite for anything effective to reduce harm from alcohol or fast food and sugary drinks. It is time politicians of all stripes realised short-sighted thinking on prevention measures will prove more costly in the long run, both in monetary terms and human misery.
