DEADLY DELAYS

Fast treatment catch-up urged after lockdown disruption,

Four hundred people could die from cancer if New Zealand does not act quickly to catch up on cancer diagnostics missed during the lockdown.

The warning from the Cancer Society of New Zealand comes after a report by the newly formed Cancer Control Agency found there were 1031 fewer cancer registrations in April 2020 compared to April 2019, a 47 per cent decrease, due to the lockdown.

The figure is in line with what other countries around the world experienced during coronavirus lockdowns. The report, released in May, has seen swift action from district health boards (DHBs) to catch up on diagnostics.

Cancer Society medical director and oncologist Dr Chris Jackson said New Zealand had a three-month window – which started ticking when lockdown ended on April 27 – to address the issue, or deaths were likely.

‘‘It’s fantastic that the Government has made a financial commitment to catch up,’’ Jackson said. ‘‘But it needs to be done quickly because if the catch-up is staggered over a long period . . . we know that people will potentially die as a result of a slow catch-up in diagnosis.

‘‘Data we saw out of the UK showed that a three-month delay on average of cancer diagnoses could potentially lead to 400 deaths in New Zealand from cancer. Unnecessary deaths. So that’s why it’s so important that we have this catch-up.’’

Cancer Control Agency chief executive Diana Sarfati said the United Kingdom studies shouldn’t be compared to New Zealand, as DHBs were moving quickly to make up lost ground, and New Zealand had done ‘‘incredibly well’’ in contrast to other countries, whose health systems were overwhelmed.

‘‘This protected people with cancer, enabling hospital services to continue and safeguarding those who are immunocompromised from the spread of Covid-19,’’ Sarfati said.

‘‘The fact that cancer treatment services were maintained at a time of so much uncertainty, with changes to how hospitals ran, and with limitations around social distancing, is a huge testament to cancer care providers across New Zealand.

‘‘A catch-up on diagnostic services has now begun, and we will continue to monitor the impact of Covid-19 on the cancer pathway. This will feed into the sector’s planning and ongoing delivery of care.’’

Government funding to address the diagnostic decrease would be used to free up services like CT scans, creating an extra surgical list paying for nurses, theatre staff, and facilities.

Jackson said judicious use of the private sector would help to ensure suitable capacity throughout the region.

‘‘And where regions are struggling to catch up we’ve got to make sure that we let people cross between DHB boundaries to catch up if need be,’’ he said.

‘‘Otherwise, you’ll get inequities according to where you live and that’s not what anyone wants.’’

Sarfati said cancer treatment was largely maintained during the lockdown for the general population, and for Ma¯ ori specifically.

The number of radiation oncology first specialist assessments was stable for Ma¯ ori and non-Ma¯ ori patients.

‘‘In general, these findings are reassuring that cancer treatment was well maintained over the lockdown period.’’

For those already diagnosed with can

cer, treatment largely continued through the Covid-19 lockdown, according to the report.

‘‘Medical oncology, radiation oncology and cancer surgery were well maintained over the period of the lockdown. This is a testament to the determination and innovation of all those in the cancer sector who have worked hard to make sure treatment continued for their patients,’’ Sarfati said.

The report also found disruptions have not increased inequities, with Ma¯ ori being less severely impacted across most measures.

Hei A huru Mowai, Maori Cancer Leadership Aotearoa, chairperson Dr Nina Scott said the agency’s collaborative approach ensured equitable outcomes.

Jackson said the Cancer Control Agency, created in December, was desperately needed and it had already made a major impact in closing inequity gaps and ensuring a cohesive approach.

Jackson said the reporting by the

agency and its strong commitment to closing the gap was already being seen.

‘‘We had strong, secure leadership, we had a nice consistent approach,’’ he said.

‘‘We had a national collaboration with a cancer agency at the front, working with clinicians in the regions to make sure that everyone was on the same page. And that means that the treatment aspect went to, you know, went on pretty much as normal.’’

Sarfati said the agency worked closely with the cancer sector during the pandemic to support the provision of services with the aim of supporting ongoing work whilst identifying where the gaps were.

‘‘By working closely with cancer clinicians, we understood that cancer treatment was continuing. However, there was concern around the disruption to diagnostic procedures,’’ she said.

‘‘The aim was to quantify the disruption to diagnostic services, confirm that treatment was continuing and assess the impact disruptions had on inequities. The focus was on getting data as quickly as possible to help plan recovery and inform policy decision-making.’’

Ministry of Health DHB performance manager Phillipa Blakey said one of the main aims behind the creation of the Cancer Control Agency was equity.

‘‘There is still much to be done to reduce inequity, however it’s reassuring to see that disruptions have not increased inequity,’’ she said.

Blakey was unable to provide the exact amount being spent on cancer services, but said the Budget allocated $31.35 million a year with a one-off boost of $282.5m over the next three years to support an increase in planned care delivery.

‘‘We’ve got to make sure that we let people cross between DHB boundaries . . . Otherwise, you’ll get inequities according to where you live.’’ Dr Chris Jackson, Cancer Society