National cancer agency wanted to halt ‘lottery’

“Unacceptable” disparities between New Zealand’s DHBs for cancer outcomes has experts calling for a new national agency specialised in tackling New Zealand’s number one killer.

Oncologist and Cancer Society medical director Chris Jackson told the Weekend Herald thousands of Kiwis were dying from cancer each year, the numbers were set to keep rising and it appeared the Government didn’t have a full plan to tackle it.

“Postcode inequalities” in emergency bowel cancer surgery, radiation treatment and lung cancer were among “serious concerns” echoed at the international Cancer Crossroads Conference in Wellington this week. Researchers and medical practitioners stressed regional and ethnicity inequalities were prevalent among all cancers. It was unacceptable and preventable.

Jackson said a national body — Government-funded but operating independently — to hold DHBs to account and help improve those disparities was crucial to cutting the alarming death rates.

Pre-election, Labour promised that $2.3 billion out of the $8b health budget expenditure would go towards getting this agency off the ground. Before being replaced in mid-2017 as Labour leader, Andrew Little — a cancer survivor — stated: “What really worries me is that cancer care can be a ‘postcode’ lottery”.

Health Minister David Clark told the Weekend Herald it had been made clear to him and Ministry of Health officials that “we have the opportunity to improve cancer care and outcomes for New Zealanders with stronger central governance and leadership”.

“The form that governance should take is under active consideration at the moment,” he said.

Ian Bissett, a professor at the University of Auckland and consultant surgeon at Auckland City Hospital, spoke at the conference about the inequalities in bowel cancer surgery — findings of the National Bowel Cancer Working Group study of which he had been a part since it was established in 2013.

The numbers presenting to emergency departments with undiagnosed bowel cancer varied between each DHB from 15 to 35 per cent, Bissett said. Patients diagnosed at ED would often have a later stage of cancer, some requiring emergency surgery, which meant a higher chance of death.

“A tenth of patients in New Zealand who have surgery in an emergency setting will die before 90 days, whereas if they have surgery in an elective setting their chance of survival is much higher.”

If symptoms were picked up earlier, then emergency presentations would drop, Bissett said.

The full report of this study will be released in two weeks.