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Issue

Vol 127 No 1400: 15 Aug 2014

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Issue Summary

SUMMARY

A comparison of cancer statistics in New Zealand and Australia: 1996–2007

John Waldon, David S Lamb, Brett Delahunt, John N Nacey, Peter J Dady, Carol A Johnson, Alan G Hall, Peter B Bethwaite, Philip Weinstein

For the years 1996-1997 and 2006-2007, the incidence and mortality of cancer in New Zealand and Australia was compared to determine if differences between the two countries had changed over the decade under study. For the 11 year timeframe of this study, total rates of cancer incidence reduced in New Zealand and increased in Australia. Over the same 11-year timeframe, cancer-specific mortality rates decreased in both countries, but there was no change in the difference between New Zealand and Australian rates, which remained 10% higher in New Zealand. We conclude that the persisting different cancer mortality rates between the two countries is likely to have been partly due to lifestyle and ethnic differences in the populations, and partly due to New Zealanders presenting with more advanced cancers and having less easy access to some treatments.

SUMMARY

Cancer mortality and incidence trends comparing New Zealand and Australia for the period 2000–2007

J Mark Elwood, Sally Ioannides, Lamees Alafeishat

A previous study showed that cancer mortality in New Zealand in 1996-97 was substantially higher than that expected from Australian rates. This study compared cancer mortality and incidence in New Zealand for 2000-2007 with rates in Australia, to assess if any differences had persisted or changed. The numbers of cancer deaths in New Zealand, by type of cancer, year, sex, and 5 year age group, were compared to the numbers that would have occurred if NZ rates had been the same as those in Australia. From 2000-2007, there were each year an average of 586 (15.1% of the total) more deaths from cancer in New Zealand women than expected from Australian rates; and 197 (4.7%) more deaths in men. Higher cancer mortality was seen for most common sites; the greatest excesses were for colorectal cancer in both men and women. Cancer incidence in New Zealand women was 3.3% higher, and incidence in men was 4.7% lower, than in Australia over this period. Cancer mortality remains substantially higher in New Zealand than in Australia, especially for women, although mortality has reduced in both countries. While the differences in 2000-07 were slightly smaller than in 1996-97, there has been little change since 2000. The greater differences in deaths than in incidence suggest that patient survival is lower in New Zealand.

SUMMARY

Why are we failing with the epidemic of obesity and other chronic diseases? A further look at aetiopathogenesis

William Ferguson

Recent scientific debate questioning the role of saturated fats in coronary artery disease has highlighted our confusion about diet in major disease. Our approach to obesity has been similarly confused, with strict advice about fat reduction clearly only being beneficial to a sub group of the general population. This paper attempts to highlight some of the complexity that is emerging in our understanding of the underlying mechanisms of these chronic disorders, and why we are doing badly in preventing and managing these conditions.

SUMMARY

Construction and use of mapping techniques to describe the geographical distribution of medication dispensing for the secondary prevention of atherosclerotic CVD in New Zealand: VIEW-2

Daniel J Exeter, Jinfeng Zhao, Grant Hanham, Corina Grey, Sue Wells, Andrew Kerr

This paper outlines the development of two alternate methods of presenting results related to the epidemiology of CVD medication dispensing among patients who have been hospitalised for CVD (see article in this issue by Kerr et al.). We demonstrate that the standard template, as used by the Health Quality and Safety Commission is effective as showing variations for a particular group (such as Mori, or patients aged 50-59, for example). By contrast, our Advanced template was designed to make comparisons between age or ethnic groups more effectively. These maps integrate data in tables, maps and graphs to efficiently display variations in secondary prevention medication to promote opportunities for front-line change.

SUMMARY

Screening for pulmonary arterial hypertension in patients with scleroderma—a New Zealand perspective

Sanjib K Ghosh, Michael M Corkill, Hamish H Hart, Kristine P Ng

Screening for pulmonary arterial hypertension in patients with scleroderma is recommended. There is a wide variation of how NZ rheumatologists screen for pulmonary hypertension in patients with scleroderma. A national pulmonary arterial hypertension screening guideline may help standardise treatment in NZ.

SUMMARY

Stakeholder engagement for the New Zealand Atlas of Healthcare Variation: cardiovascular disease secondary prevention: VIEW-3

Corina Grey, Sue Wells, Daniel J Exeter, Grant Hanham, Jinfeng Zhao, Andrew J Kerr

After collecting data and creating maps of the differences in long-term medication use among people with cardiovascular disease in New Zealand, our research group sought the opinions of doctors and healthcare managers to improve the presentation of our data and identify reasons why certain groups of people receive less medication than others. Among those with cardiovascular disease, younger people, women and those of Maori or Pacific ethnicity receive preventative medications least frequently. These differences are likely due to a combination of factors and barriers encountered by prescribers and patients. One strategy to increase the use of medication among cardiovascular patients is to regularly report the proportion of patients receiving medications to general practices to motivate these practices to ensure that all patients understand the importance and benefits of long-term preventative therapy. This feedback is also important so that practices are able to monitor their progress and identify groups of patients that may potentially be missing out.

ALL ARTICLES
SUMMARY

Desmond Alexander McQuillan

A comparison of cancer statistics in New Zealand and Australia: 1996–2007

John Waldon, David S Lamb, Brett Delahunt, John N Nacey, Peter J Dady, Carol A Johnson, Alan G Hall, Peter B Bethwaite, Philip Weinstein

Cancer mortality and incidence trends comparing New Zealand and Australia for the period 2000–2007

J Mark Elwood, Sally Ioannides, Lamees Alafeishat

Why are we failing with the epidemic of obesity and other chronic diseases? A further look at aetiopathogenesis

William Ferguson

Professional Misconduct (Med10/170D)

Health Practitioners Disciplinary Tribunal

Response to Professor Richmond’s viewpoint article on the End of Life Choice Bill

Jack Havill, Antoinette (Toni) Brown

Editorial: Outbreak of WW1

Professional Misconduct (Med10/152P)

Health Practitioners Disciplinary Tribunal

Construction and use of mapping techniques to describe the geographical distribution of medication dispensing for the secondary prevention of atherosclerotic CVD in New Zealand: VIEW-2

Daniel J Exeter, Jinfeng Zhao, Grant Hanham, Corina Grey, Sue Wells, Andrew Kerr

Falling through the cracks: New Zealand prostate cancer survivors' experiences and views regarding PSA testing

Asmita Patel, Roderick MacLeod, Jonathan Masters, Justin Keogh

Paracetamol and serious skin reactions

Screening for pulmonary arterial hypertension in patients with scleroderma—a New Zealand perspective

Sanjib K Ghosh, Michael M Corkill, Hamish H Hart, Kristine P Ng

Stakeholder engagement for the New Zealand Atlas of Healthcare Variation: cardiovascular disease secondary prevention: VIEW-3

Corina Grey, Sue Wells, Daniel J Exeter, Grant Hanham, Jinfeng Zhao, Andrew J Kerr

Editorial
Vol 127 No 1400: 15 Aug 2014

Charting progress in the battle against cancer

SUMMARY

A comparison of cancer statistics in New Zealand and Australia: 1996–2007

John Waldon, David S Lamb, Brett Delahunt, John N Nacey, Peter J Dady, Carol A Johnson, Alan G Hall, Peter B Bethwaite, Philip Weinstein

For the years 1996-1997 and 2006-2007, the incidence and mortality of cancer in New Zealand and Australia was compared to determine if differences between the two countries had changed over the decade under study. For the 11 year timeframe of this study, total rates of cancer incidence reduced in New Zealand and increased in Australia. Over the same 11-year timeframe, cancer-specific mortality rates decreased in both countries, but there was no change in the difference between New Zealand and Australian rates, which remained 10% higher in New Zealand. We conclude that the persisting different cancer mortality rates between the two countries is likely to have been partly due to lifestyle and ethnic differences in the populations, and partly due to New Zealanders presenting with more advanced cancers and having less easy access to some treatments.

SUMMARY

Cancer mortality and incidence trends comparing New Zealand and Australia for the period 2000–2007

J Mark Elwood, Sally Ioannides, Lamees Alafeishat

A previous study showed that cancer mortality in New Zealand in 1996-97 was substantially higher than that expected from Australian rates. This study compared cancer mortality and incidence in New Zealand for 2000-2007 with rates in Australia, to assess if any differences had persisted or changed. The numbers of cancer deaths in New Zealand, by type of cancer, year, sex, and 5 year age group, were compared to the numbers that would have occurred if NZ rates had been the same as those in Australia. From 2000-2007, there were each year an average of 586 (15.1% of the total) more deaths from cancer in New Zealand women than expected from Australian rates; and 197 (4.7%) more deaths in men. Higher cancer mortality was seen for most common sites; the greatest excesses were for colorectal cancer in both men and women. Cancer incidence in New Zealand women was 3.3% higher, and incidence in men was 4.7% lower, than in Australia over this period. Cancer mortality remains substantially higher in New Zealand than in Australia, especially for women, although mortality has reduced in both countries. While the differences in 2000-07 were slightly smaller than in 1996-97, there has been little change since 2000. The greater differences in deaths than in incidence suggest that patient survival is lower in New Zealand.

SUMMARY

Why are we failing with the epidemic of obesity and other chronic diseases? A further look at aetiopathogenesis

William Ferguson

Recent scientific debate questioning the role of saturated fats in coronary artery disease has highlighted our confusion about diet in major disease. Our approach to obesity has been similarly confused, with strict advice about fat reduction clearly only being beneficial to a sub group of the general population. This paper attempts to highlight some of the complexity that is emerging in our understanding of the underlying mechanisms of these chronic disorders, and why we are doing badly in preventing and managing these conditions.

SUMMARY

Construction and use of mapping techniques to describe the geographical distribution of medication dispensing for the secondary prevention of atherosclerotic CVD in New Zealand: VIEW-2

Daniel J Exeter, Jinfeng Zhao, Grant Hanham, Corina Grey, Sue Wells, Andrew Kerr

This paper outlines the development of two alternate methods of presenting results related to the epidemiology of CVD medication dispensing among patients who have been hospitalised for CVD (see article in this issue by Kerr et al.). We demonstrate that the standard template, as used by the Health Quality and Safety Commission is effective as showing variations for a particular group (such as Mori, or patients aged 50-59, for example). By contrast, our Advanced template was designed to make comparisons between age or ethnic groups more effectively. These maps integrate data in tables, maps and graphs to efficiently display variations in secondary prevention medication to promote opportunities for front-line change.

SUMMARY

Screening for pulmonary arterial hypertension in patients with scleroderma—a New Zealand perspective

Sanjib K Ghosh, Michael M Corkill, Hamish H Hart, Kristine P Ng

Screening for pulmonary arterial hypertension in patients with scleroderma is recommended. There is a wide variation of how NZ rheumatologists screen for pulmonary hypertension in patients with scleroderma. A national pulmonary arterial hypertension screening guideline may help standardise treatment in NZ.

SUMMARY

Stakeholder engagement for the New Zealand Atlas of Healthcare Variation: cardiovascular disease secondary prevention: VIEW-3

Corina Grey, Sue Wells, Daniel J Exeter, Grant Hanham, Jinfeng Zhao, Andrew J Kerr

After collecting data and creating maps of the differences in long-term medication use among people with cardiovascular disease in New Zealand, our research group sought the opinions of doctors and healthcare managers to improve the presentation of our data and identify reasons why certain groups of people receive less medication than others. Among those with cardiovascular disease, younger people, women and those of Maori or Pacific ethnicity receive preventative medications least frequently. These differences are likely due to a combination of factors and barriers encountered by prescribers and patients. One strategy to increase the use of medication among cardiovascular patients is to regularly report the proportion of patients receiving medications to general practices to motivate these practices to ensure that all patients understand the importance and benefits of long-term preventative therapy. This feedback is also important so that practices are able to monitor their progress and identify groups of patients that may potentially be missing out.

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