New study highlights gaps in colorectal cancer treatment

New study highlights gaps in colorectal cancer treatment in NZ

AUCKLAND: August 17, 2015: Around 30 percent of colon cancer patients in New Zealand (NZ) first learned they had the disease when they presented acutely to hospital. In the UK, around 20 percent of people are detected in this way.

In addition, only 60 percent of New Zealand patients with Stage 3 colon cancer (where the cancer has spread to nearby lymph nodes) had received chemotherapy, a treatment which improves the number of patients who are cured of the disease. In an Australian study, 74 percent of similar patients had received this therapy.

These are just two initial findings from a three-year study, the largest and most comprehensive ever undertaken in New Zealand, of the management of colorectal (colon and rectal, also known as “bowel”) cancer (CRC) - the country’s most common cancer.

The project’s Principal Investigator Professor Michael Findlay, director of Cancer Trials New Zealand (CTNZ) and Professor of Oncology at the University of Auckland said: “This is New Zealand’s largest ever study of colorectal cancer, and highlights that early detection and increasing the use of chemotherapy could improve outcomes for colorectal cancer in NZ.”

An overview of the initial findings of The Presentation, Investigation, Pathways, Evaluation and Treatment (PIPER) project have been presented today (August 17) at a public seminar in Auckland. The PIPER project, which began in 2011, is funded by the Health Research Council of NZ (HRC) and the Ministry of Health. The project is supported by all four cancer networks in New Zealand and has included consumer representation from Bowel Cancer New Zealand. Professor Findlay emphasised that this work was a national collaboration between scientists, universities, hospitals, and clinicians across the country.

Each year CRC kills approximately 1200 New Zealanders – similar to breast and prostate cancer combined. The incidence of CRC in New Zealand is one of the highest in the developed world, and the survival is worse than in Australia.

Professor Findlay says the PIPER project involved a national review of patient notes and relevant regional databases for all patients diagnosed with CRC in 2007 and 2008. An extended cohort of Māori and Pacific cases and a sample of non-Māori and Pacific cases has also been collected from the years 2006, 2009, 2010 and 2011, bringing the total number of cases reviewed to more than 6,300.

Project clinical lead Dr Christopher Jackson, medical oncologist and senior lecturer in Medicine at the University of Otago says the PIPER project has also found that only half of Stage 4 CRC patients (where the cancer has spread to other organs) had received chemotherapy.

“Chemotherapy can extend life up to four-fold in patients where the cancer has spread. This may represent another area where we can focus to further improve outcomes for bowel cancer,” said Dr Jackson.

Mr John Keating, colorectal surgeon from Capital and Coast DHB, said surgical management of the disease is crucial for cure.

“The PIPER project demonstrates that our surgical mortality at 30 and 90 days is similar to other countries. This internationally-accepted marker of surgical quality indicates that our surgical outcomes are comparable to those published in Australia and UK,” he commented.

Project manager Mrs Melissa Firth said this project was the result of a $1million investment from the Health Research Council and the Ministry of Health, along with the extensive work of a national team.

“This demonstrates the resource required to undertake this type of work. We don’t have the infrastructure required to monitor this level of detail on quality of care being received by patients with cancer in NZ on a day-to-day basis,” she said.

Professor Findlay explained that today’s launch represented the first findings of the report.

“We have collected over 960,000 data items and as we analyse these further we will be able to release even more detailed information over the next 6-12 months,” he added.

Following on from the next phase of analyses, the PIPER researchers plan to undertake a detailed comparison with similar projects in Australia and the United Kingdom.

“Given New Zealand’s poor colon cancer statistics, we want to know how we perform on several key quality indicators compared to other countries – what we do well, and what we could do better,” said Prof. Findlay.

ENDS

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