Perceived impact on clinical practice and logistical issues in clinical management surveys of cancer: Australian experience

Staples, Margaret; Elwood, Mark; John, Jomcy; Howes, FS; Pedersen, Karen E.

doi:10.1136/qshc.2007.024398

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…In Australia, there have been many national or state systematic surveys of the management of cancer, which have identified variations in management and gaps between optimal management and actual practice. 35 In New Zealand, there have been few national studies of cancer management, apart from a national study of colorectal cancer, 36 but many localised or site specific studies.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cancer Mortality and Incidence Between New Zealand and Australia and Reflection on Differences in Cancer Care: An Ecological Cross-Sectional Study of 2014-2018

et al. 2023

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Background Despite many background similarities, New Zealand showed excess cancer deaths compared to Australia in previous studies. This study extends this comparison using the most recent data of 2014-2018. Methods This study used publicly available cancer mortality and incidence data of New Zealand Ministry of Health and Australian Institute of Health and Welfare, and resident population data of Statistics New Zealand. Australian cancer mortality and incidence rates were applied to New Zealand population, by site of cancer, year, age and sex, to estimate the expected numbers, which were compared with the New Zealand observed numbers. Results For total cancers in 2014-2018, New Zealand had 780 excess deaths in women (17.1% of the annual total 4549; 95% confidence interval (CI) 15.8-18.4%), and 281 excess deaths in men (5.5% of the annual total 5105; 95% CI 4.3-6.7%) compared to Australia. The excess was contributed by many major cancers including colorectal, melanoma, and stomach cancer in both sexes; lung, uterine, and breast cancer in women, and prostate cancer in men. New Zealand’s total cancer incidences were lower than those expected from Australia’s in both women and men: average annual difference of 419 cases (−3.6% of the annual total 11 505; 95% CI −4.5 to −2.8%), and 1485 (−11.7% of the annual total 12 669; 95% CI -12.5 to −10.9%), respectively. Comparing time periods, the excesses in total cancer deaths in women were 15.1% in 2000-07, and 17.5% in 1996-1997; and in men 4.7% in 2000-2007 and 5.6% in 1996-1997. The differences by time period were non-significant. Conclusion Excess mortality from all cancers combined and several common cancers in New Zealand, compared to Australia, persisted in 2014-2018, being similar to excesses in 2000-2007 and 1996-1997. It cannot be explained by differences in incidence, but may be attributable to various aspects of health systems governance and performance.

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Section: Discussionmentioning

confidence: 99%

Comparison of Cancer Mortality and Incidence Between New Zealand and Australia and Reflection on Differences in Cancer Care: An Ecological Cross-Sectional Study of 2014-2018

et al. 2023

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“…To our knowledge, this study is one of few population‐based surveys of the management of pancreatic cancer. Clinical management surveys can help promote informed patient choices and may result in development and implementation of standard protocols, identification and reduction of variations in practice, promotion of multidisciplinary care and clinical research, and collection and reporting of standard datasets 17 …”

Section: Discussionmentioning

confidence: 99%

Use of chemotherapy and radiotherapy in patients with pancreatic cancer in Victoria (2002–2003): a retrospective cohort study

Jefford

Thursfield

Torn-Broers

et al. 2010

Medical Journal of Australia

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Objective: To describe the management and outcomes of a population‐based cohort of patients with pancreatic cancer treated with chemotherapy or radiotherapy in Victoria, Australia. Design, setting and patients: Questionnaire‐based study of patients diagnosed with pancreatic cancer during 2002–2003 in Victoria who were retrospectively identified from the Victorian Cancer Registry and followed up for a minimum of 5 years. Main outcome measures: Reported treatment, referral patterns and survival rates. Results: 1044 patients with pancreatic cancer were identified, of whom 927 were eligible for the study. Completed questionnaires were obtained for 831 eligible patients (response rate, 89.6%) and data for 66 patients with tumours of the ampulla of Vater and neuroendocrine tumours were excluded. Of the remaining 765 patients, 6.5% were managed in multimodality clinics. Chemotherapy was considered for 413 patients and radiotherapy was considered for 162. One‐third of the cohort (275 patients) received chemotherapy, most commonly as palliative treatment (185). Single‐agent gemcitabine was the most common palliative treatment (154), and was associated with a median overall survival of 6.6 months. Radiotherapy was used in 119 patients (15.6% of the cohort) — it was used alone or with chemotherapy, as postoperative adjuvant treatment, as potentially curative radical treatment, or as palliative treatment. For 45 patients with locally advanced disease who were treated with chemoradiation as radical treatment, median overall survival was 13.1 months. Conclusions: There appears to be under‐referral of patients to medical and radiation oncologists. Median survival of patients treated with radical chemoradiation or palliative chemotherapy is consistent with clinical trial data, but outcomes for patients in our cohort were generally poor. Development and implementation of treatment guidelines may result in improved outcomes.

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“…Australia has undertaken clinical management and population-based cancer care assessment studies [ 63 ] to a greater extent than has New Zealand. These may act as triggers for improvement in cancer care, with a focus on inequity issues and on adherence to clinical guidelines.…”

Section: Discussionmentioning

confidence: 99%

Increasing Disadvantages in Cancer Survival in New Zealand Compared to Australia, between 2000-05 and 2006-10

2016

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New Zealand has lower cancer survival compared to its neighbour Australia. If this were due to long established differences between the two patient populations, it might be expected to be either constant in time, or decreasing, as improving health services deals with inequities. In this study we compared trends in relative cancer survival ratios in New Zealand and Australia between 2000–05 and 2006–10, using data from the New Zealand Cancer Registry and the Australian Institute for Health and Welfare. Over this period, Australia showed significant improvements (6.0% in men, 3.0% in women) in overall 5-year cancer survival, with substantial increases in survival from major cancer sites such as lung, bowel, prostate, and breast cancers. New Zealand had only a 1.8% increase in cancer survival in men and 1.3% in women, with non-significant changes in survival from lung and bowel cancers, although there were increases in survival from prostate and breast cancers. For all cancers combined, and for lung and bowel cancer, the improvements in survival and the greater improvements in Australia were mainly in 1-year survival, suggesting factors related to diagnosis and presentation. For breast cancer, the improvements were similar in each country and seen in survival after the first year. The findings underscore the need to accelerate the efforts to improve early diagnosis and optimum treatment for New Zealand cancer patients to catch up with the progress in Australia.

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Perceived impact on clinical practice and logistical issues in clinical management surveys of cancer: Australian experience

Cited by 3 publications

References 18 publications

Comparison of Cancer Mortality and Incidence Between New Zealand and Australia and Reflection on Differences in Cancer Care: An Ecological Cross-Sectional Study of 2014-2018

Comparison of Cancer Mortality and Incidence Between New Zealand and Australia and Reflection on Differences in Cancer Care: An Ecological Cross-Sectional Study of 2014-2018

Use of chemotherapy and radiotherapy in patients with pancreatic cancer in Victoria (2002–2003): a retrospective cohort study

Increasing Disadvantages in Cancer Survival in New Zealand Compared to Australia, between 2000-05 and 2006-10

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