About 30 per cent of colon cancer patients in New Zealand first learned they had the disease when they presented acutely to hospital. In the UK, about 20 per cent of people are detected in this way.
In addition, only 60 per cent 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 per cent 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 New Zealand.”
An overview of the initial findings of The Presentation, Investigation, Pathways, Evaluation and Treatment (PIPER) project were presented last night at a public seminar in Auckland.
The PIPER project, which began in 2011, was funded through a $1 million investment from the Health Research Council of New Zealand 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.
HRC Chief Executive Professor Kath McPherson says the knowledge gained from this landmark study will be used by policymakers and clinicians alike to improve the management of colorectal cancer in New Zealand – a disease that each year kills about 1200 New Zealanders, similar to breast and prostate cancer combined.
“Currently the incidence of colorectal cancer in New Zealand is one of the highest in the developed world, and the survival rates are worse than in Australia. This research is crucial to deciding the best way forward to change this – it’s about improving outcomes,” says Professor McPherson.
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.
Professor Findlay explained that yesterday'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 UK.
“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 Professor Findlay.
Listen to Professor Findlay on Radio New Zealand's Checkpoint programme or watch ONE News' coverage of the study.