Country’s most comprehensive study of breast cancer highlights inequities
21 June 2018
The extensive three-year study looking at how to improve outcomes for women with breast cancer has been carried out by researchers at the University of Waikato and the Waikato District Health Board. They have used data from over 12,000 women from Auckland and Waikato, reflecting the wider New Zealand population.
More than 600 women die from breast cancer every year, and thousands more are diagnosed with it. Researchers say creating greater equity in cancer care could see a large, rapid improvement in control of the disease.
- Pacific women diagnosed with breast cancer are twice as likely to die from the disease after 5 years than New Zealand European women. They are diagnosed with breast cancer younger than other groups, and the cancer is almost twice as likely to be an aggressive form.
- Māori women diagnosed with breast cancer also have a higher mortality (times 1.76) after 5 years than New Zealand European women. They are less likely to be diagnosed through mammographic screening, or receive chemotherapy, Herceptin or surgery.
- Māori and Pacific women diagnosed through the screening programme do just as well as New Zealand European women.
- Women treated with Herceptin are 42% more likely to survive after 5 years. However, Māori and Pacific women are less likely to be treated with Herceptin than other New Zealanders.
- Older women, particularly over 70, are less likely to be treated surgically, or get chemotherapy, Herceptin, or radiotherapy.
- Public/private care: about 62% of women in the study were treated in the public health system. They had a 95% higher average risk of death compared to those in private health care.
Lead investigator Professor Ross Lawrenson says overall, outcomes for breast cancer are improving, with more women now being diagnosed through screening. He says treatments for older women need to be reassessed, along with closing the gap in treatment between those who can afford private health care and those who cannot.
Professor Lawrenson says the most important work to be done is in improving the outcomes for Māori and Pacific women, where the biggest gains can be made through earlier diagnosis. “Firstly, improving access to primary care, and making it easier and cheaper for them to see a GP and get a diagnosis. Secondly, improving access to breast screening. There is a lot of good work being done, and it needs to continue. Focusing on reducing the inequities, rather than only on new drugs and treatments has the potential to significantly improve the situation for the women most at risk, and all women.”
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