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Urgent need for investigation into variations

Bowel Cancer New Zealand wants to see an urgent investigation into the "wide variation" in mortality rates following bowel cancer surgery across the country, as revealed in the 2019 Bowel Cancer Quality Improvement Report.

Bowel Cancer NZ spokesperson Mary Bradley says, “Everyone should be able to expect the same level of bowel cancer care no matter where they live in New Zealand, whether that is the Waikato or Canterbury. It should not be a postcode lottery, where the diagnosis you receive depends on where you live in the country."

The report showed bowel cancer patients in Auckland are twice as likely to survive than other parts of the country and 80% less likely to be left with a stoma bag. In Auckland, patients had a 2.2 percent chance of dying within the 90-day period, but in Whanganui - with a similar number of patients - about 7 percent died and in Waikato the death rate was close to 6 percent.

Bradley says, “These wide variances between DHBs is completely unacceptable and we back the authors of the report in calling for an urgent investigation. As a charity we see first-hand the challenges people face in getting access to diagnostic services for bowel cancer and we know people are already experiencing unacceptable wait times.”

The report noted the rate of emergency surgery for bowel cancer was high in New Zealand and that may contribute to worse cancer outcomes overall. A recent Bowel Cancer NZ funded study ‘New Zealanders’ experiences and pathways to a diagnosis of bowel cancer: a cross-sectional descriptive study of a younger cohort’ found significant delays were experienced by many participants.

Bowel Cancer NZ spokesperson Professor Sarah Derrett says, “This indicates inequities in terms of obtaining a timely diagnosis exist in New Zealand. People aged under 60, with no tertiary qualification, having a poor first experience with a healthcare professional, and people diagnosed in public hospitals (compared to private) took longer to obtain a diagnosis.”

“Bowel Cancer NZ believes all New Zealanders should have the same chance of a timely diagnosis, wherever they live, whatever their income; being diagnosed at an earlier stage increases people’s chance of survival”, says Derrett.

Also highlighted in the report is the evident differences in pathways to diagnosis, stage of diagnosis and outcomes being experienced by Māori and Pacific New Zealanders which Bowel Cancer NZ finds very concerning.

Bowel Cancer NZ welcomes the Quality Performance Indicators for colorectal cancer as these will become a means of benchmarking over time the improvements New Zealand so badly needs.

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