The latest Atlas of Healthcare Variation has been released today, focusing on bowel cancer.
Bowel cancer is the most commonly reported cancer in New Zealand, with approximately 3000 cases and 1200 deaths each year.
Bowel cancer is the second highest cause of cancer death in New Zealand, but it can be treated successfully if it is detected and treated early.
This Atlas domain shows how people with bowel cancer from different district health boards (DHBs) are diagnosed and treated. In the Atlas people are included in the DHB where they usually live. This is not always the DHB that provided treatment.
The differences that show up are a good starting point for asking questions about why people in different DHBs may get different treatment. When these questions are asked it can help DHBs improve their services.
- For approximately one quarter of people their cancer was limited to the place where it had started, and for one in five people the cancer had spread to distant parts of their body at the time of their bowel cancer diagnosis. About a quarter of people with bowel cancer were diagnosed following a visit to an emergency department (ED).
- Two-thirds of people with bowel cancer had surgery in a public hospital and on average people stayed in hospital for 10 days after surgery. On average one in twenty people died within three months of surgery for bowel cancer.
- More than two-thirds of people were alive two years after being diagnosed with bowel cancer
- There was up to two-fold variation between DHBs for survival at three months after surgery.
- There was wide variation between DHBs in the treatment of rectal cancer before surgery with radiotherapy and up to two-fold variation in surgery that usually results in a permanent colostomy for people with rectal cancer.
- Many of the indicators showed variation between ethnic groups and/or age groups.
- While these findings may be affected by missing private hospital data the results are generally very similar to those recently reported by the Piper study. The Piper Report was a large study of bowel cancer patients and their treatment,and included data from public and private hospitals in New Zealand.
- The best comparison for the New Zealand data is available from the National Bowel Cancer Audit Reports, which cover England and Wales for a similar time period.
- More people with bowel cancer were diagnosed after a visit to an emergency department in New Zealand (27 percent) than in England and Wales (20 percent).
- The surgery rate for New Zealand bowel cancer patients (63 percent) was the same as the overall England and Wales rate.
- Survival at three months after surgery was 95 percent in New Zealand and England and Wales. Overall two year survival (67 percent) was also the same for New Zealand and England and Wales.
View the bowel cancer Atlas domain.