RESUMEN
AIM: To determine how many Maori and non-Maori deaths might have been avoidable if cancer survival in New Zealand were as high as in Australia. METHODS: Age-sex-tumour specific five-year relative survival ratios were calculated for cancer patients diagnosed with 27 tumour sites (representing about 92% of all cancers) in 2006-10. These were used to estimate the number of Maori, non-Maori and total deaths (and proportion of excess deaths) that would have been avoidable within five years of diagnosis had New Zealand's relative survival been equivalent to Australia's. RESULTS: A total of 3,631 cancer deaths (726/year; 13.4% of excess deaths) could have been avoidable. Among 25 tumours where ethnic-specific results were estimated, there were 851 potentially avoidable deaths in Maori (24.9%) and 2,758 in non-Maori (11.8%). Breast, bowel, lung and prostate tumours made up 64% of avoidable deaths. Those with the highest proportions of avoidable deaths were thyroid (44.7%), prostate (35.5%), breast (30.0%) and uterus (23.5%). More than 50% of Maori melanoma, prostate, testis and thyroid cancer deaths were avoidable. CONCLUSION: A significant number of cancer deaths could be avoidable if New Zealand achieved Australia's relative survival ratios. The proportion is much higher for Maori than for non-Maori. IMPLICATIONS: There is considerable scope to improve cancer outcomes in New Zealand.
Asunto(s)
Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Neoplasias/etnología , Neoplasias/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Etnicidad/estadística & datos numéricos , Femenino , Humanos , Incidencia , Tablas de Vida , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Vigilancia de la Población , Análisis de Supervivencia , Tasa de Supervivencia , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Enfermedades Cardiovasculares/epidemiología , Atención Primaria de Salud , Medición de Riesgo , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Diabetes Mellitus/epidemiología , Femenino , Medicina General , Humanos , Hipercolesterolemia/epidemiología , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Factores de Riesgo , Distribución por Sexo , Factores Sexuales , Fumar/epidemiologíaRESUMEN
AIM: To describe the prevalence of cardiovascular disease (CVD) in New Zealand by ethnicity and socioeconomic status using NHI-linked electronic national databases. METHOD: CVD prevalence by ethnicity and socioeconomic status in New Zealand in 2006/07 were estimated from national datasets of public hospital discharges, mortality registrations, and pharmaceutical dispensing over the period 1988-2007. RESULTS: In 2007, Maori had the highest age-standardised prevalence (7.41%) compared to non-Maori, non-Pacific, and non-Indians (4.45%). Maori males and females had the highest age-specific prevalence of CVD across virtually all age groups. There was a clear gradient of increasing CVD prevalence with increasing level of social deprivation. The corresponding age-specific CVD prevalence among the least deprived quintile of Maori were similar to the most deprived quintile of 'Other' New Zealanders. CONCLUSION: Consistent with mortality trends, this study confirms marked ethnic and socioeconomic disparities in CVD prevalence that are (at least in part) independent of each other. Aggressive targeting of CVD risk management among these relatively easily identifiable high-risk patient groups with known CVD could be a highly cost-effective way of reducing health disparities in the short term.