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Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand

In New Zealand, there are known disparities between the Indigenous Māori and the majority non-Indigenous European populations in access to cancer treatment, with resulting disparities in cancer survival. There is international evidence of ethnic disparities in the distance travelled to access cancer...

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Autores principales: Gurney, Jason, Whitehead, Jesse, Kerrison, Clarence, Stanley, James, Sarfati, Diana, Koea, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371338/
https://www.ncbi.nlm.nih.gov/pubmed/35951652
http://dx.doi.org/10.1371/journal.pone.0269593
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author Gurney, Jason
Whitehead, Jesse
Kerrison, Clarence
Stanley, James
Sarfati, Diana
Koea, Jonathan
author_facet Gurney, Jason
Whitehead, Jesse
Kerrison, Clarence
Stanley, James
Sarfati, Diana
Koea, Jonathan
author_sort Gurney, Jason
collection PubMed
description In New Zealand, there are known disparities between the Indigenous Māori and the majority non-Indigenous European populations in access to cancer treatment, with resulting disparities in cancer survival. There is international evidence of ethnic disparities in the distance travelled to access cancer treatment; and as such, the aim of this paper was to examine the distance and time travelled to access surgical care between Māori and European liver and stomach cancer patients. We used national-level data and Geographic Information Systems (GIS) analysis to describe the distance travelled by patients to receive their first primary surgery for liver or stomach cancer, as well as the estimated time to travel this distance by road, and the surgical volume of hospitals performing these procedures. All cases of liver (ICD-10-AM 3rd edition code: C22) and stomach (C16) cancer that occurred in New Zealand (2007–2019) were drawn from the New Zealand Cancer Registry (liver cancer: 866 Māori, 2,460 European; stomach cancer: 953 Māori, 3,192 European), and linked to national inpatient hospitalisation records to examine access to surgery. We found that Māori on average travel 120km for liver cancer surgery, compared to around 60km for Europeans, while a substantial minority of both Māori and European liver cancer patients must travel more than 200km for their first primary liver surgery, and this situation appears worse for Māori (36% vs 29%; adj. OR 1.48, 95% CI 1.09–2.01). No such disparities were observed for stomach cancer. This contrast between cancers is likely driven by the centralisation of liver cancer surgery relative to stomach cancer. In order to support Māori to access liver cancer care, we recommend that additional support is provided to Māori patients (including prospective financial support), and that efforts are made to remotely provide those clinical services that can be decentralised.
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spelling pubmed-93713382022-08-12 Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand Gurney, Jason Whitehead, Jesse Kerrison, Clarence Stanley, James Sarfati, Diana Koea, Jonathan PLoS One Research Article In New Zealand, there are known disparities between the Indigenous Māori and the majority non-Indigenous European populations in access to cancer treatment, with resulting disparities in cancer survival. There is international evidence of ethnic disparities in the distance travelled to access cancer treatment; and as such, the aim of this paper was to examine the distance and time travelled to access surgical care between Māori and European liver and stomach cancer patients. We used national-level data and Geographic Information Systems (GIS) analysis to describe the distance travelled by patients to receive their first primary surgery for liver or stomach cancer, as well as the estimated time to travel this distance by road, and the surgical volume of hospitals performing these procedures. All cases of liver (ICD-10-AM 3rd edition code: C22) and stomach (C16) cancer that occurred in New Zealand (2007–2019) were drawn from the New Zealand Cancer Registry (liver cancer: 866 Māori, 2,460 European; stomach cancer: 953 Māori, 3,192 European), and linked to national inpatient hospitalisation records to examine access to surgery. We found that Māori on average travel 120km for liver cancer surgery, compared to around 60km for Europeans, while a substantial minority of both Māori and European liver cancer patients must travel more than 200km for their first primary liver surgery, and this situation appears worse for Māori (36% vs 29%; adj. OR 1.48, 95% CI 1.09–2.01). No such disparities were observed for stomach cancer. This contrast between cancers is likely driven by the centralisation of liver cancer surgery relative to stomach cancer. In order to support Māori to access liver cancer care, we recommend that additional support is provided to Māori patients (including prospective financial support), and that efforts are made to remotely provide those clinical services that can be decentralised. Public Library of Science 2022-08-11 /pmc/articles/PMC9371338/ /pubmed/35951652 http://dx.doi.org/10.1371/journal.pone.0269593 Text en © 2022 Gurney et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Gurney, Jason
Whitehead, Jesse
Kerrison, Clarence
Stanley, James
Sarfati, Diana
Koea, Jonathan
Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand
title Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand
title_full Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand
title_fullStr Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand
title_full_unstemmed Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand
title_short Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand
title_sort equity of travel required to access first definitive surgery for liver or stomach cancer in new zealand
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371338/
https://www.ncbi.nlm.nih.gov/pubmed/35951652
http://dx.doi.org/10.1371/journal.pone.0269593
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