Differences in breast cancer survival between public and private care in New Zealand: Which factors contribute?
Authors: Tin Tin S et al.
Summary: Summary: This analysis examined data from all women who were diagnosed with primary breast cancer
in the Auckland and Waikato District Health Board Regions between June 2000 and May 2013. Patients
who received public care for primary treatment, mostly surgical treatment, were compared with those
who received private care in terms of demographics, mode of presentation, disease factors, comorbidity
index and treatment factors. The analysis included 14,468 patients, 8,916 (61.6%) of whom received
public care. Compared to patients treated in private care facilities, patients in the public sector were
older, more likely to be Māori, Pacifika or Asian and to reside in deprived neighbourhoods and rural
areas. Patients in the public sector were also less likely to be diagnosed through screening, less likely to
be diagnosed with early staged cancer and to receive timely cancer treatments. They were more likely
to have comorbidities. They were less likely to receive breast conserving surgery with radiotherapy but
more likely to have mastectomy without radiotherapy, or no primary surgery, even after adjusting for
stage at diagnosis and other tumour factors. They were also less likely to receive chemotherapy and
hormonal therapy. Moreover, patients in the public sector had a higher risk of mortality from breast cancer
(HR 1.95; 95% CI, 1.75 to 2.17), of which 80% was explained by baseline differences, particularly related
to ethnicity, stage at diagnosis and type of loco-regional therapy. After controlling for these demographic,
disease and treatment factors, the risk of mortality remained 14% higher in the public sector patients.
Reference: Reference: PLoS One. 2016;11(4):e0153206
Abstract
Enlisting “Aunties” to support Indigenous pregnant women to stop smoking: Feasibility study results
Authors: Glover M et al.
Summary: Summary: This feasibility project tested the effectiveness of using Māori voluntary community health
workers (“Aunties”) to identify and reach Māori pregnant women who smoke and provide cessation
support. The majority of women were Māori, 20–30 years old, had their first cigarette within 30 minutes
of waking and 58% had not tried to quit during the current pregnancy. Of the participants who completed
a follow-up interview, 33% had stopped smoking while they were pregnant and 57% had cut down.
At the follow-up interviews, the number of women who had used cessation support or products was
increased from baseline.
Reference: Reference: Nicotine Tob Res. 2016;18(5):1110-5
Abstract