Survival disparities in indigenous and non-indigenous New Zealanders with colon cancer: The role of patient comorbidity, treatment and health service factors

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dc.contributor.authorHill S
dc.contributor.authorSarfati D
dc.contributor.authorBlakely T
dc.contributor.authorRobson B
dc.contributor.authorPurdie G
dc.contributor.authorChen J
dc.contributor.authorDennett E
dc.contributor.authorCormack D
dc.contributor.authorCunningham R
dc.contributor.authorDew K
dc.contributor.authorMcCreanor T
dc.contributor.authorKawachi I
dc.date.accessioned2010-11-25T00:32:05Z
dc.date.accessioned2016-03-06T22:26:13Z
dc.date.availableNO_RESTRICTION
dc.date.available2010-11-25T00:32:05Z
dc.date.available2016-03-06T22:26:13Z
dc.date.issued2010
dc.description.abstractBackground Ethnic disparities in cancer survival have been documented in many populations and cancer types. The causes of these inequalities are not well understood but may include disease and patient characteristics, treatment differences and health service factors. Survival was compared in a cohort of Maori (Indigenous) and non-Maori New Zealanders with colon cancer, and the contribution of demographics, disease characteristics, patient comorbidity, treatment and healthcare factors to survival disparities was assessed. Methods Maori patients diagnosed as having colon cancer between 1996 and 2003 were identified from the New Zealand Cancer Registry and compared with a randomly selected sample of non-Maori patients. Clinical and outcome data were obtained from medical records, pathology reports and the national mortality database. Cancer-specific survival was examined using Kaplan�Meier survival curves and Cox hazards modelling with multivariable adjustment. Results 301 Maori and 328 non-Maori patients with colon cancer were compared. Maori had a significantly poorer cancer survival than non-Maori (hazard ratio (HR)=1.33, 95% CI 1.03 to 1.71) that was not explained by demographic or disease characteristics. The most important factors contributing to poorer survival in Maori were patient comorbidity and markers of healthcare access, each of which accounted for around a third of the survival disparity. The final model accounted for almost all the survival disparity between Maori and non-Maori patients (HR=1.07, 95% CI 0.77 to 1.47).
dc.identifier.citationHill, S., Sarfati, D., Blakely, T., Robson, B., Purdie, G., Chen, J., et al. (2010). Survival disparities in Indigenous and non-Indigenous New Zealanders with colon cancer: the role of patient comorbidity, treatment and health service factors. Journal of Epidemiology and Community Health, 64(2), 117-123. doi: 10.1136/jech.2008.083816
dc.identifier.harvestedMassey_Dark
dc.identifier.harvestedMassey_Dark
dc.identifier.issn0143-005X
dc.identifier.urihttps://hdl.handle.net/10179/1895
dc.language.isoen
dc.publisherBMJ Publishing Group Ltd
dc.relation.isbasedonBMJ Publishing Group
dc.relation.isformatofhttp://jech.bmj.com/content/64/2/117
dc.relation.isformatofhttp://dx.doi.org/10.1136/jech.2008.083816
dc.subjectCancer survival
dc.subjectMaori
dc.subjectNon-Maori
dc.subjectColon cancer
dc.subjectPatient comorbidity
dc.subjectHealth care
dc.subject.otherFields of Research::320000 Medical and Health Sciences::321200 Public Health and Health Services
dc.titleSurvival disparities in indigenous and non-indigenous New Zealanders with colon cancer: The role of patient comorbidity, treatment and health service factors
dc.typeJournal article
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