Charis Brown

Breast cancer inequities between Māori and non-Māori women in Aotearoa/New Zealand

Māori women have one of the highest incidences of breast cancer in the world. This high incidence is generally unexplained although higher rates of obesity and alcohol intake are modifiable risk factors that may be important. Māori women are less likely to attend mammographic breast screening and are likely to be diagnosed with more advanced disease. This is one of the reasons for the excess mortality. Another factor is differences in the treatment pathway. Māori women are more likely to experience delay in receiving treatment, are less likely to receive radiotherapy, are more likely to be treated with a mastectomy and are less likely to adhere to long-term adjuvant endocrine therapy. However, genetic factors in Māori women do not seem to impact significantly on mortality. This review looks at the inequity between Māori and non-Māori women and addresses the causes. It proposes ways of reducing inequity through primary prevention, increased participation in breast screening and greater standardisation of the treatment pathway for women newly diagnosed with breast cancer. We believe that health system improvements will decrease barriers to health care participation for Māori women and suggest that further research into identifying and modifying obstacles within health systems is required.

The costs of identifying undiagnosed prostate cancer in asymptomatic men in New Zealand general practice

BACKGROUND Screening for prostate cancer (PCa) using the prostate-specific antigen (PSA) test is widespread in New Zealand. Aim. This study estimates the costs of identifying a new case of PCa by screening asymptomatic men. METHODS Men aged 40+, who had PSA tests in 31 general practices in the Midland Cancer Network region during 2010, were identified. Asymptomatic men without a history of PCa were eligible for this study. A decision tree was constructed to estimate the screening costs. We assumed GPs spent 3 minutes of the initial consultation on informed consent of PCa screening. RESULTS About 70.7% of the estimated costs were incurred in general practice. The screening costs per cancer detected were NZ

Rural‐Urban Differences in Prostate‐Specific Antigen (PSA) Screening and Its Outcomes in New Zealand

10 777 (€5820; £4817). The estimated costs for men aged 60-69 were NZ

Economic evaluation of prostate cancer screening: a systematic review

6268 compared to NZ

Survival disparities between Māori and non-Māori men with prostate cancer in New Zealand.

24 290 for men aged 40-49, NZ

Prostate-specific antigen (PSA) screening and follow-up investigations in Māori and non-Māori men in New Zealand

30 022 for 50-59 and NZ

Urban Rural Differences in Breast Cancer in New Zealand

10 957 for those aged 70+. The costs for Māori were NZ

Ethnic disparities in breast cancer survival in New Zealand: Which factors contribute?

7685 compared to NZ

The use of trastuzumab in New Zealand women with breast cancer

11 272 for non-Māori. The costs for men without PSA testing history in 2007-09 were NZ

Effect of Androgen Deprivation Therapy on Bone Mineral Density in a Prostate Cancer Cohort in New Zealand: A Pilot Study

8887 compared to NZ