Aye Phyu S, Elwood J Mark, Stevanovic Vladimir
Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
N Z Med J. 2014 Dec 19;127(1407):14-26.
Previous studies have shown substantially higher mortality rates from cancer in New Zealand compared to Australia, but these studies have not included data on patient survival. This study compares the survival of cancer patients diagnosed in 2006-10 in the whole populations of New Zealand and Australia.
Identical period survival methods were used to calculate relative survival ratios for all cancers combined, and for 18 cancers each accounting for more than 50 deaths per year in New Zealand, from 1 to 10 years from diagnosis.
Cancer survival was lower in New Zealand, with 5-year relative survival being 4.2% lower in women, and 3.8% lower in men for all cancers combined. Of 18 cancers, 14 showed lower survival in New Zealand; the exceptions, with similar survival in each country, being melanoma, myeloma, mesothelioma, and cervical cancer. For most cancers, the differences in survival were maximum at 1 year after diagnosis, becoming smaller later; however, for breast cancer, the survival difference increased with time after diagnosis.
The lower survival in New Zealand, and the higher mortality rates shown earlier, suggest that further improvements in recognition, diagnosis, and treatment of cancer in New Zealand should be possible. As the survival differences are seen soon after diagnosis, issues of early management in primary care and time intervals to diagnosis and treatment may be particularly important.
以往研究表明，与澳大利亚相比，新西兰的癌症死亡率要高得多，但这些研究并未纳入患者生存数据。本研究比较了2006 - 2010年在新西兰和澳大利亚全体人群中确诊的癌症患者的生存率。
采用同期生存方法计算所有癌症合并后的相对生存比，以及新西兰每年死亡人数超过50例的18种癌症从诊断后1至10年的相对生存比。
新西兰的癌症生存率较低，所有癌症合并后，女性的5年相对生存率低4.2%，男性低3.8%。在这18种癌症中，有14种在新西兰的生存率较低；例外情况是黑色素瘤、骨髓瘤、间皮瘤和宫颈癌，这几种癌症在两国的生存率相似。对于大多数癌症，生存差异在诊断后1年时最大，随后逐渐缩小；然而，对于乳腺癌，生存差异随诊断后的时间增加。
新西兰较低的生存率以及之前显示的较高死亡率表明，新西兰在癌症的识别、诊断和治疗方面应有可能进一步改善。由于在诊断后不久就出现了生存差异，初级保健中的早期管理以及诊断和治疗的时间间隔问题可能尤为重要。
