Lao Chunhuan, Kuper-Hommel Marion, Laking George, Chepulis Lynne, Lawrenson Ross
Medical Research Unit, The University of Waikato, Hamilton.
Medical Research Centre, The University of Waikato, Hamilton.
N Z Med J. 2020 Aug 21;133(1520):15-26.
To explore variations in the use of and timeliness of chemotherapy in patients diagnosed with colorectal cancer in New Zealand.
This study included patients diagnosed with colorectal cancer in New Zealand between 1 January 2006 and 31 December 2016. The first chemotherapy regime was identified from Pharmaceutical Collection dataset. Logistic regression model was used to estimate the adjusted odds ratio of having chemotherapy by subgroup after adjustment for other factors.
27.8% (6,737/24,217) of colon cancer patients and 43.8% (3,582/8,170) of rectal cancer patients received publicly funded chemotherapy. The uptake and timeliness of chemotherapy has been improving over time. Pacific people were the least likely to receive chemotherapy, followed by Māori and Asian. Younger patients, New Zealand European, patients with metastatic disease and patients in the Southern Cancer Network were more likely to have chemotherapy in less than 10 weeks post-diagnosis. Over half of the advanced colorectal cancer patients who did not receive chemotherapy were aged 80+ years or had a short life expectancy.
Although the uptake and timeliness of chemotherapy for colorectal cancer has been improving, Māori, Pacific, Asian and older patients were less likely to receive chemotherapy and less likely to receive chemotherapy in a timely manner. There is a variation in use of chemotherapy by Region with patients in the Southern Cancer region appearing to be the most likely to receive chemotherapy and to receive it within a timely period.
探讨新西兰结直肠癌患者化疗使用情况及及时性的差异。
本研究纳入2006年1月1日至2016年12月31日期间在新西兰被诊断为结直肠癌的患者。从药品收集数据集确定首个化疗方案。采用逻辑回归模型在对其他因素进行调整后估计各亚组接受化疗的调整比值比。
27.8%（6737/24217）的结肠癌患者和43.8%（3582/8170）的直肠癌患者接受了公共资助的化疗。化疗的使用率和及时性随时间推移有所提高。太平洋岛民接受化疗的可能性最小，其次是毛利人和亚洲人。年轻患者、新西兰欧洲人、患有转移性疾病的患者以及南部癌症网络的患者在诊断后不到10周接受化疗的可能性更大。未接受化疗的晚期结直肠癌患者中，超过一半年龄在80岁及以上或预期寿命较短。
尽管结直肠癌化疗的使用率和及时性一直在提高，但毛利人、太平洋岛民、亚洲人和老年患者接受化疗的可能性较小，且不太可能及时接受化疗。化疗的使用存在地区差异，南部癌症地区的患者似乎最有可能接受化疗并及时接受化疗。
