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The New Zealand PIPER Project: colorectal cancer survival according to rurality, ethnicity and socioeconomic deprivation-results from a retrospective cohort study.

  • Sharples, Katrina J1
  • Firth, Melissa J2
  • Hinder, Victoria A3
  • Hill, Andrew G4
  • Jeffery, Mark5
  • Sarfati, Diana6
  • Brown, Charis7
  • Atmore, Carol8
  • Lawrenson, Ross A9
  • Reid, Papaarangi Mj10
  • Derrett, Sarah L11
  • Macapagal, Jerome12
  • Keating, John P13
  • Secker, Adrian H14
  • De Groot, Charles15
  • Jackson, Christopher Gca16
  • Findlay, Michael Pn17
  • 1 Associate Professor of Biostatistics, Department of Mathematics and Statistics and Department of Medicine, University of Otago, Dunedin.
  • 2 Project Manager, Discipline of Oncology, University of Auckland, Auckland.
  • 3 Research Fellow/Biostatistician, Discipline of Oncology, University of Auckland, Auckland.
  • 4 Consultant Colorectal Surgeon, Counties Manukau DHB and Professor, South Auckland Clinical School, University of Auckland, Auckland.
  • 5 Consultant Medical Oncologist, Canterbury District Health Board, Christchurch.
  • 6 Professor and Co-Head of Department, Department of Public Health, University of Otago, Wellington.
  • 7 Senior Research Fellow, National Institute of Demographic and Economic Analysis, The University of Waikato, Waikato.
  • 8 Foxley Fellow, Department of General Practice and Rural Health, University of Otago, Dunedin.
  • 9 Professor of Population Health, National Institute of Demographic and Economic Analysis, the University of Waikato, Waikato.
  • 10 Associate Professor and Tumuaki, Te Kupenga Hauora Māori, University of Auckland, Auckland.
  • 11 Associate Professor, Public Health (Health Systems and Public Policy) and Director - Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin.
  • 12 Database Development Officer, Discipline of Oncology, University of Auckland, Auckland.
  • 13 Consultant Colorectal Surgeon, Capital and Coast District Health Board and Clinical Senior Lecturer, Wellington School of Medicine, University of Otago, Wellington.
  • 14 Consultant Colorectal Surgeon, Nelson-Marlborough District Health Board, Nelson.
  • 15 Consultant Radiation Oncologist and Clinical Director, Radiation Oncology, Waikato District Health Board, Waikato.
  • 16 Consultant Medical Oncologist, Southern District Health Board and Senior Lecturer, Dunedin School of Medicine, University of Otago, Dunedin.
  • 17 Consultant Medical Oncologist, Auckland DHB; Professor of Oncology, University of Auckland; Director Cancer Trials New Zealand, Auckland. , (New Zealand)
Published Article
The New Zealand medical journal
Publication Date
Jun 08, 2018
PMID: 29879724


To investigate differences in survival after diagnosis with colorectal cancer (CRC) by rurality, ethnicity and deprivation. In this retrospective cohort study, clinical records and National Collections data were merged for all patients diagnosed with CRC in New Zealand in 2007-2008. Prioritised ethnicity was classified using New Zealand Cancer Registry data; meshblock of residence at diagnosis was used to determine rurality and socioeconomic deprivation. Of the 4,950 patients included, 1,938 had died of CRC by May 2014. The five-year risks of death from CRC were: Māori 47%; Pacific 59%; non-Māori-non-Pacific (nMnP) 38%. After adjustment for demographic characteristics, comorbidity and disease stage at diagnosis, compared to nMnP the relative risk (RR) for Māori was 1.1 (95%CI: 0.8-1.3) and for Pacific 1.8 (95% CI: 1.4-2.5). We found no differences in risk of death from CRC by rurality, but some differences by deprivation. Disparity in outcome following diagnosis with CRC exists in New Zealand. Much of this disparity can be explained by stage of disease at diagnosis for Māori, but for Pacific peoples and those in deprived areas other factors may influence outcome. Further analyses of the PIPER data will explore the impact of any differences in management.

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