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TRANSCRIPT
Midlands Prostate Cancer Study
8th July 2014
Background
• Prostate cancer is the most common cancer in men with around 3,000 registrations each year
• 600 men will die each year from prostate cancer• Men who develop prostate cancer are mostly over the age
of 65
Number of deaths from prostate cancer by age group in New Zealand 2007
0204060
80100120
140160
45 55 65 75 85+
Deaths
Age standardised incidence of prostate cancer per 100,000 men in NZ 1948 to 2007
020406080
100120140
19
48
19
54
19
60
19
66
19
72
19
78
19
84
19
90
19
96
20
02
Rate
Māori inequalities
New registrations:
115.4 per 100,000 total male population
84.4 per 100,000 Māori males
Deaths from prostate cancer:
17.3 per 100,000 total male population
25.5 per 100,000 Māori males
HRC/MOH RFP 2010 ‐ Prostate Cancer
• Due to limitations in the current evidence‐base there is uncertainty around the complications arising from treatment options for prostate cancer.
• Similarly, there is also limited information on the costs of different types of treatment and who bears the burden of these costs.
• Current randomised controlled trials show there is a small mortality benefit in PSA testing but at the expense of over diagnosis.
• There are also significant equity issues for Maori men who have higher mortality rates compared to non Maori men.
Prostate Cancer RFP
• Research will provide a description of the types of care received by men and demonstrate the equity issues, costs and complications arising from this care.
• The research will also provide details of the proportion of men who are likely to undergo a biopsy after a PSA test
Other important reports
• Select committee report 2011• Prostate taskforce 2012‐2013• Melbourne Consensus 2013
Our proposal
• Look at PSA testing in general practice• Look at differences between Māori and non‐Māori and
urban and rural patients using national data• Look at pathways of care for a cohort of men (500)
diagnosed with prostate cancer• Look at the costs and complications of treatment for
prostate cancer in a sample of 100 men including approx50 Māori.
What we did
• Our partners• The team• Advisory groups• The four phases
A Midland Study
•
Partners
• HRC and MoH• Auckland UniServices• Midland Cancer Network and our partner DHBs• Waikato/Bay of Plenty Cancer Society• Prostate Cancer Foundation• Iwi Māori Council and Kaumātua Kaunihera Group
The team ‐ investigators
• Associate Professor John Conaglen
• Associate Professor Peter Gilling
• Dr Leanne Tyrie• Mr Michael Holmes• Dr Fraser Hodgson
• Associate Professor Toni Ashton
• Associate Professor Paul Rouse
• Associate Professor Alistair Stewart
• Dr Nina Scott• Dr Helen Conaglen• Dr Geraldine Leydon
Plus
• Dr Charis Brown• Dr Zuzana Obertova• Chunhuan Lao• Alice Wang• Thilini Alwis• Tamati Peni• Diana Benfell
Academic Steering Group • Professor Ross Lawrenson (University
of Auckland (UOA)) • Dr Leanne Tyrie (Waikato DHB) • Ms Jan Smith (Midland Cancer
Network) • Dr Charles DeGroot• Mr Michael Holmes (Waikato DHB) • Ms Lyn Walker (Waikato DHB) • Dr Nina Scott Ngati Whatua, Waikato
(Waikato DHB) • Mr Peter Gilling (Bay of Plenty DHB) • Dr Helen Conaglen (UOA) • Associate Professor John Conaglen
(UOA) • Dr Fraser Hodgson (UOA and GP)
• Associate Professor Alistair Stewart (UOA) • Associate Professor Paul Rouse (UOA) • Professor Toni Ashton (UOA) • Mr John Woodford (Pathlab) • Dr Barry Smith Te Rarawa, Ngati Kahu (Lakes
DHB) • Professor Lynn Fergusson (UOA) • Dr Jim Watson (Caldera Health) • Dr Geraldine Leydon (University of
Southampton, UK) • Mr David Musgrave (Formerly Caldera Health) • Dr George Laking: Te Whakatōhea (Auckland
DHB and UOA) • Dr Richard Edlin (UOA)
Consumer Advisory Group
• Mr Graham Harbutt (Formerly Waikato Cancer Society)
• Mr Dene Ainsworth Te Ātiawa (NZ Prostate Cancer Foundation)
• Mr Jack Porima Ngati Hikairoa(Hauora Waikato)
• Mr Jeffery Morse (Counsellor) • Mr Rawiri Blundell Ngati Porou ki
uawa (Midland Cancer Network)
• Ms Margie Hamilton (Midland Cancer Network)
• Dr Nina Scott Ngati Whatua, Waikato (Waikato DHB)
• Mr Tamati Peni Raukawa (Waikato DHB)
• Mrs Tiffany Schwass (Waikato DHB) • Mrs Lauren James Ngati Whakaue, Te
Arawa, Tuhoe (Lakes DHB)
Hai Pa Harakeke
Four phases
• PSA testing in general practice• Differences between Māori and non‐Māori and urban and
rural patients using national data• Pathways of care for a cohort of men diagnosed with
prostate cancer – 150 Māori and 450 NZ Europeans• Costs and complications of treatment for prostate cancer
in a sample of 100 men using validated questionnaires completed in face to face interviews
Plan for today
• Equity• Management of PSA in general practice• Management of localised prostate cancer in the Midland
Region• A patient/partner perspective• Comments from our partners• Where to next?
THANK YOU