Author of

• 20180

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  P2.16 - Surgery (ID 717)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24667

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    P2.16-028a - Why Are Indigenous New Zealanders Not Getting Surgery (WINGS) : An Audit of Māori Lung Cancer Patients (ID 9685)

    09:30 - 09:30  |  Presenting Author(s): William Thompson
    • Abstract

    Background:
    Lung cancer is the leading cause of cancer death in New Zealand, resulting in over 1600 deaths per year. Indigenous New Zealanders (Māori) have a higher lung cancer mortality rate than non-Māori (Female RR 4.3, Male RR 2.8). Data from our local thoracic multidisciplinary meetings (MDM) was presented to our regional cancer network (Northern Regional Alliance) and identified that only 9% of Māori lung cancer patients received curative intent surgery compared to 18% of New Zealand Europeans. The Treaty of Waitangi is a founding document of New Zealand that defines the relationship between Māori and the British Crown and gives responsibility to the New Zealand government to reduce inequities in health. The aim of this audit was to review the documented reasons for not proceeding to surgery in Māori lung cancer patients.
    
    Method:
    Electronic clinical records were retrospectively reviewed for the 100 identified Maori patients in the Auckland/Northland region who were presented at the thoracic multidisciplinary meeting between January and December of 2014. Patients were included if clinical records were available, Māori ethnicity was documented and treatment recommendations were made locally. Descriptive analysis is presented.
    
    Result:
    87 of 100 patients met criteria for inclusion. 65% were female with a median age of 65(47-83). 48% were current smokers, 63(72%) had pathologically confirmed NSCLC and the majority had advanced stage disease (IASLC 7[th] Edition TNM staging: I 24%, II 6% , IIIa 18%, IIIb 11%, IV 40%).Fourteen (16%) were recommended to have surgery by the MDM, with 9 (10%) completing surgery. Of the 5 who did not complete recommended surgery, two patients were found to have advanced disease intra-operatively and three declined surgery.Of the 78 not undergoing curative intent surgery, the documented reason was advanced disease (64%), comorbidities (21%), small-cell lung cancer (8%), declined by patient (4%) and one patient was recommended stereotactic radiotherapy. Analysis will be updated to include, and compare to, 100 age/sex matched New Zealand European patients.
    
    Conclusion:
    Presentation with advanced disease and comorbidities were documented as the reason for not proceeding to surgery in the majority of Māori patients with lung cancer discussed at the thoracic MDM. Within the limits of retrospective analysis, these findings suggest that addressing comorbidities and earlier detection of lung cancer may best improve access to curative treatment options for Māori.