Survival from upper gastrointestinal cancer in New Zealand: The effect of distance from a major hospital, socio-economic status, ethnicity, age and gender.

Abstract

Upper gastrointestinal cancer is the third most common cause of cancer mortality in New Zealand. Prognosis of these and other cancers is possibly affected by the accessibility of hospitals. Several studies have revealed a reduction in survival that correlates with increasing distance from a major cancer centre. The aim of the present study was to analyse any correlation between survival from upper gastrointestinal cancer and distance from a major centre, socio-economic status, gender, age and ethnicity. Details of all 3351 patients diagnosed with cancers of the oesophagus, stomach, pancreas, liver and biliary tract between 1 January 1995 and 31 December 1997 were retrieved from the New Zealand cancer registry. The effect of age, gender, ethnicity, socio-economic status and distance from a major centre was analysed using univariate and multivariate regression analysis to identify any associations with survival. Increasing age and Maori descent were the only consistent indicators of poorer survival in this study. The relationship between distance and survival was shown to be complex and in this study deprivation had no effect on the prognosis of upper gastrointestinal cancer.