Effect of androgen deprivation therapy on serum levels of sclerostin, Dickkopf-1, and osteoprotegerin: a cross-sectional and longitudinal analysis.

Androgen deprivation therapy (ADT) for men with prostate cancer (PCa) results in accelerated bone loss and increased risk of bone fracture. The aim of the present study was to evaluate serum bone markers-sclerostin, Dickkopf-1 (DKK-1) and osteoprotegerin (OPG), in a cohort of 88 PCa patients without known bone metastases, managed with and without ADT, and to analyse their relationship with bone mineral density (BMD) and sex steroids. The cross-sectional analysis between acute-, chronic- and former-ADT groups and PCa controls showed that sclerostin and OPG levels significantly differed between them (p = 0.

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

Aim: To investigate differences in survival after diagnosis with colorectal cancer (CRC) by rurality, ethnicity and deprivation.

Methods: 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.

Ethnic disparities in breast cancer survival in New Zealand: which factors contribute?

Background: New Zealand has major ethnic disparities in breast cancer survival with Māori (indigenous people) and Pacific women (immigrants or descended from immigrants from Pacific Islands) faring much worse than other ethnic groups. This paper identified underlying factors and assessed their relative contribution to this risk differential.

Methods: This study involved all women who were diagnosed with primary invasive breast cancer in two health regions, covering about 40% of the national population, between January 2000 and June 2014.

Characteristics of and differences between Pasifika women and New Zealand European women diagnosed with breast cancer in New Zealand.

Aim: Breast cancer in New Zealand-based Pasifika women is a significant issue. Although Pasifika women have a lower incidence of breast cancer compared to New Zealand European women, they have higher breast cancer mortality and lower five-year survival. The aim of this study was to describe the characteristics and tumour biology of Pasifika women and to compare New Zealand European women to identify what factors impact on early (Stage 1 and 2) vs advanced stage (Stage 3 and 4) at diagnosis.

Effect of Androgen Deprivation Therapy on Bone Mineral Density in a Prostate Cancer Cohort in New Zealand: A Pilot Study.

Introduction: Reduction in bone mineral density (BMD) is a common side effect of androgen deprivation therapy (ADT). We aimed to examine the cross-sectional and longitudinal variation in BMD and associated bone markers in patients with nonmetastatic prostate cancer (PCa) managed with and without ADT.

Methods: Bone mineral density of the total body, lumbar spine, femoral neck, ultradistal forearm, and one-third distal radius was measured in 88 patients with PCa without bone metastases at baseline and at 6 months.

The use of trastuzumab in New Zealand women with breast cancer.

Aim: Trastuzumab was first funded in New Zealand for use in HER2+ve stage I-III breast cancer in 2007. This observational study aims to ascertain the patterns of use of trastuzumab in women with invasive HER2+ve breast cancer, and assess the effectiveness of adjuvant trastuzumab in women with stage I-III HER2+ve breast cancer.

Methods: The Waikato and Auckland Breast Cancer Registries have clinical details of 12 372 women diagnosed with invasive breast cancer between June 2000 and May 2013.

The cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy for low risk localised prostate cancer.

Background: Radical prostatectomy is the most common treatment for localised prostate cancer in New Zealand. Active surveillance was introduced to prevent overtreatment and reduce costs while preserving the option of radical prostatectomy. This study aims to evaluate the cost-effectiveness of active surveillance compared to watchful waiting and radical prostatectomy.

Urban Rural Differences in Breast Cancer in New Zealand.

Many rural communities have poor access to health services due to a combination of distance from specialist services and a relative shortage of general practitioners. Our aims were to compare the characteristics of urban and rural women with breast cancer in New Zealand, to assess breast cancer-specific and all-cause survival using the Kaplan-Meier method and Cox proportional hazards model, and to assess whether the impact of rurality is different for Māori and New Zealand (NZ) European women. We found that rural women tended to be older and were more likely to be Māori.

Methods of a national colorectal cancer cohort study: the PIPER Project.

Aim: Colorectal cancer is one of the most common cancers, and second-leading cause of cancer-related death, in New Zealand. The PIPER (Presentations, Investigations, Pathways, Evaluation, Rx [treatment]) project was undertaken to compare presentation, investigations, management and outcomes by rurality, ethnicity and deprivation. This paper reports the methods of the project, a comparison of PIPER patient diagnoses to the New Zealand Cancer Registry (NZCR) data, and the characteristics of the PIPER cohort.

Risk of fracture in men with prostate cancer on androgen deprivation therapy: a population-based cohort study in New Zealand.

Background: Androgen deprivation therapy (ADT) administered as a prostate cancer treatment is known to exert multiple side effects including bone deterioration leading to bone fracture. The current analysis is to evaluate the burden of fracture risk in the New Zealand prostate cancer (PCa) population treated with ADT, and to understand the subsequent risk of mortality after a fracture.

Methods: Using datasets created through linking records from the New Zealand Cancer Registry, National Minimal Dataset, Pharmaceutical Collection and Mortality Collection, we studied 25,544 men (aged ≥40 years) diagnosed with PCa between 2004 and 2012.

The patient perspective on a first raised PSA test.

Introduction: Approximately 350 000 prostate-specific antigen (PSA) tests are undertaken in New Zealand on a quarter of a million men each year. A number of studies have looked at PSA testing done by general practitioners (GPs) and subsequent outcomes. Few have looked at the patient perspective after a raised PSA result.

Rural-Urban Differences in Prostate-Specific Antigen (PSA) Screening and Its Outcomes in New Zealand.

Purpose: To examine prostate-specific antigen (PSA) screening patterns and outcomes in rural and urban men in New Zealand.

Methods: Men aged 40+ years were identified from 18 rural and 13 urban general practices across the Midland Cancer Network region. Computerized practice records were cross-referenced with community laboratory data to ascertain the number and level of PSA tests undertaken in 2010 and 3 years prior.

Treatment modalities for Māori and New Zealand European men with localised prostate cancer.

Objectives: To examine diagnostic and treatment pathways for Māori (the indigenous people of New Zealand [NZ]) and NZ European men with prostate cancer in order to identify causes of higher mortality rates for Māori men.

Methods: All Māori men (150) diagnosed with prostate cancer in the Midland Cancer Network region between 2007 and 2010 were identified from the NZ Cancer Registry and frequency age-matched with three randomly sampled NZ European men. Clinical records of these men were searched for information on clinical stage at diagnosis, comorbidities, and type of treatment for localised disease.

Management and characteristics of patients with metastatic prostate cancer in a cohort of New Zealand men.

Objective: This study aims to (1) characterise men diagnosed with metastatic prostate cancer, (2) describe their management and (3) look at their survival.

Methods: We identified patients registered with prostate cancer in the New Zealand Cancer Registry in the Midland Cancer Network region in 2009-2012 and examined these patients' clinical records to identify the metastatic cases. We investigated the patients' characteristics and the treatment pattern.

Prostate-specific antigen (PSA) screening and follow-up investigations in Māori and non-Māori men in New Zealand.

Background: Māori men in New Zealand have higher mortality from prostate cancer, despite having lower incidence rates. The objective of this study was to examine patterns of screening for prostate cancer in primary care and follow-up investigations after an elevated prostate-specific antigen (PSA) result in Māori and non-Māori men in order to help explain the observed differences in incidence and mortality.

Methods: Men aged 40+ years were identified from 31 general practices across the Midland Cancer Network region.

Survival disparities between Māori and non-Māori men with prostate cancer in New Zealand.

Objective: To examine temporal trends and current survival differences between Māori and non-Māori men with prostate cancer in New Zealand (NZ).

Patients And Methods: A cohort of 37,529 men aged ≥ 40 years diagnosed with prostate cancer between 1996 and 2010 was identified from the New Zealand Cancer Registry and followed until 25 May 2011. Cause of death was obtained from the Mortality Collection by data linkage.

The Use of Androgen Deprivation Therapy (ADT) and Chemotherapeutic Agents in New Zealand Men with Prostate Cancer.

Purpose: To assess the patterns of use of androgen deprivation therapy (ADT) and chemotherapeutic agents in New Zealand men with prostate cancer.

Methods: Men diagnosed with prostate cancer between 2006 and 2011 were identified from the New Zealand Cancer Registry. Through data linkage with the Pharmaceutical Collection and the National Minimum Dataset information on subsidised anti-androgens, luteinising hormone-releasing hormone (LHRH) analogues, chemotherapeutic agents, and orchidectomy was retrieved.

The costs of identifying undiagnosed prostate cancer in asymptomatic men in New Zealand general practice.

Background: Screening for prostate cancer (PCa) using the prostate-specific antigen (PSA) test is widespread in New Zealand. Aim. This study estimates the costs of identifying a new case of PCa by screening asymptomatic men.

Screening for prostate cancer in New Zealand general practice.

Objective: To ascertain the rates and patterns of prostate-specific antigen (PSA) screening in New Zealand men.

Methods: The study population included 35,958 men aged 40+ years, with no prior diagnosis of prostate cancer, enrolled in 31 general practices in the Midland Cancer Network Region of New Zealand in 2010. Computerized practice records were searched for information, including reasons for testing, for men with elevated PSA test results in 2010.

PSA testing in general practice.

Introduction: In New Zealand, prostate-specific antigen (PSA) testing has increased significantly (275 000 tests/year). Controversy exists around PSA testing as part of an unorganised screening programme.

Aim: To look at the use of PSA testing in a sample of general practices and investigate the reasons GPs undertake PSA testing.