Equity in Lung Cancer Diagnosis: Access to GPs Crucial for Survival

Lung cancer survivors in New Zealand can depend on whether they can access a general practitioner (GP), highlighting equity issues in the country's health system. Research examining 2,400 lung cancer diagnoses in Waikato between 2011 and 2021 found that those diagnosed after emergency department (ED) visits tended to have later-stage disease and poorer outcomes compared to those diagnosed after a GP referral.

Key Takeaways:

• Patients who are diagnosed with lung cancer after ED visits are more likely to have advanced disease, a more aggressive type of cancer, and have substantially poorer likelihoods of survival compared to those diagnosed after a GP referral.
• The mortality rate for Mýüori with lung cancer is three to four times that of people of European descent, with evidence suggesting delays in diagnosis and poorer access to surgery are major influences on survival rates.
• Currently, half of all general practices in New Zealand have closed their books to new patients, leaving 290,000 patients unenrolled and reliant on EDs for healthcare, with 80% of practices having closed their books to new patients at some point since 2019.
• Mýüori and Pacific patients with lung cancer were less likely to have been enrolled with a primary health organization when diagnosed and less likely to have visited a GP in the three months prior to diagnosis.
• Increasing the number of GPs and making primary care more accessible by reducing fees and increasing patient subsidies is crucial for addressing inequities in lung cancer statistics.
• The New Zealand health sector needs to substantially increase the number of GPs, with only 74 GPs per 100,000 people, compared to 110 in Australia.

Statistics:

• 2,400 lung cancer diagnoses in Waikato between 2011 and 2021.
• 27% higher diagnosis rate for Mýüori for lung cancer after ED attendance compared to non-Mýüori.
• 22% higher diagnosis rate for men compared to women after ED attendance.
• 25% of cases went to the ED two or more times in the two weeks before their diagnosis.
• Median survival for those who never went to the ED was 13.6 months, while the median survival for those with one ED visit was just three months.
• 290,000 patients unenrolled with a general practice in New Zealand.
• 74 GPs per 100,000 people in New Zealand, compared to 110 in Australia.

Sources:

• The Conversation (Au and NZ) -- By Ross Lawrenson, Professor of Population Health, University of Waikato.