Abstract
• Cancer specific survival rates are lower in New Zealand than Australia and Canada.
• A distributed model of service provision has resulted in measurable variations in care.
• Access to cancer medicines are highly regulated and tightly controlled, but there is no similar oversight for radiation oncology.
• A national child cancer network has delivered survival outcomes comparable to benchmark countries, and without ethnic or regional inequalities.
A growing gap in cancer survival is emerging between New Zealand and comparator countries such as Australia and Canada. While survival rates are impacted by early detection, receipt of high quality and timely anti-cancer treatment is clearly key. Several clinical, policy, and structural factors will influence the likelihood of receipt of optimal care. These include geographic access to treatment, waiting times, access to specialized care, and systems performance management and monitoring. We consider several of the structural issues in New Zealand affecting surgical, medical and radiation oncology and child cancer, and explore some possible solutions.