Cancer Deaths in New Zealand 2000 to 2010 October 2014.

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Cancer Deaths in New Zealand

2000 to 2010

October 2014

Ministry of Health MORT Data Data collected continuously; cause

of death added. Based on year of registration of

death, with around 3% of deaths recorded after year of death.

Publications produced annually with a delay: 2010 released October 2013

Detailed data requested, with one record for each death. De-identified data received for 311,212 deaths including underlying cause of death, contributory causes and place of death.

Context

Neoplasms

Neoplasm (Ancient Greek from neo- "new" and plasma "formation, creation") - an abnormal mass of tissue as a result of abnormal growth or division of cells. Benign neoplasmsPremalignant neoplasms (carcinoma in situ)Malignant neoplasms (cancer).Secondary neoplasms - metastatic offshoot of a primary

tumour, or an apparently unrelated tumour.

Cause of Death 2000-2010

29.1 % of deaths are from neoplasms, which includes malignant and benign neoplasms. 90,585 deaths from neoplasms over the 11 year period, or 8,235 each year on average.

Source: Analysis of Ministry of Health MORT data 2000 to 2010

Females account for 49.9% of deaths from all causes.

Cause of Death 2000-2010Neoplasms

Females account for 47.3% of deaths from neoplasms.

Historic Cause of Death 2000-2010Neoplasms

Small but steady increase in total number of deaths from neoplasms each year.

Source: Analysis of Ministry of Health MORT data 2000 to 2010Smoothing of the under 24 age bands as there is very little data.

Historic Cause of Death 2000-2010Neoplasms

Small but steady increase in total number of deaths from neoplasms each year. Proportion of deaths from neoplasms variable around 29.1% for the whole period.

Source: Analysis of Ministry of Health MORT data 2000 to 2010Smoothing of the under 24 age bands as there is very little data.

Age, Gender and Ethnicity

Cause of Death 2000-2010Neoplasms

Females account for 47.3% of deaths from neoplasms.

Deaths in New Zealand 2000-2010Neoplasms

Females account for 47.3% of deaths from neoplasms. Distinctive pattern by age with more female deaths from age 30 to 55 and over age 85.

Deaths in New Zealand 2000-2010

30.1% of all deaths are over age 85; 60.1% are over age 75 and 77.4% are over age 65.

Only 15.8% of neoplasm deaths are over age 85; 55.9% are between age 65 and 84; and 28.4% are under age 65. Only 2.6% of deaths from neoplasms are under age 40.

There is a gradual increase in the age at death, with deaths over age 85 increasing from 17.4% to 20.4% for women and from 11.3% to 15.3% for men.

For all ethnicity groups, women have proportionately more deaths under age 64 and more deaths over age 85. There are proportionally more deaths of Māori, Pacific and Asian people at younger ages compared to the Other group.

Ethnicity of Deaths 2000-2010Total Deaths

Māori make up 9.8% of total deaths

Ethnicity of Deaths 2000-2010Neoplasms

Very similar to all causes. Slightly fewer Māori and Pacific deaths than for all causes; slightly more Other deaths. Māori make up 9.5% of deaths from neoplasms.

Very strong pattern by age with very few Māori, Pacific or Asian deaths at older ages. Related to the population structure.

Source: Analysis of Ministry of Health MORT data 2000 to 2010Smoothing of the under 29 age bands where there is very little data.

A small but steady increase in the proportion of deaths amongst Māori, Pacific and Asian lives.

Analysis by Cancer Site

Average Deaths from Neoplasms 2000-2010

Using the IARC groupings, “Trachea, bronchus and lung” is the largest site (18.4%), followed by Colorectum (14.5%). Together, the two groupings ACCOUNT for one third of all deaths (32.9%).

Deaths from Neoplasms 2000-2010

Using the IARC groupings, “Trachea, bronchus and lung” is the largest site (18.4%), followed by Colorectum (14.5%). Together, the two groupings account for one third of all deaths (32.9%).

Annual Average Deaths from Neoplasms Females 2000-2010

Lung cancer is the largest group, followed by Breast and Colorectum.

Annual Average Deaths from Neoplasms Males 2000-2010

Lung cancer is the largest group, followed by Colorectum and Prostate.

Deaths from Neoplasms 2000-2010Gender

Overall, 47.3% of deaths from neoplasms are women.

Deaths from Major Neoplasms by Age, 2000-2010

The major groupings by site have very different age patterns.

Deaths from Select Neoplasms 2000-2010

Increases in deaths from Lung cancer, Colorectum and Pancreas cancer are noticeable over the period.

Deaths from Neoplasms 2000-2010Age Bands

Overall, 28.4% of deaths from neoplasms are under age 64 but this is concentrated in certain cancer sites.

Deaths from Neoplasms 2000-2010Ethnicity

Linked to age bands at which certain cancers more likely.

Annual Average Deaths from Neoplasms Māori 2000-2010

Lung cancer is by far the largest group (32.0% of Māori deaths from neoplasms), followed by Other cancers and Breast cancer (9.0%).

Annual Average Deaths from Neoplasms Pacific Peoples 2000-2010

Lung cancer is the largest group (19.7%), followed by Breast (10.3%) and then Other cancers.

Annual Average Deaths from Neoplasms Asian 2000-2010

Lung cancer is by far the largest group (20.1%), followed by Colorectum (10.9%), Other cancer and then Breast cancer (8.8%).

Annual Average Deaths from Neoplasms Other Ethnicity 2000-2010

Lung cancer is the largest group (16.8%), closely followed by Colorectum (15.7%), then Other cancers, Prostate (7.6%) and Breast (7.5%).

Neoplasms Under Age 40

Deaths Under Age 40Neoplasms

Very few at the youngest ages but rises steadily. Large increase for females from age 30 onwards. Females account for 54.6% of deaths

Neoplasm Deaths 2000-2010Under Age 40

But strong differences by age group.

Neoplasm Deaths 2000-2010Under Age 15

Brain and CNS account for 34.5% of deaths from neoplasms in this age group; Leukemia for 25.3%.

Neoplasm Deaths 2000-2010Age 15-24

Leukemia accounts for 20.3% of deaths from neoplasms in this age group; Brain and CNS for 15.1%.

Place of Death

Place of Death 2000-2010All Causes

34.2% in hospital, 30.7% in residential care and 22.3% in private residence. Note that this seriously undercounts hospice involvement as only hospice inpatient unit available as a place of death.

Place of Death 2000-2010Neoplasms

The largest proportion died in a private residence (28.2%), followed by hospital (26.5%), residential care (24.1%) and hospice inpatient unit (18.6%).

Later in life, residential care is a significant place of death from neoplasms. Hospital becomes a less likely place of death as age increases.

Source: Analysis of Ministry of Health MORT data 2000 to 2010Smoothing of the under 24 age bands where there is very little data.

Marked increase in residential care as the place of death for those with neoplasms – by 2010 equivalent to deaths in hospital.

Deaths from Neoplasms 2000-2010Place of Death

Higher proportion of deaths in hospital for some cancer sites.

Women are more likely to die in residential care than men of the same age. Men are slightly more likely to die in a private residence.

Need for Palliative Care

Palliative Care

All palliative care classifications include malignant neoplasms. All researchers except Murtagh (2013) include benign

neoplasms and those of uncertain or unknown behaviour. There seems no good reason to exclude deaths from

benign neoplasms and those of uncertain or unknown behaviour from palliative care.

Expect for planning purposes that all deaths from neoplasms needed palliative care.

However this data set does not show the age at diagnosis to be able to determine the period over which palliative care might be needed.

As people live longer with a cancer diagnosis, so the period over which palliative and supportive care is needed is increasing.

Prof Heather McLeod

Senior Analyst, Palliative CareCancer Control New Zealand

Office of the Chief Medical OfficerMinistry of Health

www.cancercontrolnz.govt.nz/palliative-care

Email: Heather_McLeod@MOH.govt.nz Mobile: 0210 279 7425

Dr Naomi Brewer

Senior Analyst, CancerCancer Control New Zealand

Office of the Chief Medical OfficerMinistry of Health

www.cancercontrolnz.govt.nz/palliative-care

Email: Naomi_Brewer@MOH.govt.nz Tel: 04 815 9240

Cancer Deaths in New Zealand 2000 to 2010 October 2014.

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