Dr David GraysonFRACS
Otolaryngologist at North Shore Hospital, Waitematā DHB David is an Otolaryngologist at North Shore Hospital, Waitematā DHB . He is also WDHB’s Clinical Lead for Patient Safety & Patient Experience. David has a strong interest in using systems approaches and digital health technologies for safer care and better experience of care. He is a member of The Global Council of The Beryl Institute leading the Transform HX programme.
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Health equity in Head Neck Cancer (HNC)
Introduction: A 2015 review1 of oropharyngeal squamous cell cancer (OPSCC) and oral cavity squamous cell cancer (OCSCC) in New Zealand prompted this study of data at WDHB.
Aim: To establish incidence rates of OPSCC and OCSCC for Māori and New Zealand Europeans (NZE) with analysis of clinical characteristics, Human Papilloma Virus (HPV) status, social deprivation and HPV vaccination.
Methods: A retrospective review of incident cases in WDHB domicile patients with a diagnosis of OPSCC or OCSCC attending the Northern Region multi disciplinary meeting (MDM) for HNC between 2014-2019. Data was analysed using a data integration and analytics platform
(QlikR ) which is integrated with our electronic medical record (Clinical Portal). Population estimates were based on the 2018 NZ Census for WDHB.
Results: In the period 2014-2019, 186 new cases of OPSCC and OCSCC were diagnosed for WDHB domicile patients, giving an overall age adjusted incidence rate (AAIR) of 4.37 per 100,000 (n=186),Māori AAIR 4.63 per 100,000 (n=16) and NZE AAIR 3.48 per 100,000 (n=148). Statistical comparisons between ethnicities were not possible due to sparse data. No disparities were observed for time to treatment from diagnosis or mortality/survival rates, in contrast with a recent study from USA2 .
Conclusions: This review establishes our local incidence rate for OPSCC and OCSCC and confirms the high proportion of HPV+ cases presenting with these sites involved. Current initiatives to vaccinate teenage boys and girls for HPV as well as improve awareness of behavioural modifications to reduce risk should be encouraged.
References: 1. Chelimo C, Elwood M. Sociodemographic differences in the incidence of oropharyngeal and oral cavity squamous cell cancers in New Zealand. Aust NZ J Public Health, 2015; 39: 162-7.
2. Jassal JS, Cramer JD. Explaining racial disparities in surgically treated head and neck cancer. Laryngoscope, 2021; 131: 1053-1059
Introduction: A 2015 review1 of oropharyngeal squamous cell cancer (OPSCC) and oral cavity squamous cell cancer (OCSCC) in New Zealand prompted this study of data at WDHB.
Aim: To establish incidence rates of OPSCC and OCSCC for Māori and New Zealand Europeans (NZE) with analysis of clinical characteristics, Human Papilloma Virus (HPV) status, social deprivation and HPV vaccination.
Methods: A retrospective review of incident cases in WDHB domicile patients with a diagnosis of OPSCC or OCSCC attending the Northern Region multi disciplinary meeting (MDM) for HNC between 2014-2019. Data was analysed using a data integration and analytics platform
(QlikR ) which is integrated with our electronic medical record (Clinical Portal). Population estimates were based on the 2018 NZ Census for WDHB.
Results: In the period 2014-2019, 186 new cases of OPSCC and OCSCC were diagnosed for WDHB domicile patients, giving an overall age adjusted incidence rate (AAIR) of 4.37 per 100,000 (n=186),Māori AAIR 4.63 per 100,000 (n=16) and NZE AAIR 3.48 per 100,000 (n=148). Statistical comparisons between ethnicities were not possible due to sparse data. No disparities were observed for time to treatment from diagnosis or mortality/survival rates, in contrast with a recent study from USA2 .
Conclusions: This review establishes our local incidence rate for OPSCC and OCSCC and confirms the high proportion of HPV+ cases presenting with these sites involved. Current initiatives to vaccinate teenage boys and girls for HPV as well as improve awareness of behavioural modifications to reduce risk should be encouraged.
References: 1. Chelimo C, Elwood M. Sociodemographic differences in the incidence of oropharyngeal and oral cavity squamous cell cancers in New Zealand. Aust NZ J Public Health, 2015; 39: 162-7.
2. Jassal JS, Cramer JD. Explaining racial disparities in surgically treated head and neck cancer. Laryngoscope, 2021; 131: 1053-1059
