NEW ZEALAND MEDICAL JOURNAL最新文献

{"title":"The volume of publicly funded treatment delivered to lung cancer cases in Aotearoa New Zealand.","authors":"Jason Gurney, Anna Davies, Jasmine Appleton, Laird Cameron, Shaun Costello, Paul Dawkins, Christopher Gca Jackson, Jonathan Koea, Virginia Signal, Jesse Whitehead, James Stanley","doi":"10.26635/6965.7383","DOIUrl":"https://doi.org/10.26635/6965.7383","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is immensely complex and resource-intensive to treat. Much of this burden falls to our public healthcare system; however, we currently do not know how much treatment we are providing for our most deadly cancer. Here we describe volumes of publicly funded surgery, radiation and systemic therapy delivered to New Zealanders with lung cancer.</p><p><strong>Methods: </strong>We identified all lung cancers registered on the New Zealand Cancer Registry from 1 January 2015 to 31 December 2021 (n=16,850). We linked cases to national treatment data, including inpatient, outpatient and pharmaceutical datasets. We counted the volume of treatment received over a 2-year window from diagnosis and determined treatment per year of diagnosed cases. We also determined the average treatment received per diagnosed case, and per treated case.</p><p><strong>Results: </strong>For each year of new lung cancer diagnoses, our public system delivered 978 surgical-days of lung cancer-specific surgery, 11,027 attendance-days of radiation therapy and 9,108 dispensings of systemic therapy over the 2-year window following diagnosis. Each treated person received an average of 1.5 surgical-days of cancer-specific surgery, 11.5 attendance-days of radiation therapy and 11.8 dispensings of systemic therapy, mostly intravenous chemotherapy. There were no obvious differences in average treatment by ethnicity.</p><p><strong>Conclusions: </strong>With the number of lung cancer diagnoses projected to increase over time, the volume of treatment delivered by our system will need to increase beyond the levels reported here. Among other actions, New Zealand must return to our world-leading tobacco cessation pathway to curb the significant future pressure caused by this common, complex and lethal cancer.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"90-120"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turning distress into distraction: using virtual reality during penicillin injections for rheumatic fever.","authors":"Julie Cooper, Jacqui Ulugia, Dhevindri Moodley, Julie Bennett","doi":"10.26635/6965.7485","DOIUrl":"10.26635/6965.7485","url":null,"abstract":"<p><strong>Aim: </strong>In Aotearoa New Zealand, people with acute rheumatic fever (ARF) receive 4-weekly intramuscular benzathine penicillin G (BPG) injections for a minimum of 10 years to prevent recurrence and progression to rheumatic heart disease. Within a phase IIA trial of a higher-dose subcutaneous injection of penicillin (SCIP), which provides at least 10 weeks of coverage, we piloted immersive virtual reality (VR) distraction to assess whether it improved injection acceptability through reductions in pain and anxiety.</p><p><strong>Methods: </strong>Ten participants aged 9-20 years used a Meta Quest VR headset during their SCIP procedure. Participants rated anxiety before and after the injection and reported both their usual injection pain (based on prior SCIP injections) and pain during the current injection using zero to 10 scales. Acceptability and user experience were assessed through structured feedback from participants, caregivers and nurses.</p><p><strong>Results: </strong>Acceptability of the VR headset was high; all participants reported they would use VR again and recommend it to others. Mean pain scores decreased from 5.1 (usual) to 3.3 (current), and mean anxiety from 3.4 (pre-injection) to 1.1 (post-injection). Nurses noted procedures were faster and patients visibly calmer, while caregivers strongly agreed that VR reduced injection-related distress.</p><p><strong>Conclusions: </strong>Immersive VR was feasible and highly acceptable during SCIP and was associated with reduced pain and anxiety, as well as smoother, faster procedures. VR distraction has the potential to improve the experience of injectable treatments, including intramuscular penicillin injections, and warrants further exploration.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"150-155"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can we value what is not measured: the need for better data on women's health and primary care.","authors":"Fiona Imlach, Natalia Boven, Vanessa Selak","doi":"10.26635/6965.7564","DOIUrl":"https://doi.org/10.26635/6965.7564","url":null,"abstract":"<p><p>Decisions about healthcare funding and delivery in Aotearoa New Zealand, as well as the monitoring of health service performance and outcomes, are driven by readily available data, in particular from administrative health datasets. Most of these national health data collections are generated through the delivery of secondary health services. Further, apart from hospitalisation and mortality collections, these lack diagnostic coding, rendering the burden and cost of chronic health conditions predominantly managed in primary care largely invisible. Many of these types of health conditions disproportionately affect women, who, despite their longer life expectancy, spend 25% more time in poor health than men, according to international research on the women's health gap. This gap is driven by conditions occurring only in women (e.g., premenstrual syndrome, endometriosis, polyendocrine metabolic ovarian syndrome) or with higher burden in women (e.g., anxiety, depression, migraine). Addressing this gap could add US$1 trillion to the global economy. In Aotearoa New Zealand, major improvements in national health data collections are urgently needed to assess the cost of the women's health gap and the burden of chronic diseases that have high social and economic impact but are undetectable or difficult to survey in our existing administrative datasets. We illustrate these issues using the example of migraine disease, the most disabling neurological condition in Australasia that also affects at least twice as many women as men.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"108-116"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of cancer research in Aotearoa New Zealand: a pathway for better cancer outcomes.","authors":"Frank Frizelle","doi":"10.26635/6965.e1641","DOIUrl":"https://doi.org/10.26635/6965.e1641","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"10-12"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public support for better controls on lobbying and industry influence in Aotearoa New Zealand: findings from a national survey.","authors":"Emma Shields, Andrew R Gray, Rose Crossin, Calvin Cochran, Louise Signal, Ella Iosua, Rana L Peniamina, Bronwen M McNoe","doi":"10.26635/6965.7537","DOIUrl":"https://doi.org/10.26635/6965.7537","url":null,"abstract":"<p><strong>Aim: </strong>Effective cancer prevention relies on policy and regulatory environments that limit population exposure to carcinogenic risks, including harmful commodities. In Aotearoa New Zealand, limited regulation of industry influence on health policy has contributed to persistent cancer inequities, particularly for Māori. This study assessed public support for controls on lobbying and industry influence in Aotearoa New Zealand, both generally and specifically relating to unhealthy food and alcohol.</p><p><strong>Methods: </strong>A panel-based survey of adults in Aotearoa New Zealand assessed support for proposed lobbying regulations, specifically mandatory rules for lobbyists, cooling-off periods and excluding the alcohol and unhealthy food industries from public health policymaking. Results were weighted by age group, gender and Māori ethnicity, and examined overall and by gender, age, ethnicity and voting intention.</p><p><strong>Results: </strong>We received 1,635 responses, which included 385 Māori (23.5%, unweighted) and 368 Pacific people (22.5%, unweighted) following oversampling of these groups who are of particular interest. There was strong public support for lobbying regulation measures. Support exceeded 60% across voters of all political parties. Mandatory rules for all lobbyists received the highest support, with over 80% support among voters for each political party and undecided voters. More than 70% overall supported excluding alcohol and unhealthy food industries from health policymaking.</p><p><strong>Conclusion: </strong>There is strong public support for regulating lobbying, indicating a clear public mandate to protect cancer-related policies from vested and commercial interests through strengthened lobbying controls.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"60-68"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public support for cancer prevention and care policies in Aotearoa New Zealand: methods of a national survey.","authors":"Bronwen M McNoe, Andrew R Gray, Ella Iosua, Rana L Peniamina, Louise Signal","doi":"10.26635/6965.7528","DOIUrl":"https://doi.org/10.26635/6965.7528","url":null,"abstract":"<p><strong>Aim: </strong>Our aim was to describe the shared elements involving design, sampling, weighting and analytic framework of a national survey of public views on cancer prevention and care in Aotearoa New Zealand for the seven topic-specific brief reports in this issue of the New Zealand Medical Journal.</p><p><strong>Methods: </strong>We conducted a nationwide, self-administered, cross-sectional online survey of adults aged 18 years or older between November and December 2025. Participants were recruited via an established online research panel using quota sampling aligned to 2023 Census benchmarks for age, gender and ethnicity, with additional recruitment to ensure adequate Māori and Pacific representation. The survey assessed public views across cancer prevention, vaccination, early detection, treatment and care, alongside political and advocacy contexts. Design and poststratification weights were applied to align the sample with population benchmarks for combinations of age groups, gender and Māori ethnicity. Analyses were descriptive and stratified by key socio-demographic characteristics, namely age, gender, ethnicity and voting intentions.</p><p><strong>Results: </strong>A total of 1,635 participants completed the survey. The effective weighted sample size was 1,161, corresponding to a worst-case margin of error of ±2.9% overall.</p><p><strong>Conclusion: </strong>This paper provides methods for a series of policy-relevant brief reports that examine public support for cancer prevention and care in Aotearoa New Zealand.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"91-100"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public support for cancer prevention, screening, treatment and care policies in Aotearoa New Zealand: a synthesis of evidence from a national survey.","authors":"Bronwen M McNoe, Rana L Peniamina, Richard Edwards, Rose Crossin, Andrew R Gray, Ella Iosua, Jerram Bateman, Shane Bradbrook, Jeannine L Stairmand, Virginia Signal, Louise Signal","doi":"10.26635/6965.7531","DOIUrl":"https://doi.org/10.26635/6965.7531","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to synthesise evidence on public support for cancer prevention, screening, treatment and care policies across the cancer continuum in Aotearoa New Zealand, and to consider implications for policy and governance.</p><p><strong>Methods: </strong>This viewpoint article draws together findings from a co-ordinated programme of national survey research comprising one shared methods paper and seven topic-specific reports examining public support for population-level prevention policies and cancer health services.</p><p><strong>Results: </strong>Across all topic areas, public support for the evidence-based cancer-related policies presented was consistently high. Strong majority support was evident for prevention, vaccination, screening, treatment and care, with broadly consistent patterns across political parties in many cases. Support was strong for population-level prevention measures targeting tobacco and vaping, unhealthy food and sugary drinks, alcohol, ultraviolet radiation exposure and vaccine-preventable infection. There was also substantial public endorsement of restrictions on industry lobbying and commercial influence over health policymaking. Strong support was observed for timely diagnosis, accessible treatment and sustainable health system funding, including a willingness to contribute through taxation when revenues are transparently earmarked.</p><p><strong>Conclusion: </strong>These findings demonstrate a clear public mandate for evidence-based cancer policy across cancer prevention, screening, treatment and care in Aotearoa New Zealand. Barriers to action appear political rather than societal, underscoring the need for decisive political leadership consistent with Te Tiriti o Waitangi and public expectations.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"101-107"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aotearoa New Zealand public strongly support investment in cancer treatment and care services: findings from a national survey.","authors":"Virginia Signal, Ella Iosua, Kate Gregory, Rachael Neumann, Jeannine L Stairmand, Jerram Bateman, Andrew R Gray, Rana L Peniamina, Louise Signal, Bronwen M McNoe","doi":"10.26635/6965.7539","DOIUrl":"https://doi.org/10.26635/6965.7539","url":null,"abstract":"<p><strong>Aim: </strong>Cancer remains a leading cause of morbidity and mortality in Aotearoa New Zealand, with rising incidence, persistent inequities and pressure on diagnosis, treatment and workforce capacity. This study examined public views on government funding, access and delivery of cancer diagnosis, treatment and supportive care services, perceptions of health workforce support and willingness to pay additional tax for healthcare funding.</p><p><strong>Methods: </strong>We analysed data from a nationally representative cross-sectional online survey of adults aged 18 years or older conducted between November and December 2025. Participants were recruited using quota sampling, with oversampling of Māori and Pacific people. Weighted analyses assessed support for eight cancer funding proposals, perceptions of health workforce support and willingness to pay additional tax.</p><p><strong>Results: </strong>We received 1,635 responses, with Māori (n=385; 23.5%, unweighted) and Pacific people (n=368; 22.5%, unweighted) oversampled. All eight proposals received very high support (weighted estimates were 91.4-94.4%), strongest among those aged ≥50 years, and substantial cross-party support by voting intention. Fewer than one-third (29.4%) thought the government was doing enough to support the health workforce. Most (62.3%) were willing to pay additional tax for healthcare funding.</p><p><strong>Conclusion: </strong>There is strong, cross-party support for increased investment in cancer services, alongside concern about health workforce sustainability. Furthermore, there is a willingness to pay additional tax for healthcare funding.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"79-90"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aotearoa New Zealanders' views of policies and funding for human papillomavirus vaccination and screening for cervical and lung cancers: a national survey.","authors":"Kate Gregory, Ella Iosua, Virginia Signal, Rachael Neumann, Jeannine L Stairmand, Andrew R Gray, Rana L Peniamina, Louise Signal, Bronwen M McNoe","doi":"10.26635/6965.7538","DOIUrl":"https://doi.org/10.26635/6965.7538","url":null,"abstract":"<p><strong>Aim: </strong>Cancer prevention and early detection are central to reducing cancer incidence, inequities and avoidable mortality in Aotearoa New Zealand. This study examined public support for human papillomavirus (HPV) vaccination policies, equitable cancer screening programmes and willingness to pay more tax for healthcare funding.</p><p><strong>Methods: </strong>A nationally representative, cross-sectional online survey of adults aged 18 years or older was conducted in November-December 2025 using quota sampling with oversampling of Māori and Pacific people. Participants reported support for two HPV vaccination policies (single-dose scheduling and increased public investment), two screening policies (free cervical screening and targeted lung cancer screening) and willingness to pay more tax for increased healthcare funding. Weighted analyses were conducted overall and by demographic characteristics and voting intention.</p><p><strong>Results: </strong>We received a total of 1,635 responses, including 385 participants identifying as Māori (23.5%, unweighted) and 368 participants identifying as Pacific peoples (22.5%, unweighted) following oversampling of these groups of particular interest. Population estimates for support were high for all policies, including single-dose HPV vaccination (77.5%), increased HPV vaccination investment (80.3%), free cervical screening (93.4%) and targeted lung cancer screening (93.3%). Majority support was observed across demographic and political groups. Most people (62.3%) were willing to pay more tax to increase healthcare funding.</p><p><strong>Conclusion: </strong>There is strong public support for HPV vaccination and screening for cervical and lung cancers. Furthermore, the majority of the Aotearoa New Zealanders are willing to pay more tax to increase healthcare funding. This indicates a clear public mandate to governments for action.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"69-78"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The public in Aotearoa New Zealand support policies to reduce alcohol harm: results from a national survey.","authors":"Rose Crossin, Ella Iosua, Emma Shields, Andrew R Gray, Louise Signal, Rana L Peniamina, Bronwen M McNoe","doi":"10.26635/6965.7534","DOIUrl":"https://doi.org/10.26635/6965.7534","url":null,"abstract":"<p><strong>Aim: </strong>Alcohol consumption is a cause of at least seven types of cancer and contributes substantially to Aotearoa New Zealand's cancer burden; population-level interventions are one way to reduce this burden. This study therefore investigates: 1) public support for increased action by politicians to reduce alcohol-related harm, and 2) what policies are both strongly supported by the public and have high consistency of support by voting intention.</p><p><strong>Methods: </strong>Data are from a nationally representative, cross-sectional online survey examining public support for evidence-based cancer-related policies in Aotearoa New Zealand.</p><p><strong>Results: </strong>We used oversampling to include a sufficient number of Māori (n=385, 23.5% of the sample) and Pacific people (n=368, 22.5%) among our sample of n=1,635. An estimated 71.1% of the population think politicians should do more to keep people safe from alcohol harm, with majority support across the political spectrum. There was overall majority support for each of the 10 alcohol policies/laws proposed, and cross-party support by voting intention across six policies. Support ranged from 54.9% for increasing the price of alcohol using excise tax to 84.4% for improved online alcohol delivery safeguards.</p><p><strong>Conclusion: </strong>There is strong public support for politicians and the government to act, and to introduce evidence-based alcohol policies recommended by the World Health Organization, with the aim of reducing alcohol-related health burdens, including cancer.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1641","pages":"37-48"},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}