New Zealand to launch national database for ovarian cancer care

Te Aho o Te Kahu, the Cancer Control Agency, is developing a new national chemotherapy database that will enable New Zealand to monitor ovarian cancer treatment outcomes on a national scale for the first time.

The database is being modelled on approaches used in Scandinavian countries such as Norway, where national cancer registries have contributed to a significant improvement in five-year ovarian cancer survival rates. For instance, Norway's survival rate has increased from 34% to over 50%, currently the highest reported among comparable countries.

Currently, New Zealand does not have a comprehensive national auditing system to track variations in ovarian cancer treatment delivery. International studies indicate that countries with such systems often achieve earlier diagnoses, more standardised care, and improved survival for patients.

Advocates for ovarian cancer patients have long argued that the establishment of a nationwide database is overdue. In countries like Norway and Denmark, the presence of such databases has enabled clinicians to review real-world treatment patterns and pinpoint opportunities for improvement. At present, New Zealand lacks the necessary data infrastructure for this level of analysis.

The new initiative comes as government agencies prepare to launch the Cancer National Clinical Network. Experts and advocates believe that the database project should be a focal point in efforts aimed at increasing ovarian cancer survival rates, especially for Māori and Pasifika women who experience higher incidence and reduced survival odds compared to other groups.

Tash Crosby, a cancer survivor and founder of the Talk Peach Gynaecological Cancer Foundation, highlighted the relevance of international oncology models.

She said, "The success of oncology treatment models in parts of Scandinavia and Australia could provide insights that New Zealand can emulate as it looks to improve survival rates associated with the disease and launches the new national network."

In 2014, Norway recorded the highest five-year ovarian cancer survival rate among six International Cancer Benchmarking Partnership countries, a group that includes New Zealand, Australia, Canada, Denmark, Ireland, Norway and the UK. Data from Norway show that the five-year survival rate rose from 34.1% in 1995 to 46.1% in 2014.

Over the same period, New Zealand's rate increased only slightly, from 34.6% to 36.3%. The Cancer Registry of Norway reported a further increase to 50.3% in 2023.

Crosby also noted the opportunity presented by recent changes to cancer care in New Zealand. She said early diagnosis is vital and emphasised the importance of culturally relevant initiatives. "Early diagnosis is key to improving outcomes and is calling for the development of more culturally relevant and targeted resources to support disease awareness levels of Māori wahine and Pacific women who are generally at higher risk of ovarian cancer, compared to those of the European/other ethnic groups."

Statistics from Te Aho o Te Kahu indicate that ovarian cancer is the sixth most common cause of cancer death among New Zealand women, with one woman diagnosed every 32 hours and one death every 60 hours.

Projections from the World Health Organization suggest that the incidence of ovarian cancer in New Zealand could grow by 19% by 2035.

Scandinavian countries have adopted national databases to track treatment patterns, allowing for quality improvement efforts and better patient outcomes. New Zealand's new national chemotherapy database, being developed by Te Aho o Te Kahu, aims to securely compile data from hospitals nationwide to enable similar analysis.

Until 2019, New Zealand did not fund PARP inhibitors, a class of medicines that hinder cancer cells from repairing DNA. In 2020, the first PARP inhibitor was funded, followed by Zejula (niraparib) in 2024. More than 100 people with advanced ovarian cancer will potentially benefit from Zejula, regardless of whether they carry a BRCA mutation.

"Building trust is crucial when working with Māori and Pacific communities, who are disproportionately affected by ovarian cancer.

However more needs to be done to focus on fostering partnerships with Māori and Pacific organisations, building those relationships, and ensuring that life-saving information is delivered in a way that resonates with their cultural values and needs," said Crosby.

She continued, "In many cases, ovarian cancer can be asymptomatic until it advances to the later stages. Some ovarian cancer subtypes may be faster growing, causing symptoms such as significant bloating or abdominal pain to present earlier, however, every individual case is different, a large proportion of women are diagnosed when ovarian cancer is advanced."

Crosby listed the symptoms of ovarian cancer as including persistent bloating, feeling full quickly, discomfort, pressure or pain in the abdomen or pelvic area, changes in bowel habits, fatigue, back pain, frequent or urgent need to urinate, abnormal vaginal bleeding, indigestion, nausea or unexplained weight changes.

She called for better community awareness to reduce stigma around gynaecological health.

"I'd like to see organisations having ovarian cancer information at their workplaces, on notice boards, in bathrooms, wherever women can see it and familiarise themselves with the symptoms.

"This kind of community awareness where women see it at multiple touch points could have a trickle-down effect where they receive the information and pass it on to friends and whanau also.

"In Australia, which had the second highest five-year survival rates of ICBP countries, we've also seen large corporates and fashion brands being involved in ovarian cancer awareness, these brands often have large social media followings and it would be great to see some New Zealand companies jump on board and make a similar commitment," Crosby added.

Brett Marett, GSK Medical Director, commented on the disease burden and the importance of advancing treatment. He said, "With the burden of ovarian cancer expected to increase within New Zealand and globally, the development of treatment options and raised awareness of the disease is critical."

Marett also described the role of PARP inhibitors: "PARP inhibitors are a targeted maintenance therapy that may increase the length of time before cancer progresses."

"The access to funded PARP inhibitor treatment options for ovarian cancer may offer hope for the many Kiwi women and their whanau that are impacted by this disease each year."