Cancer
Major sites by DHB region of residence
2006–2008
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Disclaimer
The purpose of this publication is to inform discussion and assist policy development. The
opinions expressed in the publication do not necessarily reflect the official views of the Ministry of
Health.
All care has been taken in the production of this publication. The data is deemed to be accurate at
the time of publication, but may be subject to slight changes over time as further information is
received. It is advisable to check the current status of figures given here with the Ministry of Health
before quoting or using them in further analysis.
National collection, coding and collation of cancer registrations is a complex process. This is
because the information in the New Zealand Cancer Registry comes from laboratory reports,
hospital information and mortality information, and cannot be finalised until data has become
available from all sources. In addition, several steps are required to ensure the final information is
of good quality.
The Ministry of Health makes no warranty, expressed or implied, nor assumes any legal liability or
responsibility for the accuracy, correctness, completeness or use of the information or data in this
publication. Further, the Ministry of Health shall not be liable for any loss or damage arising
directly or indirectly from the information or data presented in this publication.
The Ministry of Health welcomes comments and suggestions about this publication.
Citation: Ministry of Health. 2011. Cancer: Major sites by DHB region of
residence 2006–2008. Wellington: New Zealand
Published in June 2011 by the
Ministry of Health
PO Box 5013, Wellington, New Zealand
ISBN 978-0-478-37474-2 (online)
HP 5347
This document is available on the Ministry of Health’s website:
http://www.moh.govt.nz
Contents
Introduction
1
Ethnicity and Deprivation
2
Total Cancer Registrations and Deaths
(ICD* codes C00–96 and D45–D47)
5
Registrations
Deaths
5
5
Lung Cancer Registrations and Deaths
(ICD codes C33–34)
Registrations
Deaths
9
9
9
Colorectal Cancer Registrations and Deaths
(ICD codes C18–C21)
Registrations
Deaths
13
13
13
Prostate Cancer Registrations and Deaths
(ICD code C61)
Registrations
Deaths
17
17
17
Female Breast Cancer Registrations and Deaths
(ICD code C50)
21
Registrations
Deaths
21
21
Explanatory Notes
25
General information relating to cancer data collection
Rate calculations
Confidence intervals
Deprivation
Domicile
Additional information available from the Ministry of Health
References
25
25
29
29
29
30
31
Cancer: Major sites by DHB region of residence 2006–2008
iii
List of Tables
Table N-1: World Health Organization world standard population
Table N-2: Accumulated population data, 2006, 2007 and 2008
25
26
List of Figures
Figure 1:
Figure 2:
Figure 3:
Figure 4:
Figure 5:
Figure 6:
Figure 7:
Figure 8:
Figure 9:
Figure 10:
Figure 11:
Figure 12:
Figure 13:
Figure 14:
Figure 15:
Figure 16:
Figure 17:
Figure 18:
Figure 19:
Figure 20:
Figure 21:
Figure 22:
iv
Percentage Māori population by DHB region of domicile, 2006–2008
Deprivation (NZDep01) by domicile code, 2006–2008
Total cancer registration rates by DHB region, 2006–2008
Total cancer mortality rates by DHB region, 2006–2008
Total cancer registration rates by DHB region, 2006–2008
Total cancer mortality rates by DHB region, 2006–2008
Lung cancer registration rates by DHB region, 2006–2008
Lung cancer mortality rates by DHB region, 2006–2008
Lung cancer registration rates by DHB region, 2006–2008
Lung cancer mortality rates by DHB region, 2006–2008
Colorectal cancer registration rates by DHB region, 2006–2008
Colorectal cancer mortality rates by DHB region, 2006–2008
Colorectal cancer registration rates by DHB region, 2006–2008
Colorectal cancer mortality rates by DHB region, 2006–2008
Prostate cancer registration rates by DHB region, 2006–2008
Prostate cancer mortality rates by DHB region, 2006–2008
Prostate cancer registration rates by DHB region, 2006–2008
Prostate cancer mortality rates by DHB region, 2006–2008
Female breast cancer registration rates by DHB region, 2006–2008
Female breast cancer mortality rates by DHB region, 2006–2008
Female breast cancer registration rates by DHB region, 2006–2008
Female breast cancer mortality rates by DHB region, 2006–2008
Cancer: Major sites by DHB region of residence 2006–2008
3
4
6
7
8
8
10
11
12
12
14
15
16
16
18
19
20
20
22
23
24
24
Introduction
This document is being released to expand on information contained in the publication
Cancer: New registrations and deaths 2008, which was released by the Ministry of
Health in May 2011. Recent Ministry publications relating to cancer can be accessed
from the Ministry of Health’s website at:
http://www.moh.govt.nz/moh.nsf/indexmh/dataandstatistics-subjects-cancer
The Cancer: New registrations and deaths 2008 publication contains a chapter detailing
cancer registrations and deaths by District Health Board (DHB) region of residence. It
provides information on total cancer registrations and total cancer deaths. This report
presents an expanded version of that information. In addition to total rates of cancer
registration and death by DHB region, four individual cancer sites are also shown:
 lung cancer
 colorectal cancer
 prostate cancer
 breast cancer in females.
These sites were chosen as they were some of the most commonly registered cancers
in 2008, and also had high enough mortality figures to enable robust calculations to be
produced. Data for 2006, 2007 and 2008 was aggregated to minimise the effects of
year-on-year variance in the data.
This document uses age-standardised rates to compare cancer registration and death
information for patients residing in different DHB regions. Age-standardised rates were
used as they adjust for differences in age distribution of the populations being compared
and allow comparison to be made between differing groups, in this instance between
DHB regions (see Explanatory notes).
Confidence intervals were also calculated to enable the significance of any differences
between rates by DHB region and the New Zealand rate to be assessed (see
Explanatory notes).
Information in this report is presented in two ways.

Maps show varying shades to distinguish between DHB regions that have
significantly higher or lower rates than the national rate.

The same data is also displayed in charts showing the actual calculated rate for each
DHB region of domicile and the confidence intervals surrounding it.
This report does not attempt to interpret any observed differences in rates between
DHB regions. The information has been released to provide a description of the
available data and to promote further discussion.
Cancer: Major sites by DHB region of residence 2006–2008
1
Ethnicity and Deprivation
Although the use of age-standardised rates adjusts for differences in age structures
between DHB regions, none of the information in this report has been adjusted to
account for differences in either ethnicity or deprivation.
Different DHB regions show different proportions of Māori in their populations, and
because Māori tend to exhibit higher rates of cancer, this will affect rates of registration
and death to some extent.
Different DHB regions also show different levels of socioeconomic deprivation, which
has been associated with various health outcomes, and those who are most deprived
generally experience poorer health (White et al 2008; Benzeval et al 2001).
It is therefore important to consider the differences in population structure when reading
this report. Figure 1 shows the different proportions of Māori in the DHB region
populations. Figure 2 shows the patterns of deprivation across New Zealand by
domicile code (see Explanatory notes) and also shows the DHB region boundaries.
Other aspects that should be taken into account when considering differences between
DHB regions include rurality and access to treatment, possible hereditary biases in
populations, and the fact that the rate shown in each case is the rate for that region and
not that of all the individuals within it.
2
Cancer: Major sites by DHB region of residence 2006–2008
Figure 1: Percentage Māori population by DHB region of domicile, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Hawke's
Bay
Legend
Māori population
MidCentral
percent of total population, 2006-2008
Capital &
Coast
<10% Māori
10-20% Māori
>20% Māori
Nelson
Marlborough
Wairarapa
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Cancer: Major sites by DHB region of residence 2006–2008
3
Figure 2: Deprivation (NZDep01) by domicile code, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Bay of
Plenty
Waikato
Lakes
Tairawhiti
Taranaki
Legend
Hawke's
Bay
District Health Boards
NZ Deprivation Index 2001
Whanganui
Deciles
1 least deprived
Nelson
Marlborough
2
Capital &
Coast
3
4
Wairarapa
5
Hutt
Valley
6
7
8
West
Coast
9
10 most deprived
Canterbury
Southland
South
Canterbury
Otago
4
MidCentral
Cancer: Major sites by DHB region of residence 2006–2008
Total Cancer Registrations and Deaths (ICD* codes
C00–96 and D45–D47)
Registrations
Figure 3 is a map of New Zealand showing total cancer registration rates by DHB region
using 2006, 2007 and 2008 aggregated data. The varying shades shown on the map
distinguish between DHB regions that have significantly higher or lower registration
rates than the New Zealand rate.

Controlling for the differing age structures within each DHB region, patients living in
four regions had age-standardised cancer registration rates that were significantly
higher than the national rate (Northland, Bay of Plenty, Lakes and Canterbury).

Six regions had registration rates that were significantly lower than the national rate
(Counties Manukau, Capital & Coast, Wairarapa, Hutt Valley, Otago and Southland).

All of the other remaining DHB regions had rates with 95 percent confidence limits
that overlapped with the New Zealand registration rate, meaning that, statistically
speaking, they were no different from the national rate.
The same data is shown in Figure 5, showing the calculated age-standardised rate and
the spread of the confidence intervals for each DHB region.
Deaths
Figure 4 is a map of age-standardised total cancer mortality rates by DHB region for the
years 2006–2008. Again, the varying shades show regions with significantly higher or
significantly lower rates of death than the national rate.

The map shows that patients living in eight regions had age-standardised cancer
mortality rates that were significantly higher than the national rate (these regions
were mostly centred around the middle and upper North Island, with the exception of
Otago DHB).

Four DHBs had mortality rates that were significantly lower than the national rate
(Waitemata, Auckland, Capital & Coast and Canterbury).
Figure 6 shows the same death information shown in Figure 4. The confidence
intervals in this figure are broader than those seen in the corresponding registrations
information (Figure 5) due to the lower numbers of deaths resulting in greater variability
within the data.
*
Note: The International Statistical Classification of Diseases and Related Health Problems, Tenth
Revision, Australian Modification (ICD-10-AM) Third Edition was used to classify the registration data
used in this report. The Second and Sixth Editions of the same publication were used to classify the
mortality data used in this report. More information is in the Cancer: New registrations and deaths
2008 publication, which can be found at: http://www.moh.govt.nz/moh.nsf/indexmh/dataandstatisticssubjects-cancer.
Cancer: Major sites by DHB region of residence 2006–2008
5
Figure 3: Total cancer registration rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer registration rates, 2006 to 2008
MidCentral
Difference from the national rate
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Cancer Registry
Note: The rate used is the age-standardised rate per 100,000 DHB population, standardised to the World
Health Organization (WHO) world standard population; 95 percent confidence intervals.
6
Cancer: Major sites by DHB region of residence 2006–2008
Figure 4: Total cancer mortality rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer death rates, 2006 to 2008
MidCentral
Difference from the national rate
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Mortality Collection
Note: The rate used is the age-standardised rate per 100,000 DHB population, standardised to the WHO
world standard population; 95 percent confidence intervals.
Cancer: Major sites by DHB region of residence 2006–2008
7
Figure 5: Total cancer registration rates by DHB region, 2006–2008
450
Registration rate
400
350
300
250
200
150
100
50
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Cancer Registry
Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the
WHO world standard population.
Figure 6: Total cancer mortality rates by DHB region, 2006–2008
400
Mortality rate
350
300
250
200
150
100
50
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Mortality Collection
Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the
WHO world standard population.
8
Cancer: Major sites by DHB region of residence 2006–2008
Lung Cancer Registrations and Deaths
(ICD codes C33–34)
Registrations
Cancer of the trachea, bronchus and lung (lung cancer) was the fifth most common
cancer to be registered in 2008, accounting for 9 percent of all cancer registrations.

Figure 7 shows that patients living in four DHB regions had lung cancer registration
rates that were significantly higher than the New Zealand rate (Northland, Lakes,
Counties Manukau and Tairawhiti).

Two DHB regions (Nelson Marlborough and Canterbury) had rates that were
significantly lower.
The same data is shown in Figure 9, but includes the age-standardised rate and shows
the spread of the confidence intervals for each DHB region.
Deaths
Lung cancer accounted for 19 percent of all deaths from cancer in 2008 and was the
leading cause of cancer death in that year.

Figure 8 shows the rates of death from lung cancer, and exhibits a very similar
pattern to that seen for registrations in Figure 9. All but three DHB regions showed
the same significance grouping for cancer death as they did for registrations.

Waikato and Whanganui DHB regions had higher rates of death but registration rates
that were not significantly different from the national rate.

Waitemata DHB region had a lower rate of death but a registration rate that was not
statistically different from the national rate.
Figure 10 shows the same death information as Figure 8 in the form of a chart.
Cancer: Major sites by DHB region of residence 2006–2008
9
Figure 7: Lung cancer registration rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer registration rates, 2006 to 2008
Difference from the national rate
MidCentral
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Cancer Registry
Note: The rate used is the age-standardised rate per 100,000 DHB population, standardised to the WHO
world standard population; 95 percent confidence intervals.
10
Cancer: Major sites by DHB region of residence 2006–2008
Figure 8: Lung cancer mortality rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer death rates, 2006 to 2008
Difference from the national rate
MidCentral
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Mortality Collection
Note: The rate used is the age-standardised rate per 100,000 DHB population, standardised to the WHO
world standard population; 95 percent confidence intervals.
Cancer: Major sites by DHB region of residence 2006–2008
11
Figure 9: Lung cancer registration rates by DHB region, 2006–2008
60
Registration rate
50
40
30
20
10
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Cancer Registry
Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the
WHO world standard population.
Figure 10: Lung cancer mortality rates by DHB region, 2006–2008
60
Mortality rate
50
40
30
20
10
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Mortality Collection
Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the
WHO world standard population.
12
Cancer: Major sites by DHB region of residence 2006–2008
Colorectal Cancer Registrations and Deaths
(ICD codes C18–C21)
Registrations
Cancer of the colorectum and anus (colorectal cancer) was the second most common
cancer to be registered in 2008, constituting 14 percent of all cancer registrations.

Figure 11 is a map of colorectal cancer registration rates. It shows that patients
residing in the three most southerly DHB regions exhibited significantly higher
registration rates than the New Zealand rate.

Waitemata, Counties Manukau, Tairawhiti, Capital & Coast and Hutt Valley DHB
regions had registration rates that were significantly lower than the national rate.
The same data is shown in Figure 13, but includes the age-standardised rate and
shows the spread of the confidence intervals for each DHB region.
Deaths
Colorectal cancer was the second most common cause of cancer deaths in 2008
(15 percent of all deaths from cancer).

Figure 12 shows that the three most southerly DHB regions had significantly higher
rates of death from colorectal cancer (as was true for registrations). In addition,
Waikato DHB region had a mortality rate that was significantly higher than the
national rate.

Only patients residing in Waitemata DHB region showed a colorectal cancer mortality
rate that was significantly lower than the national rate.
The information in Figure 12 is replicated in Figure 14 as a chart.
Cancer: Major sites by DHB region of residence 2006–2008
13
Figure 11: Colorectal cancer registration rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer registration rates, 2006 to 2008
MidCentral
Difference from the national rate
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Cancer Registry
Note: The rate used is the age-standardised rate per 100,000 DHB population, standardised to the WHO
world standard population; 95 percent confidence intervals.
14
Cancer: Major sites by DHB region of residence 2006–2008
Figure 12: Colorectal cancer mortality rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer death rates, 2006 to 2008
MidCentral
Difference from the national rate
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Mortality Collection
Note: The rate used is the age-standardised rate per 100,000 DHB population, standardised to the WHO
world standard population; 95 percent confidence intervals.
Cancer: Major sites by DHB region of residence 2006–2008
15
Figure 13: Colorectal cancer registration rates by DHB region, 2006–2008
80
Registration rate
70
60
50
40
30
20
10
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Cancer Registry
Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the
WHO world standard population.
Figure 14: Colorectal cancer mortality rates by DHB region, 2006–2008
80
Mortality rate
70
60
50
40
30
20
10
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Mortality Collection
Note: The rate shown is the age-standardised rate per 100,000 DHB population, standardised to the
WHO world standard population.
16
Cancer: Major sites by DHB region of residence 2006–2008
Prostate Cancer Registrations and Deaths
(ICD code C61)
Registrations
Prostate cancer was the most common cancer to be registered in 2008, both within the
total population and for males. This cancer accounted for 28 percent of all male cancer
registrations in 2008.

Figure 15 is a map of prostate cancer registration rates. It shows that five DHB
regions had registration rates that were significantly higher than the national rate
(Northland, Waitemata, Whanganui, Nelson Marlborough and Canterbury).

Patients residing in Taranaki, Wairarapa, South Canterbury, Otago and Southland
DHB regions had rates that were significantly lower than the New Zealand rate.
The same data is shown in Figure 17, but includes the age-standardised rate and
shows the spread of the confidence intervals for each DHB region.
Deaths
Prostate cancer was the third most common cause of cancer death in men in 2008 and
accounted for 15 percent of male cancer deaths in that year.

Figure 16 shows that there were no DHB regions with prostate cancer mortality rates
significantly higher than the national rate.

Patients who lived in Waitemata, Auckland, and Capital and Coast DHB regions had
rates of death from prostate cancer that were significantly lower than the national
rate.
Figure 18 shows the same mortality information as Figure 16, in the form of a chart.
Cancer: Major sites by DHB region of residence 2006–2008
17
Figure 15: Prostate cancer registration rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer registration rates, 2006 to 2008
Difference from the national rate
MidCentral
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Cancer Registry
Note: The rate used is the age-standardised rate per 100,000 male DHB population, standardised to the
WHO world standard population; 95 percent confidence intervals.
18
Cancer: Major sites by DHB region of residence 2006–2008
Figure 16: Prostate cancer mortality rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Legend
Whanganui
Hawke's
Bay
Age-standardised cancer death rates, 2006 to 2008
Difference from the national rate
MidCentral
Significantly lower
Capital &
Coast
Not significantly different
Wairarapa
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Mortality Collection
Note: The rate used is the age-standardised rate per 100,000 male DHB population, standardised to the
WHO world standard population; 95 percent confidence intervals.
Cancer: Major sites by DHB region of residence 2006–2008
19
Figure 17: Prostate cancer registration rates by DHB region, 2006–2008
160
Registration rate
140
120
100
80
60
40
20
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Cancer Registry
Note: The rate shown is the age-standardised rate per 100,000 male DHB population, standardised to the
WHO world standard population.
Figure 18: Prostate cancer mortality rates by DHB region, 2006–2008
160
Mortality rate
140
120
100
80
60
40
20
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Mortality Collection
Note: The rate shown is the age-standardised rate per 100,000 male DHB population, standardised to the
WHO world standard population.
20
Cancer: Major sites by DHB region of residence 2006–2008
Female Breast Cancer Registrations and Deaths
(ICD code C50)
Registrations
Breast cancer was the most common cancer to be registered for women (accounting for
28 percent of all female cancer registrations) in 2008.

Figure 19 is a map of female breast cancer registration rates. It shows that only two
of the 21 DHB regions had rates that were different from the national rate.

Only Waitemata DHB region had a rate that was higher than the national rate.

The Nelson Marlborough DHB region had a rate that was significantly lower than the
national rate.
The same data is shown in Figure 21, but includes the age-standardised rate and
shows the spread of the confidence intervals for each DHB region.
Deaths
Breast cancer was the second most common cause of cancer death in women in 2008
(accounting for 15 percent of female cancer deaths).

Figure 20 shows that only one DHB region (Taranaki) showed a female breast cancer
mortality rate that was significantly higher than the national rate.

Patients residing in the Northland region showed a rate of death that was significantly
lower than the national rate.
Figure 22 shows the same mortality information as Figure 20, in the form of a chart.
Cancer: Major sites by DHB region of residence 2006–2008
21
Figure 19: Female breast cancer registration rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer registration rates, 2006 to 2008
MidCentral
Difference from the national rate
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Cancer Registry
Note: The rate used is the age-standardised rate per 100,000 female DHB population, standardised to
the WHO world standard population; 95 percent confidence intervals.
22
Cancer: Major sites by DHB region of residence 2006–2008
Figure 20: Female breast cancer mortality rates by DHB region, 2006–2008
Northland
Waitemata
Auckland
Counties Manukau
Waikato
Bay of
Plenty
Tairawhiti
Lakes
Taranaki
Whanganui
Legend
Hawke's
Bay
Age-standardised cancer death rates, 2006 to 2008
Difference from the national rate
MidCentral
Capital &
Coast
Significantly lower
Wairarapa
Not significantly different
Significantly higher
Nelson
Marlborough
Hutt
Valley
West
Coast
Canterbury
South
Canterbury
Otago
Southland
Source: New Zealand Mortality Collection
Note: The rate used is the age-standardised rate per 100,000 female DHB population, standardised to
the WHO world standard population; 95 percent confidence intervals.
Cancer: Major sites by DHB region of residence 2006–2008
23
Figure 21: Female breast cancer registration rates by DHB region, 2006–2008
120
Registration rate
100
80
60
40
20
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Cancer Registry
Note: The rate shown is the age-standardised rate per 100,000 female DHB population, standardised to
the WHO world standard population.
Figure 22: Female breast cancer mortality rates by DHB region, 2006–2008
120
Mortality rate
100
80
60
40
20
Southland
Otago
South Canterbury
Canterbury
West Coast
Nelson Marlborough
Wairarapa
Hutt Valley
Capital & Coast
Whanganui
MidCentral
Taranaki
Hawke's Bay
Tairawhiti
Bay of Plenty
Lakes
Waikato
Counties Manukau
Auckland
Waitemata
Northland
0
Source: New Zealand Mortality Collection
Note: The rate shown is the age-standardised rate per 100,000 female DHB population, standardised to
the WHO world standard population.
24
Cancer: Major sites by DHB region of residence 2006–2008
Explanatory Notes
General information relating to cancer data collection
For information relating to the New Zealand Cancer Registry, disease coding, timeliness
of data and relevant legislation, please see the Explanatory notes in the Cancer: New
registrations and deaths 2008 publication, which can be found on the Ministry of
Health’s website: http://www.moh.govt.nz/moh.nsf/indexmh/dataandstatistics-subjectscancer
Rate calculations
Age-specific rates show the number of events (for example, cancer registrations or
deaths) per 100,000 of the population in each age group.
Age-standardised rates adjust for differences in age distribution of the populations being
compared. They are calculated by the direct standardisation method, which multiplies
the age-specific rates by a standard population. The standard population used in this
publication is the World Health Organization (WHO) world standard population.
Table N-1: World Health Organization world standard population
Age group
0–4
Population
Age group
Population
8860
50–54
5370
5–9
8690
55–59
4550
10–14
8600
60–64
3720
15–19
8470
65–69
2960
20–24
8220
70–74
2210
25–29
7930
75–79
1520
30–34
7610
80–84
910
35–39
7150
85+
635
40–44
6590
45–49
6040
Total
100,035
Source: Ahmad et al 2001
The 2006, 2007 and 2008 accumulated estimated resident population by age group and
sex, as at 30 June each year, (grouped by age group and DHB) is shown below.
Cancer: Major sites by DHB region of residence 2006–2008
25
Table N-2: Accumulated population data, 2006, 2007 and 2008
Sex
Total
0
5–
10–
15–
20–
25–
30–
35–
40–
45–
50–
55–
60–
65–
70–
75–
80–
85+
6770
Northland
Total:
461200
32540
34720
38050
33930
21680
19680
24220
30060
33340
35050
32460
30220
26510
22890
16590
13470
9000
Male:
226700
16360
17670
19580
17670
11190
9270
11370
14160
15820
16710
15970
14930
13050
11650
8310
6590
4050
2310
Female:
234500
16170
17050
18470
16260
10500
10420
12840
15900
17520
18340
16480
15290
13460
11240
8280
6870
4950
4470
19780
Waitemata
Total:
1538700
106690
106240
112290
116570
104380
96050
104560
124290
126190
118120
96470
85680
69790
53840
40090
33140
24600
Male:
753400
55190
54190
57640
59580
53360
47350
49440
59120
60830
57260
46890
42020
33910
25820
18980
15190
10240
6400
Female:
785300
51510
52050
54660
56990
51020
48700
55120
65180
65380
60860
49570
43640
35870
28020
21100
17950
14370
13370
17440
Auckland
Total:
1299600
84810
74580
76510
90360
126010
124940
110800
106580
101000
91330
76850
64550
48910
38000
26740
22320
17840
Male:
637100
43720
38410
39460
45360
61430
61300
53640
51620
49740
44740
37750
32140
24120
18450
12780
10140
7090
5230
Female:
662500
41080
36170
37060
45000
64590
63650
57150
54960
51260
46590
39090
32420
24780
19560
13960
12180
10750
12210
Counties Manukau
Total:
1392800
117780
115390
118200
117220
99050
88810
92510
106080
106600
98110
81070
70370
56900
43290
29980
23430
15960
12090
Male:
681400
60530
58740
60280
59880
49050
41990
43020
49870
51460
47780
39920
34500
27890
21100
14120
10760
6680
3810
Female:
711400
57240
56640
57920
57340
50000
46830
49480
56200
55140
50310
41140
35870
29010
22210
15850
12690
9270
8280
14900
Waikato
Total:
1059600
76980
77160
81800
83200
73320
64020
64460
73710
75210
75620
67230
60630
50590
41920
32580
27340
18900
Male:
520200
38800
39420
42490
42100
37320
32090
30970
34900
36100
36580
32990
29740
24680
20430
15900
12660
8110
4880
Female:
539500
38170
37740
39290
41100
36000
31950
33490
38820
39130
39030
34250
30900
25910
21490
16690
14680
10810
10030
3680
Lakes
Total:
304400
23640
23720
24740
22850
16790
17390
19370
22100
22050
22850
19360
17650
14760
12100
8950
7460
5030
Male:
149300
12140
12250
12630
11770
8470
8240
9240
10500
10450
11170
9400
8520
7260
6030
4340
3540
2060
1200
Female:
155300
11500
11470
12110
11070
8320
9170
10130
11600
11600
11690
9950
9130
7510
6080
4600
3920
2960
2480
Bay of Plenty
Total:
609500
41920
44250
47100
43440
29470
30090
34500
41250
43650
44930
40820
36980
32760
29500
23480
20130
14520
10800
Male:
296800
21670
22980
24000
22370
14850
14530
16380
19040
20710
21590
19560
18120
15770
14060
11280
9650
6320
3800
Female:
312900
20250
21270
23090
21070
14610
15550
18120
22220
22930
23340
21260
18860
16980
15440
12200
10470
8190
7020
Total:
137700
11320
11530
12260
11090
7590
7110
8030
9260
9500
10180
9110
8090
6020
5140
4030
3370
2270
1840
Male:
67100
5790
5900
6200
5760
3640
3350
3810
4290
4530
4810
4570
4110
2990
2480
1890
1490
910
560
Female:
70600
5530
5630
6060
5330
3940
3760
4220
4980
4970
5360
4530
3990
3030
2660
2150
1880
1360
1290
458900
32910
34050
36680
34240
23480
23280
27110
31280
33240
34540
30400
29180
23780
19500
15080
12970
9450
7720
Tairawhiti
Hawke’s Bay
Total:
26
Cancer: Major sites by DHB region of residence 2006–2008
Sex
Total
0
5–
10–
15–
20–
25–
30–
35–
40–
45–
50–
55–
60–
65–
70–
75–
80–
85+
Male:
223300
16760
17280
18910
17330
12060
11140
12750
14900
15780
16640
14800
14260
11800
9420
7170
5920
3770
2540
Female:
235600
16150
16770
17760
16910
11420
12140
14370
16390
17460
17890
15610
14910
11970
10070
7890
7050
5680
5190
5740
Taranaki
Total:
322300
21700
22620
24330
24110
17250
17270
19310
22150
23340
24360
21600
19640
16360
13670
11290
9990
7690
Male:
158800
11260
11710
12380
12500
9010
8580
9220
10580
11440
11790
10720
9860
8100
6650
5420
4600
3090
1920
Female:
163500
10440
10910
11950
11610
8250
8700
10090
11560
11910
12570
10880
9790
8270
7020
5860
5390
4600
3820
MidCentral
Total:
493000
33140
33620
36140
40190
36610
28750
28670
32570
34380
35350
30610
28440
24130
20920
16810
14220
10360
8080
Male:
239900
16860
16970
18380
20150
18590
14060
13670
15440
16400
17360
14730
13810
11790
10130
8020
6620
4300
2580
Female:
253100
16310
16650
17780
20050
18030
14700
14990
17130
17980
17990
15860
14620
12330
10790
8790
7600
6060
5500
3610
Whanganui
Total:
190800
12660
13370
15200
14720
10270
9140
10320
12260
13500
14400
13100
11630
9760
8670
7230
6360
4610
Male:
93400
6410
6950
7790
7630
5410
4600
4890
5880
6520
6970
6490
5790
4710
4030
3310
3000
1890
1140
Female:
97400
6230
6420
7400
7090
4860
4540
5440
6380
6980
7420
6600
5830
5050
4640
3920
3360
2730
2460
Capital & Coast
Total:
843900
55920
52200
52530
60000
74610
68210
66180
68930
66230
60140
49990
44560
35110
27790
20710
17150
12950
10630
Male:
408200
28380
26400
26910
29420
35400
33570
31420
32810
31960
29280
24180
21810
17160
13280
9790
7680
5340
3400
Female:
435700
27540
25800
25610
30580
39220
34640
34750
36130
34270
30860
25810
22740
17970
14510
10930
9480
7620
7220
5680
Hutt Valley
Total:
424200
31140
31070
31950
32770
26250
24680
28640
33080
32930
32690
26790
24040
19130
15160
11310
9880
7110
Male:
208700
16010
16070
16390
16780
13260
11870
13740
16030
15960
15970
13250
12090
9510
7390
5270
4430
2920
1680
Female:
215700
15110
15010
15540
15990
13000
12800
14890
17040
16960
16710
13540
11940
9630
7750
6060
5450
4190
4000
2270
Wairarapa
Total:
118800
7790
7980
8870
8340
4890
5110
6100
7700
8210
9170
8880
8530
7220
6070
4700
4110
2910
Male:
57950
3880
4060
4480
4300
2600
2420
2930
3600
3990
4370
4410
4250
3620
2970
2330
1850
1200
680
Female:
60800
3900
3920
4390
4040
2280
2680
3150
4090
4220
4800
4470
4280
3600
3090
2370
2270
1700
1580
19760
23460
28690
30720
33120
29820
28680
23810
18610
14330
11970
9110
7280
Nelson Marlborough
Total:
403900
24720
25520
27990
27400
18890
Male:
199900
12550
13220
14570
14400
10030
9790
11490
13750
14610
16130
14830
14190
12060
9290
7000
5530
3880
2540
Female:
204000
12140
12300
13420
12990
8870
9960
11970
14940
16110
17000
14990
14500
11730
9320
7330
6430
5240
4740
96700
5930
6070
7160
6370
4470
4850
5600
6870
7730
8330
7320
6620
5510
4570
3290
2700
1870
1450
West Coast
Total:
Male:
49100
3220
3110
3630
3360
2390
2360
2620
3290
3860
4320
3940
3490
2820
2370
1710
1340
850
460
Female:
47600
2720
2970
3530
3000
2080
2470
2990
3580
3870
4010
3370
3130
2690
2200
1590
1350
1010
1000
Cancer: Major sites by DHB region of residence 2006–2008
27
Canterbury
Sex
Total
0
5–
10–
15–
20–
25–
30–
35–
40–
45–
50–
55–
60–
65–
70–
75–
80–
85+
24640
Total:
1469400
94420
91970
97400
106860
105880
89890
96730
111140
111200
109750
96430
88340
71050
57390
44950
40670
30670
Male:
720000
48270
46720
49780
55190
54800
44380
46210
53510
53980
54020
47440
43500
34950
27760
21060
18130
12510
7770
Female:
749400
46160
45270
47620
51670
51060
45510
50520
57630
57210
55730
48990
44840
36110
29620
23890
22540
18140
16890
3600
South Canterbury
Total:
165700
9350
10370
11910
11330
6930
7020
8730
10840
12070
13010
12060
11760
9780
8690
7210
6440
4640
Male:
81500
4840
5370
6180
5880
3710
3460
4230
5250
5700
6330
6140
5950
4840
4190
3400
3040
1800
1160
Female:
84200
4500
5000
5730
5450
3220
3560
4490
5600
6360
6690
5910
5810
4950
4500
3810
3400
2820
2440
Otago
Total:
557600
30920
31520
34120
48610
52640
31040
32270
36010
38480
41040
37410
34580
28010
23630
18650
16600
12260
9860
Male:
272400
15720
16270
17580
23890
25890
15360
15740
17190
18590
20090
18860
17110
14040
11610
8870
7630
4950
2960
Female:
285400
15190
15270
16540
24720
26740
15680
16530
18820
19900
20950
18540
17470
13980
12020
9780
8970
7310
6900
4990
Southland
Total:
331300
22130
21510
22980
22000
20420
22140
23210
24580
25460
25740
22190
19730
15800
13280
10440
8780
5900
Male:
165800
11440
11050
11970
11490
10410
11030
11630
11990
12540
12830
11460
10240
8060
6610
5080
4090
2350
1450
Female:
165600
10690
10460
11010
10510
10010
11110
11590
12580
12920
12900
10720
9490
7740
6670
5360
4680
3550
3540
Other and unspecified
Total:
1260
15
25
30
20
65
70
105
90
85
135
160
135
145
85
55
35
10
0
Male:
850
5
20
15
15
45
55
75
65
45
85
100
95
90
65
35
30
10
0
Female:
420
0
10
15
15
15
15
30
20
30
50
55
45
55
25
25
5
0
0
182850
Total
Total:
12681620
878425
869495
918210
955625
880955
799300
834895
939535
955115
937980
810135
730025
595830
484695
368480
312545
227645
Male:
6211480
449805
444745
471255
486825
442935
390795
398495
447785
461015
456835
398410
360550
293260
235785
176075
143920
94335
58480
Female:
6470440
428610
424765
446965
468785
438015
408515
436390
491760
494130
481105
411660
369505
302600
248920
192445
168625
133320
124410
Source: Statistics New Zealand
Note: Because of rounding, individual figures in this table do not always add up to the stated totals.
28
Cancer: Major sites by DHB region of residence 2006–2008
Confidence intervals
The confidence intervals in this publication have been calculated using the methods
presented in Keyfitz (1966).
A confidence interval is a range of values used to describe the uncertainty around a
single value (such as an age-standardised rate). Confidence intervals describe how
different the estimate could have been if chance had led to a different set of data.
Confidence intervals are calculated with a stated probability, typically 95 percent (which
would indicate that there is a 95 percent chance that the true value lies within the
confidence intervals).
Deprivation
The New Zealand Social Deprivation Index is a measure of socioeconomic status
calculated for small geographic areas. The calculation uses a range of variables from
the 2001 and 2006 Census of Population and Dwellings, which represent nine
dimensions of social deprivation. The Social Deprivation Index is calculated at the level
of meshblocks (geographical units containing a median of 90 people), and the Ministry
of Health maps these to domicile codes, which are built up to the relevant geographic
scale using weighted average ‘usually resident population’ counts from the Census.
The nine variables (proportions in small areas) in the index, by decreasing weight, are:

income: people aged 18 to 59 receiving a means-tested benefit

employment: people aged 18 to 59 who are unemployed

income: people living in an equivalised household whose income is below a certain
threshold

communication: people with no access to a telephone

transport: people with no access to a car

support: people aged under 60 living in a single-parent family

qualifications: people aged 18 to 59 with no qualifications

living space: people living in an equivalised household below a bedroom occupancy
threshold

owned home: people not living in their own home.
Further information can be obtained from:
http://www.moh.govt.nz/moh.nsf/pagesmh/3357?Open.
Domicile
Domicile codes used for health collections are four-digit Health Domicile Codes. These
codes are based on geographic areas and were created by Statistics New Zealand from
its six-digit Census Area Unit Codes. From 2006 to 2008, the Health Domicile Codes
used are based on the 2001 Census Area Unit Codes.
Cancer: Major sites by DHB region of residence 2006–2008
29
Additional information available from the Ministry of Health
If you require additional information, analysis, material not included in this report, or
material tabulated in different ways, please contact:
National Collections and Reporting
National Health Board
Ministry of Health
PO Box 5013
Wellington
New Zealand
Phone (04) 496 2000
Fax (04) 816 2898
Email [email protected]
Further Ministry of Health publications can be found online at
http://www.moh.govt.nz/dataandstatistics.
30
Cancer: Major sites by DHB region of residence 2006–2008
References
Ahmad O, Boschi-Pinto C, Lopez AD, et al. 2001. Age Standardization of Rates: A new WHO
standard. Geneva: World Health Organization GPE Discussion Paper Series: No. 31.
URL: http://www.who.int/healthinfo/paper31.pdf. Accessed 3 March 2011.
Benzeval M, Judge K, Shouls S. 2001. Understanding the relationship between income and
health: How much can be gleaned from cross-sectional data? Social Policy and Administration
35: 376–96.
Keyfitz N. 1966. Sampling variance of standardized mortality rates. Human Biology 38:
309–17.
Ministry of Health. 2000. Cancer: New registrations and deaths 1996. Wellington: Ministry of
Health.
Ministry of Health. 2010. Cancer: New registrations and deaths 2006. Wellington: Ministry of
Health.
Ministry of Health. 2011. Cancer: New registrations and deaths 2008. Wellington: Ministry of
Health.
White P, Gunston J, Salmond C, et al. 2008. Atlas of Socioeconomic Deprivation in New
Zealand NZDep2006. Wellington: Ministry of Health.
Cancer: Major sites by DHB region of residence 2006–2008
31