title: Methods of a national colorectal cancer cohort study: the PIPER Project.
abstract: OBJECTIVE
  Colorectal cancer is one of the most common cancers, and second-leading cause of cancer-related death, in New Zealand. The PIPER (Presentations, Investigations, Pathways, Evaluation, Rx [treatment]) project was undertaken to compare presentation, investigations, management and outcomes by rurality, ethnicity and deprivation. This paper reports the methods of the project, a comparison of PIPER patient diagnoses to the New Zealand Cancer Registry (NZCR) data, and the characteristics of the PIPER cohort.
  
  
  METHODS
  National, retrospective cohort review of secondary care medical records (public and private) of all cases of ICD-10-AM C18-C20 on the NZCR in the calendar years 2007 and 2008 (main cohort) and an extended sample of Māori and Pacific cases, and non-Māori non-Pacific controls in 2006 and 2009 (extended cohort).
  
  
  RESULTS
  Of the 6,387 patients identified from the NZCR 5,610 (88%) were eligible for PIPER. Reasons for exclusion were non-adenocarcinoma histology (3%) and non-colorectal primary (2%). Data were collected on 3,695 patients with colon cancer, 1,385 with rectal cancer and 466 with cancer of the recto sigmoid junction.
  
  
  CONCLUSIONS
  The PIPER Project has generated comprehensive population level data detailing the diagnosis and management of colorectal adenocarcinoma in New Zealand. This will be used to assess the care provided to patients, and the impact of variations in care occurring between patient groups.
authors.affiliation: Project Manager, Discipline of Oncology, University of Auckland, Auckland.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Firth
authors.affiliation: Associate Professor of Biostatistics, Department of Mathematics and Statistics and Department of Medicine, University of Otago, Dunedin.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Sharples
authors.affiliation: Research Fellow/Biostatistician, Discipline of Oncology, University of Auckland, Auckland.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Hinder
authors.affiliation: Database Development Officer, Discipline of Oncology, University of Auckland, Auckland.
authors.forename: Jerome
authors.initials: J
authors.lastname: Macapagal
authors.affiliation: Professor and Co-Head of Department, Department of Public Health, University of Otago, Wellington.
authors.forename: Diana
authors.initials: D
authors.lastname: Sarfati
authors.affiliation: Associate Professor, Public Health (Health Systems and Public Policy) and Director - Injury Prevention Research Unit, Department of Preventative and Social Medicine, University of Otago, Dunedin.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Derrett
authors.affiliation: Consultant Colorectal Surgeon, Counties Manukau DHB and Professor, South Auckland Clinical School, University of Auckland, Auckland.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
authors.affiliation: Senior Research Fellow, National Institute of Demographic and Economic Analysis, the University of Waikato, Waikato.
authors.forename: Charis
authors.initials: C
authors.lastname: Brown
authors.affiliation: Associate Professor and Tumuaki, Te Kupenga Hauora Māori, University of Auckland, Auckland.
authors.forename: Papaarangi Mj
authors.initials: PM
authors.lastname: Reid
authors.affiliation: Professor of Population Health, National Institute of Demographic and Economic Analysis, the University of Waikato, Waikato.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Lawrenson
authors.affiliation: Foxley Fellow, General Practice and Rural Health, University of Otago, Dunedin.
authors.forename: Carol
authors.initials: C
authors.lastname: Atmore
authors.affiliation: Consultant Colorectal Surgeon, Capital and Coast District Health Board and Clinical Senior Lecturer, Wellington School of Medicine, University of Otago, Wellington.
authors.forename: John P
authors.initials: JP
authors.lastname: Keating
authors.affiliation: Consultant Medical Oncologist, Canterbury District Health Board, Christchurch.
authors.forename: Mark
authors.initials: M
authors.lastname: Jeffery
authors.affiliation: Consultant Colorectal Surgeon, Nelson-Marlborough District Health Board, Nelson.
authors.forename: Adrian H
authors.initials: AH
authors.lastname: Secker
authors.affiliation: Consultant Radiation Oncologist and Clinical Director, Radiation Oncology, Waikato District Health Board, Waikato.
authors.forename: Charles
authors.initials: C
authors.lastname: De Groot
authors.affiliation: Consultant Medical Oncologist, Southern District Health Board and Senior Lecturer, Dunedin School of Medicine, University of Otago, Dunedin.
authors.forename: Christopher Gca
authors.initials: CG
authors.lastname: Jackson
authors.affiliation: Consultant Medical Oncologist, Auckland DHB; Professor of Oncology, University of Auckland; Director Cancer Trials New Zealand, Auckland.
authors.forename: Michael Pn
authors.initials: MP
authors.lastname: Findlay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D018579:Patient Selection; D012004:Rectal Neoplasms / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies