Cancer and Aboriginal people in Australia: A review of the literature

Abstract

This paper provides a thematic review of the literature on cancer in Aboriginal people in Australia, focusing on experiences in diagnosis, treatment and care as well as addressing sociocultural factors to guide the public health response to poorer treatment outcomes. A search of both medical and social scientific databases for journal articles published between 1995 and 2006 show that cancer incidence and possibly survival and mortality data are likely to be underestimated in Aboriginal people. Aboriginal people are more likely to die from cancer than non-Aboriginal Australians. There are significant differences between the cancer experiences of those living in the city and in rural or remote areas. There is also a relative absence of literature on cancer in Aboriginal men, who are likely to have particular needs during diagnosis, treatment and care. In drawing conclusions from these data, it can be seen that Aboriginal people with cancer have poorer outcomes than non-Aboriginal Australians, and there is a need for further research in the patterns of care and predictors of outcomes in Aboriginal men and women with cancer. Particular attention should be given to the different needs and experiences of Aboriginal people in urban or rural/remote areas. These findings indicate an urgent need to allocate additional resources to the treatment and care of Aboriginal people with cancer, in addition to screening interventions. There is also a continuing need to acknowledge cultural differences in the health beliefs of Aboriginal people and to work in partnership with Aboriginal community controlled health organisations.

One size fits all? The discursive framing of cultural difference in health professional accounts of providing cancer care to Aboriginal people

“…Aboriginal Australians between 45 and 64 are significantly more likely to die from cancer than non-Aboriginal Australians (Australian Institute of Health and Welfare 2011a). Clinical and epidemiological attention to these issues began to be made visible in the 1990s and early 2000s (e.g., Condon et al 2003;Veroni, Gracey, and Rouse 1994), gaining increasing prominence in the last few years (e.g., Garvey et al 2011;Newman et al 2008;Supramaniam, Grindley, and Pulver 2006). Research from New Zealand has also shown that survival from cancer is lower among the Māori people of that country (Hill et al 2010).…”

“I can’t do this, it’s too much”: building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers

“…While a 2008 review of the literature argued that an understanding of Aboriginal people's experience of cancer must take account of the social, economic and cultural context of people's lives (Newman, Butow et al 2008), there has been little work which focuses on the intersection of these issues with health policy and service delivery.…”

Lung cancer in rural and remote Aboriginal and Torres Strait Islander communities in Queensland: awareness and identifying health needs in a cultural context

“…Indigenous Australians might be reluctant to seek aggressive cancer treatments such as surgery or chemotherapy if they are unable to continue with personal responsibilities given the lifestyle impacts or they might view other social and economic aspects of their life as more important than health. 26 People's views on health can be influenced by their culture which may also influence the decision to seek health care. For example, cancer can raise feelings of shame and fear for an Indigenous…”

“…23,26 The Indigenous definition of being healthy includes the ability to continue with social and family responsibilities. Indigenous Australians might be reluctant to seek aggressive cancer treatments such as surgery or chemotherapy if they are unable to continue with personal responsibilities given the lifestyle impacts or they might view other social and economic aspects of their life as more important than health.…”

“…26 The ability to carry out social and family responsibilities is a measure of good health and this is thought to be a reason why medical treatments such as surgery may be declined. 17,26,27 To better understand the causes of lung cancer disparities between Indigenous and non-Indigenous Australians a literature review was undertaken. The literature review provides the reader a brief outline of history, culture and social determinants of Indigenous Australians.…”