Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality

Abstract

BackgroundNational cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting.MethodsWe used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005.ResultsSurvival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents.ConclusionsCancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people.

The first comprehensive report on Indigenous Australian women's inequalities in cervical screening: A retrospective registry cohort study in Queensland, Australia (2000‐2011)

“…The cervical cancer incidence is approximately 2 times higher (20 vs 9 per 100,000) and the mortality rates are 4 times higher (8 vs 2 deaths per 100,000) for Indigenous women versus non‐Indigenous women 1. Indigenous women are more likely to have advanced disease when they are diagnosed3 and lower survival rates than non‐Indigenous women (5‐year survival rate, 57.6% vs 78.3%) 4…”

Factors Associated With Cancer-Specific and Overall Survival Among Indigenous and Non-Indigenous Gynecologic Cancer Patients in Queensland, Australia

“…12 There is also evidence that survival differences between Australian Indigenous and non-Indigenous cancer patients are most prominent in the first years following diagnosis. 13,14 No study has comprehensively explored the demographic and clinical factors that may explain poorer survival among Australian Indigenous gynecologic cancer patients. This article assesses the factors associated with 1-and 5-year survival rates for Indigenous compared with non-Indigenous women diagnosed with a gynecologic cancer in Queensland.…”

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

“…The Indigenous relative survival analysis for lung cancer over years 2001-2007 was significantly lower than nonIndigenous cases (age adjusted to age distribution of non-Indigenous cases). 56 Research has also found that the survival difference for Indigenous Australians with cancer compared to non-Indigenous was mostly during the first year after diagnosis. 6,56 5 There is evidence however, that suggests a higher incidence of fatal Indigenous Non-Indigenous…”

“…These two factors contribute to the cause of poor outcomes. 56 Remoteness of residence also contributes to poor cancer outcomes but whether non-Indigenous cancer patients living in similar demographic and socio-economic circumstances have similar outcomes needs to be more fully investigated.…”

“…Relevant health information suited to patients' will provide them the knowledge and confidence to seek cancer care and continue with treatments. 56,60 Other reasons that may delay Indigenous Australians seeking or completing cancer care is the culture about seeking permission for medical treatment from family, Elders or others who have authority within the tribal group. As previously discussed, this consent process can take time.…”