Improving Access to Cancer Treatment Services in Australia’s Northern Territory—History and Progress

Abstract

Cancer is the leading cause of death in the Northern Territory (NT), Australia’s most sparsely populated jurisdiction with the highest proportion of Aboriginal people. Providing cancer care to the NT’s diverse population has significant challenges, particularly related to large distances, limited resources and cultural differences. This paper describes the developments to improve cancer treatment services, screening and end-of-life care in the NT over the past two decades, with a particular focus on what this means for the NT’s Indigenous peoples. This overview of NT cancer services was collated from peer-reviewed literature, government reports, cabinet papers and personal communication with health service providers. The establishment of the Alan Walker Cancer Care Centre (AWCCC), which provides radiotherapy, chemotherapy and other specialist cancer services at Royal Darwin Hospital, and recent investment in a PET Scanner have reduced patients’ need to travel interstate for cancer diagnosis and treatment. The new chemotherapy day units at Alice Springs Hospital and Katherine Hospital and the rapid expansion of tele-oncology have also reduced patient travel within the NT. Access to palliative care facilities has also improved, with end-of-life care now available in Darwin, Alice Springs and Katherine. However, future efforts in the NT should focus on increasing and improving travel assistance and support and increasing the availability of appropriate accommodation; ongoing implementation of strategies to improve recruitment and retention of health professionals working in cancer care, particularly Indigenous health professionals; and expanding the use of telehealth as a means of delivering cancer care and treatment.

“A Huge Gap”: Health Care Provider Perspectives on Cancer Screening for Aboriginal and Torres Strait Islander People in the Northern Territory

“…Several participants were concerned with the lack of access to screening and diagnostic services (such as mammograms and medical imaging), particularly in remote and very remote communities. Australians living in remote areas generally have poorer access to health care than those living in major cities [34], and the NT has poorer access to health services and cancer services compared to other jurisdictions in Australia [35]. Improved access to cancer screening is needed to improve cancer outcomes, particularly for remote, socially disadvantaged, or vulnerable populations [27,36,37], and this is a focus area in the recently published Australian Cancer Plan [38] and the Aboriginal and Torres Strait Islander Cancer Plan [39].…”

“…It is also vital to increase the number of Aboriginal health professionals working in PHC and supporting cancer screening in the NT. Aboriginal staff are critical to improving the cultural safety of health care and screening, and existing Aboriginal health staff need to be in a supportive and culturally safe workplace [35]. Again, the Australian Cancer Plan and the Aboriginal and Torres Strait Islander Cancer Plan both emphasize the importance of recruiting, training, and retaining a strong Aboriginal workforce across both primary healthcare and cancer care [38,39].…”

Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review

“…Aboriginal and Torres Strait Islander peoples experience disadvantage across a range of socioeconomic and health indicators, have lower average life expectancy, and are more likely to live in more remote areas than other Australians ( 2 ), with Australian oncology services typically concentrated in major cities ( 12 ). There is also a substantial travel burden for cancer patients in more remote areas to attend oncology care in cities ( 13 , 14 ). There is evidence that Aboriginal and Torres Strait Islander peoples face additional logistical, systemic, health system and social barriers, including perceptions about cancer and its treatment and a lack of culturally appropriate care ( 2 , 15 – 18 ) that likely contribute to disparate health outcomes.…”