Oncology service initiatives and research in regional Australia

Abstract

The past decade has seen an expansion in cancer research in rural and regional Australia driven in part by the recognition that cancer patients in remote areas experience poorer outcomes than their metropolitan counterparts. This work has led to the development of more effective cancer networks and new models of care designed to meet the particular needs of the rural cancer patient. It is hoped that the growth of cancer research in regional centres will, in time, reduce the disparity between rural and urban communities and improve outcomes for cancer patients across both populations.

Variations in outcomes for Indigenous women with breast cancer in Australia: A systematic review

“…Although recent initiatives such as the establishment of Regional Cancer Centres (Murphy et al, 2015;Smith, 2012) should increase access to specialised services in regional Australia, geographical variations in access to multidisciplinary care remains a challenge. A multidisciplinary team approach to treatment planning is regarded as best practice and has been consistently shown to improve clinical outcomes for cancer patients (Prades, Remue, van Hoof, & Borras, 2015 (Cunningham et al, 2008;Kolahdooz et al, 2014;Miller et al, 2010;Tranberg et al, 2015).…”

“…Hence, other innovative strategies also need to be considered and explored, such as models of care that are specifically designed to address the social, cultural and treatment needs of Indigenous cancer patients. Additional approaches include cancer education programmes which support the role of Indigenous Health Workers (Le et al, 2013;Murphy et al, 2015;Smith, 2012;Whop et al, 2012;Zorbas & Elston, 2016), a key source of cancer information, health promotion and support for Indigenous patients undergoing cancer treatment (Bernardes et al, 2012). Studies from other countries have consistently attributed the well-documented poorer breast cancer survival (Dachs et al, 2008;DeSantis et al, 2014;Javid et al, 2014;Lawrenson et al, 2016;Nishri et al, 2015) in Indigenous populations to greater comorbidity burden, socioeconomic disadvantage, geographic location, cultural issues and variations in the timeliness, accessibility and quality of cancer services involving early detection, diagnosis and treatment (Javid et al, 2014;Kolahdooz et al, 2014;Lawrenson et al, 2016;Seneviratne et al, 2014;Tranberg et al, 2015).…”

“…Even though Australia has a publicly funded universal access health care system, its sheer geographical size and concentration of oncology services in major metropolitan centres (Underhill et al, 2009) means that a cancer diagnosis can present unique challenges for rural women including long travel distances and inadequate access to specialised care (AIHW, 2012a;Smith, 2012). The establishment of regional cancer centres over recent years and other local-level initiatives may help improve accessibility of cancer care in the long term for rural and Indigenous cancer patients (Murphy et al, 2015;Smith, 2012). However, additional logistic and cultural barriers, including perceptions about cancer detection and treatment and a lack of culturally appropriate care are also likely to impact on Indigenous people's utilisation of cancer care and treatment services (Cunningham, Rumbold, Zhang, & Condon, 2008;Kolahdooz et al, 2014;Miller et al, 2010;Tranberg et al, 2015).…”

“…Additional approaches include cancer education programmes which support the role of Indigenous Health Workers(Le et al, 2013;Murphy et al, 2015;Smith, 2012;Whop et al, 2012;Zorbas & Elston, 2016), a key source of cancer information, health promotion and support for Indigenous patients undergoing cancer treatment(Bernardes et al, 2012).While the review found consistent evidence for variations in breast cancer survival, studies reporting other outcomes were limited. Additional approaches include cancer education programmes which support the role of Indigenous Health Workers(Le et al, 2013;Murphy et al, 2015;Smith, 2012;Whop et al, 2012;Zorbas & Elston, 2016), a key source of cancer information, health promotion and support for Indigenous patients undergoing cancer treatment(Bernardes et al, 2012).While the review found consistent evidence for variations in breast cancer survival, studies reporting other outcomes were limited.…”

Patterns of care in patients with pancreatic cancer

“…14, 15 The reasons for survival disparities are unclear, although differences in access to treatment have been suggested. 16,17 There have been few attempts to describe management of pancreatic cancer in Australia. A population-based study in Victoria described under-utilisation of treatments but, apart from examining the association with age, they did not explore patient or health system factors that might influence treatment decisions.…”