Exploring differences in survival from cancer among indigenous and non-indigenous australians: Implications for health service delivery and research

Alwin Chong, David Roder

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The aim of this study is to compare cancer survivals of Indigenous and non-Indigenous Australians and consider health-service and research implications Cancer registry data from South Australia were used to calculate disease-specific survivals for Indigenous (n=671) and sampled non-Indigenous (n=15,799) patients diagnosed during 1977-2007, using Kaplan-Meier estimates and Cox proportional hazards regression. Indigenous and non-Indigenous five-year survivals were respectively: 40% and 57% for all cancer sites combined; 61% and 80% for female breast; 34% and 56% for colon/rectum; and 63% and 73% for cervix; whereas one-year survivals for cancers of unknown primary site were 5% and 22% respectively. Conversely, although not statistically significant (p=0.262), lung cancer survival tended to be higher in Indigenous than non-Indigenous patients. For all sites combined, Indigenous patients had lower survivals up to 70-79 years. The relative risk of death in Indigenous compared with non-Indigenous patients was 2.0 after adjusting for socio-demographic factors and diagnostic period, reducing to 1.4 when also adjusting for prognosis by primary site. Relative risks were 3.7 and 2.7 respectively for Indigenous compared with non-Indigenous patients from Far North remote communities. We conclude that relative risks for Indigenous compared with non-Indigenous patients for all cancers combined are elevated, as seen in the Northern Territory and Queensland. Despite uncertain accuracy of recording of Indigenous status, independent studies show risk elevations and point to the need to prevent cancers, particularly those of high lethal potential, to detect cancers earlier, and to complete planned treatment. A concerted health-service response is needed to address contributing geographic, socio-economic and cultural factors.

LanguageEnglish
Pages953-961
Number of pages9
JournalAsian Pacific Journal of Cancer Prevention
Volume11
Issue number4
Publication statusPublished - 2010
Externally publishedYes

Keywords

  • 5 year survival
  • Cancer
  • Indigenous
  • Non-indigenous

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

Cite this

@article{f793b9ccbee846fa8c2749f1ec1fe08a,
title = "Exploring differences in survival from cancer among indigenous and non-indigenous australians: Implications for health service delivery and research",
abstract = "The aim of this study is to compare cancer survivals of Indigenous and non-Indigenous Australians and consider health-service and research implications Cancer registry data from South Australia were used to calculate disease-specific survivals for Indigenous (n=671) and sampled non-Indigenous (n=15,799) patients diagnosed during 1977-2007, using Kaplan-Meier estimates and Cox proportional hazards regression. Indigenous and non-Indigenous five-year survivals were respectively: 40{\%} and 57{\%} for all cancer sites combined; 61{\%} and 80{\%} for female breast; 34{\%} and 56{\%} for colon/rectum; and 63{\%} and 73{\%} for cervix; whereas one-year survivals for cancers of unknown primary site were 5{\%} and 22{\%} respectively. Conversely, although not statistically significant (p=0.262), lung cancer survival tended to be higher in Indigenous than non-Indigenous patients. For all sites combined, Indigenous patients had lower survivals up to 70-79 years. The relative risk of death in Indigenous compared with non-Indigenous patients was 2.0 after adjusting for socio-demographic factors and diagnostic period, reducing to 1.4 when also adjusting for prognosis by primary site. Relative risks were 3.7 and 2.7 respectively for Indigenous compared with non-Indigenous patients from Far North remote communities. We conclude that relative risks for Indigenous compared with non-Indigenous patients for all cancers combined are elevated, as seen in the Northern Territory and Queensland. Despite uncertain accuracy of recording of Indigenous status, independent studies show risk elevations and point to the need to prevent cancers, particularly those of high lethal potential, to detect cancers earlier, and to complete planned treatment. A concerted health-service response is needed to address contributing geographic, socio-economic and cultural factors.",
keywords = "5 year survival, Cancer, Indigenous, Non-indigenous",
author = "Alwin Chong and David Roder",
year = "2010",
language = "English",
volume = "11",
pages = "953--961",
journal = "Asian Pacific Journal of Cancer Prevention",
issn = "1513-7368",
publisher = "Asian Pacific Organization for Cancer Prevention",
number = "4",

}

TY - JOUR

T1 - Exploring differences in survival from cancer among indigenous and non-indigenous australians

T2 - Asian Pacific Journal of Cancer Prevention

AU - Chong, Alwin

AU - Roder, David

PY - 2010

Y1 - 2010

N2 - The aim of this study is to compare cancer survivals of Indigenous and non-Indigenous Australians and consider health-service and research implications Cancer registry data from South Australia were used to calculate disease-specific survivals for Indigenous (n=671) and sampled non-Indigenous (n=15,799) patients diagnosed during 1977-2007, using Kaplan-Meier estimates and Cox proportional hazards regression. Indigenous and non-Indigenous five-year survivals were respectively: 40% and 57% for all cancer sites combined; 61% and 80% for female breast; 34% and 56% for colon/rectum; and 63% and 73% for cervix; whereas one-year survivals for cancers of unknown primary site were 5% and 22% respectively. Conversely, although not statistically significant (p=0.262), lung cancer survival tended to be higher in Indigenous than non-Indigenous patients. For all sites combined, Indigenous patients had lower survivals up to 70-79 years. The relative risk of death in Indigenous compared with non-Indigenous patients was 2.0 after adjusting for socio-demographic factors and diagnostic period, reducing to 1.4 when also adjusting for prognosis by primary site. Relative risks were 3.7 and 2.7 respectively for Indigenous compared with non-Indigenous patients from Far North remote communities. We conclude that relative risks for Indigenous compared with non-Indigenous patients for all cancers combined are elevated, as seen in the Northern Territory and Queensland. Despite uncertain accuracy of recording of Indigenous status, independent studies show risk elevations and point to the need to prevent cancers, particularly those of high lethal potential, to detect cancers earlier, and to complete planned treatment. A concerted health-service response is needed to address contributing geographic, socio-economic and cultural factors.

AB - The aim of this study is to compare cancer survivals of Indigenous and non-Indigenous Australians and consider health-service and research implications Cancer registry data from South Australia were used to calculate disease-specific survivals for Indigenous (n=671) and sampled non-Indigenous (n=15,799) patients diagnosed during 1977-2007, using Kaplan-Meier estimates and Cox proportional hazards regression. Indigenous and non-Indigenous five-year survivals were respectively: 40% and 57% for all cancer sites combined; 61% and 80% for female breast; 34% and 56% for colon/rectum; and 63% and 73% for cervix; whereas one-year survivals for cancers of unknown primary site were 5% and 22% respectively. Conversely, although not statistically significant (p=0.262), lung cancer survival tended to be higher in Indigenous than non-Indigenous patients. For all sites combined, Indigenous patients had lower survivals up to 70-79 years. The relative risk of death in Indigenous compared with non-Indigenous patients was 2.0 after adjusting for socio-demographic factors and diagnostic period, reducing to 1.4 when also adjusting for prognosis by primary site. Relative risks were 3.7 and 2.7 respectively for Indigenous compared with non-Indigenous patients from Far North remote communities. We conclude that relative risks for Indigenous compared with non-Indigenous patients for all cancers combined are elevated, as seen in the Northern Territory and Queensland. Despite uncertain accuracy of recording of Indigenous status, independent studies show risk elevations and point to the need to prevent cancers, particularly those of high lethal potential, to detect cancers earlier, and to complete planned treatment. A concerted health-service response is needed to address contributing geographic, socio-economic and cultural factors.

KW - 5 year survival

KW - Cancer

KW - Indigenous

KW - Non-indigenous

UR - http://www.scopus.com/inward/record.url?scp=78650707748&partnerID=8YFLogxK

M3 - Article

VL - 11

SP - 953

EP - 961

JO - Asian Pacific Journal of Cancer Prevention

JF - Asian Pacific Journal of Cancer Prevention

SN - 1513-7368

IS - 4

ER -