Aboriginal children with cancer: The patient and healthcare worker perspective

Jessop, Sophie; Hill, Shandelle; Bicanin, Kon; Day, Tanya; Turner, Jess; O'Connell, Megan; Highfold, Rose; Revesz, Tom

doi:10.1002/pbc.30747

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Indigenous Australians represent 3.3% of the total Australian population, but 26.3% of the NT population [ 16 ]. Indigenous Australians experience barriers in accessing cancer health care stemming from geographic remoteness of residence, low socio-economic status, racism in health care services and a lack of culturally appropriate and coordinated cancer care [ 27 , 28 , 29 ]. Corresponding disparities in cancer health outcomes for Indigenous Australians have persisted over decades, prompting a strong focus of achieving equity in cancer outcomes for Indigenous Australians within the new Australian Cancer Plan and the Aboriginal and Torres Strait Islander Cancer Plan [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Childhood Cancer Incidence and Survival in South Australia and the Northern Territory, 1990–2017, with Emphasis on Indigenous Peoples

Mashtoub,

Ullah,

Collinson

et al. 2024

Cancers

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Background & Aims: Reports of a rise in childhood cancer incidence in Australia and globally prompted the investigation of cancer incidence and survival in South Australia (SA) and the Northern Territory (NT) over a 28-year period, with emphasis on Indigenous peoples. Methods: This cross-sectional analysis of two prospective longitudinal databases, the SA and NT Cancer Registries (1990–2017), included all reported cases of childhood cancers. Poisson regression provided estimates of incidence rate ratios and survival was modelled using Cox proportional hazard models for children aged <5 and ≥5 years. Results: A total of 895 patients across SA (N = 753) and the NT (N = 142) were ascertained. Overall and in the NT, childhood cancer incidence was higher in males compared with females (IRR 1.19 [1.04–1.35] and 1.43 [1.02–2.01], respectively). Lymphocytic leukemia was the most reported cancer type across all locations. With reference to the 1990–1999 era (181.67/100,000), cancer incidence remained unchanged across subsequent eras in the combined cohort (SA and NT) (2000–2009: 190.55/100,000; 1.06 [0.91–1.25]; 2010–2017: 210.00/100,000; 1.15 [0.98–1.35]); similar outcomes were reflected in SA and NT cohorts. Cancer incidence amongst non-Indigenous children significantly decreased from the 1990–1999 era (278.32/100,000) to the 2000–2009 era (162.92/100,000; 0.58 [0.35–0.97]). Amongst 39 Indigenous children in the NT, incidence rates remained unchanged across eras (p > 0.05). With reference to the 1990–1999 era, overall survival improved in subsequent eras in SA (2000–2009: HR 0.53 [0.38–0.73]; 2010–2017: 0.44 [0.28–0.68]); however, remained unchanged in the NT (2000–2009: 0.78 [0.40–1.51]; 2010–2017: 0.50 [0.24–1.05]). In the NT, overall survival of Indigenous patients was significantly lower compared with the non-Indigenous cohort (3.42 [1.92–6.10]). While the survival of Indigenous children with cancer significantly improved in the last two eras (p < 0.05), compared to the 1990–1999 era, no change was noted amongst non-Indigenous children in the NT (p > 0.05). Conclusions: The incidence of childhood cancers has remained unchanged over 28-years in SA and the NT. Encouragingly, improved survival rates over time were observed in SA and amongst Indigenous children of the NT. Nevertheless, survival rates in Indigenous children remain lower than non-Indigenous children.

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Section: Discussionmentioning

confidence: 99%

Childhood Cancer Incidence and Survival in South Australia and the Northern Territory, 1990–2017, with Emphasis on Indigenous Peoples

Mashtoub,

Ullah,

Collinson

et al. 2024

Cancers

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Towards precision cancer medicine for Aboriginal and Torres Strait Islander cancer health equity

Clark (Adnyamathanha),

Buck (Kamilaroi),

Richards‐Satour (Adnyamathanha and Barngarla)

et al. 2024

Medical Journal of Australia

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Summary Delivering cancer control at scale for Aboriginal and Torres Strait Islander communities is a national priority that requires Aboriginal and Torres Strait Islander leadership and codesign, as well as significant involvement of the Aboriginal community‐controlled health sector. The unique genomic variation observed among Aboriginal and Torres Strait Islander peoples may have implications for standard and precision medicine. Yet, Aboriginal and Torres Strait Islander peoples are absent from, or under‐represented within, human reference genome resources, genomic studies, cancer studies, cancer cell lines, patient‐derived xenografts and cancer clinical trials. Genomics‐guided precision cancer medicine offers an opportunity to reduce cancer health disparities experienced by Aboriginal and Torres Strait Islander peoples through personalising prevention, diagnosis, treatment and long term management. Here, we describe what is required to ensure that Aboriginal and Torres Strait Islander peoples can receive the benefits of precision cancer medicine. Equity of access to care, an Aboriginal and Torres Strait Islander cancer workforce, and appropriate genome reference resources are important for safe and effective cancer medicine. Building Indigenous data sovereignty principles and Aboriginal and Torres Strait Islander governance into research is required to protect Aboriginal and Torres Strait Islander rights and collective interests. Aboriginal and Torres Strait Islander community engagement should be undertaken to develop an understanding of the unique cultural and ethical considerations for precision cancer research. Local and national genomic health research guidelines are needed to define a consensus best practice in genomics research with Aboriginal and Torres Strait Islander peoples.

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Aboriginal children with cancer: The patient and healthcare worker perspective

Cited by 2 publications

References 13 publications

Childhood Cancer Incidence and Survival in South Australia and the Northern Territory, 1990–2017, with Emphasis on Indigenous Peoples

Childhood Cancer Incidence and Survival in South Australia and the Northern Territory, 1990–2017, with Emphasis on Indigenous Peoples

Towards precision cancer medicine for Aboriginal and Torres Strait Islander cancer health equity

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