Are Aboriginal people more likely to be diagnosed with more advanced cancer?

Gibberd, Alison; Supramaniam, Rajah; Dillon, Anthony; Armstrong, Bruce K.; O’Connell, Dianne

doi:10.5694/mja14.00701

Cited by 24 publications

(20 citation statements)

References 15 publications

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“…Kelly et al 47 found that fewer crcs diagnosed in Alaska Native people were localized (30% vs. 38% in white U.S. patients), which could be related to lower screening rates; however, the percentages of individuals diagnosed with regional or distant-stage crc were more similar. In contrast, Gibberd et al 49 found no significant difference in stage at diagnosis for Australian Aboriginal people compared with non-Aboriginal people diagnosed with bca or crc.…”

Section: Discussionmentioning

confidence: 84%

Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

et al. 2016

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Section: Discussionmentioning

confidence: 84%

Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

et al. 2016

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“…Previous studies have similarly reported that Aboriginal peoples had more advanced stage [4–6, 20] but to our knowledge only one previous study in addition to ours has systematically examined cancer site-specific differences [19]. Age-stratified analyses indicated that the association between Aboriginal status and advanced stage tended to be stronger in younger age groups, however, interaction was not statistically significant.…”

Section: Discussionmentioning

confidence: 50%

“…In addition, available data indicate that Aboriginal peoples have a higher incidence of cancers with a poorer prognosis, reflecting differences in risk factor prevalence [17, 18]. Compared with non-Aboriginal people, Aboriginal peoples were more likely to be diagnosed with advanced stages for head and neck cancers [19], colon/rectum, breast, and cervix cancers, and non-Hodgkin lymphoma but not lung cancer [20]. Some studies have found lower survival among Aboriginal than non-Aboriginal people, even after adjustment for stage [4, 6, 9, 20], whereas other studies have indicated that the survival gap narrowed and became non-significant after adjustment for stage and other clinical factors [16] or after adjustment for comorbidities, socioeconomic disadvantage and remoteness [5].…”

Section: Introductionmentioning

confidence: 99%

After accounting for competing causes of death and more advanced stage, do Aboriginal and Torres Strait Islander peoples with cancer still have worse survival? A population-based cohort study in New South Wales

et al. 2017

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BackgroundAboriginal and Torres Strait Islander peoples in Australia have been found to have poorer cancer survival than non-Aboriginal people. However, use of conventional relative survival analyses is limited due to a lack of life tables. This cohort study examined whether poorer survival persist after accounting for competing risks of death from other causes and disparities in cancer stage at diagnosis, for all cancers collectively and by cancer site.MethodsPeople diagnosed in 2000–2008 were extracted from the population-based New South Wales Cancer Registry. Aboriginal status was multiply imputed for people with missing information (12.9%). Logistic regression models were used to compute odds ratios (ORs) with 95% confidence intervals (CIs) for ‘advanced stage’ at diagnosis (separately for distant and distant/regional stage). Survival was examined using competing risk regression to compute subhazard ratios (SHRs) with 95%CIs.ResultsOf the 301,356 cases, 2517 (0.84%) identified as Aboriginal (0.94% after imputation). After adjusting for age, sex, year of diagnosis, socio-economic status, remoteness, and cancer site Aboriginal peoples were more likely to be diagnosed with distant (OR 1.30, 95%CI 1.17–1.44) or distant/regional stage (OR 1.29, 95%CI 1.18–1.40) for all cancers collectively. This applied to cancers of the female breast, uterus, prostate, kidney, others (those not included in other categories) and cervix (when analyses were restricted to cases with known stages/known Aboriginal status). Aboriginal peoples had a higher hazard of death than non-Aboriginal people after accounting for competing risks from other causes of death, socio-demographic factors, stage and cancer site (SHR 1.40, 95%CI 1.31–1.50 for all cancers collectively). Consistent results applied to colorectal, lung, breast, prostate and other cancers.ConclusionsAboriginal peoples with cancer have an elevated hazard of cancer death compared with non-Aboriginal people, after accounting for more advanced stage and competing causes of death. Further research is needed to determine reasons, including any contribution of co-morbidity, lifestyle factors and differentials in service access to help explain disparities.

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“…“Between 2008 and 2012, Indigenous Australians were 1.3 times more likely to die from all cancers combined than non-Indigenous Australians” (Australian Institute of Health and Welfare [AIHW] & Australasian Association of Cancer Registries, 2014, p. 21). This is partly because Aboriginal and Torres Strait Islander peoples are more likely to be diagnosed with more advanced cancers—and particularly cancers with higher mortality rates (AIHW & Australasian Association of Cancer Registries, 2014; Gibberd, Supramaniam, Dillon, Armstrong, & O’Connell, 2015). …”

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confidence: 99%

Knowing, Being, and Doing: Aboriginal and Non-Aboriginal Collaboration in Cancer Services

Zubrzycki

Shipp

Jones³

2017

Qual Health Res

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This qualitative inquiry explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers. Each worker had participated, for a period of 2 to 5 years, in an Australian Government–funded project in which a range of health initiatives led to improved access to cancer services by Aboriginal communities in a rural region of South Eastern Australia. Initiatives which addressed high rates of mortality from cancer, poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Aboriginal health workers. These relationships were regarded as personally and professionally transformative. Through the sharing of knowledge, skills, and experiences, new ways of knowing, being, and doing emerged. Developing a deeper understanding of cross-cultural collaboration is one way of addressing complex health problems and building the capacity of the health workforce.

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Are Aboriginal people more likely to be diagnosed with more advanced cancer?

Cited by 24 publications

References 15 publications

Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

After accounting for competing causes of death and more advanced stage, do Aboriginal and Torres Strait Islander peoples with cancer still have worse survival? A population-based cohort study in New South Wales

Knowing, Being, and Doing: Aboriginal and Non-Aboriginal Collaboration in Cancer Services

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