Comparing colorectal cancer treatment and survival for Aboriginal and non‐Aboriginal people in New South Wales

Abstract

Objectives: Our aim was to compare surgical treatment rates and survival rates for Aboriginal and non‐Aboriginal people in New South Wales with colorectal cancer, and to describe the medical treatment received by a sample of Aboriginal people with colorectal cancer. Design, setting and participants: All people diagnosed with colorectal cancer in NSW during 2001–2007 were identified and their cancer registry records linked to hospital admissions data and death records. A medical records audit of a sample of Aboriginal people diagnosed with colorectal cancer during 2000–2011 was also conducted. Main outcome measures: Cause‐specific survival, odds of surgical treatment, and the proportions of people receiving adjuvant treatments. Results: Of 29 777 eligible colorectal cancer cases, 278 (0.9%) involved Aboriginal people. Similar proportions of Aboriginal (76%) and non‐Aboriginal (79%) people had undergone surgical treatment. Colorectal cancer‐specific survival was similar for Aboriginal and non‐Aboriginal people up to 18 months after diagnosis, but 5 years post‐diagnosis the risk of death for Aboriginal people who had had surgical treatment was 68% higher than for non‐Aboriginal people (adjusted hazards ratio, 1.68; 95% CI, 1.32–2.09). Of 145 Aboriginal people with colorectal cancer identified by the medical records audit, 117 (81%) had undergone surgery, and 56 (48%) had also received adjuvant chemotherapy and/or radiotherapy. Conclusions: Aboriginal people with colorectal cancer had poorer survival rates than non‐Aboriginal people, although rates of surgical treatment, complications and follow‐up colonoscopy were similar. More work is needed to identify and understand why outcomes for Aboriginal people with colorectal cancer are different from those of other New South Wales residents.

Lung, breast and bowel cancer treatment for Aboriginal people in New South Wales: a population‐based cohort study

“…For bowel cancer, our results strengthen findings from an earlier population‐based study in NSW that found similar surgery rates between Aboriginal and non‐Aboriginal bowel cancer patients during 2001–2007 14 . That study reported that adjuvant chemotherapy and radiotherapy use for Aboriginal people, based on a medical record review of a sample of Aboriginal people diagnosed 2001–2010 ( n = 145), was the same as that reported in NSW population‐based treatment pattern surveys.…”

“…In New South Wales (NSW), Aboriginal people were less likely to receive surgery than non‐Aboriginal people for non‐metastatic non‐small cell lung cancer, 13 breast cancer 8 and localised or regional prostate cancer 9 . Similar surgery rates were observed between Aboriginal and non‐Aboriginal people for colorectal cancer 14 . Cancer treatment can be complex, requiring consultation with specialists and treatment in specialist centres.…”

Mortalidade por câncer em populações indígenas no Estado do Acre, Brasil

“…Câncer colorretal está entre as principais causas de óbito em populações nativas de países desenvolvidos 31,58,59,60,61 . Disparidades étnicas traduzidas em diagnóstico tardio e pior sobrevida desse câncer foram observadas entre indígenas em comparação a populações não indígenas 62,63,64,65 . No presente estudo, a maior mortalidade entre homens indígenas, tendo como referência a população masculina do Acre e da Região Norte, sugere menor acesso ao diagnóstico e tratamento precoce da doença.…”

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

“…[17][18][19] Aboriginal and Torres Strait Islander people in Australia (respectfully referred to here as Indigenous Australians) comprise 3% of the total Australian population, 20 and experience socioeconomic and health disparities. [18][19][20]23,26,27 In Australia, the availability of health services generally decreases with increase in remoteness. 22 Compared with mainstream Australia, they experience marked disparities in cancer mortality 23 and survival, 18,19,24 which are largely attributed to being diagnosed later, 18,19,25 receiving less treatment 18,19 and experiencing higher rates of comorbidities.…”

“…22 Compared with mainstream Australia, they experience marked disparities in cancer mortality 23 and survival, 18,19,24 which are largely attributed to being diagnosed later, 18,19,25 receiving less treatment 18,19 and experiencing higher rates of comorbidities. [18][19][20]23,26,27 In Australia, the availability of health services generally decreases with increase in remoteness. [28][29][30] As a higher proportion of Indigenous Australians live in rural areas, 20 together with other Australians they have worse cancer outcomes than those living in major cities.…”