Aims:
  • To identify areas for improvement to cancer care for Indigenous Australians.
Objectives:
  • To determine the extent to which Indigenous patients receive less than ideal curative treatment compared to non-Indigenous patients
  • To identify how survival compares for those who do and do not receive recommended care, if this varies by age, sex and urban/rural/remote residence and if it is this changing over time,
Summary:

Cancer survival is lower for Indigenous than other Australians; two local studies indicated that fewer Indigenous patients received recommended treatment. Intensive patterns of care studies are currently being undertaken for Indigenous patients in Queensland and New South Wales.

This work includes:

  • examining variability in treatment for the main cancer groups (e.g. breast, lung, colorectal and cervix), looking specifically at timing and type of treatment, and adherence to clinical practice guidelines
  • investigating the ways in which Indigenous people with cancer make decisions about their treatment, including uptake, completion and cessation
  • examining the role of social/cultural issues in decision-making; exploring the views of patients, carers and health professionals about the barriers and facilitators to accessing appropriate treatment
  • examining the influence of co-morbidities (presence, number, severity) on treatment decision-making and treatment outcomes
  • investigating the use of community and allied health cancer services, and the clinical and socio-demographic factors that influence their use.

The methods used in these funded studies require substantial resources, and it may not be appropriate (or necessary) to replicate these in other jurisdictions. However, it is feasible and useful to replicate key aspects of this work using existing and linked datasets to assess the similarities/differences across Australia. The involvement of the AIs from New Zealand, Canada and the USA will provide a further opportunity to compare our results with those in Indigenous populations elsewhere.

Implications for policy and practice:

National data on the treatment of cancer for Indigenous people will be available for the first time. Areas for improvement in care (with references to guidelines and benchmarks) will be identified, and this information will help direct future work of the Centre for Research Excellence DISCOVER-TT.

Our research has found: 

Researchers from Discover-TT will conduct a systematic literature review of patterns of cancer care for Aboriginal and Torres Strait Islander in Australia and Maori people in New Zealand.

The review follows on from a preliminary assessment conducted by Dr Suzanne Moore on behalf of Discover-TT, which identified a dearth of knowledge surrounding cancer treatment for Indigenous people. 

The review will be a collaborative effort between DISCOVER-TT researchers from NSW, Queensland and New Zealand, namely Dianne O’Connell, Rajah Supramaniam, Diana Sarfati, Joan Cunningham, Patricia Valery and Suzanne Moore.

One face-to-face meeting and one teleconference have been held to define the scope and methods of the review which is expected to be completed by February 2015.

Chief investigators:
  • Professor Dianne O’Connell, Cancer Council New South Wales
Project manager:
  • Professor Dianne O’Connell
Contact information:
Project dates:

2013 - 2015.

Collaborators:
  • Cancer Council New South Wales
  • James Cook University
  • Queensland Health
  • University of Otago, New Zealand
  • Australian Indigenous HealthInfoNet.

Chief and associate investigators: