Aims:
  • To investigate the patterns of care, quality of life, and comorbidities in Indigenous people with cancers and compare them with non-Indigenous cancer patients, and against clinical guidelines.

Objectives:
  • To identify factors that are modifiable (those related to health services).
Summary:

Despite a similar incidence of cancers, Indigenous Australians have higher mortality rates and poorer survival compared to other Australians. The reasons for this are multi-faceted and may be due to later cancer stage at diagnosis, reduced uptake of or access to treatment, increased comorbidities, and higher rates of more aggressive cancers, however, little is known about these.

Through medical chart reviews, we will investigate the patterns of care of a large cohort of Indigenous and non-Indigenous cancer patients to document and compare diagnostic, treatment and follow-up practices, and determinants of these.

Through qualitative interviews, the study will explore health care professionals' perspectives about Indigenous and non-Indigenous patients who commenced treatment to examine their clinical decision-making, particularly in the context of comorbidity, Indigeneity and geographical isolation from cancer care services; and those who did not commence treatment to examine their reasons for non-uptake or non-completion.

The study will also explore the patients' perspective about their treatment; their experiences and understanding of cancer and treatment choices, including reasons for uptake of specific treatment option.

Implications for policy and practice:

The experience of treatment and the quality of life for the cancer patient would improve if the deficiencies and inequities were addressed. Our results will transfer knowledge about coordination of care to policy and practice and will ultimately lead to improvements in the health of the increasing numbers of Indigenous people with cancer.

Our research has found:

Findings from the medical chart review work suggest that treatment, comorbidities and stage at diagnosis explain most of the poorer cancer outcomes among Indigenous patients. There is a need for a greater understanding of the reasons for delays in diagnosis, and to explain why less cancer treatments are provided (reduced uptake or access to treatment, or this is confounded by un/measured comorbidity). The effect of comorbidity on survival differences need to be fully quantified.

Data collection is under way for the qualitative arm of the study.

Chief Investigators:
Project Manager:
  • Associate Professor Patrica Valery
Project dates:

This project commenced in 2011 and will conclude in 2013.

Funders:
  • National Health and Medical Research Council (NHMRC)
 
  1. Mooi, J.K., Whop, L.J., Valery, P.C., & Sabesan, S.S. (2012). Teleoncology for Indigenous patients: the responses of patients and health workers. Australian Journal of Rural Health, 20(5), 265-269.
  2. Whop, L.J., Garvey, G., Lokuge, K., Mallitt, K.A., & Valery, P.C. (2012). Cancer support services – are they appropriate and accessible for Indigenous cancer patients in Queensland, Australia? Rural and Remote Health, 12, 2018.
  3. Moore, S.P., O’Rourke, P., Mallitt, K.A., Garvey, G., Green, A.C., Coory, M., & Valery, P.C. (2010). MJA paper; Cancer incidence and mortality in Indigenous Australians in Queensland, 1997-2006. Medical Journal of Australia, 193(10),590-3.