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

Journal Article


Abstract


  • Background: Aboriginal Australians have higher cancer mortality than non-Aboriginal Australians. Lower rates of cancer treatment among Aboriginal people can contribute to this. Aims: To investigate demographic, clinical and access factors associated with lung, breast and bowel cancer treatment for Aboriginal people compared with non-Aboriginal people in New South Wales, Australia. Methods: Population-based cohort study using linked routinely collected datasets, including all diagnoses of primary lung, breast or bowel cancer from January 2009 to June 2012. Treatment (surgery, radiotherapy or chemotherapy) within 6 months from diagnosis was measured. Access was measured using minimum distance to radiotherapy or hospital with a cancer-specific multidisciplinary team, visit to a specialist and possession of private health insurance. Logistic regression modelling was employed. Results: There were 587 Aboriginal and 34 015 non-Aboriginal people diagnosed with cancer. For lung cancer, significantly fewer Aboriginal than non-Aboriginal people received surgery (odds ratio 0.46, 95% confidence interval 0.29���0.73, P < 0.001) or any treatment (surgery, chemotherapy or radiotherapy; odds ratio 0.64, 95% confidence interval 0.47���0.88, P = 0.006) after adjusting for sex, age, disease extent and comorbidities. They were less likely to have an attendance with a surgeon (27.0%, 62/230 vs 33.3%, 2865/8597, P = 0.04) compared with non-Aboriginal people. There were no significant differences in cancer treatment for Aboriginal people compared with non-Aboriginal people for breast or bowel cancers after adjusting for patient sex, age, disease extent and comorbidities. Conclusion: Aboriginal people were significantly less likely to receive surgery for lung cancer than non-Aboriginal people and had fewer attendances with a surgeon, suggesting a need to strengthen referral pathways.

Publication Date


  • 2021

Citation


  • Fitzadam, S., Lin, E., Creighton, N., & Currow, D. C. (2021). Lung, breast and bowel cancer treatment for Aboriginal people in New South Wales: a population-based cohort study. Internal Medicine Journal, 51(6), 879-890. doi:10.1111/imj.14967

Scopus Eid


  • 2-s2.0-85104316255

Start Page


  • 879

End Page


  • 890

Volume


  • 51

Issue


  • 6

Place Of Publication


Abstract


  • Background: Aboriginal Australians have higher cancer mortality than non-Aboriginal Australians. Lower rates of cancer treatment among Aboriginal people can contribute to this. Aims: To investigate demographic, clinical and access factors associated with lung, breast and bowel cancer treatment for Aboriginal people compared with non-Aboriginal people in New South Wales, Australia. Methods: Population-based cohort study using linked routinely collected datasets, including all diagnoses of primary lung, breast or bowel cancer from January 2009 to June 2012. Treatment (surgery, radiotherapy or chemotherapy) within 6 months from diagnosis was measured. Access was measured using minimum distance to radiotherapy or hospital with a cancer-specific multidisciplinary team, visit to a specialist and possession of private health insurance. Logistic regression modelling was employed. Results: There were 587 Aboriginal and 34 015 non-Aboriginal people diagnosed with cancer. For lung cancer, significantly fewer Aboriginal than non-Aboriginal people received surgery (odds ratio 0.46, 95% confidence interval 0.29���0.73, P < 0.001) or any treatment (surgery, chemotherapy or radiotherapy; odds ratio 0.64, 95% confidence interval 0.47���0.88, P = 0.006) after adjusting for sex, age, disease extent and comorbidities. They were less likely to have an attendance with a surgeon (27.0%, 62/230 vs 33.3%, 2865/8597, P = 0.04) compared with non-Aboriginal people. There were no significant differences in cancer treatment for Aboriginal people compared with non-Aboriginal people for breast or bowel cancers after adjusting for patient sex, age, disease extent and comorbidities. Conclusion: Aboriginal people were significantly less likely to receive surgery for lung cancer than non-Aboriginal people and had fewer attendances with a surgeon, suggesting a need to strengthen referral pathways.

Publication Date


  • 2021

Citation


  • Fitzadam, S., Lin, E., Creighton, N., & Currow, D. C. (2021). Lung, breast and bowel cancer treatment for Aboriginal people in New South Wales: a population-based cohort study. Internal Medicine Journal, 51(6), 879-890. doi:10.1111/imj.14967

Scopus Eid


  • 2-s2.0-85104316255

Start Page


  • 879

End Page


  • 890

Volume


  • 51

Issue


  • 6

Place Of Publication