TY - JOUR
T1 - Cancer survival for Aboriginal and Torres Strait Islander Australians
T2 - A national study of survival rates and excess mortality
AU - Condon, John R.
AU - Zhang, Xiaohua
AU - Baade, Peter
AU - Griffiths, Kalinda
AU - Cunningham, Joan
AU - Roder, David M.
AU - Coory, Michael
AU - Jelfs, Paul L.
AU - Threlfall, Tim
N1 - Funding Information:
This study was funded by NHMRC project grant number 436014. Joan Cunningham was supported by NHMRC Fellowship number 545200. The funding body was not involved in: study design; collection, analysis, or interpretation of data; writing the manuscript; or the decision to submit the manuscript for publication. We thank state and territory Cancer Registries and the Australian Institute of Health and Welfare for access to cancer registrations data.
PY - 2014/1/31
Y1 - 2014/1/31
N2 - Background: National cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting.Methods: We used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005.Results: Survival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents.Conclusions: Cancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people.
AB - Background: National cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting.Methods: We used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005.Results: Survival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents.Conclusions: Cancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people.
KW - Australia
KW - Australian Aboriginal
KW - Cancer
KW - Cause-specific survival
KW - Indigenous Australian
KW - Relative survival
KW - Survival
KW - Torres Strait Islander
UR - http://www.scopus.com/inward/record.url?scp=84893202464&partnerID=8YFLogxK
U2 - 10.1186/1478-7954-12-1
DO - 10.1186/1478-7954-12-1
M3 - Article
AN - SCOPUS:84893202464
SN - 1478-7954
VL - 12
JO - Population Health Metrics
JF - Population Health Metrics
IS - 1
M1 - 1
ER -