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The first year counts: cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006

Cramb, Susanna M., Garvey, Gail, Valery, Patricia C., Williamson, John D. and Baade, Peter D. (2012). The first year counts: cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006. Medical Journal of Australia,196(4):270-274.

Document type: Journal Article
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IRMA ID cspargoxPUB17
NHMRC Grant No. 1005334
Title The first year counts: cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006
Author Cramb, Susanna M.
Garvey, Gail
Valery, Patricia C.
Williamson, John D.
Baade, Peter D.
Journal Name Medical Journal of Australia
Publication Date 2012
Volume Number 196
Issue Number 4
ISSN 1326-5377   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84857876240
Start Page 270
End Page 274
Total Pages 4
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.

Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.

Main outcome measures:
Hazard ratios for the categories of area-socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.

Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous people (61.9%; 95% CI, 61.7%–62.2%). There was no evidence that this differential varied by remoteness (P = 0.780) or area-socioeconomic disadvantage (P = 0.845). However, it did vary by time after diagnosis. In a time-varying survival model stratified by age, sex and cancer type, the 50% excess mortality in the first year (adjusted HR, 1.50; 95% CI, 1.38–1.63) reduced to near unity at 2 years after diagnosis (HR, 1.03; 95% CI, 0.78–1.35).

Conclusions: After a wide disparity in cancer survival in the first 2 years after diagnosis, Indigenous patients with cancer who survive these 2 years have a similar outlook to non-Indigenous patients. Access to services and socioeconomic factors are unlikely to be the main causes of the early lower Indigenous survival, as patterns were similar across remoteness and area-socioeconomic disadvantage. There is an urgent need to identify the factors leading to poor outcomes early after diagnosis among Indigenous people with cancer.
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