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Survival of indigenous and non-Indigenous Queenslanders after a diagnosis of lung cancer: a matched cohort study

Coory, Michael D., Green, Adele C., Stirling, Janelle and Valery, Patricia C. (2008). Survival of indigenous and non-Indigenous Queenslanders after a diagnosis of lung cancer: a matched cohort study. Medical Journal of Australia,188(10):562-566.

Document type: Journal Article
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IRMA ID 75039815xPUB385
Title Survival of indigenous and non-Indigenous Queenslanders after a diagnosis of lung cancer: a matched cohort study
Author Coory, Michael D.
Green, Adele C.
Stirling, Janelle
Valery, Patricia C.
Journal Name Medical Journal of Australia
Publication Date 2008
Volume Number 188
Issue Number 10
ISSN 0025-729X   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-47049116448
Start Page 562
End Page 566
Total Pages 5
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective: To compare survival of Indigenous and non-Indigenous lung cancer patients and to investigate any corresponding differences in stage, treatment and comorbidities.

Design and setting:
Cohort study of 158 Indigenous and 152 non-Indigenous patients (frequency-matched on age, sex and rurality) diagnosed with lung cancer between 1996 and 2002 and treated in Queensland public hospitals.

Main outcome measures:
Survival after diagnosis of lung cancer; effects of stage at diagnosis, treatment, comorbidities and histological subtype on lung cancer-specific survival.

Survival of Indigenous lung cancer patients was significantly lower than that of non-Indigenous patients (median survival, 4.3 v 10.3 months; hazard ratio, 1.48; 95% CI, 1.14–1.92). Of 158 Indigenous patients, 72 (46%) received active treatment with chemotherapy, radiotherapy or surgery compared with 109 (72%) of the 152 non-Indigenous patients, and this treatment disparity remained after adjusting for histological subtype, stage at diagnosis, and comorbidities (adjusted risk ratio, 0.65; 95% CI, 0.53–0.73). The treatment disparity explained most of the survival deficit: the hazard ratio reduced to 1.10 (95% CI, 0.83–1.44) after inclusion of treatment variables in the proportional hazards survival model. The remaining survival deficit was explained by the higher prevalence of comorbidities among Indigenous cancer patients, mainly diabetes.

Conclusion: Survival after a diagnosis of lung cancer is worse for Indigenous patients than for non-Indigenous patients, and differences in treatment between the two groups are mainly responsible.

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