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Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality

Condon, John R., Zhang, Xiaohua, Baade, Peter D., Griffiths, Kalinda E., Cunningham, Joan, Roder, David M., Coory, Michael, Jelfs, Paul L. and Threlfall, Tim (2014). Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality. Population Health Metrics,12(Article No. 1).

Document type: Journal Article
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IRMA ID 11436xPUB13
NHMRC Grant No. 436014
545200
Title Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality
Author Condon, John R.
Zhang, Xiaohua
Baade, Peter D.
Griffiths, Kalinda E.
Cunningham, Joan
Roder, David M.
Coory, Michael
Jelfs, Paul L.
Threlfall, Tim
Journal Name Population Health Metrics
Publication Date 2014
Volume Number 12
Issue Number Article No. 1
ISSN 1478-7954   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84893202464
Total Pages 11
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract 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.
Keywords Cancer
Survival
Australia
Australian Aboriginal
Torres Strait Islander
Indigenous Australian
Relative survival
Cause-specific survival
DOI http://dx.doi.org/10.1186/1478-7954-12-1   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 2.0 License
URL https://creativecommons.org/licenses/by/2.0/au


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