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Factors Associated With Cancer-Specific and Overall Survival Among Indigenous and Non-Indigenous Gynecologic Cancer Patients in Queensland, Australia

Diaz, Abbey, Moore, Suzanne P., Martin, Jennifer, Green, Adele C., Garvey, Gail and Valery, Patricia C. (2015). Factors Associated With Cancer-Specific and Overall Survival Among Indigenous and Non-Indigenous Gynecologic Cancer Patients in Queensland, Australia. International Journal of Gynecological Cancer,25(3):542-547.

Document type: Journal Article
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IRMA ID 75039815xPUB842
Title Factors Associated With Cancer-Specific and Overall Survival Among Indigenous and Non-Indigenous Gynecologic Cancer Patients in Queensland, Australia
Author Diaz, Abbey
Moore, Suzanne P.
Martin, Jennifer
Green, Adele C.
Garvey, Gail
Valery, Patricia C.
Journal Name International Journal of Gynecological Cancer
Publication Date 2015
Volume Number 25
Issue Number 3
ISSN 1048-891X   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84924351639
Start Page 542
End Page 547
Total Pages 6
Place of Publication United Kingdom
Publisher Lippincott Williams & Wilkins, Ltd.
Field of Research 111701 - Aboriginal and Torres Strait Islander Health
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective: Aboriginal and Torres Strait Islander women have a higher mortality rate due to gynecologic cancer compared with non-Indigenous women. For cervical cancer, Australian Indigenous women are less likely to survive 5 years following diagnoses than non-Indigenous women. This study investigates the factors associated with gynecologic cancer treatment and survival among Queensland indigenous and non-Indigenous women.

Methods: Australian Indigenous women diagnosed with uterine, cervical, ovarian, or other gynecologic cancers during 1998–2004 in the public hospital system were included. They were frequency matched on age (±5 years), residential remoteness, and cancer type to a random sample of non-Indigenous women. One- and 5-year cancer-specific survival was examined according to Indigenous status using Cox proportional hazards regression.

Results: Indigenous women (n = 137) compared with non-Indigenous women (n = 120) were less likely to be diagnosed with localized disease (49% vs 65%, P = 0.02) and had more comorbidities (52% vs 21%, P < 0.001). Indigenous women were less likely to receive any cancer treatment compared with non-Indigenous women (91% vs 98%, P = 0.01), although when excluding those with metastatic cancer, there was no significant difference in uptake of treatment (95% vs 91%, respectively, P = 0.31). Among those who did undergo treatment, there was no difference in time to treatment (median difference 0.5 days, P = 0.98). Gynecologic cancer–specific survival differences between Indigenous and non-Indigenous women were most prominent in the first year following diagnosis (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.06–3.38) and were no longer significant 5 years after diagnosis (HR, 1.47 [95% CI, 0.97–2.25]). For cervical cancer, crude 1-year survival was poorer for Indigenous women compared with non-Indigenous women (HR, 2.46 [95% CI, 1.03–5.90]), but was no different when adjusted for stage and treatment of cancer (HR, 1.00 [95% CI, 0.45–2.24]).

Conclusions:
Improving the early diagnosis of cervical cancer in Indigenous women may increase cancer-specific survival in the year following diagnosis.

DOI http://dx.doi.org/10.1097/IGC.0000000000000375   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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