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The impact of comorbidity on the survival and supportive care needs of Aboriginal and Torres Strait Islander Australians diagnosed with cancer

Diaz, Abbey (2018). The impact of comorbidity on the survival and supportive care needs of Aboriginal and Torres Strait Islander Australians diagnosed with cancer. Doctor of Philosophy Thesis, Charles Darwin University.

Document type: Thesis
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Author Diaz, Abbey
Title The impact of comorbidity on the survival and supportive care needs of Aboriginal and Torres Strait Islander Australians diagnosed with cancer
Institution Charles Darwin University
Publication Date 2018-04
Thesis Type Doctor of Philosophy
Supervisor Valery, Patricia C.
Subjects 1117 - Public Health and Health Services
Abstract Aboriginal and Torres Strait Islander people (respectfully referred hereafter as Indigenous Australians) have lower cancer survival, unique supportive care needs, and higher prevalence of chronic disease comorbidity than non-Indigenous Australians, but little is known about how comorbidity relates to survival and unmet supportive care needs for Indigenous Australians diagnosed with cancer.

This thesis contains a series of research papers that each contribute to the overarching goal of better understanding the relationship between the higher prevalence of comorbidity and cancer outcomes for Indigenous Australians, by addressing the studies’ primary, secondary, and tertiary research aims. These aims include:

 Primary aim: describe and compare the relationship between comorbidity and gynaecological cancer survival for Indigenous and non-Indigenous women, with a particular focus on cervical cancer survival.

 Secondary aim: examine the relationship between comorbidity and unmet supportive care needs for newly diagnosed Indigenous cancer patients in Queensland.

 Tertiary aims: (a) synthesise existing evidence on the relationship between comorbidity and women’s participation in cancer screening; and (b) assess the accuracy of patient self-reported comorbidity and treatment data in comparison to data collected from patients’ medical charts.

The principal finding arising from this thesis was that Indigenous people’s higher comorbidity burden contributed little to their lower cancer survival and unmet needs after diagnosis. While it remains essential that cancer services and program are equipped to provide timely, optimal, and culturally appropriate care to patients with complex needs, such as comorbidity, this finding highlights the need for primary care and acute cancer care services to better engage with and ensure access for all Indigenous people, even those without comorbidity who may be assumed to be relatively healthy.
Additional Notes Please note that some articles have been removed due to copyright restrictions.


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