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Cancer in indigenous Australians in the Northern Territory of Australia

Condon, John R. (2004). Cancer in indigenous Australians in the Northern Territory of Australia. PhD Thesis, Charles Darwin University.

Document type: Thesis
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Author Condon, John R.
Title Cancer in indigenous Australians in the Northern Territory of Australia
Institution Charles Darwin University
Publication Date 2004
Thesis Type PhD
Subjects 1112 - Oncology and Carcinogenesis
1199 - Other Medical and Health Sciences
Abstract Compared to the whole Australian population, Indigenous Australians in the Northern Territory (NT) in 1991-2000 had higher mortality from lung and other smoking-related cancers, cervical and liver cancers, but lower mortality from cancers of the colon and rectum, breast, ovary, prostate, kidney, bladder, melanoma and lymphoma. For liver and lung cancers, higher mortality was almost entirely explained by higher incidence; survival is very low for all people with these cancers, Indigenous or otherwise. For cervical cancer, higher mortality was partly because of higher incidence and partly because of lower survival. For other cancers, Indigenous incidence rates were lower than the total Australian rate, but mortality rates were higher than expected because of lower survival for Indigenous people. Mortality rates from lung cancer and most smoking-related cancers increased between 1977 and 2000. Between 1991 and 2001, Indigenous incidence and mortality rates both increased for breast cancer but decreased for cervical cancer, although confidence intervals around trend estimates were wide; it will be several years before it can be confirmed whether these trends have been sustained. For cancers of the colon and rectum, breast, cervix and non-Hodgkin lymphoma, a higher proportion of Indigenous than non-Indigenous people had advanced disease at diagnosis, but for lung cancer the opposite was true. No explanation for the later diagnosis of cancer in Indigenous people was found among the factors examined in this study. Compared to non-Indigenous people, cancer survival was lower for all Indigenous people, and more so for those who spoke an Indigenous language as their first language ("Indigenous-language speakers") than for those who spoke English as their first language ("English- language speakers"). For English-language speakers, after adjustment for stage at diagnosis and cancer site, cancer survival was similar to that of non-Indigenous people. For Indigenous-language speakers lower cancer survival was partly due to these factors and partly due to deficiencies in cancer treatment, including being less likely to be recommended, to chose and to complete curative treatment. However, these factors did not fully explain the lower cancer survival of Indigenous-language speakers; other factors, which are distinctive features of these Indigenous people, were also involved and remain to be elucidated.

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