Planning for the Best

Tripartite National Strategic Plan for Radiation Oncology 2012-2022

Cancer Impact on the Indigenous Population

A recent study found that cancer was responsible for 18% of total deaths among Indigenous Australians11. Although cancer death rates were similar for Indigenous and non-Indigenous Australians aged less than 35 years or 65 years and over, Indigenous Australians in the middle age groups had higher mortality rates than non Indigenous Australians11. The study concluded that a difference in treatment between the two groups was mainly responsible for lower survival rate among Indigenous Australians.

The Rural Doctors Association in their submission to the Tripartite Committee stated that Indigenous Australians with cancer are twice more likely to die within five years of diagnosis than non-Indigenous Australians and urgent action is required to improve Indigenous access to multidisciplinary cancer care12.

Indigenous people are more likely to be diagnosed with cancers that have a lower survival rate than non-Indigenous people. A recent publication, reported that compared to other Australians, Indigenous Australians had much higher incidence of lung and other smoking-related cancers, cervix, uterus and liver cancer, but much lower incidence of breast, prostate, testis, colorectal and brain cancer, melanoma of skin, lymphoma and leukaemia. Incidence was higher in remote areas for some cancers (including several smoking-related cancers) but lower for others. The incidence rate ratios (IRRs) for smoking-related cancers were higher in younger than older people (Xiahua, Z and Condon, J. Est. cancer incidence in Indigenous Australians, 2011).

Cancer survival is lower for Indigenous than other Australians; two local studies indicated that fewer Indigenous patients received recommended treatment5,6,23.

A study from Queensland concluded that the lower survival rate for Indigenous patients is within the first two years after diagnosis and that the outlook for those who survive the first two years had a similar outlook to non-Indigenous people. This study has shown no disparity among people in relation to socio economic or remoteness factors13.

Some research indicates that clinical under-staging and non-staging of cancer in Indigenous patients could be linked to socioeconomic factors or lack of access to care as well as to possible physician bias15.

Lower participation rate in cancer screening programs among Indigenous Australians is a factor that leads to late diagnosis of cancer. For many patients, this is exacerbated by the limited access to care or patient preferences regarding treatments (especially in rural areas).

Data collection, and in particular consistent use of an Indigenous identifier, has improved in recent years but remains variable across the health jurisdictions. Nationally, the data is not adequate to enable analysis of the overall trends in cancer among the Indigenous population and their access to radiotherapy.