Planning for the Best

Tripartite National Strategic Plan for Radiation Oncology 2012-2022

Indigenous Access to and Utilisation of Radiotherapy

Access Issues

There are inherent systemic problems and historical bias in the health care system concerning access to services for Indigenous peoples18. Research shows that there are disparities between the cancer treatments received by Indigenous and non-Indigenous Australians.

For example, a study on survival of Indigenous and non-Indigenous Queenslanders after a diagnosis of lung cancer18 has found that 46% of Indigenous patients received active treatment with chemotherapy, radiotherapy or surgery compared with 72% of non-Indigenous patients. The percentage of Indigenous patients who received radiotherapy was 31% compared to 42.8% for non-Indigenous patients. The study concluded that the differences in treatment between the two groups were mainly responsible for the difference in survival rates.

Stakeholder consultation during the development of this Plan highlighted concerns around the disadvantage experienced by Aboriginal and Torres Strait Islander patients in accessing radiotherapy services in a timely fashion.

The financial burden of cancer and the expenses associated with travel to receive treatments are a barrier to Indigenous patients living in rural and remote areas of Australia. These issues are explored in Supporting Regional and Rural Access to Radiation Oncology Services.

Published research and information on Aboriginal and Torres Strait Islander cancer patients from metropolitan areas appears to be very limited.

Cultural Considerations

There is limited availability of culturally appropriate educational resources for Aboriginal and Torres Strait Islander communities and patients with regards to cancer. As a result, awareness of cancer, including causes, prevention and treatment options, is limited.

Some research papers note that in certain communities patients believe that cancer is payback for offending a family member16 or as punishment for wrongdoings17 and a person who believes so would not seek treatment for cancer. Most Indigenous patients would prefer to be cared for by their community members.

In some communities, language has acted as a barrier to services as well. There are cultural and language variations across Indigenous communities in different geographical regions, and therefore cultural considerations must be tailored to suit local circumstances.

Compared to other areas in healthcare, oncology does not have a strong presence of workers with Aboriginal and Torres Strait Islander background who can bridge the language and cultural gaps. More emphasis needs to be placed on Aboriginal Liaison Officers within cancer –care facilities, including radiation oncology, to help culturally-appropriate service provision.

In the Northern Territory, initiatives in improving the understanding and uptake of radiotherapy treatment options and complementary support services have been given a boost with the establishment of the first radiation oncology facility in the Territory. These initiatives include: the development and integration of cancer knowledge into Aboriginal Health Worker (AHW) qualifications; the creation of placement opportunities for AHWs at the Cancer Care Centre; the production (and intended translation) of a DVD resource to explain and demystify radiation treatments; and continued promotion and evaluation of prevention messages21.