Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality

Population Health Metrics

Tim Threlfall²  Paul L Jelfs⁷  Michael Coory⁴  David M Roder¹  Joan Cunningham³  Kalinda Griffiths⁵  Peter Baade⁸  Xiaohua Zhang⁶  John R Condon³ 

[1] University of South Australia, Adelaide, SA, Australia;Department of Health Western Australia, Western Australian Cancer Registry, Perth, WA, Australia;Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia;Murdoch Children’s Research Institute, University of Melbourne, Melbourne, Vic, Australia;University of Sydney, Sydney, NSW, Australia;Northern Territory Department of Health, Darwin, NT, Australia;Australian Bureau of Statistics, Canberra, ACT, Australia;Cancer Council Queensland, Brisbane, QLD, Australia

关键词: Cause-specific survival;    Relative survival;    Indigenous Australian;    Torres Strait Islander;    Australian Aboriginal;    Australia;    Survival;    Cancer;   

Others  :  802788
DOI  :  10.1186/1478-7954-12-1

 received in 2013-07-14, accepted in 2014-01-15,  发布年份 2014

【 摘 要 】

Background

National cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting.

Methods

We used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005.

Results

Survival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents.

Conclusions

Cancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people.

【 授权许可】

   
2014 Condon et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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