What is known?
Australian Aboriginal and Torres Strait Islander people diagnosed with cancer are known to experience poorer survival, with these survival disparities mainly restricted to the first two years after diagnosis. With improved accuracy and completeness of identifying Aboriginal and Torres Strait Islander peoples over the whole study period, our goal was to examine whether the survival disparity among Aboriginal and Torres Strait Islander peoples diagnosed with cancer in Queensland has changed over time.
What is new?
On average, cancer survival among Aboriginal and Torres Strait Islander cancer patients in Queensland has increased between 1998-2007 and 2008-2017, however they still experience lower survival compared to other Queensland cancer patients.
After adjustment for age at diagnosis, sex, remoteness, area-disadvantage and broad survival-based cancer categories, the five-year cancer-specific survival rate for Aboriginal and Torres Strait Islander people diagnosed with cancer increased from 61% in 1998-2007 to 66% in 2008-2017. Over the same period, the corresponding survival estimates for other Queenslanders diagnosed with cancer were 67% and 70%. This resulted in average hazard ratios over the five-year interval after diagnosis of 1.45 for 1998-2007 and 1.42 for 2008-2017.
During 1998-2007, the survival disparity was more pronounced soon after diagnosis. In the latter time period, 2008-2017, the survival disparity has expanded so it is now evident up to the fifth year after diagnosis.
What does this mean?
While previous messaging of “the first year counts” for Aboriginal and Torres Strait Islander patients is still relevant, these results highlight how the subsequent follow-up years after a diagnosis of cancer also require important attention.
There is an urgent need to better understand the complex and multifaceted factors that underlie this gap, including the potential role of co-morbidities, behavioural risk factors, cancer screening and diagnostic pathways, and treatment patterns. These factors can be used to guide targeted, evidence-based interventions, and to motivate the high levels of support and commitment that will be required for these interventions to be implemented across the health sector.
Contact: Peter Baade
Reference: Peng Y, Baade P. Survival disparities among recently diagnosed Aboriginal and Torres Strait Islander cancer patients in Australia remain. Cancer Causes and Control. 2021. doi: https://doi.org/10.1007/s10552-021-01474-6.