Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review

descriptive epidemiology

What is known?

Aboriginal and Torres Strait Islander peoples continue to experience poorer cancer survival than other Australians. Key drivers of these disparities are not well understood.

This systematic review aimed to summarise existing evidence on Aboriginal and Torres Strait Islander cancer survival disparities and identify key factors driving these disparities.

What is new?

Recent studies demonstrated that there was a consistent pattern of poorer cancer survival for Aboriginal and Torres Strait Islander peoples – across all of the 30 population-based studies.

Most studies were state based, necessary due to the differences in the quality of the Aboriginal and Torres Strait Islander identifying information across different states/territories in Australia.

We found that the evidence was inconsistent regarding whether the following factors explained this disparity: residential remoteness, socioeconomic status, more advanced stage at diagnosis, greater comorbidities (coexisting conditions), and variations in treatment.

For lung and female breast cancer, there was some evidence that differences in treatment and comorbidities helped explain the poorer survival for Aboriginal and Torres Strait Islander peoples compared to other Australians. The type of treatment and severity of disease at diagnosis were both found to be influential factors for cervical cancer.

However, even after adjusting for these factors, there remained a significant survival disparity for all cancers combined. This indicates that other, unmeasured factors affect the survival of Aboriginal and Torres Strait Islander cancer patients.

What does this mean?

While some of the poorer cancer survival outcomes by Aboriginal and Torres Strait Islander cancer patients can be explained, substantial disparities remain unexplained in the literature.

Our study highlights the need for further research that combine quantitative data and qualitative reports. More information and clarity is required about the cancer experience from Aboriginal and Torres Strait Islander patient’s perspective, so we can better understand the reasons for the survival dipartites in order to create evidence-based action.

Contact: Paramita Dasgupta

Reference: Dasgupta P, Martinez Harris V, Garvey G, Aitken J, Baade P. Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review. Frontiers in Oncology. 2022. doi: 10.3389/fonc.2022.96840.

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