Cancer Care for Indigenous Australians

Indigenous people in Queensland are less likely to receive adequate management for lung cancer, according to a research paper published in the 19 May Indigenous health issue of The Medical Journal of Australia.

Dr Michael Coory from the University of Queensland's School of Population Health and his co-authors compared survival of Indigenous and non-Indigenous lung cancer patients treated in Queensland public hospitals between 1996 and 2002. One hundred and fifty-eight Indigenous and 152 non-Indigenous patients took part.

Lung cancer is the most common cancer among Indigenous Australians, accounting for 27 per cent of all cancer deaths compared to 17 per cent of cancer deaths in non-Indigenous Australians. Age-adjusted incidence is about twice as high for Indigenous people compared to non-Indigenous people and age-adjusted mortality is three to four times higher.

The researchers investigated the corresponding differences in stage, treatment and comorbidities (the presence of additional disorders or diseases, such as diabetes).

Dr Coory said that survival after a lung cancer diagnosis was worse for Indigenous patients than for non-Indigenous patients - with the median survival being 4.3 months compared to 10.3 months - and the differences in treatment between the two groups was mainly to blame.

"Indigenous lung cancer patients often need to travel long distances to access specialist services and they may have particularly fatalistic views of lung cancer and its treatment.

"A smaller percentage of Indigenous than non-Indigenous patients received chemotherapy, radiotherapy or surgery. There was a similar pattern for active treatment overall," he said.

In an accompanying editorial, Dr John Boffa, Public Health Medical Officer for the Central Australian Aboriginal Congress, said late diagnosis of Indigenous people was a key factor leading to poorer treatment outcomes.

"As Indigenous people do not have the same level of access to primary medical care as non-Indigenous Australians, GPs detecting cancer early is less likely.

Despite substantial additional funding since 1995, the gap in access to primary medical care is widening, mainly due to worsening access to the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme.

"The 'Close the Gap' campaign recently announced by the Federal Government is indeed timely," he said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

Dr John Boffa 08 8951 4444 or 0418 812 141
Dr Michael Coory 07 4080 1000 or 0409 578 577
Kylie Butler (AMA) 02 6270 5466 or 0417 652 488

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