Indigenous Australians do not have the high standard of health that Australians have in general, and have worse outcomes for several diseases including cancer.

In their study Patricia Valery (Queensland Institute of Medical Research, Herston, Queensland, Australia) and colleagues assessed differences in disease stage at diagnosis, treatment, and survival between 800 non-Indigenous and 800 Indigenous people in Queensland, Australia. For accurate comparison, non-Indigenous patients were matched with Indigenous cancer patients for age, sex, place of residence, cancer site, and year of diagnosis. Only patients using the public hospital system were included in the study as the majority of Indigenous people do not use private hospitals. The investigators found that Indigenous people had lower survival rates, even after they took into account confounding factors such as stage at diagnosis, cancer treatment, and other illnesses. On the medical charts they examined, the researchers found that Indigenous people were less likely to have their cancer stage recorded (12% vs 7%) and had fewer cases of early stage cancer than non-Indigenous Australians (47% vs 53%). Indigenous people were also less likely to receive cancer treatment and had to wait longer for surgery than their non-Indigenous counterparts.

Dr Valery states: "We need to identify the specific sociodemographic and cultural factors contributing to the patterns of survival in the Aboriginal and Torres Strait Islander population of Australia. The interplay of access to care, differences in patient preferences for treatment and in patients' clinical understanding require a holistic and culturally respectful approach. Modification of some of these factors could well translate into meaningful public-health and clinic
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
1-Jun-2006