Hanna E Tervonen1, Sanchia Aranda2, David Roder3, Richard Walton4, Deborah Baker4, Hui You4, David Currow5. 1. School of Health Sciences, Centre for Population Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. Electronic address: hanna.tervonen@unisa.edu.au. 2. Cancer Council Australia, GPO Box 4708, Sydney, NSW 2001, Australia; Cancer Institute NSW, GPO Box 41, Alexandria, Sydney, NSW 1435, Australia; School of Health Sciences, University of Melbourne, 161 Barry Street, Carlton, Victoria 3053, Australia. 3. School of Health Sciences, Centre for Population Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; Cancer Institute NSW, GPO Box 41, Alexandria, Sydney, NSW 1435, Australia. 4. Information Analysis Unit, Cancer Institute NSW, GPO Box 41, Alexandria, Sydney, NSW 1435, Australia. 5. Cancer Institute NSW, GPO Box 41, Alexandria, Sydney, NSW 1435, Australia.
Abstract
BACKGROUND: Aboriginal and Torres Strait Islander people (referred to in this paper as "Aboriginal people") generally have lower cancer survivals and more advanced stages at diagnosis than non-Aboriginal people. There is conflicting evidence on whether these disparities vary by socio-economic disadvantage and geographic remoteness. This study examines variations in these disparities in New South Wales (NSW), Australia. METHODS: Data for cancers diagnosed in 2000-2008 were extracted from the NSW Cancer Registry (n=264,219). Missing Aboriginal status (13.3%) was multiply imputed. Logistic regression and competing risk regression models were used to examine likelihood of advanced summary stage and risk of cancer death among Aboriginal compared with non-Aboriginal people by socio-economic disadvantage (categorised into quintiles 1: least disadvantaged-5: most disadvantaged) and remoteness. RESULTS: Aboriginal people showed a general pattern of more advanced stage at diagnosis compared with non-Aboriginal people across socio-economic disadvantage and remoteness categories. After adjusting for demographic factors, year of diagnosis, summary stage and cancer site, Aboriginal people living outside the least disadvantaged areas had an increased risk of cancer death compared with non-Aboriginal people living in similar areas (sub-hazard ratio SHR 1.41, 95% confidence interval CI 1.09-1.81; SHR 1.59, 95%CI 1.31-1.93; SHR 1.42, 95%CI 1.22-1.64 and SHR 1.34, 95%CI 1.22-1.48 for quintiles 2-5, respectively). Compared with non-Aboriginal people, Aboriginal people had an elevation in the risk of cancer death irrespective of the remoteness, with the most pronounced elevations detected in remote/very remote areas (SHR 1.56, 95%CI 1.10-2.21). CONCLUSION: Compared with non-Aboriginal people, Aboriginal people had a higher risk of cancer death and higher likelihood of more advanced stage across socio-economic disadvantage and remoteness categories. All areas appear to require attention in endeavours to improve cancer survival outcomes for Aboriginal people. Crown
BACKGROUND: Aboriginal and Torres Strait Islander people (referred to in this paper as "Aboriginal people") generally have lower cancer survivals and more advanced stages at diagnosis than non-Aboriginal people. There is conflicting evidence on whether these disparities vary by socio-economic disadvantage and geographic remoteness. This study examines variations in these disparities in New South Wales (NSW), Australia. METHODS: Data for cancers diagnosed in 2000-2008 were extracted from the NSW Cancer Registry (n=264,219). Missing Aboriginal status (13.3%) was multiply imputed. Logistic regression and competing risk regression models were used to examine likelihood of advanced summary stage and risk of cancer death among Aboriginal compared with non-Aboriginal people by socio-economic disadvantage (categorised into quintiles 1: least disadvantaged-5: most disadvantaged) and remoteness. RESULTS: Aboriginal people showed a general pattern of more advanced stage at diagnosis compared with non-Aboriginal people across socio-economic disadvantage and remoteness categories. After adjusting for demographic factors, year of diagnosis, summary stage and cancer site, Aboriginal people living outside the least disadvantaged areas had an increased risk of cancer death compared with non-Aboriginal people living in similar areas (sub-hazard ratio SHR 1.41, 95% confidence interval CI 1.09-1.81; SHR 1.59, 95%CI 1.31-1.93; SHR 1.42, 95%CI 1.22-1.64 and SHR 1.34, 95%CI 1.22-1.48 for quintiles 2-5, respectively). Compared with non-Aboriginal people, Aboriginal people had an elevation in the risk of cancer death irrespective of the remoteness, with the most pronounced elevations detected in remote/very remote areas (SHR 1.56, 95%CI 1.10-2.21). CONCLUSION: Compared with non-Aboriginal people, Aboriginal people had a higher risk of cancer death and higher likelihood of more advanced stage across socio-economic disadvantage and remoteness categories. All areas appear to require attention in endeavours to improve cancer survival outcomes for Aboriginal people. Crown
Authors: Marilyn Lyford; Margaret M Haigh; Siddhartha Baxi; Shelley Cheetham; Shaouli Shahid; Sandra C Thompson Journal: Int J Environ Res Public Health Date: 2018-02-14 Impact factor: 3.390
Authors: Dorothy A Rhoades; John Farley; Stephen M Schwartz; Kimberly M Malloy; Wenyu Wang; Lyle G Best; Ying Zhang; Tauqeer Ali; Fawn Yeh; Everett R Rhoades; Elisa Lee; Barbara V Howard Journal: Cancer Epidemiol Date: 2021-07-19 Impact factor: 2.890
Authors: David Banham; David Roder; Marion Eckert; Natasha J Howard; Karla Canuto; Alex Brown Journal: BMC Health Serv Res Date: 2019-10-29 Impact factor: 2.655