Lisa J Whop1, Christina M Bernardes1,2, Srinivas Kondalsamy-Chennakesavan3, Deepak Darshan3,4, Naven Chetty5, Suzanne P Moore1, Gail Garvey1, Euan Walpole6, Peter Baade7, Patricia C Valery1,2. 1. Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia. 2. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 3. Toowoomba Hospital and Darling Downs Hospital and Health Service, Toowoomba, Queensland, Australia. 4. Rural Clinical School, School of Medicine, The University of Queensland, Toowoomba, Queensland, Australia. 5. Mater Adult Hospital, Brisbane, Queensland, Australia. 6. Princess Alexandra Hospital and Metro South Health and Hospital Service, Brisbane, Queensland, Australia. 7. Cancer Council Queensland, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. METHODS: Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. RESULTS: A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1). CONCLUSIONS: The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people.
BACKGROUND:Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. METHODS: Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. RESULTS: A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLCpatients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1). CONCLUSIONS: The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people.
Authors: J Dunn; G Garvey; P C Valery; D Ball; K M Fong; S Vinod; D L O'Connell; S K Chambers Journal: Support Care Cancer Date: 2016-10-10 Impact factor: 3.603
Authors: Abbey Diaz; Peter D Baade; Patricia C Valery; Lisa J Whop; Suzanne P Moore; Joan Cunningham; Gail Garvey; Julia M L Brotherton; Dianne L O'Connell; Karen Canfell; Diana Sarfati; David Roder; Elizabeth Buckley; John R Condon Journal: PLoS One Date: 2018-05-08 Impact factor: 3.240
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