David Banham1, David Roder2, Dorothy Keefe3, Gelareh Farshid4, Marion Eckert5, Margaret Cargo2, Alex Brown6. 1. Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia; Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia. Electronic address: david.banham@sahmri.com. 2. Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia. 3. Transforming Health, SA Health, Hindmarsh Square, Adelaide, SA, 5000, Australia; Faculty of Health Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia. 4. Faculty of Health Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia. 5. School of Nursing and Midwifery, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia. 6. Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia; Aboriginal Health Research Group, Sansom Institute for Health Research, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
Abstract
BACKGROUND/AIM: This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. METHODS: This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977-2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990-2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. RESULTS: Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p<0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. CONCLUSION: Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas.
BACKGROUND/AIM: This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. METHODS: This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977-2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990-2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. RESULTS: Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p<0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. CONCLUSION: Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas.
Authors: David Banham; David Roder; Dorothy Keefe; Gelareh Farshid; Marion Eckert; Natasha Howard; Karla Canuto; Alex Brown Journal: BMC Health Serv Res Date: 2019-06-14 Impact factor: 2.655
Authors: John A Woods; Judith M Katzenellenbogen; Kevin Murray; Claire E Johnson; Sandra C Thompson Journal: BMJ Open Date: 2021-03-16 Impact factor: 2.692
Authors: Rachel Reilly; Jasmine Micklem; Paul Yerrell; David Banham; Kim Morey; Janet Stajic; Marion Eckert; Monica Lawrence; Harold B Stewart; Alex Brown Journal: Health Expect Date: 2018-04-24 Impact factor: 3.377
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