Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?
OBJECTIVE
To examine whether hospital patients with cancer who were identified as Indigenous were as likely to receive surgery for the cancer as non-Indigenous patients.


METHODS
Epidemiological survey of all Western Australian (WA) patients who had a cancer registration in the state-based WA Record Linkage Project that mentioned cancer of the breast (1982-2000) or cancer of the lung or prostate (1982-2001).


METHODS
The likelihoods of receiving breast-conserving surgery or mastectomy for breast cancer, lung surgery for lung cancer, or radical or non-radical prostatectomy for prostate cancer were compared between the Indigenous and non-Indigenous populations using adjusted logistic regression analyses.


RESULTS
Indigenous people were less likely to receive surgery for their lung cancer (odds ratio [OR], 0.64; 95% CI, 0.41-0.98). Indigenous men were as likely as non-Indigenous men to receive non-radical prostatectomy (OR, 0.69; 95% CI, 0.40-1.17); only one Indigenous man out of 64 received radical prostatectomy. Indigenous women were as likely as non-Indigenous women to undergo breast-conserving surgery (OR, 0.86; 95% CI, 0.60-1.21).


CONCLUSIONS
These results indicate a different pattern of surgical care for Indigenous patients in relation to lung and prostate, but not breast, cancer. Reasons for these disparities, such as treatment choice and barriers to care, require further investigation.
School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. shall@sph.uwa.edu.au
Sonja E
SE
Hall
Caroline E
CE
Bulsara
Max K
MK
Bulsara
Timothy G
TG
Leahy
Margaret R
MR
Culbong
Delia
D
Hendrie
C D'Arcy J
CD
Holman
D001943:Breast Neoplasms / Q000208:ethnology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000208:ethnology* / Q000601:surgery*; D008297:Male; D008408:Mastectomy / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D016017:Odds Ratio; D011013:Pneumonectomy / Q000706:statistics & numerical data; D011468:Prostatectomy / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000601:surgery*; D014904:Western Australia / Q000453:epidemiology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples