Stage at diagnosis and cancer survival for Indigenous Australians in the Northern Territory.
OBJECTIVE
To investigate whether Indigenous Australians with cancer have more advanced disease at diagnosis than other Australians, and whether late diagnosis explains lower Indigenous cancer survival rates.


METHODS
Retrospective cohort study.


METHODS
Indigenous and non-Indigenous people diagnosed with cancers of the colon and rectum, lung, breast or cervix and non-Hodgkin lymphoma in the Northern Territory of Australia in 1991-2000.


METHODS
SEER summary stage of cancer at diagnosis (local, regional or distant spread), cause-specific cancer survival rates and relative risk of cancer death.


RESULTS
Diagnosis with advanced disease (regional or distant spread) was more common for Indigenous people (70%; 95% CI, 62%-78%) than for non-Indigenous people (51%; 95% CI, 53%-59%) with cancers of the colon and rectum, breast, cervix and non-Hodgkin lymphoma, but for lung cancer the opposite was found (Indigenous, 56% [95% CI, 46%-65%] v non-Indigenous, 69% [95% CI, 64%-75%]). Stage-adjusted survival rates were lower for Indigenous people for each cancer site. With few exceptions, the relative risk of cancer death was higher for Indigenous people for each category of stage at diagnosis for each cancer site.


CONCLUSIONS
Health services apparently could, and should, be performing better for Indigenous people with cancer in the Northern Territory, and probably elsewhere in Australia. This study has demonstrated that data from cancer registers, enhanced with data on stage at diagnosis, can be used to monitor health service performance for Indigenous Australians in the Northern Territory; similar data is available in other States, and could be used to monitor health service performance for Indigenous people throughout Australia.
Condon
John R
JR
Menzies School of Health Research, Box 41096, Casuarina, NT 0811, Australia. john.condon@menzies.edu.au
Barnes
Tony
T
Armstrong
Bruce K
BK
Selva-Nayagam
Sid
S
Elwood
J Mark
JM
D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology*; D015876:Northern Territory / Q000453:epidemiology; D044382:Population Groups / Q000706:statistics & numerical data*; D016019:Survival Analysis