Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review

Article

Dasgupta, Dasgupta, Harris, Veronica Martinez, Garvey, Gail, Aitken, Joanne F. and Baade, Peter D.. 2022. "Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review." Frontiers in Oncology. 12. https://doi.org/10.3389/fonc.2022.968400
Article Title

Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review

ERA Journal ID200521
Article CategoryArticle
AuthorsDasgupta, Dasgupta, Harris, Veronica Martinez, Garvey, Gail, Aitken, Joanne F. and Baade, Peter D.
Journal TitleFrontiers in Oncology
Journal Citation12
Article Number968400
Number of Pages15
Year2022
PublisherFrontiers Media SA
Place of PublicationSwitzerland
ISSN2234-943X
Digital Object Identifier (DOI)https://doi.org/10.3389/fonc.2022.968400
Web Address (URL)https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.968400/full
Abstract

Background: While cancer survival among Aboriginal and Torres Strait Islander peoples has improved over time, they continue to experience poorer cancer survival than other Australians. Key drivers of these disparities are not well understood. This systematic review aimed to summarise existing evidence on Aboriginal and Torres Strait Islander cancer survival disparities and identify influential factors and potential solutions.

Methods: In accordance with PRISMA guidelines, multiple databases were systematically searched for English language peer-reviewed articles on cancer survival by Aboriginal and Torres Strait Islander status published from 1/1/2008 to 4/05/2022. Observational studies presenting adjusted survival measures in relation to potential causal factors for disparities were included. Articles were screened independently by two authors. Included studies were critically assessed using Joanna Briggs Institute tools.

Results: Thirty population-based and predominantly state-level studies were included. A consistent pattern of poorer unadjusted cancer survival for Aboriginal and Torres Strait Islander peoples was evident. Studies varied widely in the covariates adjusted for including a combination of socio-demographics, cancer stage, comorbidities, and treatment. Potential contributions of these factors varied by cancer type. For lung and female breast cancer, adjusting for treatment and comorbidities reduced the survival disparity, which, while still elevated was no longer statistically significant. This pattern was also evident for cervical cancer after adjustment for stage and treatment. However, most studies for all cancers combined, or colorectal cancer, reported that unexplained survival disparities remained after adjusting for various combinations of covariates.

Conclusions: While some of the poorer survival faced by Aboriginal and Torres Strait Islander cancer patients can be explained, substantial disparities likely to be related to Aboriginal determinants, remain. It is imperative that future research consider innovative study designs and strength-based approaches to better understand cancer survival for Aboriginal and Torres Strait Islander peoples and to inform evidence-based action.

KeywordsAboriginal and Torres Strait Islander; inequalities; Australia; cancer; survival
Byline AffiliationsCancer Council Queensland, Australia
University of Queensland
Queensland University of Technology
Institute for Resilient Regions
Griffith University
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A longitudinal study of post-traumatic growth and psychological distress in colorectal cancer survivors
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Location of residence and breast cancer stage: a SEER population-based analysis
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Understanding dementia amongst indigenous Australians
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Making sense of dementia: understanding amongst indigenous Australians
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Lifetime ultraviolet exposure estimates for selected population groups in south east Queensland
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Effect of childhood and adolescent ultraviolet exposures on cumulative exposure in south east Queensland schools
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Evaluation of differences in ultraviolet exposure during weekend and weekday activities
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