Comparison of Epidemiology, Demography, Treatment (Surgery and Radiotherapy), and Survival Between Aboriginal and Torres Strait Islander and Non-Indigenous Women With Cervical Cancer in NSW, Australia in 2009–2018

Background: Health outcomes for Aboriginal and Torres Strait Islander people in Australia are significantly worse than in the non-Indigenous population. 

Aim: To evaluate demographic factors and treatment (surgery and radiotherapy) rates for cervical cancer and to compare these between the Aboriginal and non-Aboriginal populations to identify any differences in outcomes or modifiable treatment differences between the populations. 

Methods: Retrospective cohort analysis of all patients in the state of New South Wales, Australia, diagnosed with cervical cancer between 2009 and 2018 using linked registry, treatment, and death data. 

Results: The crude incidence rate for cervical cancer in Aboriginal women in NSW (17.29/100,000) was more than double the rate among non-Aboriginal women (6.77/100,000). Aboriginal women were diagnosed with cervical cancer, including metastatic disease, at a younger age. There was no significant difference in presentation stage, surgery or radiotherapy treatment rates, or overall survival at 5 years between the two populations. 

Conclusion: Although access to cancer care looks similar as an aggregate in Aboriginal versus non-Aboriginal populations, there were disparities with reduced access to care (patients who did not receive either radiotherapy or surgery) among Aboriginal patients who were socioeconomically disadvantaged or residing in remote areas. The lower age of cancer diagnosis among Aboriginal women may have effects on survivorship, including negative effects on fertility, loss of income, and other personal, social, and economic consequences. Efforts to improve access to care, including screening, diagnosis, and treatment, should be targeted toward younger Aboriginal women and those who are socioeconomically disadvantaged or those residing in remote areas.