Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment

Lisa Whop, Christina Bernardes, S Kondalsamy-chennakesavan, Deepak Darshan, N Chetty, Suzanne Moore, Gail Garvey, Euan WALPOLE, Peter Baade, Patricia Valery

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types.

    Methods: Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately.

    Results: A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1).

    Conclusions: The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people. 
    Original languageEnglish
    Pages (from-to)224-231
    Number of pages8
    JournalAsia-Pacific Journal of Clinical Oncology
    Volume13
    Issue number5
    Early online date21 Mar 2016
    DOIs
    Publication statusPublished - Oct 2017

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    Non-Small Cell Lung Carcinoma
    Uterine Cervical Neoplasms
    Guidelines
    Neoplasms
    Therapeutics
    Lung Neoplasms
    Queensland
    Hospital Records
    Medical Records
    Registries
    Comorbidity
    Research Design
    Survival
    Incidence

    Cite this

    Whop, Lisa ; Bernardes, Christina ; Kondalsamy-chennakesavan, S ; Darshan, Deepak ; Chetty, N ; Moore, Suzanne ; Garvey, Gail ; WALPOLE, Euan ; Baade, Peter ; Valery, Patricia . / Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment. In: Asia-Pacific Journal of Clinical Oncology. 2017 ; Vol. 13, No. 5. pp. 224-231.
    @article{594f4d55f6864aa38ceea64634996d27,
    title = "Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment",
    abstract = "Background: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving {"}suboptimal treatment{"} compared to {"}optimal treatment{"} according to clinical guidelines for two cancer types. Methods: Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. Results: A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95{\%} CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95{\%} CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56{\%} Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95{\%} CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95{\%} CI, 1.1-4.1). Conclusions: The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people. ",
    author = "Lisa Whop and Christina Bernardes and S Kondalsamy-chennakesavan and Deepak Darshan and N Chetty and Suzanne Moore and Gail Garvey and Euan WALPOLE and Peter Baade and Patricia Valery",
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    year = "2017",
    month = "10",
    doi = "10.1111/ajco.12463",
    language = "English",
    volume = "13",
    pages = "224--231",
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    Whop, L, Bernardes, C, Kondalsamy-chennakesavan, S, Darshan, D, Chetty, N, Moore, S, Garvey, G, WALPOLE, E, Baade, P & Valery, P 2017, 'Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment', Asia-Pacific Journal of Clinical Oncology, vol. 13, no. 5, pp. 224-231. https://doi.org/10.1111/ajco.12463

    Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment. / Whop, Lisa; Bernardes, Christina; Kondalsamy-chennakesavan, S; Darshan, Deepak; Chetty, N; Moore, Suzanne; Garvey, Gail; WALPOLE, Euan; Baade, Peter; Valery, Patricia .

    In: Asia-Pacific Journal of Clinical Oncology, Vol. 13, No. 5, 10.2017, p. 224-231.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Indigenous Australians with non–small cell lung cancer or cervical cancer receive suboptimal treatment

    AU - Whop, Lisa

    AU - Bernardes, Christina

    AU - Kondalsamy-chennakesavan, S

    AU - Darshan, Deepak

    AU - Chetty, N

    AU - Moore, Suzanne

    AU - Garvey, Gail

    AU - WALPOLE, Euan

    AU - Baade, Peter

    AU - Valery, Patricia

    N1 - NHMRC Grant: 1004643

    PY - 2017/10

    Y1 - 2017/10

    N2 - Background: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. Methods: Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. Results: A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1). Conclusions: The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people. 

    AB - Background: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. Methods: Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. Results: A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1). Conclusions: The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people. 

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    U2 - 10.1111/ajco.12463

    DO - 10.1111/ajco.12463

    M3 - Article

    VL - 13

    SP - 224

    EP - 231

    JO - Asia-Pacific Journal of Clinical Oncology

    JF - Asia-Pacific Journal of Clinical Oncology

    SN - 1743-7555

    IS - 5

    ER -