The first year counts

cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006

Susanna Cramb, Gail Garvey, Patricia Valery, John Williamson, Peter Baade

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.

    Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.

    Main outcome measures:
     Hazard ratios for the categories of area-socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.

    Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous people (61.9%; 95% CI, 61.7%–62.2%). There was no evidence that this differential varied by remoteness (P = 0.780) or area-socioeconomic disadvantage (P = 0.845). However, it did vary by time after diagnosis. In a time-varying survival model stratified by age, sex and cancer type, the 50% excess mortality in the first year (adjusted HR, 1.50; 95% CI, 1.38–1.63) reduced to near unity at 2 years after diagnosis (HR, 1.03; 95% CI, 0.78–1.35).

    Conclusions: After a wide disparity in cancer survival in the first 2 years after diagnosis, Indigenous patients with cancer who survive these 2 years have a similar outlook to non-Indigenous patients. Access to services and socioeconomic factors are unlikely to be the main causes of the early lower Indigenous survival, as patterns were similar across remoteness and area-socioeconomic disadvantage. There is an urgent need to identify the factors leading to poor outcomes early after diagnosis among Indigenous people with cancer.
    Original languageEnglish
    Pages (from-to)270-274
    Number of pages5
    JournalMedical Journal of Australia
    Volume196
    Issue number4
    DOIs
    Publication statusPublished - 2012

    Fingerprint

    Survival
    Neoplasms
    Queensland
    Early Diagnosis
    Outcome Assessment (Health Care)
    Mortality
    Population

    Cite this

    Cramb, Susanna ; Garvey, Gail ; Valery, Patricia ; Williamson, John ; Baade, Peter. / The first year counts : cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006. In: Medical Journal of Australia. 2012 ; Vol. 196, No. 4. pp. 270-274.
    @article{2c04ad45ec434446b779c6d31060b4fa,
    title = "The first year counts: cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006",
    abstract = "Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.Main outcome measures: Hazard ratios for the categories of area-socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3{\%}; 95{\%} CI, 47.8{\%}–52.8{\%}) compared with non-Indigenous people (61.9{\%}; 95{\%} CI, 61.7{\%}–62.2{\%}). There was no evidence that this differential varied by remoteness (P = 0.780) or area-socioeconomic disadvantage (P = 0.845). However, it did vary by time after diagnosis. In a time-varying survival model stratified by age, sex and cancer type, the 50{\%} excess mortality in the first year (adjusted HR, 1.50; 95{\%} CI, 1.38–1.63) reduced to near unity at 2 years after diagnosis (HR, 1.03; 95{\%} CI, 0.78–1.35).Conclusions: After a wide disparity in cancer survival in the first 2 years after diagnosis, Indigenous patients with cancer who survive these 2 years have a similar outlook to non-Indigenous patients. Access to services and socioeconomic factors are unlikely to be the main causes of the early lower Indigenous survival, as patterns were similar across remoteness and area-socioeconomic disadvantage. There is an urgent need to identify the factors leading to poor outcomes early after diagnosis among Indigenous people with cancer.",
    keywords = "adolescent, adult, age, aged, article, Australia, breast cancer, cancer classification, cancer incidence, cancer mortality, cancer survival, colorectal cancer, controlled study, descriptive research, esophagus cancer, female, hazard ratio, human, indigenous people, kidney cancer, liver cancer, lung cancer, major clinical study, male, malignant neoplastic disease, melanoma, myeloid leukemia, myeloma, nonhodgkin lymphoma, ovary cancer, pancreas cancer, population research, prostate cancer, residential area, sex ratio, socioeconomics, stomach cancer, survival rate, survival time, uterine cervix cancer, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Early Diagnosis, Female, Health Services, Indigenous, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasms, Oceanic Ancestry Group, Population Groups, Queensland, Reference Values, Retrospective Studies, Risk Assessment, Sex Factors, Socioeconomic Factors, Survival Analysis, Young Adult",
    author = "Susanna Cramb and Gail Garvey and Patricia Valery and John Williamson and Peter Baade",
    year = "2012",
    doi = "10.5694/mja11.11194",
    language = "English",
    volume = "196",
    pages = "270--274",
    journal = "Medical Journal of Australia",
    issn = "0025-729X",
    publisher = "Australasian Medical Publishing Company",
    number = "4",

    }

    The first year counts : cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006. / Cramb, Susanna; Garvey, Gail; Valery, Patricia ; Williamson, John; Baade, Peter.

    In: Medical Journal of Australia, Vol. 196, No. 4, 2012, p. 270-274.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - The first year counts

    T2 - cancer survival among Indigenous and non-Indigenous Queenslanders, 1997-2006

    AU - Cramb, Susanna

    AU - Garvey, Gail

    AU - Valery, Patricia

    AU - Williamson, John

    AU - Baade, Peter

    PY - 2012

    Y1 - 2012

    N2 - Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.Main outcome measures: Hazard ratios for the categories of area-socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous people (61.9%; 95% CI, 61.7%–62.2%). There was no evidence that this differential varied by remoteness (P = 0.780) or area-socioeconomic disadvantage (P = 0.845). However, it did vary by time after diagnosis. In a time-varying survival model stratified by age, sex and cancer type, the 50% excess mortality in the first year (adjusted HR, 1.50; 95% CI, 1.38–1.63) reduced to near unity at 2 years after diagnosis (HR, 1.03; 95% CI, 0.78–1.35).Conclusions: After a wide disparity in cancer survival in the first 2 years after diagnosis, Indigenous patients with cancer who survive these 2 years have a similar outlook to non-Indigenous patients. Access to services and socioeconomic factors are unlikely to be the main causes of the early lower Indigenous survival, as patterns were similar across remoteness and area-socioeconomic disadvantage. There is an urgent need to identify the factors leading to poor outcomes early after diagnosis among Indigenous people with cancer.

    AB - Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.Main outcome measures: Hazard ratios for the categories of area-socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous people (61.9%; 95% CI, 61.7%–62.2%). There was no evidence that this differential varied by remoteness (P = 0.780) or area-socioeconomic disadvantage (P = 0.845). However, it did vary by time after diagnosis. In a time-varying survival model stratified by age, sex and cancer type, the 50% excess mortality in the first year (adjusted HR, 1.50; 95% CI, 1.38–1.63) reduced to near unity at 2 years after diagnosis (HR, 1.03; 95% CI, 0.78–1.35).Conclusions: After a wide disparity in cancer survival in the first 2 years after diagnosis, Indigenous patients with cancer who survive these 2 years have a similar outlook to non-Indigenous patients. Access to services and socioeconomic factors are unlikely to be the main causes of the early lower Indigenous survival, as patterns were similar across remoteness and area-socioeconomic disadvantage. There is an urgent need to identify the factors leading to poor outcomes early after diagnosis among Indigenous people with cancer.

    KW - adolescent

    KW - adult

    KW - age

    KW - aged

    KW - article

    KW - Australia

    KW - breast cancer

    KW - cancer classification

    KW - cancer incidence

    KW - cancer mortality

    KW - cancer survival

    KW - colorectal cancer

    KW - controlled study

    KW - descriptive research

    KW - esophagus cancer

    KW - female

    KW - hazard ratio

    KW - human

    KW - indigenous people

    KW - kidney cancer

    KW - liver cancer

    KW - lung cancer

    KW - major clinical study

    KW - male

    KW - malignant neoplastic disease

    KW - melanoma

    KW - myeloid leukemia

    KW - myeloma

    KW - nonhodgkin lymphoma

    KW - ovary cancer

    KW - pancreas cancer

    KW - population research

    KW - prostate cancer

    KW - residential area

    KW - sex ratio

    KW - socioeconomics

    KW - stomach cancer

    KW - survival rate

    KW - survival time

    KW - uterine cervix cancer

    KW - Adolescent

    KW - Adult

    KW - Age Factors

    KW - Aged

    KW - Aged, 80 and over

    KW - Cross-Sectional Studies

    KW - Early Diagnosis

    KW - Female

    KW - Health Services, Indigenous

    KW - Humans

    KW - Male

    KW - Middle Aged

    KW - Multivariate Analysis

    KW - Neoplasms

    KW - Oceanic Ancestry Group

    KW - Population Groups

    KW - Queensland

    KW - Reference Values

    KW - Retrospective Studies

    KW - Risk Assessment

    KW - Sex Factors

    KW - Socioeconomic Factors

    KW - Survival Analysis

    KW - Young Adult

    UR - http://www.scopus.com/inward/record.url?scp=84857876240&partnerID=8YFLogxK

    U2 - 10.5694/mja11.11194

    DO - 10.5694/mja11.11194

    M3 - Article

    VL - 196

    SP - 270

    EP - 274

    JO - Medical Journal of Australia

    JF - Medical Journal of Australia

    SN - 0025-729X

    IS - 4

    ER -