Improving outcomes from hepatitis B and hepatocellular carcinoma in remote-dwelling Aboriginal people in Australia’s Northern Territory through education, early diagnosis, culturally sensitive care, and strong community partnerships

Abstract

Hepatocellular Carcinoma (HCC) presents a significant health challenge in the Northern Territory (NT), characterised by high morbidity and mortality rates. Addressing this issue requires a comprehensive and multifaceted approach, as outlined in this PhD study. The rising incidence of HCC necessitates critical interventions, including raising awareness and education to prevent disease. These risk factors predominantly include excessive alcohol consumption, metabolic-associated steatotic liver disease (MASLD), and chronic infections with hepatitis B virus (HBV) and hepatitis C virus (HCV).This research underscores the critical need for early diagnosis and timely treatment of HCC to mitigate mortality rates, and this study demonstrates that achieving these goals is feasible. A pivotal recommendation from this research is the expansion of the “one-stop-shop” surveillance program to reach more remote communities within the NT. This initiative willenhance accessibility and uptake of HCC surveillance and treatment services in underserved areas, thereby improving early detection and clinical outcomes.An integral aspect of this PhD study is the emphasis on culturally appropriate healthcare delivery. It highlights the necessity of adhering to the guidance provided by the Aboriginal Health Workforce and creating educational materials in Aboriginal languages. Such measures are crucial to ensure that healthcare services are culturally safe and resonate well with Aboriginal communities. Developing and disseminating culturally relevant educational content is fundamental to fostering greater community engagement and trust.This study also demonstrates the profound impact of robust community engagement. Building trusting and respectful relationships with communities has been identified as essential for engaging hard-to-reach populations in cancer surveillance initiatives. The success of these efforts hinges on a sustained commitment to implementing holistic models of care that are co-designed with consumers. This approach addresses the clinical aspects of HCC management and incorporates the social and cultural dimensions of health, ensuring a more comprehensive and effective intervention strategy.

Date of Award	2025
Original language	English
Awarding Institution	Charles Darwin University (CDU)
Supervisor	Jane Davies (Supervisor) & Joshua Davis (Supervisor)