Breast cancer diagnosis, patterns of care and burden of disease in Queensland, Australia (1998–2004): does being Indigenous make a difference?
- 541 Downloads
We compared patterns of care, comorbidity, disability-adjusted life-years (DALYs) and survival in Indigenous and non-Indigenous women with breast cancer in Queensland, Australia (1998–2004).
A cohort study of Indigenous (n = 110) and non-Indigenous women (n = 105), frequency matched on age and remoteness. We used Pearson’s Chi-squared analysis to compare proportions, hazard models to assess survival differences and calculated disability-adjusted life years (DALYs).
Indigenous women were more likely to be socially disadvantaged (43 vs. 20 %, p < 0.01) have comorbidity (42 vs. 18 % p < 0.01), and have regional spread or distant metastasis (metastasis, 51 vs. 36 %, p = 0.02) than non-Indigenous women; there was no difference in treatment patterns. More Indigenous women died in the follow-up period (p = 0.01). DALY’s were 469 and 665 per 100,000 for Indigenous and non-Indigenous women, respectively, with a larger proportion of the burden attributed to premature death among the former (63 vs. 59 %).
Indigenous women with breast cancer received comparable treatment to their non-Indigenous counterparts. The higher proportion of DALYs related to early death in Indigenous women suggests higher fatality with breast cancer in this group. Later stage at diagnosis and higher comorbidity presence among Indigenous women reinforce the need for early detection and improved management of co-existing disease.
KeywordsIndigenous Breast cancer Comorbidities Cancer stage Treatment Disability-adjusted life years
S. Moore was supported by a National Health and Medical Research Council (NHMRC) Training Scholarship for Indigenous Australian Health Research (No. 389935) and a Postdoctoral Fellowship from the International Agency for Research on Cancer/Cancer Australia. The NHMRC Project Grant (No. 1004643) partly funded this project. S Moore and P Valery were also supported by the former Australian Centre for International and Tropical Health, UQ. PC Valery was supported by an Australian Research Council Future Fellowship (No. 100100511). This work was produced as part of the In-Kind activities of the Lowitja Institute incorporating the Cooperative Research Centre for Aboriginal and Torres Strait Islander Health. The authors declare that they have no competing interests.
Compliance with ethical standards
SP Moore participated in the conception, design, analyses of the data, interpretation of results, writing and editing the manuscript. I Soerjomataram conducted analysis of DALYS, interpretation of results, and editing of the manuscript. A Green participated in the conception, design, analyses of the data, interpretation of results and editing the manuscript. G Garvey participated in the interpretation of results and editing the manuscript. J Martin participated in the interpretation of results and editing the manuscript. P Valery participated in the conception, design, analyses of the data, interpretation of results and editing the manuscript. We confirm that all authors have seen and approved its final version.
- American Cancer Society (2002) Cancer facts and figures 2002. In: Society American Cancer (ed) Cancer facts and figures. American Cancer Society, AtlantaGoogle Scholar
- Australian Bureau of Statistics (2003) Information Paper: Socio-Economic Indexes for Areas (SEIFA). Information paper, vol, vol 2039. Australian Bureau of Statistics, CanberraGoogle Scholar
- Australian Institute of Health and Welfare (2014) Mortality and life expectancy of Indigenous Australian’s 2008–2012. AIHW, CanberraGoogle Scholar
- Australian Institute of Health and Welfare and Cancer Australia (2012) Breast cancer in Australia: an overview. In: Australian Institute of Health and Welfare (ed). vol AIHW cat. No. CAN 67 Cancer Series Number 71, CanberraGoogle Scholar
- Australian Institute of Health and Welfare and National Breast and Ovarian Cancer Centre (2009) Breast cancer in Australia: an overview, 2009. Vol Cancer series no. 50. Cat.no. CAN 46. AIHW, CanberraGoogle Scholar
- Condon J (2004) Cancer and Indigenous Australians in the Northern Territory (Thesis). Charles Darwin University, Darwin, N.T. AustraliaGoogle Scholar
- Huo D, Ikpatt F, Khramtsov A, Dangou JM, Nanda R, Dignam J, Zhang B, Grushko T, Zhang C, Oluwasola O, Malaka D, Malami S, Odetunde A, Adeoye AO, Iyare F, Falusi A, Perou CM, Olopade OI (2009) Population differences in breast cancer: survey in indigenous African women reveals over-representation of triple-negative breast cancer. J Clin Oncol 27(27):4515–4521CrossRefPubMedPubMedCentralGoogle Scholar
- National Health and Medical Research Centre (2001) Clinical practice guidelines for the management of early breast cancer: 2nd edition. In: Prepared by the iSource National Breast Cancer Centre (ed). National Health and Medical Research Council, CanberraGoogle Scholar
- Queensland Government (2012) Census 2011: Women in Queensland In: Queensland GovernmentTreasury and Trade: Office of Economic and Statistical Research (ed). Brisbane, p 1–4Google Scholar
- Queensland Government (2013) Queensland women 2013—a statistical snapshot. In: Queensland Government: Department of Communities Child Safety and Disability Services (ed). Brisbane, p 1–6Google Scholar
- Roder D (2007) Epidemiology of cancer in indigenous Australians: implications for service delivery. Cancer Forum 31(2):85–90Google Scholar
- Sheppard AJ, Chiarelli AM, Marrett LD, Nishri ED, Trudeau ME (2011) Stage at diagnosis and comorbidity influence breast cancer survival in first nations women in Ontario. Canada, Cancer Epidemiol Biomarkers PrevGoogle Scholar