Cancer Causes & Control

, Volume 24, Issue 12, pp 2099–2106

Cancer survival in Indigenous and non-Indigenous Australian children: what is the difference?

  • Patricia C. Valery
  • Danny R. Youlden
  • Peter D. Baade
  • Leisa J. Ward
  • Adele C. Green
  • Joanne F. Aitken
Original paper

Abstract

Purpose

This study assessed variation in childhood cancer survival by Indigenous status in Australia, and explored the effect of place of residence and socio-economic disadvantage on survival.

Methods

All children diagnosed with cancer during 1997–2007 were identified through the Australian Pediatric Cancer Registry. Cox regression analysis was used to assess the adjusted differences in survival.

Results

Overall, 5-years survival was 75.0 % for Indigenous children (n = 196) and 82.3 % for non-Indigenous children (n = 6,376, p = 0.008). Compared to other children, Indigenous cases had 1.36 times the risk of dying within 5 years of diagnosis after adjustments for rurality of residence, socio-economic disadvantage, cancer diagnostic group, and year of diagnosis (95 % CI 1.01–1.82). No significant survival differential was found for leukemias or tumors of the central nervous system; Indigenous children were 1.83 times more likely (95 % CI 1.22–2.74) than other children to die within 5 years from ‘other tumors’ (e.g., lymphomas, neuroblastoma). Among children who lived in ‘remote/very remote/outer regional’ areas, and among children with a subgroup of ‘other tumors’ that were staged, being Indigenous significantly increased the likelihood of death (HR = 1.69, 95 % CI 1.10–2.59 and HR = 2.99, 95 % CI 1.35–6.62, respectively); no significant differences by Indigenous status were seen among children with stage data missing.

Conclusions

Differences in place of residence, socio-economic disadvantage, and cancer diagnostic group only partially explain the survival disadvantage of Indigenous children. Other reasons underlying the disparities in childhood cancer outcomes by Indigenous status are yet to be determined, but may involve factors such as differences in treatment.

Keywords

Cancer survival Indigenous Childhood Australia 

References

  1. 1.
    Australian Bureau of Statistics (2011) The health and welfare of Aboriginal and Torres Strait Islander peoples. Australia Bureau of Statistics, CanberraGoogle Scholar
  2. 2.
    Eckerman A, Dowd T, Martin M, Dixon L, Gray R, Chong E. (1992) Bina[ng] goonj: bridging cultures in Aboriginal health. Department of Aboriginal and Multicultural Studies, University of New England, ArmidaleGoogle Scholar
  3. 3.
    Durie M (2004) Understanding health and illness: research at the interface between science and indigenous knowledge. Int J Epidemiol 33:1138–1143PubMedCrossRefGoogle Scholar
  4. 4.
    Cottrell J, Street J, Chong A, Roder D (2007) Comparing cancer profiles and survival of aboriginal and non-aboriginal patients in South Australia: where are the opportunities for improving Aboriginal health? Asian Pac J Cancer Prev 8:495–501PubMedGoogle Scholar
  5. 5.
    Valery PC, Coory M, Stirling J, Green AC (2006) Cancer diagnosis, treatment, and survival in Indigenous and non-Indigenous Australians: a matched cohort study. Lancet 367:1842–1848PubMedCrossRefGoogle Scholar
  6. 6.
    Cramb SM, Garvey G, Valery PC, Williamson JD, Baade PD (2012) The first year counts: cancer survival among Indigenous and non-Indigenous Queenslanders, 1997–2006. Med J Aust 196:270–274PubMedCrossRefGoogle Scholar
  7. 7.
    Condon JR, Barnes T, Armstrong BK, Selva-Nayagam S, Elwood JM (2005) Stage at diagnosis and cancer survival for Indigenous Australians in the Northern Territory. Med J Aust 182:277–280PubMedGoogle Scholar
  8. 8.
    Lanier AP, Holck P, Ehrsam Day G, Key C (2003) Childhood cancer among Alaska Natives. Pediatrics 112:e396PubMedCrossRefGoogle Scholar
  9. 9.
    Linabery AM, Ross JA (2008) Childhood and adolescent cancer survival in the US by race and ethnicity for the diagnostic period 1975–1999. Cancer 113:2575–2596PubMedCrossRefGoogle Scholar
  10. 10.
    McKinney PA, Feltbower RG, Parslow RC et al (1999) Survival from childhood cancer in Yorkshire, UK: effect of ethnicity and socio-economic status. Eur J Cancer 35:1816–1823PubMedCrossRefGoogle Scholar
  11. 11.
    Stiller CA, Bunch KJ, Lewis IJ (2000) Ethnic group and survival from childhood cancer: report from the UK Children’s Cancer Study Group. Br J Cancer 82:1339–1343PubMedCrossRefGoogle Scholar
  12. 12.
    Douglas NM, Dockerty JD (2007) Survival by ethnicity for children diagnosed with cancer in New Zealand during 1990–1993. J Paediatr Child Health 43:173–177PubMedCrossRefGoogle Scholar
  13. 13.
    Stefan DC, Stones D, Dippenaar A, Kidd M (2009) Ethnicity and characteristics of Hodgkin lymphoma in children. Pediatr Blood Cancer 52:182–185PubMedCrossRefGoogle Scholar
  14. 14.
    MacDougall LG (1985) Acute childhood leukaemia in Johannesburg. Leuk Res 9:765–767PubMedCrossRefGoogle Scholar
  15. 15.
    Hesseling PB, Wessels G, van Riet FA (1995) The Tygerberg Hospital Children’s Tumour Registry 1983–1993. Eur J Cancer 31A:1471–1475PubMedCrossRefGoogle Scholar
  16. 16.
    Valery PC, Youlden DR, Baade PD, Ward LJ, Green AC, Aitken JF (2013) Cancer incidence and mortality in Indigenous Australian children, 1997–2008. Pediatr Blood Cancer 60:156–158PubMedCrossRefGoogle Scholar
  17. 17.
    Youlden DR, Baade PD, Valery PC, Ward LJ, Green AC, Aitken JF (2011) Differentials in survival for childhood cancer in Australia by remoteness of residence and area disadvantage. Cancer Epidemiol Biomarkers Prev 20:1649–1656PubMedCrossRefGoogle Scholar
  18. 18.
    Australian Bureau of Statistics (2011) Deaths Australia 2010 [Cat no 3302.0] Australian Bureau of Statistics, CanberraGoogle Scholar
  19. 19.
    Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P (2005) International Classification of Childhood Cancer, 3rd edn. Cancer 103:1457–1467Google Scholar
  20. 20.
    Desandes E, Berger C, Tron I et al (2008) Childhood cancer survival in France, 1990–1999. Eur J Cancer 44:205–215PubMedCrossRefGoogle Scholar
  21. 21.
    Baade PD, Youlden DR, Valery PC et al (2010) Population-based survival estimates for childhood cancer in Australia during the period 1997–2006. Br J Cancer 103:1663–1670PubMedCrossRefGoogle Scholar
  22. 22.
    Department of Health and Aged Care (2000) Measuring remoteness: Accessibility/Remoteness Index of Australia (ARIA). Department of Health and Aged Care, CanberraGoogle Scholar
  23. 23.
    Australian Bureau of Statistics (2004) Census of population and housing: Socio-Economic Indexes for Area’s (SEIFA), Australia, 2001. Australian Bureau of Statistics, CanberraGoogle Scholar
  24. 24.
    Moore SP, Green AC, Garvey G, Coory MD, Valery PC (2011) A study of head and neck cancer treatment and survival among indigenous and non-indigenous people in Queensland, Australia, 1998 to 2004. BMC cancer 11:460PubMedCrossRefGoogle Scholar
  25. 25.
    Children’s Oncology G, Aplenc R, Alonzo TA et al (2006) Ethnicity and survival in childhood acute myeloid leukemia: a report from the Children’s Oncology Group. Blood 108:74–80CrossRefGoogle Scholar
  26. 26.
    Redaniel MT, Laudico A, Mirasol-Lumague MR, Alcasabas AP, Pulte D, Brenner H (2010) Geographic and ethnic differences in childhood leukaemia and lymphoma survival: comparisons of Philippine residents, Asian Americans and Caucasians in the United States. Br J CancerGoogle Scholar
  27. 27.
    Paradies Y, Cunningham J (2002) Placing Aboriginal and Torres Strait Islander mortality in an international context. Aust NZ J Public Health 26:11–16CrossRefGoogle Scholar
  28. 28.
    Young M (2001) Assessing the quality of identification of Aboriginal and Torres Strait Islander people in Western Australian hospital data, 2000\. Health Department of Western Australia, PerthGoogle Scholar
  29. 29.
    Dasgupta P, Baade PD, Aitken JF, Turrell G (2012) Multilevel determinants of breast cancer survival: association with geographic remoteness and area-level socioeconomic disadvantage. Breast Cancer Res Treat 132:701–710PubMedCrossRefGoogle Scholar
  30. 30.
    Wells KJ, Battaglia TA, Dudley DJ et al (2008) Patient navigation: state of the art or is it science? Cancer 113:1999–2010PubMedCrossRefGoogle Scholar
  31. 31.
    Shahid S, Finn L, Bessarab D, Thompson SC (2009) Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services. BMC Health Serv Res 9:132PubMedCrossRefGoogle Scholar
  32. 32.
    Clinical Oncological Society of Australia, The Cancer Council Australia, The National Cancer Control Initiative 2002 (2003) Optimising cancer care in Australia. National Cancer Control Initiative, Melbourne, pp 1–122Google Scholar
  33. 33.
    Alessandri AJ (2011) Parents know best: or do they? Treatment refusals in paediatric oncology. J Paediatr Child Health 47:628–631PubMedCrossRefGoogle Scholar
  34. 34.
    Mancini J, Simeoni MC, Parola N et al (2012) Adherence to leukemia maintenance therapy: a comparative study among children, adolescents, and adults. Pediatr Hematol Oncol 29:428–439PubMedCrossRefGoogle Scholar
  35. 35.
    Landier W (2011) Age span challenges: adherence in pediatric oncology. Semin Oncol Nurs 27:142–153PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Patricia C. Valery
    • 1
  • Danny R. Youlden
    • 2
  • Peter D. Baade
    • 2
    • 3
    • 4
    • 1
  • Leisa J. Ward
    • 2
  • Adele C. Green
    • 5
    • 6
  • Joanne F. Aitken
    • 2
    • 7
  1. 1.Menzies School of Health ResearchCharles Darwin UniversitySpring HillAustralia
  2. 2.Cancer Council QueenslandKelvin Grove, BrisbaneAustralia
  3. 3.School of Public HealthQueensland University of TechnologyBrisbaneAustralia
  4. 4.Griffith Health InstituteGriffith UniversityGold CoastAustralia
  5. 5.School of Translational MedicineUniversity of ManchesterManchesterUK
  6. 6.Cancer and Population StudiesQueensland Institute of Medical ResearchBrisbaneAustralia
  7. 7.School of Population HealthUniversity of QueenslandBrisbaneAustralia

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