Background
Higher mortality from cancer for Indigenous people compared with other Australians has been reported in most states and territories over the last decade. Closing this gap in cancer outcomes for Indigenous people will require translating the emerging evidence on the barriers and enablers to optimal cancer diagnosis and care into coordinated programs and clinical practice.
Aims
To summarise the current qualitative and quantitative results available from NSW and Queensland, the states that have the largest Indigenous populations, and describe the optimal pathways to translate these results into measurable and meaningful improvements in cancer mortality for Indigenous Australians.
Results
There is growing evidence that Indigenous people are independently, or in partnership with local health services, increasingly accessing cancer diagnosis and treatment services. However this increase is not universal. Aboriginal patterns of care studies in NSW and Queensland have independently identified access and outcome gaps between geographical regions, age groups and between men and women. Qualitative studies in both states have also identified low socio-economic status, mistrust of the health system and complexity of health care as barriers to optimal diagnosis and care. The evidence also suggests that a lack of culturally appropriate supportive care may explain poorer longer term cancer outcomes. As well as describing these gaps we will identify previous successes and current challenges in reducing cancer mortality for Indigenous people.
Discussion
Improving cancer outcomes for Indigenous people will require a network of coordinated services to address the complex determinants of their cancer care. Informing, piloting and sustaining these services are the biggest challenges currently facing researchers, clinicians and cancer service providers respectively. Translation of key research findings into practical coordinated programs and clinical practice that impact on cancer mortality for Indigenous Australians is the first key step in this process.