Academic journal article Australian Health Review

The Experience of Lung Cancer in Aboriginal and Torres Strait Islander Peoples and What It Means for Policy, Service Planning and Delivery

Academic journal article Australian Health Review

The Experience of Lung Cancer in Aboriginal and Torres Strait Islander Peoples and What It Means for Policy, Service Planning and Delivery

Article excerpt

Background

Aboriginal and Torres Strait Islander (hereafter, Aboriginal) peoples are over represented in cancer deaths1 and are 2.5 times more likely to die within five years of cancer diagnosis than are non-Aboriginal Australians.2 From 1992-1996 four groups of conditions accounted for almost 70% of the total excess deaths in the Aboriginal population of Western Australia and the Northern Territory.3 These conditions were: circulatory conditions including ischaemic heart disease, cerebrovascular disease and hypertension (26%); injury and poisoning including homicide, assaults, suicide and transport injuries (15%); respiratory conditions (16%); and endocrine conditions including diabetes mellitus (10%).3 As a result, chronic conditions including heart disease, stroke and diabetes have been the focus of healthcare, policies, and interventions for Aboriginal Australians. Whilst addressing these chronic conditions remains central in improving the health of Aboriginal Australians, cancer, particularly lung cancer, is also an important health problem in this context.

Smoking rates in Aboriginal Australians contribute significantly to morbidity and mortality.1 Lung cancer is the most common cancer amongst Aboriginal Australians and accounts for the most cancer mortalities (nearly 5% of all deaths of Aboriginal people).4 In 2005-06, lung cancer was the most common of all malignant cancers resulting in hospitalisation amongst Aboriginal males (a total of 140 hospitalisations). During the same period, of all malignant cancers lung cancer was the second most common reason for hospitalisation amongst Aboriginal women accounting for 112 hospitalisations, second only to breast cancer (140 hospitalisations).1 This suggests there is a need for a greater focus on the prevention and early diagnosis of lung cancer in Aboriginal Australians. To date, there are minimal data available reporting lung cancer survival rates for Aboriginal Australians.5 While the high mortality rate can be linked to high incidence, there are other explanations, which are discussed throughout the paper.

Aim

To examine the experience of lung cancer amongst Aboriginal Australians and identify reasons for poorer outcomes and lower levels of treatment compared with non-Aboriginal Australians, and opportunities for early intervention.

Method

An integrative review was undertaken, including both experimental and non-experimental studies, to obtain information regarding Aboriginal Australians and lung cancer. Literature was sought via electronic database searches and journal hand-searching for the period from January 1995 to July 2010 using the search terms 'lung cancer', 'Indigen*', 'Aborig*' and 'Australia'. Databases used included Indigenous HealthInfoNet, SCOPUS, PsycInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, HealthInsite and Google Scholar. Reference lists from articles retrieved were also searched for additional articles or information. Articles were included if they addressed lung cancer care in Australian Aboriginal and Torres Strait Islander people. Information was extracted using a standardised data extraction tool based upon the Critical Appraisal Skills Program (CASP) tools.6 Thematic analysis was then undertaken to identify key themes emerging from the literature.7

Findings

The key word search retrieved 37 articles that met the aims of this study. Aboriginal Australians have poorer rates of survival than non-Aboriginal Australians, often experience late diagnoses, and receive less aggressive treatment than do non-Aboriginal Australians. Aboriginal Australians with lung cancer are younger, more likely to live in rural or remote areas, and to have a greater economic disadvantage than are their non-Aboriginal counterparts. 8 Most cancers over-represented in Aboriginal Australians are largely preventable, with lung cancer providing a good example where rates in non-Aboriginal men have been declining. …

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