Public Health Commons^™

The First Year Counts: Cancer Survival Among Indigenous And Non-Indigenous Queenslanders, 1997–2006, Susanna M. Cramb, Gall Garvey, Patricia C. Valery, John D. Williamson, Peter D. Baade

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.

Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.

Main outcome measures: Hazard ratios for the categories of area- socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.

Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous …

Indigenous Beliefs About Biomedical And Bush Medicine Treatment Efficacy For Indigenous Cancer Patients: A Review Of The Literature, K. D. Schaik, S. C. Thompson

Aboriginal Policy Research Consortium International (APRCi)

Background: Australia’s Indigenous people suffer from higher cancer mortality than non-Indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-Indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both ‘bush medicine’ and biomedical, in order to provide recommendations to healthcare providers about accommodating Indigenous beliefs when treating cancer.

Methods: A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. Results: Literature suggests that Indigenous beliefs …

Counting The Cost: Estimating The Number Of Deaths Among Recently Released Prisoners In Australia, Stuart A. Kinner, David B. Preen, Azar Kariminia, Tony Butler, Jessica Y. Andrews, Mark Stoové, Matthew Law

Aboriginal Policy Research Consortium International (APRCi)

Objective: To estimate the number of deaths among people released from prison in Australia in the 2007–08 financial year, within 4 weeks and 1 year of release. Design, participants and setting: Application of crude mortality rates for ex-prisoners (obtained from two independent, state-based record-linkage studies [New South Wales and Western Australia]) to a national estimate of the number and characteristics of people released from prison in 2007–08. Main outcome measures: Estimated number of deaths among adults released from Australian prisons in 2007–08, within 4 weeks and 1 year of release, classified by age, sex, Indigenous status and cause of death. …

Cancer Incidence And Mortality In Indigenous Australians In Queensland, 1997–2006, Suzanne P. Moore, Peter K. O'Rourke, Kylie-Ann Mallitt, Gail Garvey, Adèle C. Green, Michael D. Coory, Patricia C. Valery

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine cancer incidence and mortality in Indigenous Queenslanders. Design, setting and patients: Assessment of indirectly standardised incidence and mortality ratios for Indigenous Australians in Queensland diagnosed with cancer from 1997 to 2006, compared with the total Queensland population. Main outcome measures: Standardised incidence and mortality ratios. Results: Compared with the total Queensland population, Indigenous Queenslanders had a lower overall incidence of cancer (standardised incidence ratio, 0.79; 95% CI, 0.75–0.82), but a higher incidence of some of the more fatal cancer types. Overall cancer mortality was higher (standardised mortality ratio, 1.36; 95% CI, 1.28–1.45) and similar to rates for …

Birthweight And Natural Deaths In A Remote Australian Aboriginal Community, Wendy E. Hoy, Jennifer L. Nicol

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To describe associations between birthweight and infant, child and early adult mortality from natural causes in a remote Australian Aboriginal community against a background of rapidly changing mortality due to better health services. Design, participants and setting: Cohort study of 995 people with recorded birthweights who were born between 1956 and 1985 to an Aboriginal mother in a remote Australian Aboriginal community. Participants were followed through to the end of 2006. Main outcome measures: Rates of natural deaths of infants (aged 0 to < 1 year), children (aged 1 to < 15 years) and adults (aged 15 to < 37 years), compared by birth intervals (1956–1965, 1966–1975 and 1976–1985 for infants and children, and 1956–1962 and 1963–1969 for adults) and by birthweight. Results: Birthweights were low, but increased over time. Deaths among infants and children decreased dramatically over time, but deaths among adults did not. Lower birthweights were associated with higher mortality. Adjusted for birth interval, hazard ratios for deaths among infants, children and adults born at weights below their group birthweight medians were 2.30 (95% CI, 1.13–4.70) ), 1.78 (95% CI, 1.03–3.07) and 3.49 (95% CI, 1.50–8.09), respectively. The associations were significant individually for deaths associated with diarrhoea in infants, with cardiovascular and renal disease in adults, and marginally significant for deaths from pulmonary causes in children and adults. Conclusion: The striking improvements in infant and child survival over time must be applauded. We confirmed a predisposing effect of lower birthweights on deaths in infants and children, and showed, for the first time, an association between lower birthweights and deaths in adults. Together, these factors are probably contributing to the current epidemic of chronic disease in Aboriginal people, an effect that will persist for decades. Similar phenomena are probably operating in developing countries.

Lower Than Expected Morbidity And Mortality For An Australian Aboriginal Population: 10-Year Follow-Up In A Decentralised Community, Kevin G. Rowley, Kerin O'Dea, Ian Anderson, Robyn Mcdermott, Karmananda Saraswati, Ricky Tilmouth, Iris Roberts, Joseph Fitz, Zaimin Wang, Alicia Jenkins, James D. Best, Zhiqiang Wang, Alex Brown

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toexaminemortalityfromallcausesandfromcardiovasculardisease(CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Mainoutcomemeasures: MortalityfromallcausesandCVD,andhospitalisationwith CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.

Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than …

Long-Term Trends In Indigenous Deaths From Chronic Diseases In The Northern Territory: A Foot On The Brake, A Foot On The Accelerator, David P. Thomas, John R. Condon, Ian P. Anderson, Shu Q. Li, Stephen Halpin, Joan Cunningham, Steven L. Guthridge

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. Design: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population.

Participants: NT Indigenous and total Australian populations, 1977–2001. Main outcome measures: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. Results: DeathratesfromIHDandDMamongNTIndigenouspeoplesincreased between 1977 and 2001, but this increase slowed after 1990. …

Stage At Diagnosis And Cancer Survival For Indigenous Australians In The Northern Territory, John R. Condon, Tony Barnes, Bruce K. Armstrong, Sid Selva-Nayagam, J. Mark Elwood

Aboriginal Policy Research Consortium International (APRCi)

Objective: To investigate whether Indigenous Australians with cancer have more advanced disease at diagnosis than other Australians, and whether late diagnosis explains lower Indigenous cancer survival rates. Design: Retrospective cohort study.

Setting and participants: Indigenous and non-Indigenous people diagnosed with cancers of the colon and rectum, lung, breast or cervix and non-Hodgkin lymphoma in the Northern Territory of Australia in 1991–2000. Main outcome measures: SEER summary stage of cancer at diagnosis (local, regional or distant spread), cause-specific cancer survival rates and relative risk of cancer death.

Results: Diagnosis with advanced disease (regional or distant spread) was more common for Indigenous …