Sharing the challenge of cancer control for Indigenous Australians: a national agenda.
Australia's record of cancer survival is one of the best in the world, yet Aboriginal and Torres Strait Islander people (Indigenous Australians) continue to experience disparities in cancer outcomes. Indigenous Australians have a slightly lower rate of cancer diagnosis but a 30% higher mortality rate due to cancer than non Indigenous Australians (AIHW 2014) Cancer is the second most common cause of death for Indigenous Australians and the data tell us that cancer is an increasingly important issue (AIHW 2014) It is a very compelling and disturbing story. Between 1998 and 2012, there has been a 16% increase in the age standardised mortality rate due to cancer for Indigenous people, whereas the rate for non indigenous people fell by 10% during the same period (AIHW 2015) Central to addressing this widening cancer mortality gap is the recognition that the development and survival of cancer is closely associated with the social and behavioural determinants of health as well as the performance of health systems. Aboriginal and Torres Strait Islander people have a different pattern of cancer incidence (AIHW 2014) with a higher rate of cancers that are preventable (lung, liver, cervical cancers) and higher levels of modifiable risk factors relevant to cancer including smoking, risky alcohol consumption, poor diet, low levels of physical activity and high levels of infection such as hepatitis B (AIHW Cancer Australia 2013) Additionally, Aboriginal and Torres Strait Islander people are less likely to engage effectively with the health system. The evidence tells us they are less likely to participate in cancer screening (Roder et al. 2012) more likely to be diagnosed with advanced stages of disease and less likely to receive adequate treatment or be hospitalised for cancer (AIHW&Cancer Australia 2013) As the national cancer control agency, Cancer Australia identified the need for an evidence informed strategic and shared agenda to drive national and coordinated approaches to improving cancer outcomes for Aboriginal and Torres Strait Islander people. Cancer Australia's National Aboriginal and Torres Strait Islander Cancer Framework (Cancer Australia 2015) (Framework) was developed in collaboration with Menzies School of Health Research and defines evidence based priorities resulting from a review of the evidence, including population health data, as well as broad stakeholder consultation through face to face workshops, facilitated online discussion forums, an online survey and a national forum. The process ensured that the views of over 500 individuals or groups were heard and that the Framework embraced the needs and aspirations of Indigenous people themselves. Indigenous participants made up nearly 60% of those who attended the forums, and 35% of those who participated in the survey, with strong Indigenous leadership in both the Correspondence address: Helen Zorbas, Cancer Australia, Strawberry Hills NSW, Australia (e mail: helen.zorbas@canceraustralia.gov.au)
European journal of cancer care