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Mashtoub S, Ullah S, Collinson A, Singh GR, Clark (Adnyamathanha) J, Leemaqz S, Paltiel O, Roder DM, Saxon B, McKinnon R, Pandol SJ, Roberts CT, Barreto SG. Childhood Cancer Incidence and Survival in South Australia and the Northern Territory, 1990-2017, with Emphasis on Indigenous Peoples. Cancers (Basel) 2024; 16:2057. [PMID: 38893175 PMCID: PMC11171054 DOI: 10.3390/cancers16112057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND & AIMS Reports of a rise in childhood cancer incidence in Australia and globally prompted the investigation of cancer incidence and survival in South Australia (SA) and the Northern Territory (NT) over a 28-year period, with emphasis on Indigenous peoples. METHODS This cross-sectional analysis of two prospective longitudinal databases, the SA and NT Cancer Registries (1990-2017), included all reported cases of childhood cancers. Poisson regression provided estimates of incidence rate ratios and survival was modelled using Cox proportional hazard models for children aged <5 and ≥5 years. RESULTS A total of 895 patients across SA (N = 753) and the NT (N = 142) were ascertained. Overall and in the NT, childhood cancer incidence was higher in males compared with females (IRR 1.19 [1.04-1.35] and 1.43 [1.02-2.01], respectively). Lymphocytic leukemia was the most reported cancer type across all locations. With reference to the 1990-1999 era (181.67/100,000), cancer incidence remained unchanged across subsequent eras in the combined cohort (SA and NT) (2000-2009: 190.55/100,000; 1.06 [0.91-1.25]; 2010-2017: 210.00/100,000; 1.15 [0.98-1.35]); similar outcomes were reflected in SA and NT cohorts. Cancer incidence amongst non-Indigenous children significantly decreased from the 1990-1999 era (278.32/100,000) to the 2000-2009 era (162.92/100,000; 0.58 [0.35-0.97]). Amongst 39 Indigenous children in the NT, incidence rates remained unchanged across eras (p > 0.05). With reference to the 1990-1999 era, overall survival improved in subsequent eras in SA (2000-2009: HR 0.53 [0.38-0.73]; 2010-2017: 0.44 [0.28-0.68]); however, remained unchanged in the NT (2000-2009: 0.78 [0.40-1.51]; 2010-2017: 0.50 [0.24-1.05]). In the NT, overall survival of Indigenous patients was significantly lower compared with the non-Indigenous cohort (3.42 [1.92-6.10]). While the survival of Indigenous children with cancer significantly improved in the last two eras (p < 0.05), compared to the 1990-1999 era, no change was noted amongst non-Indigenous children in the NT (p > 0.05). CONCLUSIONS The incidence of childhood cancers has remained unchanged over 28-years in SA and the NT. Encouragingly, improved survival rates over time were observed in SA and amongst Indigenous children of the NT. Nevertheless, survival rates in Indigenous children remain lower than non-Indigenous children.
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Affiliation(s)
- Suzanne Mashtoub
- Department of Surgery, Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia;
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (S.U.); (S.L.); (R.M.)
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (S.U.); (S.L.); (R.M.)
| | | | - Gurmeet R. Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, NT 0800, Australia;
| | - Justine Clark (Adnyamathanha)
- Indigenous Genomics, Telethon Kids Institute, Adelaide, SA 5000, Australia;
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Shalem Leemaqz
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (S.U.); (S.L.); (R.M.)
| | - Ora Paltiel
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem 9112102, Israel;
- Department of Hematology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - David M. Roder
- Cancer Epidemiology and Population Health, UniSA Allied Health and Human Performance, Adelaide, SA 5001, Australia;
| | - Benjamin Saxon
- Department of Haematology/Oncology, Women’s and Children’s Hospital, Adelaide, SA 5000, Australia;
- Paediatric Education, University of Adelaide, Adelaide, SA 5005, Australia
| | - Ross McKinnon
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (S.U.); (S.L.); (R.M.)
- Flinders Health and Medical Research Institute, Adelaide, SA 5042, Australia
| | - Stephen J. Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - Claire T. Roberts
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (S.U.); (S.L.); (R.M.)
- Flinders Health and Medical Research Institute, Adelaide, SA 5042, Australia
| | - Savio George Barreto
- Department of Surgery, Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia;
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (S.U.); (S.L.); (R.M.)
- Flinders Health and Medical Research Institute, Adelaide, SA 5042, Australia
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Henningham M, Gilroy J, McGlone J, Meehan D, Nila F, McAtamney A, Buchanan T. Utilising the CREATE quality appraisal tool to analyse Aboriginal and Torres Strait Islander peoples' involvement and reporting of cancer research in Australia. Aust N Z J Public Health 2024; 48:100142. [PMID: 38574430 DOI: 10.1016/j.anzjph.2024.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE We aimed to evaluate Aboriginal and Torres Strait Islander involvement in research focusing on cancer experiences using an Aboriginal and Torres Strait Islander quality appraisal tool (the QAT). METHODS We conducted a systematic review of the peer-reviewed literature on Aboriginal and Torres Strait Islander peoples' experiences associated with cancer, recently published elsewhere. We then appraised articles for the inclusion of Aboriginal and Torres Strait Islander-led research, community consultation, and involvement. RESULTS 91 articles were appraised. A lack of Aboriginal and Torres Strait Islander-led research and consultation was reported in the majority of articles, only 10 (11%) demonstrated success across seven (50%) or more questions of the QAT. CONCLUSIONS This review underscores the need for anti-racist research and publication practices that actively engage Aboriginal and Torres Strait Islander peoples and researchers. This approach is vital to enhance cancer outcomes within these communities. IMPLICATIONS FOR PUBLIC HEALTH To advance and prioritise appropriate involvement of Aboriginal and Torres Strait Islander peoples in cancer research, the onus must be on 'systems owners,' including academic journals and institutions, to require and report genuine engagement as standard practice. Researchers will produce higher-calibre research with a strengths-based focus, advancing the cause of equitable research.
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Affiliation(s)
- Mandy Henningham
- Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - John Gilroy
- Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Farhana Nila
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
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Gilroy J, Henningham M, Meehan D, Nila F, McGlone J, McAtamney A, Whittaker K, Brown B, Varlow M, Buchanan T. Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer. BMC Public Health 2024; 24:523. [PMID: 38378574 PMCID: PMC10877816 DOI: 10.1186/s12889-024-18070-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia. METHODS A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations. RESULTS Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings. CONCLUSION Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.
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Affiliation(s)
- John Gilroy
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Mandy Henningham
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia.
| | - Farhana Nila
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | | | | | - Bena Brown
- Inala Indigenous Health Service, Metro South Health, Inala, QLD, 4077, Australia
| | - Megan Varlow
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Tanya Buchanan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
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Slater P, Hastings Y, Nicholson J, Noyes M, Benitez L, Pollock K, Peacock R, Cox A, Gunning R, Caris K, Petersen D, Henry C, Spanner R, Beckett K, Chisholm C. Fifteen years of shared care for paediatric oncology, haematology and palliative patients across Queensland: The role of Regional Case Managers. Aust J Rural Health 2022. [PMID: 36577741 DOI: 10.1111/ajr.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/21/2022] [Accepted: 12/04/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE A shared care model was implemented in 2006 in Queensland to facilitate paediatric oncology, haematology and palliative care patients receiving care as close to home as possible. Following initial diagnosis, care planning and treatment at the tertiary children's hospital, appropriate local care was coordinated by Regional Case Managers (RCMs) established at each of 10 Shared Care Units (SCUs). This enabled safe and quality regional care supported by a statewide network providing clinical governance and education. This paper examines learnings from 15 years of this shared care. SETTING Ten hospitals throughout Queensland facilitated a statewide model of shared care for paediatric oncology, haematology and palliative care patients, supported by a tertiary hub in Brisbane. PARTICIPANTS Regional Case Managers in Shared Care Units and their supporting staff. DESIGN Staff from SCUs were surveyed and focus group interviews conducted. RESULTS The paper reviews the attributes, knowledge and experience required for RCMs. Standards of care were supported through education workshops, clinical placements, chemotherapy credentialing, guidelines and standards. RCMs facilitated communication and information sharing with the tertiary centre, advocated for their cohort of patients locally and streamlined and supported the family's experience of care. CONCLUSION The RCM role provided invaluable clinical leadership for the care of paediatric oncology, haematology and palliative patients across Queensland. As new treatments evolve, the expertise and coordination provided by the RCMs will be even more critical. Achieving high-quality shared care outcomes is underpinned by the RCMs drive to achieve statewide safety and support for this cohort of children.
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Affiliation(s)
- Penelope Slater
- Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Yvonne Hastings
- Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Jessica Nicholson
- Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Michelle Noyes
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Lori Benitez
- Toowoomba Hospital, Toowoomba, Queensland, Australia
| | - Kobi Pollock
- Bundaberg Base Hospital, Bundaberg Central, Queensland, Australia
| | - Rinnah Peacock
- Rockhampton Hospital, Rockhampton, Queensland, Australia
| | - Anita Cox
- Gold Coast University Hospital, Southport, Queensland, Australia
| | | | - Karen Caris
- Mackay Base Hospital, Mackay, Queensland, Australia
| | | | - Catherine Henry
- Townsville University Hospital, Douglas, Queensland, Australia
| | - Rachael Spanner
- Bundaberg Hospital, Bundaberg Central, Queensland, Australia
| | - Karen Beckett
- Townsville University Hospital, Douglas, Queensland, Australia
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