Factors associated with cancer-specific and overall survival among indigenous and non-indigenous gynecologic cancer patients in Queensland, Australia: a matched cohort study

Diaz, Abbey, Moore, Suzanne P., Martin, Jennifer H., Green, Adele C., Garvey, Gail and Valery, Patricia C. (2015) Factors associated with cancer-specific and overall survival among indigenous and non-indigenous gynecologic cancer patients in Queensland, Australia: a matched cohort study. International Journal of Gynecological Cancer, 25 3: 542-547. doi:10.1097/IGC.0000000000000375


Author Diaz, Abbey
Moore, Suzanne P.
Martin, Jennifer H.
Green, Adele C.
Garvey, Gail
Valery, Patricia C.
Title Factors associated with cancer-specific and overall survival among indigenous and non-indigenous gynecologic cancer patients in Queensland, Australia: a matched cohort study
Journal name International Journal of Gynecological Cancer   Check publisher's open access policy
ISSN 1525-1438
1048-891X
Publication date 2015-03-10
Year available 2015
Sub-type Article (original research)
DOI 10.1097/IGC.0000000000000375
Volume 25
Issue 3
Start page 542
End page 547
Total pages 6
Place of publication London, United Kingdom
Publisher Lippincott Williams and Wilkins
Collection year 2016
Language eng
Formatted abstract
Objective: Aboriginal and Torres Strait Islander women have a higher mortality rate due to gynecologic cancer compared with non-Indigenous women. For cervical cancer, Australian Indigenous women are less likely to survive 5 years following diagnoses than non-Indigenous women. This study investigates the factors associated with gynecologic cancer treatment and survival among Queensland indigenous and non-Indigenous women.

Methods: Australian Indigenous women diagnosed with uterine, cervical, ovarian, or other gynecologic cancers during 1998-2004 in the public hospital system were included. They were frequency matched on age (±5 years), residential remoteness, and cancer type to a random sample of non-Indigenous women. One- and 5-year cancer-specific survival was examined according to Indigenous status using Cox proportional hazards regression.

Results: Indigenous women (n = 137) compared with non-Indigenous women (n = 120) were less likely to be diagnosed with localized disease (49% vs 65%, P = 0.02) and had more comorbidities (52% vs 21%, P < 0.001). Indigenous women were less likely to receive any cancer treatment compared with non-Indigenous women (91% vs 98%, P = 0.01), although when excluding those with metastatic cancer, there was no significant difference in uptake of treatment (95% vs 91%, respectively, P = 0.31). Among those who did undergo treatment, there was no difference in time to treatment (median difference 0.5 days, P = 0.98). Gynecologic cancer-specific survival differences between Indigenous and non-Indigenous women were most prominent in the first year following diagnosis (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.06-3.38) and were no longer significant 5 years after diagnosis (HR, 1.47 [95% CI, 0.97-2.25]). For cervical cancer, crude 1-year survival was poorer for Indigenous women compared with non-Indigenous women (HR, 2.46 [95% CI, 1.03-5.90]), but was no different when adjusted for stage and treatment of cancer (HR, 1.00 [95% CI, 0.45-2.24]).

Conclusions: Improving the early diagnosis of cervical cancer in Indigenous women may increase cancer-specific survival in the year following diagnosis.
Keyword Cancer
Cervical
Gynecologic
Indigenous survival
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
School of Medicine Publications
 
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