Boyd, Rowena; Charakidis, Michail; Burgess, Paul; Dugdale, Sarah; Castillon, Craig; Sutandar, Dzulfikaar; Wright, Alyson

Author(s)

Boyd, Rowena

Charakidis, Michail

Burgess, Paul

Dugdale, Sarah

Castillon, Craig

Sutandar, Dzulfikaar

Wright, Alyson

Publication Date

2025-04-21

Abstract

To investigate cancer survival for Aboriginal and non-Aboriginal peoples in the Northern Territory during the period 1991-2020, across the 15 most prevalent primary cancer sites.Retrospective cohort study of Northern Territory Cancer Registry notifications.NT residents diagnosed with an invasive cancer from 1 January 1991 to 31 December 2020.Five-year survival for all cancers and for 15 primary cancer sites by 10-year periods of diagnosis, and excess hazard ratios comparing excess mortality following cancer diagnosis for Aboriginal peoples compared with non-Aboriginal peoples.Of 17 759 cancer registrations analysed, 3350 (18.9%) had Indigenous status recorded as Aboriginal. Five-year survival improved significantly from 1991-2000 to 2011-2020 for all populations, including Aboriginal (males, 20.5% to 37.1%; females, 32.3% to 47.2%) and non-Aboriginal (males, 50.0% to 65.9%; females, 64.5% to 75.4%). The gap in 5-year cancer survival for Aboriginal peoples closed by 12.4% (4.0 percentage difference) for females, but only by 2.4% (0.7 percentage difference) for males. For all 15 cancer sites, 5-year survival improved, but Aboriginal peoples experienced excess mortality, ranging from an excess hazard ratio of 1.3 for mortality following diagnosis of liver cancer to 6.1 for prostate cancer during the period 2011-2020.Cancer survival has improved for Aboriginal and non-Aboriginal peoples in the NT. However, the gap in survival outcomes for Aboriginal peoples persists. Further research is required on pathways to close the gap, including: improving access to care, understanding social and cultural factors, reducing diagnostic and treatment delays, and promoting greater equity of Aboriginal participation in clinical trials. Quality improvement approaches led by Aboriginal peoples should be prioritised to tailor culturally appropriate preventive strategies.

Affiliation

Northern Territory Department of Health, Darwin, NT.

Royal Darwin Hospital, Darwin, NT.

Charles Darwin University, Darwin, NT.

Northern Territory Department of Health, Darwin, NT.

Citation

Med J Aust . 2025 Apr 21. doi: 10.5694/mja2.52656. Online ahead of print.

ISSN

1326-5377

OrcId

0000-0001-7178-7419

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/40259612/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/14252

Title

Improved cancer survival in the Northern Territory: identifying progress and disparities for Aboriginal peoples, 1991-2020.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Boyd, Rowena Charakidis, Michail Burgess, Paul Dugdale, Sarah Castillon, Craig Sutandar, Dzulfikaar Wright, Alyson
Publication Date	2025-04-21
Abstract	To investigate cancer survival for Aboriginal and non-Aboriginal peoples in the Northern Territory during the period 1991-2020, across the 15 most prevalent primary cancer sites.Retrospective cohort study of Northern Territory Cancer Registry notifications.NT residents diagnosed with an invasive cancer from 1 January 1991 to 31 December 2020.Five-year survival for all cancers and for 15 primary cancer sites by 10-year periods of diagnosis, and excess hazard ratios comparing excess mortality following cancer diagnosis for Aboriginal peoples compared with non-Aboriginal peoples.Of 17 759 cancer registrations analysed, 3350 (18.9%) had Indigenous status recorded as Aboriginal. Five-year survival improved significantly from 1991-2000 to 2011-2020 for all populations, including Aboriginal (males, 20.5% to 37.1%; females, 32.3% to 47.2%) and non-Aboriginal (males, 50.0% to 65.9%; females, 64.5% to 75.4%). The gap in 5-year cancer survival for Aboriginal peoples closed by 12.4% (4.0 percentage difference) for females, but only by 2.4% (0.7 percentage difference) for males. For all 15 cancer sites, 5-year survival improved, but Aboriginal peoples experienced excess mortality, ranging from an excess hazard ratio of 1.3 for mortality following diagnosis of liver cancer to 6.1 for prostate cancer during the period 2011-2020.Cancer survival has improved for Aboriginal and non-Aboriginal peoples in the NT. However, the gap in survival outcomes for Aboriginal peoples persists. Further research is required on pathways to close the gap, including: improving access to care, understanding social and cultural factors, reducing diagnostic and treatment delays, and promoting greater equity of Aboriginal participation in clinical trials. Quality improvement approaches led by Aboriginal peoples should be prioritised to tailor culturally appropriate preventive strategies.
Affiliation	Northern Territory Department of Health, Darwin, NT. Northern Territory Department of Health, Darwin, NT. Royal Darwin Hospital, Darwin, NT. Charles Darwin University, Darwin, NT. Northern Territory Department of Health, Darwin, NT. Northern Territory Department of Health, Darwin, NT. Northern Territory Department of Health, Darwin, NT. Northern Territory Department of Health, Darwin, NT. Northern Territory Department of Health, Darwin, NT.
Citation	Med J Aust . 2025 Apr 21. doi: 10.5694/mja2.52656. Online ahead of print.
ISSN	1326-5377
OrcId	0000-0001-7178-7419
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/40259612/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/14252
Title	Improved cancer survival in the Northern Territory: identifying progress and disparities for Aboriginal peoples, 1991-2020.
Type of document	Journal Article
Entity Type	Publication

Improved cancer survival in the Northern Territory: identifying progress and disparities for Aboriginal peoples, 1991-2020.

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