Taylor, Emma V

Dugdale, Sarah

Connors, Christine

Garvey, Gail

Thompson, Sandra C

2024-01-27

Cancer is one of the leading causes of death for Aboriginal and Torres Strait Islander people in the Northern Territory (NT). Accessible and culturally appropriate cancer screening programs are a vital component in reducing the burden of cancer. Primary health care plays a pivotal role in facilitating the uptake of cancer screening in the NT, due to the significant challenges caused by large distances, limited resources, and cultural differences. This paper analyses health care provider perspectives and approaches to the provision of cancer screening to Aboriginal people in the NT that were collected as part of a larger study. Semi-structured interviews were conducted with 50 staff from 15 health services, including 8 regional, remote, and very remote primary health care (PHC) clinics, 3 hospitals, a cancer centre, and 3 cancer support services. Transcripts were thematically analysed. Cancer screening by remote and very remote PHC clinics in the NT is variable, with some staff seeing cancer screening as a "huge gap", while others see it as lower priority compared to other conditions due to a lack of resourcing and the overwhelming burden of acute and chronic disease. Conversely, some clinics see screening as an area where they are performing well, with systematic screening, targeted programs, and high screening rates. There was a large variation in perceptions of the breast screening and cervical screening programs. However, participants universally reported that the bowel screening kit was complicated and not culturally appropriate for their Aboriginal patients, which led to low uptake. System-level improvements are required, including increased funding and resourcing for screening programs, and for PHC clinics in the NT. Being appropriately resourced would assist PHC clinics to incorporate a greater emphasis on cancer screening into adult health checks and would support PHCs to work with local communities to co-design targeted cancer screening programs and culturally relevant education activities. Addressing these issues are vital for NT PHC clinics to address the existing cancer screening gaps and achieving the Australian Government pledge to be the first nation in the world to eliminate cervical cancer as a public health problem by 2035. The implementation of the National Lung Cancer Screening Program in 2025 also presents an opportunity to deliver greater benefits to Aboriginal communities and reduce the cancer burden.

Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA 6530, Australia.

Health Statistics and Informatics, NT Health, Darwin, NT 0800, Australia.

Public Health Division, NT Health, Darwin, NT 0800, Australia.

The School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia.

Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA 6530, Australia.

Int J Environ Res Public Health . 2024 Jan 27;21(2):141. doi: 10.3390/ijerph21020141.

1660-4601

0000-0002-8612-4738

0000-0001-5065-5716

0000-0003-0327-7155

https://pubmed.ncbi.nlm.nih.gov/38397632/?otool=iaurydwlib

https://hdl.handle.net/10137/13340

Aboriginal and Torres Strait Islander

Australia

Indigenous

bowel cancer screening

breast cancer screening

cancer screening

cervical cancer screening

colorectal cancer screening

primary health care

remote

Adult

Female

Humans

Early Detection of Cancer

Australian Aboriginal and Torres Strait Islander Peoples

Northern Territory

Uterine Cervical Neoplasms

Health Services, Indigenous

Lung Neoplasms

Health Personnel

"A Huge Gap": Health Care Provider Perspectives on Cancer Screening for Aboriginal and Torres Strait Islander People in the Northern Territory.

Journal Article

Publication