Cancer in Australian Aboriginal children: room for improvement.

Abstract

AIM:

The study aims to analyse clinical data and outcome in Aboriginal and non-Aboriginal children with cancer.

METHODS:

This is a retrospective case-note review of biological features, treatment outcome and survival in Aboriginal and non-Aboriginal children with a malignancy who were treated at the Women's and Children's Hospital, a tertiary referral hospital, from January 1997 through March 2011. Two separate analyses were performed: firstly, for each Aboriginal patient comparisons were made with two age, sex and diagnosis-matched control patients; then secondly, results for the Aboriginal group of patients were compared with the whole non-Aboriginal group of patients.

RESULTS:

In the first analysis, Aboriginal children had a significantly higher 'remoteness index' (6.14 vs. 0.95; P < 0.001) and were less likely to be enrolled on clinical trials. Survival analysis of the Aboriginal patients and their matched controls showed a trend towards inferior overall survival for the Indigenous children (P = 0.066). In the second analysis, Aboriginal children tended to have a higher proportion of leukaemias and lymphomas and had an overrepresentation of acute myeloid leukaemia (AML) (P = 0.009). The mean age among Aboriginal children with AML and lymphoma was lower (AML: 3.5 vs. 8 years, P = 0.065; lymphoma: 7.5 vs. 11.9 years, P = 0.01). A higher proportion of Aboriginal children died (P = 0.004).

CONCLUSIONS:

Aboriginal children present with a somewhat different pattern of cancer, are less likely to be enrolled on studies and seem to have increased mortality. There is a need for improvement in study enrolment, treatment delivery, care coordination and suitably supported residential facilities.

• Authors: Laura Rotte, Jordan Hansford, Maria Kirby, Michael Osborn, Ram Suppiah, Petra Ritchie, Heather Tapp, Michael Rice, Tamas Revesz
• Journal: Journal of paediatrics and child health (J Paediatr Child Health) Vol. 49 Issue 1 Pg. 27-32 (Jan 2013) ISSN: 1440-1754 [Electronic] Australia
• PMID: 23198875 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
• Copyright: © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Topics

• Adolescent
• Child
• Child, Preschool
• Clinical Trials as Topic
• Female
• Follow-Up Studies
• Health Status Disparities
• Healthcare Disparities (ethnology, statistics & numerical data)
• Humans
• Infant
• Infant, Newborn
• Male
• Matched-Pair Analysis
• Native Hawaiian or Other Pacific Islander
• Neoplasms (diagnosis, ethnology, mortality, therapy)
• Northern Territory (epidemiology)
• Retrospective Studies
• South Australia (epidemiology)
• Survival Analysis
• Treatment Outcome