12:30pm Federation Ballroom presentation by Jacinta Elston from Cancer Australia.

1. Our Health Counts:
Improving Cancer Outcomes
National Aboriginal Community Controlled
Health Organisation Conference
Canberra
31 October 2017
Professor Jacinta Elston, James Cook University
Jennifer Chynoweth, Cancer Australia

2. 1. What is the impact of cancer on Aboriginal and Torres
Strait Islander people?
2. Why is there a disparity in cancer outcomes between
Indigenous and non-Indigenous Australians?
3. What is being done to address the disparity?
4. What can be done at the primary health care level to
improve outcomes?
Outline

3. What is the impact of cancer on Aboriginal
and Torres Strait Islander people?
Increasing numbers of Indigenous Australians are
being diagnosed with cancer and Indigenous
Australians are about 30 per cent more likely to die
from cancer than non-Indigenous Australians.

4. Survival for all cancers combined
80
1984-1988
70
60
50
40
30
20
10
0
1989-1993 1994-1998 1999-2003 2004-2008 2009-2013
5YEARRELATIVESURVIVAL%
Reference: Australian Institute of Health and Welfare 2017. Cancer in Australia 2017. Cancer series no.101. Cat. no.
CAN 100. Canberra: AIHW. Supplementary material

5. Cancer incidence over time
300
350
400
450
500
2002 2004 2006 2008 2010 2012
Indigenous
Non-Indigenous
Linear (Indigenous)
Linear (Non-Indigenous)
Rate per 100,000
Reference: Prepared and sourced by the Australian Institute of Health and Welfare, 2017

6. Cancer mortality over time
References: Prepared by the Australian Institute of Health and Welfare 2017
21%
13%

7. Lung cancer and cervical cancer
Lung cancer and cervical cancer, by Indigenous status, age-
standardised incidence (2008–2012) and mortality (2010–2014) rates
(per 100,000)
0
10
20
30
40
50
60
70
80
90
Incidence Mortality
Indigenous
Non-Indigenous
Lung cancer
0
2
4
6
8
10
12
14
16
Incidence Mortality
Indigenous
Non-Indigenous
Cervical cancer
Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2017. Cancer in Australia: in brief 2017. Cancer
series no. 102. Cat. no. CAN 101. Canberra: AIHW.

8. Why is there a disparity in cancer
outcomes between Indigenous and non-
Indigenous Australians?
There are a range of contributing factors to the
difference in cancer outcomes between Indigenous
and non-Indigenous Australians

9. Why the disparity?
Factors include:
 Higher levels of modifiable risk factors
 Lower participation in screening
 Later stage at diagnosis
 Less likely to receive adequate cancer treatment
Reference: Australian Institute of Health and Welfare (2017) Cancer in Australia 2017. Cancer series no.101. Cat. no. CAN 100. Canberra: AIHW.

10. Modifiable risk factors
Tobacco smoke
UV Radiation
Diet
Overweight and obesity
Infections
Alcohol
Physical inactivity
Other
Whiteman et al, Cancer in Australia in 2010 attributable to modifiable factors: summary and conclusions, published in
Australian and New Zealand Journal of Public Health, 2016, vo.39. no 5

11. Why the disparity?
Factors include:
 Higher levels of modifiable risk factors
 Lower participation in screening
 Later stage at diagnosis
 Less likely to receive adequate cancer treatment
Reference: Australian Institute of Health and Welfare (2017) Cancer in Australia 2017. Cancer series no.101. Cat. no. CAN 100. Canberra: AIHW.

12. What is being done to address the disparity in
cancer outcomes between Indigenous and non-
Indigenous Australians?
Many individuals, communities, organisations and
governments are working to help improve cancer outcomes
for Indigenous Australians.

13. Cancer Australia
A national shared leadership approach
 National Aboriginal and Torres Strait Islander
Cancer Framework
 Leadership Group on Aboriginal and Torres Strait
Islander Cancer Control
 Optimal Care Pathway for Aboriginal and Torres
Strait Islander people with cancer

14. Cancer Australia
Framework Priorities
1. Improving knowledge, attitudes and understanding
2. Focusing on prevention activities
3. Increasing access to and participation in cancer
screening
4. Ensuring early diagnosis
5. Ensuring optimal and culturally appropriate care
6. Ensuring families and carers are supported
7. Strengthening services and systems to deliver good
quality, integrated services

15. Cancer Australia
Leadership Group on Aboriginal and Torres Strait
Islander Cancer Control
 Fosters engagement and collaboration across the sector and
leads a shared agenda for improving outcomes
 Chaired by Professor Jacinta Elston, it brings together experts,
and people with a lived experience of cancer
 Identifies and leverages opportunities to improve cancer
outcomes at system, service and community levels

16. Cancer Australia
Optimal Care Pathway for Aboriginal and Torres
Strait Islander people with cancer
 Aims to develop a national Optimal Care Pathway (OCP) to
guide the delivery of culturally appropriate, consistent,
safe, high quality, and evidence based care for Aboriginal
and Torres Strait Islander people with cancer.

17. Cancer Australia
OCP for Aboriginal and Torres Strait Islander people with cancer
 The pathway outlines the steps of
optimal care across the cancer
continuum
 Informs health services in
identifying and implementing
areas for quality improvement
across the cancer care continuum
Intent
Step1
Prevention & early
detection
Step 2
Presentation, initial
investigations &
referral
Step 3
Diagnosis, staging
& treatment
planning
Step 4
Treatment
Step 5
Care after initial
treatment &
recovery
Step 6
Managing
recurrent, residual
& metastatic
disease
Step 7
End-of-life care

18.  Reducing risk
 Awareness raising and early detection
 Evidence based, culturally appropriate care
 Expanding research
Success across the sector

19. Women’s Business and Our Lungs,
Our Mob Workshops
Riverina Medical and Dental
Aboriginal Corporation, Wagga Wagga
Umoona Tjutagku Health Service
Aboriginal Corporation, Coober
Pedy

20. What can be done at the primary health
care level to improve cancer outcomes?
1. Raise awareness on cancer and risk factors
2. Encourage immunisation and screening
3. Consider cancer risk factors in primary health checks
4. Implement cancer Optimal Care Pathways
http://www.cancervic.org.au/for-health-professionals/optimal-care-
pathways

21. What can be done at the primary health
care level to improve cancer outcomes?
5. Support coordinated care for cancer patients
6. Link in with regional and state Cancer Councils
7. Use the National Aboriginal and Torres Strait Islander
Cancer Framework for high level guidance and direction
8. Use the Supportive Care Needs Assessment Tool
http://www.scnatip.org/
9. Support research and data collection

22. Cancer Australia
Building community capacity
 Raising community awareness about cancer
 Building capacity of Aboriginal and Torres Strait Islander Health
Workers
 Supporting sustainable change at the local level

23. #LotsToLiveFor

24. Pink Ribbon Breakfast 2017

25. www.canceraustralia.gov.au
@canceraustralia YouTube.com/canceraustralia