Disparities in Cancer Care in Australia and the Pacific

Disparities in cancer care across populations become apparent only when there is a cancer registry to record the cancer incidence and mortality statistics and data capture is comprehensive. In Australia, one of the obvious disparities is geography, with mortality in some cancers being worse with increasing remoteness. The reasons are not just poorer access to screening and treatment but lifestyle and occupational factors which encompass increased cancer risk factors compared with urban counterparts. There are also higher proportions of lower socioeconomic groups and Aboriginal and Torres Strait Islanders, both of which in addition to remoteness have poorer cancer outcomes. Indigenous Australians have a higher exposure to risk factors of smoking and obesity, live remotely, and have lower participation rates in screening and treatment than nonIndigenous Australians. Immigrants to Australia from diverse backgrounds have a lower incidence of the common cancers and a lower overall mortality. They have a different spectrum of cancers such as more liver cancer because of their exposure to hepatitis B. The M (a) over bar ori in New Zealand are well studied and display disparities in cancer outcomes similar to Indigenous Australians. There is less known of the Pacific Islanders, but they often have worse outcomes than Europeans living in the same environment, a greater exposure to risk factors, and the added problem of often needing to travel from the Pacific Islands to New Zealand for treatment. Poorer socioeconomic status is the other major factor associated with poorer outcomes in cancer treatment. Often, low socioeconomic status groups have lifestyles with higher levels of smoking and obesity, do not participate in screening as readily, and may not be able to afford unsubsidized treatments such as high-cost drugs. The Oncologist 2011;16:930-934