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|Title:||Cancer in Australian Aboriginal children: room for improvement|
|Citation:||Journal of Paediatrics and Child Health, 2013; 49(1):27-32|
|Laura Rotte, Jordan Hansford, Maria Kirby, Michael Osborn, Ram Suppiah, Petra Ritchie, Heather Tapp, Michael Rice and Tamas Revesz|
|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.|
|Keywords:||cancer; child; ethnicity; outcome|
|Rights:||© 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians)|
|Appears in Collections:||Paediatrics publications|
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