Declaration of conflict of interest: None declared.
Cancer in Australian Aboriginal children: Room for improvement
Article first published online: 2 DEC 2012
© 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 1, pages 27–32, January 2013
How to Cite
Rotte, L., Hansford, J., Kirby, M., Osborn, M., Suppiah, R., Ritchie, P., Tapp, H., Rice, M. and Revesz, T. (2013), Cancer in Australian Aboriginal children: Room for improvement. Journal of Paediatrics and Child Health, 49: 27–32. doi: 10.1111/jpc.12026
- Issue published online: 16 JAN 2013
- Article first published online: 2 DEC 2012
- Manuscript Accepted: 26 JUL 2012
The study aims to analyse clinical data and outcome in Aboriginal and non-Aboriginal children with cancer.
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.
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).
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.