BACKGROUND: Despite relative advances in some aspects of Indigenous healthcare, there still remains a distinct disparity in the cancer care sought out by and available to Indigenous Australians. Access to cultural-specific cancer services, a mistrust of healthcare providers and late presentations for care are all key factors leading to this discrepancy in outcomes.
AIM: This paper aims to identify barriers to providing optimal cultural specific cancer for Indigenous Australians, as well as highlighting key strategies and initiatives already undertaken to improving health outcomes and potential future directions.
METHODS: A narrative literature review of Australian medical journals, peer-review articles as well published conference proceedings as well as state and federal Government commissioned studies was undertaken using major medical databases and search engines.
RESULTS: Significant advances have been made to address the disparity in cancer-care outcomes amongst indigenous Australians. The ‘Close the Gap’ and ‘practice incentive payment’ initiatives have demonstrably increased engagement of indigenous persons in cancer management on a primary care level. Aboriginal Healthcare Workers (AHCW) have also facilitated engagement in cancer care, with evidence of increased retention and follow-up compliance. However, indigenous persons are still more likely to have delayed diagnosis for breast (13%), bowel (41%) and prostate (27%) cancer than their non-indigenous counterparts and have an across-the-board higher mortality rate by 16%. Pervasive deep-seated cultural beliefs of cancer being a ‘punishment’ for some sort of transgression also contribute to lesser use of oncology services. Additionally, traditional disenfranchisement from ‘white man medicine’ remains an issue for engaging with established cancer care services. Financial issues, regional proximity and transport issues remain a barrier to accessible cancer services.
CONCLUSION: While there have been significant healthcare initiatives and programs to engage Indigenous Australians in comprehensive cancer care, outcome discrepancies remain in comparison to non-indigenous Australians. Further work is required to address this disparity.