Health system performance and outcomes for Indigenous Australians with cancer: a national study.

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Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained about health system performance for Indigenous Australians from national administrative databases and registers. This project will assess health system performance and outcome for Indigenous people with cancer at a national level for the first time. It will compare Indigenous with non-Indigenous cancer survival rates for Australia as a whole, including regional (urban-rural-remote) variations and time trends. For those states where data on stage at diagnosis and hospital treatment are available, it will also investigate the performance of diagnostic and treatment services for Indigenous cancer patients by comparing their stage at diagnosis and surgical treatment with that for non-Indigenous patients. Time trends for each of these issues will be examined using data from those states with data of adequate quality and consistency over the past 10-15 years. This project will provide the methodological basis for regular reporting of Indigenous cancer survival and related statistics in the national cancer reporting system and demonstrate that national monitoring of the acute care system for Indigenous people is possible for other conditions. The results of this research will directly inform acute care policy and practice for Indigenous people with cancer (particularly the relative need for improvement in primary health or acute care services), and have implications for the performance of the acute care system system more generally for Indigenous Australians.