• Sonja E Hall, Caroline E Bulsara, Max K Bulsara, Timothy G Leahy, Margaret R Culbong, Delia Hendrie, and C D'Arcy J Holman.
• School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. shall@sph.uwa.edu.au
• Med. J. Aust. 2004 Aug 16; 181 (4): 191194191-4.

ObjectiveTo examine whether hospital patients with cancer who were identified as Indigenous were as likely to receive surgery for the cancer as non-Indigenous patients.Design, Setting And PatientsEpidemiological survey of all Western Australian (WA) patients who had a cancer registration in the state-based WA Record Linkage Project that mentioned cancer of the breast (1982-2000) or cancer of the lung or prostate (1982-2001).Main Outcome MeasuresThe likelihoods of receiving breast-conserving surgery or mastectomy for breast cancer, lung surgery for lung cancer, or radical or non-radical prostatectomy for prostate cancer were compared between the Indigenous and non-Indigenous populations using adjusted logistic regression analyses.ResultsIndigenous people were less likely to receive surgery for their lung cancer (odds ratio [OR], 0.64; 95% CI, 0.41-0.98). Indigenous men were as likely as non-Indigenous men to receive non-radical prostatectomy (OR, 0.69; 95% CI, 0.40-1.17); only one Indigenous man out of 64 received radical prostatectomy. Indigenous women were as likely as non-Indigenous women to undergo breast-conserving surgery (OR, 0.86; 95% CI, 0.60-1.21).ConclusionsThese results indicate a different pattern of surgical care for Indigenous patients in relation to lung and prostate, but not breast, cancer. Reasons for these disparities, such as treatment choice and barriers to care, require further investigation.

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