Treatment and Survival Outcomes for Indigenous Australians Within the Victorian Lung Cancer Registry.

Abstract

Introduction: Indigenous Australian lung cancer patients are known to have poorer survival outcomes, later stage at diagnosis, and significant comorbidities. Socioeconomic disadvantage, cultural awareness and access to healthcare are key factors that impact outcomes of indigenous populations. Our goal was to explore risk factors, patterns of management and survival outcomes in Indigenous compared to non- Indigenous Australian patients using the Victorian Lung Cancer Registry (VLCR). Method(s): A retrospective observational cohort study, using data collected on primary lung cancer patients in the VLCR between January 2011 and January 2024. Multivariate Cox regression and propensity matched survival analysis was performed to assess impacts of patient and clinical variables on survival. Result(s): We included 171 Indigenous and 17,343 non-Indigenous Australian patients. Indigenous lung cancer patients were younger in age (<60 years: 41% vs 17.2%, p<0.001), had lower socioeconomic status, were more likely to be current smokers (99% vs 87%, p<0.001) and had higher levels of respiratory comorbidity (36% vs 23%, p<0.001) Figure 1. Indigenous patients had lower receipt of guideline concordant treatment (53% vs 59%, p=0.084) Figure 2. Survival outcomes were not statistically significant but slightly lower for Indigenous compared to non-Indigenous Australian lung cancer patients (median survival 1.3 vs 1.6 years, HR=1.13, p=0.2). Conclusion(s): We found lung cancer patients of Indigenous status were more likely to have demographic disadvantage and clinical risk factors that contributed to poorer management and survival outcomes compared to patients of non-Indigenous status. 16% of the Indigenous population were aged <50 at diagnosis posing eligibility concerns for the upcoming National Lung Cancer Screening Program. Identifying barriers to healthcare and treatment in the Indigenous Australian population is an important research priority to improve disparities between the two populations.