Treatment and Survival Outcomes for Indigenous and Non-Indigenous Australians Within the Victorian Lung Cancer Registry: A Retrospective Cross-Sectional Cohort Study.

Abstract

Our goal was to explore and compare risk factors, patterns of management and survival outcomes in Indigenous compared with non-Indigenous Australian patients using the Victorian Lung Cancer Registry (VLCR). A retrospective observational cohort study of the VLCR. Data collected from the VLCR between 18 January 2011 and 24 January 2024. Primary lung cancer patients in the VLCR. Patient, disease and management characteristics of Indigenous and non-Indigenous Australian patients. Impacts of patient and clinical variables on treatment and survival, measured by multivariable Cox regression and propensity-matched survival analysis. We included 186 Indigenous and 17,439 non-Indigenous Australian patients. Indigenous Australian lung cancer patients were younger in age {median, 62 years (interquartile range [IQR], 55-69 years) vs. median, 71 years (IQR, 63-77 years); p < 0.001}, had lower socio-economic status (lowest quintile, 57 patients [31%] vs. 3274 patients [19%]; p < 0.001), were more likely to be current smokers (118 patients [65%] vs. 5963 patients [35%]; p < 0.001) and had higher levels of respiratory comorbidity (64 patients [34%] vs. 4088 patients [23%]; p < 0.001). There were no statistically significant differences in receipt of guideline-concordant treatment (82 patients [51%] vs. 8036 patients [56%]; p = 0.12) and survival outcomes (median survival, 1.4 vs. 1.5 years; hazard ratio, 1.06 [95% confidence interval, 0.88-1.27]). We found lung cancer patients of Indigenous status were more likely to have demographic disadvantage and clinical risk factors that may contribute to discrepancies in management compared with patients of non-Indigenous status. Identifying barriers to healthcare and treatment in the Indigenous Australian population is an important research priority to improve disparities between the two populations.