University of Sydney, Sydney, NSW
Cancer Council NSW, Sydney, NSW.
Med J Aust. 2016 Mar 7;204(4):156. doi: 10.5694/mja15.01153.
Our aim was to compare surgical treatment rates and survival rates for Aboriginal and non-Aboriginal people in New South Wales with colorectal cancer, and to describe the medical treatment received by a sample of Aboriginal people with colorectal cancer.
DESIGN, SETTING AND PARTICIPANTS: All people diagnosed with colorectal cancer in NSW during 2001-2007 were identified and their cancer registry records linked to hospital admissions data and death records. A medical records audit of a sample of Aboriginal people diagnosed with colorectal cancer during 2000-2011 was also conducted.
Cause-specific survival, odds of surgical treatment, and the proportions of people receiving adjuvant treatments.
Of 29 777 eligible colorectal cancer cases, 278 (0.9%) involved Aboriginal people. Similar proportions of Aboriginal (76%) and non-Aboriginal (79%) people had undergone surgical treatment. Colorectal cancer-specific survival was similar for Aboriginal and non-Aboriginal people up to 18 months after diagnosis, but 5 years post-diagnosis the risk of death for Aboriginal people who had had surgical treatment was 68% higher than for non-Aboriginal people (adjusted hazards ratio, 1.68; 95% CI, 1.32-2.09). Of 145 Aboriginal people with colorectal cancer identified by the medical records audit, 117 (81%) had undergone surgery, and 56 (48%) had also received adjuvant chemotherapy and/or radiotherapy.
Aboriginal people with colorectal cancer had poorer survival rates than non-Aboriginal people, although rates of surgical treatment, complications and follow-up colonoscopy were similar. More work is needed to identify and understand why outcomes for Aboriginal people with colorectal cancer are different from those of other New South Wales residents.
本研究旨在比较新南威尔士州（NSW）的原住民和非原住民结直肠癌患者的手术治疗率和生存率，并描述了一组结直肠癌原住民患者所接受的治疗。
设计、地点和参与者：2001 年至 2007 年间在 NSW 被诊断患有结直肠癌的所有患者均被识别出来，并将他们的癌症登记记录与住院记录和死亡记录进行了链接。此外，还对 2000 年至 2011 年间被诊断患有结直肠癌的原住民患者进行了医疗记录审核。
结直肠癌特异性生存率、手术治疗的可能性以及接受辅助治疗的比例。
在 29777 例符合条件的结直肠癌病例中，有 278 例（0.9%）涉及原住民。原住民（76%）和非原住民（79%）接受手术治疗的比例相似。在诊断后 18 个月内，原住民和非原住民的结直肠癌特异性生存率相似，但在诊断后 5 年内，接受手术治疗的原住民的死亡风险是非原住民的 68%（调整后的风险比为 1.68；95%CI，1.32-2.09）。通过医疗记录审核，确定了 145 例患有结直肠癌的原住民患者，其中 117 例（81%）接受了手术治疗，56 例（48%）还接受了辅助化疗和/或放疗。
尽管手术治疗率、并发症和随访结肠镜检查相似，但患有结直肠癌的原住民患者的生存率低于非原住民患者。需要做更多的工作来确定和理解为什么原住民结直肠癌患者的预后与其他新南威尔士州居民不同。
