Department of Oncology, Latrobe Regional Hospital, Traralgon, Victoria, Australia.
Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand.
Curr Opin Support Palliat Care. 2021 Sep 1;15(3):162-168. doi: 10.1097/SPC.0000000000000558.
Persistent and significant inequalities for Indigenous people with cancer around the globe exist, arising from colonial settlement of Indigenous land with profound social, economic and cultural impacts. We summarize recent publications concerning cancer disparities affecting Australian Aboriginal and Torres Strait Islander Peoples and Aotearoa New Zealand Māori Peoples.
Cancer-free survival and overall survival statistics testify to the urgent need to 'close the gap'. For Indigenous peoples in Australia and New Zealand, disparity persists along the cancer care pathway, from increased risk factors to lower screening access, health resource utilization and survivorship care. Recent publications highlight multimorbidity as contributing to poor cancer outcomes in Indigenous populations. The implementation of tailored Optimal Care Pathways is described, as is the validation of tailored tools capturing the perspectives of Indigenous persons. Finally, the importance of Indigenous-led research is emphasized.
Cancer-specific outcomes in Indigenous people of Australia and New Zealand remain poor with many widening disparities compared to non-indigenous populations. A growing body of epidemiological, health service and clinical research is documenting both the problems and potential solutions. Further work is needed in both broad health policies and the workforce, in building cultural competence to optimize individual care encounters.
综述目的：在全球范围内，癌症患者在原住民中仍然存在持续且显著的不平等现象，这是由于原住民土地被殖民化，带来了深远的社会、经济和文化影响。我们总结了最近有关影响澳大利亚原住民和托雷斯海峡岛民以及新西兰毛利人的癌症差异的出版物。
最新发现：无癌生存率和总生存率的统计数据证明了迫切需要“缩小差距”。在澳大利亚和新西兰的原住民中，从增加的风险因素到更低的筛查机会、卫生资源利用和生存护理，癌症护理途径中仍然存在差异。最近的出版物强调了多种疾病对原住民人群癌症预后不良的影响。描述了定制最佳护理路径的实施情况，以及验证了捕捉原住民观点的定制工具。最后，强调了由原住民领导的研究的重要性。
总结：澳大利亚和新西兰原住民的癌症特异性结局仍然较差，与非原住民人群相比，存在许多扩大的差异。越来越多的流行病学、卫生服务和临床研究正在记录问题和潜在的解决方案。在广泛的卫生政策和劳动力中，都需要进一步的工作，以建立文化能力，优化个体护理体验。
