Quantifying the Diagnosis and Survival of Early Onset Bowel Cancer Among First Nations Peoples in Queensland, Australia

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-03-21 DOI:10.1002/cam4.70821

Tsegaw Amare Baykeda, Shafkat Jahan, Kirsten Howard, Rakhee Raghunandan, Gail Garvey

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Abstract

Introduction

The incidence of early-onset bowel cancer (EOBC) is increasing in Australia and globally. However, the burden of EOBC among First Nations Australians is rarely determined. This study aimed to quantify the diagnosis and survival rates of EOBC among First Nations Peoples in Queensland, Australia.

Methods

CancerCostMod, a linked administrative dataset of patients diagnosed with cancer in Queensland from 1st July 2011 to 30th June 2015, was used. EOBC was defined as a diagnosis of bowel cancer (i.e., colon, rectosigmoid, or rectal cancer) at 18–49 years of age. A multivariable logistic regression analysis was employed to determine the association of Indigenous status and other factors with a diagnosis of EOBC. Five-year survival rates were used to estimate the survival rate.

Results

Of 11,702 bowel cancer cases, 9.2% (95% CI: 8.7%–9.7%) were EOBC, with 19% among First Nations peoples and 9% among Non-First Nations. First Nations Australians had 2.6 times the odds of EOBC diagnosis (95% CI: 1.7–4.0) compared with Non-First Nations Australians. Overall, EOBC patients showed a significantly higher 5-year survival rate of 77% compared with 60% for late-onset bowel cancer patients. However, First Nations EOBC patients showed a lower 5-year survival rate (73%) than Non-First Nations EOBC patients (77%).

Conclusion

First Nations Australians have more than double the diagnosis rates and lower 5-year survival for EOBC compared to Non-First Nations. Whilst the recent lowering of the age eligibility for the National Bowel Cancer Screening Program is a beneficial strategy to address the increasing incidence of EOBC, special consideration should be given to addressing the higher diagnosis rates and lower survival among First Nations Australians. This study raises the potential for further lowering the age eligibility for First Nations Australians to ensure younger First Nations Australians can access screening for earlier detection, thereby improving their survival from bowel cancer.

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量化诊断和早发性肠癌的第一民族在昆士兰，澳大利亚的生存。

在澳大利亚和全球范围内，早发性肠癌（EOBC）的发病率正在上升。然而，土著澳大利亚人的EOBC负担很少确定。本研究旨在量化澳大利亚昆士兰州第一民族EOBC的诊断和生存率。方法：使用2011年7月1日至2015年6月30日在昆士兰州诊断为癌症的患者的相关管理数据集CancerCostMod。EOBC被定义为在18-49岁时被诊断为肠癌（即结肠癌、直肠乙状结肠癌或直肠癌）。采用多变量logistic回归分析来确定土著身份和其他因素与EOBC诊断的关系。用5年生存率来估计生存率。结果：11,702例肠癌病例中，9.2% （95% CI: 8.7%-9.7%）为EOBC，其中19%为第一民族，9%为非第一民族。第一民族澳大利亚人患EOBC的几率是非第一民族澳大利亚人的2.6倍（95% CI: 1.7-4.0）。总体而言，EOBC患者的5年生存率为77%，而晚发性肠癌患者的5年生存率为60%。然而，原住民EOBC患者的5年生存率（73%）低于非原住民EOBC患者（77%）。结论：与非原住民相比，澳大利亚原住民的EOBC诊断率是原住民的两倍多，5年生存率较低。虽然最近降低了国家肠癌筛查计划的年龄资格是解决EOBC发病率增加的有益策略，但应特别考虑解决澳大利亚原住民中较高的诊出率和较低的生存率。这项研究提出了进一步降低土著澳大利亚人年龄资格的可能性，以确保年轻的土著澳大利亚人能够获得早期发现的筛查，从而提高他们的肠癌存活率。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.