Closing the gap - lung cancer evaluation and treatment among indigenous and non-indigenous patients in the Top End, Northern Territory, Australia.

backgroundLung cancer outcomes have been reported to be poorer in the indigenous population of the Northern Territory (NT). We examine whether longer diagnostic and treatment time frames contribute to the observed survival disparity.

aimsAssess the time frames to diagnosis and treatment of lung cancer in the Top End, NT, Australia.

methodsDemographic, clinical and survival data were assessed and compared between indigenous and non-indigenous patients diagnosed with lung cancer between January 2015 and December 2020.

resultsOut of 534 medical records assessed, 388 patients with complete data were included, of which 91 (23%, males 55%) were indigenous and 297 (77%, mles 65%) non-indigenous, with a mean age of 60 and 66 years, respectively. Median time from initial computed tomography (CT) scan to diagnosis (22 vs 23 days, P = 0.94) and initial CT to treatment were similar (61 vs 60 days, P = 0.61) in indigenous versus non-indigenous patients. Diagnostic and treatment time frames were shorter in remote compared to urban patients (initial CT to diagnosis 18 vs 27 days, P = 0.002; initial CT to treatment 46 vs 65 days, P = 0.15). Indigenous patients had lower 1-year median survival, and remote patients had lower 1- and 3-year median survival. Higher rates of inpatient evaluation were observed in indigenous and remote residing patients (indigenous 54% vs 46%, P = 0.2; remote 58% vs 45%, P = 0.038).

conclusionLung cancer care pathways are similar in indigenous and non-indigenous populations, even by remoteness. Lower survival rates among indigenous and remote patients highlight a need for more research.