Background:
The 2022-2027 NSW Cancer Plan identified multicultural communities as being a key group disproportionately affected by cancer.1 CALD populations commonly face significant challenges when accessing healthcare which leads to health disparities when compared to non-CALD populations.2 The reasons for these disparities are varied.3,4 SWSLHD hosts a significant multicultural population with 43.3% born overseas and 45.3% speaking a language other than English at home.5
Aim:
To investigate the impact of CALD status on extent of disease at presentation and treatment patterns in SWSLHD’s bowel cancer patients.
Method:
A retrospective analysis of patients who had an encounter with SWSLHD Cancer Services and were diagnosed with a primary bowel cancer between 01/01/2013 and 31/12/2022.
A multivariate logistic regression model accounting for CALD status, age, gender, socioeconomic status (SES) was used to analyse extent of disease and treatment patterns variations.
Results:
The model found no statistical significance when considering extent of disease against CALD status. However, there was a statistically significant result for SES (p=0.019), with the most disadvantaged (quintiles 1-2) being more likely to have distant metastasis or recurrent disease (OR:1.202, CI95%:1.030-1.403).
The model found no statistically significant difference between receiving any treatment modality and CALD status. However, the most disadvantaged quintiles were more likely to receive any form of treatment compared to the more advantaged quintiles, with statistically significant results found for radiotherapy(p=0.036) and palliative care(p=<0.001).
Conclusion:
CALD status was not found to be significantly associated with extent of disease or treatment patterns in SWSLHD’s bowel cancer patients. Unlike CALD status, SES was a statistically significant predictor for having distant metastasis or recurrent bowel disease and for receiving radiotherapy and palliative care interventions for the advanced disease.