Introduction: Despite the increasing trend in Australia and globally, the burden of early-onset bowel cancer (EOBC) among First Nations Australians is rarely determined. This study aimed to quantify the diagnosis and survival of EOBC among First Nations peoples in Queensland, Australia.
Methods: We used data from the CancerCostMod, a linked administrative dataset that includes all cancer patients diagnosed in Queensland, Australia between 2011 and 2015. 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 average survival rates were used to estimate the survival rate.
Results: Of 11,702 bowel cancer cases, 9.19% (95% CI: 8.67%–9.72%) were EOBC, with 19.35% among First Nations peoples and 9.05% among non-First Nations. First Nations peoples had 2.62 times the odds of EOBC diagnosis (95% CI: 1.73–3.99) compared with non-First Nations peoples. Overall EOBC patients showed a significantly higher five-year survival rate of 77.11% compared with 59.66% for late-onset patients. However, First Nations EOBC patients showed a lower five-year survival rate (73.18%) than that of non-First Nations EOBC patients (77.20%).
Conclusion: First Nations Australians have more than double early onset bowel cancer diagnosis and subsequent lower 5-year survival rates compared to non-First Nations. Whilst the recent lowering of the age eligibility for national bowel screening is a beneficial strategy to address the increasing trend in EOBC, special consideration should be given to addressing the higher likelihood of EOBC diagnosis among First Nations Australians. This study raises the potential of further lowering the age eligibility for First Nations Australians in Australia to ensure that younger First Nations Australians can access treatment earlier thereby improving their survival outcomes from bowel cancer.