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McKay CD, Gubhaju L, Gibberd AJ, McNamara BJ, Banks E, Azzopardi P, Williams R, Eades S. Cardiometabolic health markers among Aboriginal adolescents from the Next Generation Youth Wellbeing Cohort Study. Aust N Z J Public Health 2024; 48:100139. [PMID: 38447271 DOI: 10.1016/j.anzjph.2024.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/28/2023] [Accepted: 02/11/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE The objective of this study was to investigate cardiometabolic health markers among Aboriginal adolescents aged 10-24 years and relationships with age, gender, and body composition. METHODS Baseline data (2018-2020) from the Next Generation Youth Wellbeing Cohort Study (Western Australia, New South Wales, and Central Australia) on clinically assessed body mass index, waist/height ratio, blood pressure, glycated haemoglobin (HbA1c), total and high-density lipoprotein cholesterol, total/high-density lipoprotein cholesterol ratio, and triglycerides were analysed. RESULTS Among 1100 participants, the proportion with individual health markers within the ideal range ranged from 59% for total cholesterol to 91% for HbA1c. Four percent had high blood pressure, which was more common with increasing age and among males; 1% had HbA1c indicative of diabetes. Healthier body composition (body mass index and waist/height ratio) was associated with having individual health markers in the ideal range and with an ideal cardiometabolic profile. CONCLUSIONS Most Aboriginal adolescents in this study had cardiometabolic markers within the ideal range, though markers of high risk were present from early adolescence. Ideal health markers were more prevalent among those with healthy body composition. IMPLICATIONS FOR PUBLIC HEALTH Specific screening and management guidelines for Aboriginal adolescents and population health initiatives that support maintenance of healthy body composition could help improve cardiometabolic health in this population.
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Affiliation(s)
- Christopher D McKay
- Melbourne School of Population and Global Health, The University of Melbourne, Australia.
| | - Lina Gubhaju
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Alison J Gibberd
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Bridgette J McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Emily Banks
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Australia
| | - Peter Azzopardi
- Murdoch Children's Research Institute, Australia; Telethon Kids Institute, Australia
| | | | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
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McKay CD, Gubhaju L, Gibberd AJ, McNamara BJ, Macniven R, Joshy G, Roseby R, Williams R, Yashadhana A, Fields T, Porykali B, Azzopardi P, Banks E, Eades SJ. Health behaviours associated with healthy body composition among Aboriginal adolescents in Australia in the 'Next Generation: Youth Well-being study'. Prev Med 2023; 175:107715. [PMID: 37775084 DOI: 10.1016/j.ypmed.2023.107715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
This study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10-24 years and examined associations with health behaviours and self-rated health. Data were cross-sectional from the 'Next Generation: Youth Well-being study' baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR). Overall, 48% of participants had healthy BMI and 64% healthy WHtR, with healthy body composition more common among younger adolescents. Higher physical activity was associated with healthy body composition (5-7 days last week vs none; adjusted prevalence ratio (aPR) healthy BMI 1.31 [95% CI 1.05-1.64], and healthy WHtR 1.30 [1.10-1.54]), as was recommended sleep duration (vs not; aPR healthy BMI 1.56 [1.19-2.05], and healthy WHtR 1.37 [1.13-1.67]). There was a trend for higher proportion of healthy body composition with more frequent fast food consumption. Healthy body composition was also associated with higher self-rated health ('very good/excellent' vs 'poor/fair'; aPR healthy BMI 1.87 [1.45-2.42], and healthy WHtR 1.71 [1.40-2.10]). Culturally appropriate community health interventions with a focus on physical activity and sleep may hold promise for improving body composition among Aboriginal adolescents.
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Affiliation(s)
- Christopher D McKay
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Lina Gubhaju
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison J Gibberd
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bridgette J McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rona Macniven
- School of Population Health, UNSW, Sydney, NSW, Australia
| | - Grace Joshy
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Robert Roseby
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Robyn Williams
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Aryati Yashadhana
- School of Population Health, UNSW, Sydney, NSW, Australia; Centre for Primary Health Care & Equity, UNSW, Sydney, NSW, Australia
| | - Ted Fields
- School of Population Health, UNSW, Sydney, NSW, Australia; Centre for Primary Health Care & Equity, UNSW, Sydney, NSW, Australia
| | - Bobby Porykali
- Guunu-maana (Heal) Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Heath, Sydney, NSW, Australia
| | - Peter Azzopardi
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; Telethon Kids Institute, Perth, WA, Australia
| | - Emily Banks
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Cohen EAK, Gibberd AJ. Wavelet Spectra for Multivariate Point Processes. Biometrika 2021. [DOI: 10.1093/biomet/asab054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Summary
Wavelets provide the flexibility to analyse stochastic processes at different scales. Here, we apply them to multivariate point processes as a means of detecting and analysing unknown non-stationarity, both within and across data streams. To provide statistical tractability, a temporally smoothed wavelet periodogram is developed and shown to be equivalent to a multi-wavelet periodogram. Under a stationary assumption, the distribution of the temporally smoothed wavelet periodogram is demonstrated to be asymptotically Wishart, with the centrality matrix and degrees of freedom readily computable from the multi-wavelet formulation. Distributional results extend to wavelet coherence; a time-scale measure of inter-process correlation. This statistical framework is used to construct a test for stationarity in multivariate point-processes. The methodology is applied to neural spike train data, where it is shown to detect and characterize time-varying dependency patterns.
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Affiliation(s)
- E A K Cohen
- Department of Mathematics, Imperial College London, South Kensington Campus, London SW7 2AZ, U.K
| | - A J Gibberd
- Department of Mathematics and Statistics, Lancaster University, Bailrigg, Lancaster LA1 4YF, U.K
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Gibberd AJ, Tyler J, Falster K, Preen DB, Hanly M, Clarke MJ, McNamara BJ, Eades SJ, Scurrah KJ. Pregnancy and birth characteristics of Aboriginal twins in two Australian states: a data linkage study. BMC Pregnancy Childbirth 2021; 21:448. [PMID: 34182932 PMCID: PMC8240393 DOI: 10.1186/s12884-021-03945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/31/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Perinatal outcomes for singleton pregnancies are poorer, on average, for Aboriginal people than non-Aboriginal people, but little is known about Aboriginal multifetal pregnancies. Yet multifetal pregnancies and births are often more complicated and have poorer outcomes than singleton pregnancies. We describe the pregnancies, births and perinatal outcomes for Aboriginal twins born in Western Australia (WA) and New South Wales (NSW) with comparisons to Aboriginal singletons in both states and to non-Aboriginal births in NSW. Materials and methods Whole-population birth records and birth and death registrations were linked for all births during 2000–2013 (WA) and 2002–2008 (NSW). Hospital records and the WA Register of Developmental Anomalies - Cerebral Palsy were linked for all WA births and hospital records for a subset of NSW births. Descriptive statistics are reported for maternal and child demographics, maternal health, pregnancy complications, births and perinatal outcomes. Results Thirty-four thousand one hundred twenty-seven WA Aboriginal, 32,352 NSW Aboriginal and 601,233 NSW non-Aboriginal births were included. Pregnancy complications were more common among mothers of Aboriginal twins than Aboriginal singletons (e.g. 17% of mothers of WA twins had hypertension/pre-eclampsia/eclampsia vs 8% of mothers of singletons) but similar to mothers of NSW non-Aboriginal twins. Most Aboriginal twins were born in a principal referral, women’s or large public hospital. The hospitals were often far from the mother’s home (e.g. 31% of mothers of WA Aboriginal twins gave birth at hospitals located more than 3 h by road from their home). Outcomes were worse for Aboriginal liveborn twins than Aboriginal singletons and non-Aboriginal twins (e.g. 58% of NSW Aboriginal twins were preterm compared to 9% of Aboriginal singletons and 49% non-Aboriginal twins). Conclusions Mothers of Aboriginal twins faced significant challenges during the pregnancy, birth and the postnatal period in hospital and, in addition to accessible specialist medical care, these mothers may need extra practical and psychosocial support throughout their journey. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03945-9.
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Affiliation(s)
- Alison J Gibberd
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.
| | - Jessica Tyler
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Kathleen Falster
- School of Population Health, The University of New South Wales, Sydney, Australia
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Mark Hanly
- Centre for Big Data Research in Health, The University of New South Wales, Sydney, Australia
| | - Marilyn J Clarke
- Mid North Coast Local Health District, Port Macquarie, Australia
| | - Bridgette J McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.,Curtin Medical School, Curtin University, Perth, Australia
| | - Katrina J Scurrah
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
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Gibberd AJ, Simpson JM, Jones J, Williams R, Stanley F, Eades SJ. A large proportion of poor birth outcomes among Aboriginal Western Australians are attributable to smoking, alcohol and substance misuse, and assault. BMC Pregnancy Childbirth 2019; 19:110. [PMID: 30940112 PMCID: PMC6444570 DOI: 10.1186/s12884-019-2252-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 03/19/2019] [Indexed: 11/23/2022] Open
Abstract
Background Aboriginal infants have poorer birth outcomes than non-Aboriginal infants. Harmful use of tobacco, alcohol, and other substances is higher among Aboriginal women, as is violence, due to factors such as intergenerational trauma and poverty. We estimated the proportion of small for gestational age (SGA) births, preterm births, and perinatal deaths that could be attributed to these risks. Methods Birth, hospital, mental health, and death records for Aboriginal singleton infants born in Western Australia from 1998 to 2010 and their parents were linked. Using logistic regression with a generalized estimating equation approach, associations with birth outcomes and population attributable fractions were estimated after adjusting for demographic factors and maternal health during pregnancy. Results Of 28,119 births, 16% of infants were SGA, 13% were preterm, and 2% died perinatally. 51% of infants were exposed in utero to at least one of the risk factors and the fractions attributable to them were 37% (SGA), 16% (preterm) and 20% (perinatal death). Conclusions A large proportion of adverse outcomes were attributable to the modifiable risk factors of substance use and assault. Significant improvements in Aboriginal perinatal health are likely to follow reductions in these risk factors. These results highlight the importance of identifying and implementing risk reduction measures which are effective in, and supported by, Aboriginal women, families, and communities. Electronic supplementary material The online version of this article (10.1186/s12884-019-2252-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alison J Gibberd
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. .,Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie St, Melbourne, Victoria, 3010, Australia.
| | - Judy M Simpson
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jocelyn Jones
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Robyn Williams
- Baker Heart and Diabetes Institute, Aboriginal Health Domain, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie St, Melbourne, Victoria, 3010, Australia
| | - Fiona Stanley
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Sandra J Eades
- Baker Heart and Diabetes Institute, Aboriginal Health Domain, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie St, Melbourne, Victoria, 3010, Australia
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Gibberd AJ, Simpson JM, McNamara BJ, Eades SJ. Maternal fetal programming of birthweight among Australian Aboriginal infants: a population-based data linkage study. Lancet Glob Health 2019; 7:e523-e532. [PMID: 30799143 DOI: 10.1016/s2214-109x(18)30561-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/12/2018] [Accepted: 12/05/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Low birthweight, which is common among Australian Aboriginal infants, has been found to persist across generations because of shared genetic and environmental factors and possibly fetal programming. Fetal programming refers to the response of a fetus to hostile uterine conditions with lifelong effects and possibly, in turn, providing a poorer uterine environment for future offspring. Fetal programming might have a greater effect in populations that have undergone rapid lifestyle transitions-for example, Indigenous populations. Disentangling causal effects is difficult, but family-based approaches could provide insights. We explored whether poor maternal fetal growth caused low birthweight in Aboriginal infants. METHODS In this data linkage study, we used linked administrative health records of 12 865 singleton Aboriginal infants born in Western Australia between 1980 and 2010 and their relatives (including siblings born in 2011). Electronic birth records included all births since 1980 with at least 20 weeks completed gestation or a birthweight of 400 g. We compared parental-offspring birthweight associations using three approaches-a regression analysis of the complete sample, adjusting for confounding variables; a comparison of the maternal-offspring and paternal-offspring associations; and a within-cousin group comparison. We used binary and continuous measures of birthweight. We categorised infants and their parents as small for gestational age (SGA) if their birthweight was below the first decile of birthweights for all singleton livebirths of the same sex and gestational age in Australia between 1998 and 2007. FINDINGS The relative risk (RR) of SGA birth was higher for infants with SGA mothers than for those with non-SGA mothers (RR 1·65, 95% CI 1·49 to 1·83), after adjusting for grandmaternal parity. After additional adjustment for maternal height, the risk remained higher for those with non-SGA mothers (RR 1·51, 1·36 to 1·68). The maternal birthweight Z score coefficient was 0·17 (95% CI 0·14 to 0·20), compared with 0·13 (0·10 to 0·16) for paternal birthweight, a difference of 0·03 (-0·01 to 0·08). In the cousin analysis, the maternal-offspring association was fully attenuated (0·00, 95% CI -0·05 to 0·06). Conditions in the current pregnancy were strongly associated with offspring birthweight Z score. Smoking was associated with a mean decrease of 0·39 (95% CI -0·45 to -0·34) in offspring birthweight Z score, drug misuse with a decrease of 0·31 (-0·43 to -0·20), and diabetes with an increase of 0·58 (0·39 to 0·77). INTERPRETATION We found little support for maternal fetal programming causing low offspring birthweight. The similar maternal and paternal influence on birthweight and our cousin analysis suggested transmission of genetic and environmental factors could explain much of the maternal-offspring birthweight association. Compared with other risk factors in the current pregnancy, fetal programming appears to have little or no role in the high numbers of infants with low birthweight among Aboriginal populations. FUNDING National Health and Medical Research Council of Australia and Bellberry Ltd.
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Affiliation(s)
- Alison J Gibberd
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Judy M Simpson
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Bridgette J McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Baker Heart and Diabetes Institute, Aboriginal Health Domain, Melbourne, VIC, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Baker Heart and Diabetes Institute, Aboriginal Health Domain, Melbourne, VIC, Australia
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Gibberd AJ, Simpson JM, Eades SJ. Use of family relationships improved consistency of identification of Aboriginal people in linked administrative data. J Clin Epidemiol 2017; 90:144-155. [DOI: 10.1016/j.jclinepi.2017.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/17/2017] [Accepted: 06/30/2017] [Indexed: 11/29/2022]
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Gibberd AJ, Simpson JM, Eades SJ. No official identity: a data linkage study of birth registration of Aboriginal children in Western Australia. Aust N Z J Public Health 2016; 40:388-94. [DOI: 10.1111/1753-6405.12548] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/01/2015] [Accepted: 03/01/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Judy M. Simpson
- School of Public Health; University of Sydney; New South Wales
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Rodger JC, Supramaniam R, Gibberd AJ, Smith DP, Armstrong BK, Dillon A, O'Connell DL. Prostate cancer mortality outcomes and patterns of primary treatment for Aboriginal men in New South Wales, Australia. BJU Int 2015; 115 Suppl 5:16-23. [PMID: 25124107 PMCID: PMC4409091 DOI: 10.1111/bju.12899] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare prostate cancer mortality for Aboriginal and non-Aboriginal men and to describe prostate cancer treatments received by Aboriginal men. PATIENTS AND METHODS We analysed cancer registry records for all men diagnosed with prostate cancer in New South Wales (NSW) in 2001-2007 linked to hospital inpatient episodes and deaths. More detailed information on androgen-deprivation therapy and radiotherapy was obtained from medical records for 87 NSW Aboriginal men diagnosed in 2000-2011. The main outcomes were primary treatment for, and death from, prostate cancer. Analysis included Cox proportional hazards regression and logistic regression. RESULTS There were 259 Aboriginal men among 35,214 prostate cancer cases diagnosed in 2001-2007. Age and spread of disease at diagnosis were similar for Aboriginal and non-Aboriginal men. Prostate cancer mortality 5 years after diagnosis was higher for Aboriginal men (17.5%, 95% confidence interval (CI) 12.4-23.3) than non-Aboriginal men (11.4%, 95% CI 11.0-11.8). Aboriginal men were 49% more likely to die from prostate cancer (hazard ratio 1.49, 95% CI 1.07-1.99) after adjusting for differences in demographic factors, stage at diagnosis, health access and comorbidities. Aboriginal men were less likely to have a prostatectomy for localised or regional cancer than non-Aboriginal men (adjusted odds ratio 0.60, 95% CI 0.40-0.91). Of 87 Aboriginal men with full staging and treatment information, 60% were diagnosed with localised disease. Of these, 38% had a prostatectomy (± radiotherapy), 29% had radiotherapy only and 33% had neither. CONCLUSION More research is required to explain differences in treatment and mortality for Aboriginal men with prostate cancer compared with non-Aboriginal men. In the meantime, ongoing monitoring and efforts are needed to ensure Aboriginal men have equitable access to best care.
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Affiliation(s)
| | | | | | - David P. Smith
- Cancer Research DivisionCancer Council NSWSydneyNSW
- Griffith Health InstituteGriffith UniversityGold CoastQLDAustralia
| | | | - Anthony Dillon
- Institute for Positive Psychology and EducationAustralian Catholic UniversitySydneyNSW
| | - Dianne L. O'Connell
- Cancer Research DivisionCancer Council NSWSydneyNSW
- School of Public HealthThe University of SydneySydneyNSW
- Faculty of MedicineSchool of Public Health and Community MedicineUniversity of New South WalesSydneyNSW
- Faculty of Health and MedicineSchool of Medicine and Public HealthUniversity of NewcastleSydneyNSW
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