NACCHO Aboriginal Health and #rethinksugarydrink : A new campaign asking people to reduce their sugar intake highlights the link between obesity and 13 different types of cancer

 ” Obesity is now a leading preventable cause of cancer , but less than half of all Australians are aware of the link . A new campaign launched today by Cancer Council Victoria is aiming to change this.

In a ground-breaking new public awareness campaign, Cancer Council Victoria will expose the link between obesity and 13 types of cancer by depicting the toxic fat around internal organs.

As many as 98% of Australians are aware that obesity is a risk factor for type 2 diabetes and heart disease, but as little as 40% of Australians know about its link with cancer . ”

Being above a healthy weight is now a leading preventable cause of cancer. Our new campaign urges people to avoid to reduce their risk

You wouldn’t put this much sugar in a tea or coffee? But if you’re drinking one soft drink a day, over 20 years – that’s 73,000 teaspoons.”

Dr Gihan Jayaweera

A third of Victorians admit to drinking more than a litre of sugary drink each week 7, that’s more than 5.5kgs of sugar a year. We want people to realise that they could be drinking their way towards weight gain, obesity and toxic fat, increasing their risk of 13 types of cancer,”

Dr Ahmad Aly

 ” 69% of Aboriginal and Torres Strait Islander people are considered overweight (29%) or obese (40%); among children this is 30% (20% overweight, 10% obese) “

Read over 60 NACCHO Aboriginal Health and Obesity articles

Or see Statistics part 2 Below 

SEE NEWS COVERAGE

https://www.9news.com.au/7f9400a3-9f9d-4e39-9eb2-eef88a7291ce

Cancer Council Victoria CEO, Todd Harper, acknowledged that the campaign’s portrayal of toxic fat could be confronting but said so was the fact that nearly two-thirds of Australians were overweight or obese 4.

“While talking about weight is a sensitive issue, we can’t shy away from the risk being above a healthy weight poses to our health.” Mr Harper said.

“With around 3,900 cancers in Australia each year linked to being above a healthy weight, it’s vital that we work hard to help people understand the link and encourage them to take steps to reduce their risk 5.”

Sugary drinks contribute the most added sugar to Australians’ diets 6, so Cancer Council Victoria is focusing on how these beverages can lead to unhealthy weight gain, which can increase the risk of certain cancers. The campaign will communicate that one way of reducing the risk is to cut sugary drinks from your diet.

The ad features Melbourne surgeon Dr Ahmad Aly exposing in graphic detail what sugary drinks could be doing to your health, as his laparoscopic camera delves inside a patient’s body to expose the dangerous toxic fat around internal organs.

Watch Video 

Dr Aly has seen first-hand the impact toxic fat has on people’s health and hopes the campaign will make people think again before reaching for sugary drinks.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that while the campaign aims to get people thinking about their own habits, Cancer Council Victoria and partner organisations are also working to encourage governments, the food industry, and communities to make changes.

“It’s virtually impossible to escape the enormous amount of marketing for sugary drinks surrounding us on TV, social media and public transport. It’s also easier to get a sugary drink than it is to find a water fountain in many public places, and that’s got to change. We need to take sugary drinks out of schools, recreation and healthcare settings to make it easier for Victorians to make healthy choices.”

“The need for a healthy weight strategy in Victoria, as well as nationally, is overdue. In the same way tobacco reforms have saved lives, we now need to apply the same approach to improving diets”, Ms Martin said.

Case study: Fiona Humphreys

Since giving up the sweet stuff, Fiona Humphreys has more energy and has managed to shed the kilos and keep them off.

“I used to drink at least two sugary drinks every day as a pick me up, one in the morning and one in the afternoon. I was addicted to the sugar rush and thought I needed them to get through my busy day.”

“After giving up sugary drinks I saw an immediate change in both my mood and my waistline. I lost 7 kilos just by making that one simple change and I haven’t looked back.”

“I decided to go cold turkey and switched to soda or mineral water with a slice of lime or lemon. I tricked my mind to enjoy the bubbles and put it into a beautiful glass. I feel healthier and my mind is clearer as a result.”

The campaign will run for five weeks and be shown on TV and radio and will feature across social media channels as well as outdoors across the state.

A dedicated campaign website cancervic.org.au/healthyweight will provide factsheets for health professionals and consumers and digital elements about how to make small lifestyle changes to improve people’s health.

Top tips to avoid sugary drinks 

  • Avoid going down the soft drink aisle at the supermarket and beware of the specials at the checkout and service stations.
  • If you’re eating out, don’t go with the default soft drink – see what other options there are, or just ask for water.
  • Carry a water bottle, so you don’t have to buy a drink if you’re thirsty.
  • Herbal teas, sparkling water, home-made smoothies or fruit infused water are simple alternatives that still taste great.
  • For inspiration and recipe ideas visit cancervic.org.au/healthyweight

How is sugar linked to weight gain

Sugar is a type of carbohydrate which provides energy to the body. However, eating too much sugar over time can lead to weight gain. Strong evidence shows that being above a healthy weight increases the risk of developing 13 different types of cancer and chronic diseases including cardiovascular disease and type 2 diabetes.

Let’s unpack what happens when our body receives more energy than it needs, how this can lead to weight gain and what you can do to decrease your risk of cancer.

Where do we find sugar?

In terms of health risks, we need to be concerned about ‘added sugar’. That is, sugar that has been added to food or drink.

Natural sugars in foods

  • Fruit and milk products
  • High in nutrients – vitamins, minerals, fibre or calcium.
  • We should eat these foods every day.

Sugar added to food

  • Processed foods
  • These foods are unhealthy and high in energy (kJ).
  • They don’t have other nutrients we need such as fibre, vitamins and minerals.
  • We should limit these foods.

Aboriginal and Torres Strait Islander Communities

Aboriginal and Torres Strait Islander communities tend to have higher rates of obesity and sugary drink consumption and experience poorer health outcomes as a result.

We know that more than half of the Aboriginal and Torres Strait Islander community drink sugary drinks almost every day.

The Overview also examined factors contributing to health, including nutrition and body weight. Some statistics of note include:

  • dietary risks contribute 9.7% to the total burden of disease for Aboriginal people
  • 69% of Aboriginal and Torres Strait Islander people are considered overweight (29%) or obese (40%); among children this is 30% (20% overweight, 10% obese)
  • 54% of Indigenous Australians meet the daily recommended serves of fruit; only 8% meet the daily recommended serves of vegetables
  • both measures are lower in remote communities compared with urban areas and intake is far more likely to be inadequate among the unemployed and those who did not finish school
  • on average, Aboriginal and Torres Strait Islander people consume 41% of their daily energy in the form of discretionary foods — 8.8% as cereal-based products (cakes, biscuits & pastries) and 6.9% as non-alcoholic beverages (soft drinks)
  • average daily sugar consumption is 111g — two-thirds (or the equivalent of 18tsp of white sugar) of which are free sugars from discretionary foods and beverages
  • 22% of Aboriginal people reported running out of food and being unable to afford more in the past 12 months; 7% said they had run out and gone hungry — both were more prevalent in remote areas

In the latest issue of JournalWatch, Dr Melissa Stoneham takes a look at obesity in Australia’s remote Indigenous communities and the struggle to eat well against the odds

Read in full at Croakey

Yorta Yorta woman Michelle Crilly gave up her sugary drink habit and hasn’t looked back. Watch her story.

Video: Rethink Sugary Drink - Michelle Crilly

Read more about the ‘Our Stories’ campaign and hear from more inspiring Victorian Aboriginal community members who have cut back on sugary drinks on our partner site Rethink Sugary Drink.

NACCHO Aboriginal Health and #BreastCancerAwarenessMonth : Download @AIHW BreastScreen Australia monitoring report :Download #Indigenous Resources from @CancerAustralia 

 

” Around 55% of women in the targeted age group of 50–74 participated in the BreastScreen Australia in 2015–2016 with more than 1.7 million screening. Breast cancer mortality has decreased since BreastScreen Australia began from 74 deaths per 100,000 women aged 50–74 in 1991 to 44 deaths per 100,000 women in 2015.

While Indigenous women experience a lower age-standardised incidence rate of breast cancer than non-Indigenous women (rate ratio of 0.9; AIHW 2017c), breast cancer is still the most common cancer diagnosed in Indigenous women. “

Download the full AIHW Report aihw-can-116

NACCHO Aboriginal Women’s Health #BreastCancerAwareness #getChecked : 1.Download #Indigenous Resources from @CancerAustralia 

Participation in BreastScreen Australia and breast cancer outcomes in Indigenous women

Aboriginal and Torres Strait Islander women of Australia, hereafter respectfully referred to as Indigenous women, experience a high burden from breast cancer.

While Indigenous women experience a lower age-standardised incidence rate of breast cancer than non-Indigenous women (rate ratio of 0.9; AIHW 2017c), breast cancer is still the most common cancer diagnosed in Indigenous women.

Aspects of breast cancer and breast screening in Indigenous women are reported by the AIHW and others in various reports and publications, but considering these data individually is not as valuable as considering all available data collectively.

This chapter therefore brings together the BreastScreen Australia participation, incidence and mortality data that previously appeared in several places in this report, and supplements these with additional analyses on incidence, survival and mortality, as well as incorporating data and findings from other published sources.

5.1 Participation in BreastScreen Australia in Indigenous women

Indigenous status of women who participate in BreastScreen Australia is self-reported by women at the time of their screen.

In 2015–2016, participation of Indigenous women aged 50–74 in BreastScreen Australia was 39.1%, compared with the non-Indigenous rate of 54.3% (age-standardised).

Participation trends for Indigenous and non-Indigenous women are shown in Figure 5.1. Historical Indigenous participation rates have been recalculated using new Indigenous population estimates so that meaningful comparisons between reporting periods can be made (see Box 5.1).

Trend data show that the participation rates in Indigenous women aged 50–69 have increased, from around 32%–33% for all reporting periods between 2001–2002 and 2011–2012 to 38% in 2014–2015 and 39% in 2015–2016—although Indigenous women have always had a lower participation rate than non-Indigenous women (Figure 5.2).

Lower participation of Indigenous women may reflect a decreased opportunity to screen, compared with non-Indigenous women, and/or different screening behaviour of Indigenous women (that is, being less likely to screen even with the same opportunity to do so). There may also be a level of under-reporting of Indigenous status in BreastScreen data (as Indigenous status is self-reported by women at the time of their screen), which would also have the effect of lowering the apparent participation rate. This is because under-identification of Indigenous women in BreastScreen data would reduce the size of the numerator without affecting the denominator.

 

Figure 5.1: Participation of women aged 50–74 in BreastScreen Australia, by Indigenous status, 2015–2016 

Source: AIHW analysis of BreastScreen Australia data. Data for this figure are available in Table A1.8.

Figure 5.2: Participation of women aged 50–69 in BreastScreen Australia, by Indigenous status, 1996–1997 to 2015–2016

42 BreastScreen Australia monitoring report 2018

Box 5.1: Indigenous populations

This report uses Indigenous population estimates based on the 2011 Census, which were the most recent estimates available at the time of preparation of this report.

New Indigenous population estimates were released by the ABS in 2014 based on the 2011 Census. These estimates included backcasts of the Indigenous population, as well as population projections to 2026. The backcast estimates of the Indigenous population were considerably larger than those previously published based on the 2006 Census.

This is in part due to improvements in Census coverage and enumeration of Indigenous Australians in the 2011 Census, and an increased likelihood that individuals identified themselves and their children as Indigenous. Historical Indigenous participation rates have been recalculated using these new Indigenous population estimates so that meaningful comparisons between reporting periods can be made over time. Rates presented in this report should not be compared with previously published rates that used population estimates based on the 2006 Census.

Results of a recent Queensland project, ‘Closing the Gap in Breast Cancer Screening’, suggest that different screening behaviour of Indigenous women may play a significant role in their lower participation rates. This project aimed to address barriers to screening for Indigenous women through culturally appropriate messages, art shows and partnerships with local Indigenous groups, in order to build trust, educate and support Indigenous women to attend BreastScreen Australia. The project reported an increase in Indigenous participation from 49% to 56% in 2 years.

Initiatives such as these are common to state and territory BreastScreen programs. These strategies and initiatives are designed to be culturally sensitive and appropriate to the knowledge, attitudes and beliefs of Aboriginal and Torres Strait Islander women. They include dedicated and appropriate communication resources, group bookings for Indigenous women who would prefer to attend as a group, and the use of Indigenous artwork. BreastScreen workers liaise closely with Aboriginal Health Workers and Aboriginal and Torres Strait Islander community groups to increase acceptance of screening.

In the last quarter of 2014–15, the Australian Government ran the National BreastScreen Australia Campaign to support the expansion of the program to women aged 50–74. The campaign included additional communication activities for Aboriginal and Torres Strait Islander consumers, with materials developed in consultation with Aboriginal and Torres Strait Islander women.

Access to BreastScreen services for Indigenous women is a national policy feature of BreastScreen Australia, which has developed National Accreditation Standards (NAS) Measures to ensure that this policy feature is met by services accredited through BreastScreen Australia (see Box 3.3 for more information on NAS Measures and accreditation). These NAS Measures, along with other NAS Measures related to access and participation in BreastScreen Australia, underpin BreastScreen Australia’s aim to maximise the proportion of women in the target population who are screened every 2 years. Table 3.1 shows the NAS Measures related to participation.

5.2 Breast cancer outcomes in Indigenous women

The source of national cancer incidence data in Australia is the Australian Cancer Database (ACD), which is compiled from data supplied by state and territory cancer registries. The cancer registers rely on pathology forms as their primary source of information—which do not include Indigenous status in all states and territories. However, the cancer registers collect

BreastScreen Australia monitoring report 2018 43

information from additional sources, such as hospital records and death records, which allows for information on Indigenous status to be collected where possible.

The level of identification of Indigenous status in the ACD for the period 2009–2013 is considered sufficient to enable analysis in 5 jurisdictions, with data from New South Wales, Victoria, Queensland, Western Australia and the Northern Territory. While the majority (89.9%) of Australian Indigenous people live in these 5 jurisdictions, the degree to which data for these jurisdictions are representative of data for all Indigenous people is unknown (ABS 2012).

Analysis of data from these jurisdictions showed that, in 2009–2013, Indigenous women aged 50–74 had a lower incidence rate of breast cancer, at 251 new cases per 100,000 women, compared with 285 new cases for non-Indigenous women (Figure 5.3)—with a similar trend for all ages (99 compared with 111 per 100,00 women).

Note: Rates age-standardised to the Australian population as at 30 June 2001; ‘Total’ rate includes women with a ‘not stated’ Indigenous status and is therefore greater than the ‘Non-Indigenous’ rate.

Source: AIHW Australian Cancer Database 2014. Data for this figure are available in Table A7.8.

Figure 5.3: Incidence of breast cancer in women aged 50–74 (New South West, Victoria, Queensland, Western Australia and the Northern Territory), by Indigenous status, 2009–2013

Survival

Crude survival was also calculated, and found to be lower for Indigenous women, compared with non-Indigenous women—crude survival was 73.7% for Indigenous women of all ages, compared with 84.3% for non-Indigenous women of all ages during the period 2009–2013. Similarly, crude survival was lower in Indigenous women when restricted to women aged 50–74 (75.4% compared with 89.0% for non-Indigenous women).

Mortality

The source of mortality data is the AIHW National Mortality Database, in which information on Indigenous status is considered to be adequate for reporting for 5 jurisdictions: New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.

In 2011–2015, the mortality rate from breast cancer was higher in Indigenous women aged 50–74, at 55 deaths per 100,000 women, compared with 46 deaths for non-Indigenous women (Figure 5.4). While participation in BreastScreen Australia has a direct effect on the incidence of breast cancer, additional factors come into play for mortality from breast cancer, such as the stage of cancer at diagnosis, and access to treatment.

NACCHO Aboriginal Health and #Cancer Policies , Strategies and Future directions : Latest @HealthInfoNet review shows many cancers are preventable among Aboriginal and Torres Strait Islander people

‘The review shows that cultural safety in service provision, increased participation in breast, bowel and cervical screening and reduction in risk factors will improve outcomes for cancer among Aboriginal and Torres Strait Islander people.

The good news is that many cancers are considered to be preventable. Lung cancer is the most commonly diagnosed cancer among Aboriginal and Torres Strait Islander people, followed by breast cancer, bowel cancer and prostate cancer.

Tobacco smoking is still seen as the greatest risk factor for cancer’.

HealthInfoNet Director, Professor Neil Drew

Read over 75 Aboriginal Health and Cancer articles published by NACCHO last 6 years

“Aboriginal and Torres Strait Islander Community Controlled Health Services

Aboriginal and Torres Strait Islander Community Controlled Health Services are located in all jurisdictions and are funded by the federal,state and territory governments and other sources [91].

They are planned and governed by local Aboriginal and Torres Strait and Torres
Strait Islander communities and aim to deliver holistic and culturally appropriate health and health-related services.

Services vary in the primary health care activities they offer. Possible activities include: diagnosis and treatment of illness or disease; management of chronic illness; transportation to medical appointments; outreach clinic services; immunisations; dental services; and dialysis services.

Aboriginal and Torres Strait Islander cancer support groups have been identified as important for improving cancer awareness and increasing participation in cancer screening services [92].

Aboriginal women attending these support groups have reported an increased
understanding of screening and reported less fear and concern over cultural appropriateness, with increases in screening rates [19].

Support groups have also been found to help in follow up and ongoing care for cancer survivors [19, 93], particularly where they are shaped to meet the needs of Aboriginal and Torres Strait Islander people [73, 94].”

See Page 12 of Review

Download Review+of+cancer+among+Aboriginal+and+Torres+Strait+Islander+people

The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University has published a new Review of cancer among Aboriginal and Torres Strait Islander people.

The review, written by University of Western Australia staff (Margaret Haigh, Sandra Thompson and Emma Taylor), in conjunction with HealthInfoNet staff (Jane Burns, Christine Potter, Michelle Elwell, Mikayla Hollows, Juliette Mundy), provides general information on factors that contribute to cancer among Aboriginal and Torres Strait Islander people.

It provides detailed information on the extent of cancer including incidence, prevalence and survival, mortality, burden of disease and health service utilisation.

This review discusses the issues of prevention and management of cancer, and provides information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people.

The review provides:

  • general information on factors (historical/protective/risk) that contribute to cancer among Aboriginal and Torres Strait Islander people
  • detailed information on the extent of cancer among Aboriginal and Torres Strait Islander people, including: incidence, prevalence and survival data; mortality and burden of disease and health service utilisation
  • a discussion of the issues of prevention and management of cancer
  • information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people
  • a conclusion on the possible future directions for combating cancer in Australia

Selected Extracts

Policies and strategies

There are very few national policies and strategies that focus specifically on cancer in the Aboriginal and Torres Strait Islander population. The National Aboriginal and Torres Strait Islander Cancer Framework is therefore significant as the first national approach to addressing the gap in cancer outcomes that currently exists between Aboriginal and Torres Strait Islander people and the non-Indigenous population [132]. However, over the past 30 years, there have been a number of relevant strategies and frameworks developed addressing cancer in the general population, and broader aspects of Aboriginal and Torres Strait Islander health. A selection of national policy developments relevant to addressing cancer among Aboriginal and Torres Strait Islander people are described briefly below.

Selected national policy developments relevant to addressing cancer among Aboriginal and Torres Strait Islander people

2018 Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia is released
2016 National Framework for Gynaecological Cancer Control is released
2015 First National Aboriginal and Torres Strait Islander Cancer Framework is released
2015 Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan is released
2014 Second Cancer Australia Strategic Plan 2014–2019 is published
2013 First National Aboriginal and Torres Strait Islander Health Plan 2013–2023 is published
2011 First Cancer Australia Strategic Plan 2011–2014 is published
2008 National Cancer Data Strategy for Australia is released
2003 Report Optimising Cancer Care in Australia is published
1998 First National health priority areas cancer control report is published
1996 Cancer becomes one of four National health priority areas (NHPA)
1988 Health for all Australians report is released
1987 First National Cancer Prevention Policy for Australia is published

 

It was not until the late 1980s that national cancer control strategies and policies began to be developed [133]. In 1987, the first National Cancer Prevention Policy for Australia, was published by the Australian Cancer Society (ACS) (now the Cancer Council Australia) based on a series of expert workshops [134].

It outlined what prevention activities were currently being undertaken, what should be undertaken and suggested a number of goals, targets and strategies in the areas of cancer prevention and early detection and screening. This policy has been updated many times over the years [133] and is still in publication as the National cancer control policy [135].

The following year, in 1988, the Health for all Australians report, commissioned by the Australian Health Ministers’ Advisory council (AHMAC), recognised that cancers could be influenced by primary or secondary prevention strategies [136]. The report recommended nine goals and 15 targets related to cancers, based on those put forward by the National Cancer Prevention Policy for Australia. Cancer prevention and strategies relating to breast, cervical and skin cancer and tobacco smoking were recommended as initial priorities under the National Program for Better Health. These were then endorsed at the Australian Health Ministers Conference and funding was provided.

In 1996, cancer control was identified as one of four National health priority areas (NHPA). This led, the following year, to the publication of the First report on national health priority areas 1996, which outlined 26 indicators spanning the continuum of cancer care, and included outcome indicators, indicators relating to patient satisfaction and the creation of hospital based cancer registries [137].

In 1998, the first NHPA cancer control report was produced [138]. It identified a number of opportunities for improvements in cancer control, including within ‘special populations such as Indigenous people’ [138].

In 2003, the report Optimising cancer care in Australia was jointly developed by The Cancer Council Australia, the Clinical Oncological Society of Australia (COSA) and the National Cancer Control Initiative (NCCI), with strong consumer input [139]. This report made 12 key recommendations, including that the needs of Aboriginal and Torres Strait Islander people be the focus of efforts to bridge gaps in access to and utilisation of culturally sensitive cancer services.

In 2008, the National Cancer Data Strategy for Australia aimed to provide direction for collaborative efforts to increase data availability, consistency and quality [140]. It reported that although Indigenous status is recorded by cancer registries, data quality is poor, and recommended that the quality of Indigenous markers in hospital and death statistics collections needs to improve if cancer registries are to have better data.

In 2011, Cancer Australia published the first Cancer Australia strategic plan 2011–2014, which aimed to identify future trends in national cancer control and to outline strategies for the organisation to improve outcomes for all Australians diagnosed with cancer [141]. It was followed in 2014, by the Cancer Australia Strategic Plan 2014–2019, which had an increased focus on improving quality of cancer care and outcomes for Aboriginal and Torres Strait Islander people [142].

In 2013, the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (the Health plan) was developed to provide a long-term, evidence-based policy framework approach to closing the gap in disadvantage experienced by Aboriginal and Torres Strait Islander people [143].

The Health plan emphasises the importance of culture in the health of Aboriginal and Torres Strait Islander people and the rights of individuals to a safe, healthy and empowered life. Its vision is for the Australian health system to be free of racism and inequity and all Aboriginal and Torres Strait Islander people to have access to health services that are effective, high quality, appropriate and affordable. This led to the publication of the Implementation plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 in 2015 [90], which outlines the strategies, actions and deliverables required for the Australian Government and other key stakeholders to implement the Health plan.

The first National Aboriginal and Torres Strait Islander Cancer Framework (the Framework­) was released in 2015, to address disparities and improve cancer outcomes for Aboriginal and Torres Strait Islander people [56]. It provides strategic direction by setting out seven priority areas for action and suggests enablers that may help in planning or reviewing strategies to address each of the priority areas. The Framework aims to improve cancer outcomes for Aboriginal and Torres Strait Islander people by ensuring timely access to good quality and appropriate cancer related services across the cancer continuum.

In 2016, Cancer Australia released the National Framework for Gynaecological Cancer Control to guide future directions in national gynaecological cancer control to improve outcomes for women affected, as well as their families and carers [144]. It aims to ensure the provision of best practice and culturally appropriate care to women across Australia by offering strategies across six priority areas, of which one pertains specifically to improving outcomes for Aboriginal and Torres Strait Islander women.

In 2018, Cancer Australia released the Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia [145]. It aims to improve the outcomes and experiences of people affected by lung cancer by supporting the uptake of five principles: patient-centred care; multidisciplinary care; timely access to evidence-based care; coordination, communication and continuity of care and data-driven improvements.

Future directions

The National Aboriginal and Torres Strait Islander Cancer Framework (the Framework­) provides guidance for individuals, communities, organisations and governments [56]. The Framework was developed in partnership with Menzies School of Health Research, and was informed by a systematic review of the evidence and extensive national consultations. The parties involved in these consultations included Aboriginal and Torres Strait Islander people affected by cancer, health professionals working with Aboriginal and Torres Strait Islander people and experts in Indigenous cancer control. The Framework outlined seven evidence-based priority areas for action as follows:

  • improving knowledge and attitudes about cancer
  • focusing prevention activities
  • increasing participation in screening and immunisation
  • ensuring early diagnosis
  • delivering optimal and culturally appropriate treatment and care
  • involving, informing and supporting families and carers
  • strengthening the capacity of cancer-related services to meet the needs of Aboriginal and Torres Strait Islander people.

Each of these priorities was accompanied by a number of enablers to assist in planning or reviewing strategies to address that priority. The enablers provide flexible approaches to meeting the priorities that allow for local context and needs.

The development of the Framework has been responsible for gathering national support and agreement on the priorities and for creating a high level of expectation around the ability to address the growing cancer disparity [146]. Cancer Australia has since commenced a number of projects and initiatives that focus on one or more of the priorities identified by the Framework. One project aims to identify critical success factors and effective approaches to increasing mammographic screening participation for Aboriginal and Torres Strait Islander women [147]. A leadership group on Aboriginal and Torres Strait Islander cancer control tasked with driving a shared agenda to improve cancer outcomes has also been established [148]. In addition, the development of a monitoring and reporting plan for the Framework is underway.

Quality data are critical to understanding the variations in cancer care and outcomes of Aboriginal and Torres Strait Islander people, and to inform policy, service provision and clinical practice initiatives to improve those outcomes. However, it has been repeatedly reported in the literature and by the Framework, that current data are inadequate or incomplete, and there is a significant need for improved local, jurisdictional and national data on Aboriginal and Torres Strait Islander people with cancer [56149-151]. In particular, the need for primary healthcare services to address the under identification of Aboriginal and Torres Strait Islander status in data registries. A project currently underway in SA, which is likely to have relevance to other regions, aims to develop an integrated comprehensive, cancer monitoring and surveillance system for Aboriginal people, while also incorporating their experiences with cancer services [149].

Both the Framework and the literature have identified a need for a more supportive and culturally appropriate approach across the cancer care continuum for Aboriginal and Torres Strait Islander people [5677151152]. The Wellbeing Framework for Aboriginal and Torres Strait Islander Peoples Living with Chronic Disease, (Wellbeing framework), aims to assist healthcare services to improve the quality of life and quality of care, as well as health outcomes, for Aboriginal and Torres Strait Islander people living with chronic disease [153]. This addresses the identified need for more supportive and culturally appropriate care as it attempts to incorporate the social, emotional, cultural and spiritual aspects of health and wellbeing, as well as the physical aspects.

The Wellbeing framework is underpinned by two core values, which are considered fundamental to the care of Aboriginal and Torres Strait Islander people [153154]. These core values highlight that wellbeing is supported by:

  • upholding people’s identities in connection to culture, spirituality, families, communities and country and
  • having culturally safe primary healthcare services in place.

The Wellbeing framework consists of four essential elements for supporting the wellbeing of Aboriginal and Torres Strait Islander people living with chronic disease [153154]. These show the importance of having:

  • locally defined, culturally safe primary health care services
  • appropriately skilled and culturally competent health care teams
  • holistic care throughout the lifespan
  • best practice care that addresses the particular needs of a community.

The Wellbeing framework suggests a number of practical and measurable applications for applying or achieving the underlying principles of each element. It has the capacity to be adapted by primary healthcare services, in consultation with the communities they serve, to more effectively meet the chronic and cancer care needs of their communities [153154].

 

The Leadership Group on Aboriginal and Torres Strait Islander Cancer Control was established in 2016-17 to:

  • provide strategic advice and specialist expertise in Indigenous cancer control
  • encourage cross-sector collaboration in addressing the priorities in the National Aboriginal and Torres Strait Islander Cancer Framework
  • share knowledge across the sector to leverage opportunities.

Concluding comments

Despite considerable improvements in cancer detection and treatment over recent decades, Aboriginal and Torres Strait Islander people diagnosed with cancer generally experience poorer outcomes than non-Indigenous people for an equivalent stage of disease [2797]. This is highlighted by statistics which showed that, despite lower rates of prevalence and hospitalisation for all cancers combined for Aboriginal and Torres Strait Islander people compared with non-Indigenous people, between 1998 and 2015, the age-standardised mortality rate ranged from 195 to 246 per 100,000 while the rate for non-Indigenous people decreased from 194 to 164 per 100,000 [2].

Furthermore for 2007–2014, while 65% of non-Indigenous people had a chance of surviving five years after receiving a cancer diagnosis, only 50% of Aboriginal and Torres Strait Islander people did [2].

The disparities are particularly pronounced for some specific cancers – for lung cancer the age-standardised incidence rate for Aboriginal and Torres Strait Islander people was twice that for non-Indigenous people, while for cervical cancer the rate was 2.5 times the rate for non-Indigenous people for 2009–2013 [2].

The factors contributing to these poorer outcomes among Aboriginal and Torres Strait Islander people are complex. They reflect a broad range of historical, social and cultural determinants and the contribution of lifestyle and other health risk factors [6], combined with lower participation in screening programs, later diagnosis, lower uptake and completion of cancer treatment, and the presence of other chronic diseases [2798155]. Addressing the various factors that contribute to the development of cancer among Aboriginal and Torres Strait Islander people is important, but improvements in some of these areas, particularly in reducing lifestyle and behavioural risk factors, are likely to take some time to be reflected in better outcomes.

Current deficiencies in the prevention and management of cancer suggest there is considerable scope for better services that should lead to improvements in the short to medium term. Effective cancer prevention and management programs that are tailored to community needs and are culturally appropriate are vital for the current and future health of Aboriginal and Torres Strait Islander people [5657]. Providing effective cancer prevention and management also requires improved access to both high quality primary health care services and tertiary specialist services. Effective and innovative programs for the prevention and management of cancer among Aboriginal and Torres Strait Islander people do exist on an individual basis and, in some cases, the efforts made to engage Aboriginal and Torres Strait Islander people in screening programs, in particular, are impressive. However, a more coordinated, cohesive national approach is also required.

Reducing the impact of cancer among Aboriginal and Torres Strait Islander people is a crucial aspect in ‘closing the gap’ in health outcomes. The National Aboriginal and Torres Strait Islander cancer framework [56] may be an important first step in addressing the current disparity in cancer outcomes and raises the probability of real progress being made. Cancer Australia has recently released the Optimal Care pathway for Aboriginal and Torres Strait Islander people which recommends new approaches to cancer care and with the aim of reducing disparities and improving outcomes and experiences for Aboriginal and Torres Strait Islander people with cancer [156]. As encouraging as these developments are, substantial improvements will also depend upon the effective implementation of comprehensive strategies and policies that address the complexity of the factors underlying the disadvantages experienced by Aboriginal and Torres Strait Islander people.

Action beyond the health service sector that addresses the broader historical, social and cultural determinants of health are also required if real progress is to be made [6].

NACCHO Aboriginal Health #ACCHO Deadly Good News stories : From #NT #QLD #NSW #VIC #WA Features New Optimal Care Pathway for our mob with cancer provides principles & guidance to ensure that #cancer care is culturally safe and responsive @CancerAustralia

1.VIC : Melanie Hill Lane Aboriginal Health Worker and Cancer Survior from MDAS ACCHO Kerang has been part of developing Australia’s first Indigenous Cancer Protocol

2.1 NSW : Penrith is set to become the home of a new primary health care service that will help to address the health needs of the local Aboriginal community.

2.2 NSW: Summer Hunt now in charge at Coomealla Health Aboriginal Corporation #becauseofherwecan

3.1 NT : Congress Alice Springs : Blow Breathe Cough video activity in Western Arrernte

3.2 NT Danila Dilba ACCHO Deadly Choices Building up a new generation of future leaders

4.1 WA: AHCWA : Commencing the delivery of the Certificate II Family Well-being

5.1 QLD : Rapid Response Syphilis Testing at Wuchopperen Health Service

 View hundreds of ACCHO Deadly Good News Stories over past 6 years

 

MORE INFO AND REGISTER FOR NACCHO AGM

How to submit a NACCHO Affiliate  or Members Good News Story ?

Email to Colin Cowell NACCHO Media 

Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday /Friday

1.VIC : Melanie Hill Lane Aboriginal Health Worker and Cancer Survior from MDAS ACCHO Kerang has been part of developing Australia’s first Indigenous Cancer Protocol

“Melanie Hill Lane with her children (From L) Dakoda 11, Chardae 9,Taj 13 and Kai 16. Picture: Daryl Pinder.”

When Melanie Lane was diagnosed with cancer six years ago, she became part of a grim and growing statistic: the rising number of Aboriginal and Torres Strait Islanders afflicted by the disease, with a 40 per cent greater likelihood of dying from it than non-indigenous Australians.

A non-smoker and Aboriginal health worker, the mum of four was blown away by her surprise lung tumour diagnosis at the age of 37 during a scan for an unrelated complaint.

Now recovered, she says the treatment and round of surgeries that cleared her two years later — including a partial lung removal — would probably have been a vastly better experience with a new cancer protocol being launched this week by Indigenous Health Minister Ken Wyatt.

Download Optimal care pathway for Aboriginal and
Torres Strait Islander people with cancer

optimal-care-pathway-for-aboriginal-and-torres-strait-islander-people-with-cancer

The Australian-first “Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer” includes a detailed series of printed resources to be distributed throughout the health system aimed at practitioners and patients. It works from the principle that indigenous Australians have specific cultural needs and their outcomes will be better if these are taken into account.

Low screening rates and later-stage diagnoses are troubling hurdles, according to Jacinta Elston, pro-vice-­chancellor (indigenous) at Monash University and, like Ms Lane, a contributor to the new Cancer Australia resource.

“We know Aboriginal and Torres Strait Islanders are not getting the best out of the system,” said Professor Elston, a breast cancer survivor herself. “Whether it’s late presentation to healthcare services or lack of access to same-stage treatment, which could be to do with cultural appropriateness of services or people living in poverty not having the same access.

“Or Stolen Generations, where people have a lot of other things going on in life, or people living with chronic diseases; if you’re living with other diseases … then being in the right mindset to do all the right preventative things might be difficult.”

With cancer now the second- leading cause of death of indigenous Australians after cardiovascular disease, Mr Wyatt predicted the new approach could have a significant effect on attempts to close the gap on indigenous health disadvantage.

“The impacts of trauma across generations of our people, including historical events, must be acknowledged and addressed,” he said. “It is important for health services and programs to understand that the biological impact of stress and trauma can be an underlying cause of poor health.”

VIEW VIDEO

Prof Tom Calma explains how the new Optimal Care Pathway will help to ensure quality care for Indigenous Australians with cancer to improve their treatment experience & outcomes

A new, first of its kind, Optimal Care Pathway released today identifies approaches to quality care for Aboriginal and Torres Strait Islander people with cancer to improve their cancer treatment experience and outcomes.

Cancer is the third leading cause of fatal burden of disease for Aboriginal and Torres Strait Islander people who are, on average, 40 per cent more likely to die from cancer than non-Indigenous Australians.

Healthcare that is patient-focused and that is respectful of, and responsive to, the preferences, needs and values of patients, is critical to good health care outcomes.

The Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer provides health services and health professionals across all sectors in Australia with principles and guidance to ensure that care is responsive to the needs of Indigenous people.

Cancer Australia is calling on health professionals and health services involved in the delivery of cancer care at every level to read, use, adopt and embed the Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer into their practice.

The Optimal Care Pathway is accompanied by consumer resources, which outline what patients should expect on the cancer pathway, and the care they should be offered, from tests and diagnosis, through to treatment and care after treatment, management of cancer that has spread, and end-of-life care.

Cancer Australia has partnered with the Department of Health and Human Services (DHHS) Victoria, in collaboration with Cancer Council Victoria, to develop this first population-based Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer.

Cancer Australia gratefully acknowledge the contribution of Cancer Australia’s Leadership Group on Aboriginal and Torres Strait Islander Cancer Control, who provided high level expert advice and guidance throughout the development of the Optimal Care Pathway.

For more information

2.1 NSW : Penrith is set to become the home of a new primary health care service that will help to address the health needs of the local Aboriginal community.

Wellington Aboriginal Corporation Health Service (WACHS) recently announced the opening of the new Penrith Aboriginal Medical Service clinic, which is set to help fill the gap in the health needs of Aboriginal locals.

WACHS’ Executive Manager of Business Services, Adam Stuart, said the clinic will deliver a comprehensive primary health care service, similar to the services offered at their Greater Western Aboriginal Health Service centre in Mt Druitt.

“We look forward to establishing a new service to really address something that is probably a gap in the health needs of the Aboriginal population in that area,” he said.

“There is a whole range of access barriers sometimes to the hospital system, so this is about a service that provides a culturally safe service for that area and that community.”

The new clinic will create six positions with a GP, nurses, Aboriginal health workers and transportation aids set to help make up the service.

Mr Stuart said these services were a recognition of the Aboriginal population’s health needs in the Nepean Blue Mountains region.

“We know that the Aboriginal population in the Nepean and western Sydney area is one of the largest numbers in the country and the demographics of that population show they are a lot younger community,” he said.

“The other thing is that we know that the disparities in health outcomes is well documented, so we want to look at a primary health care service that can assist in going some way in addressing that need.”

Mr Stuart said it was important to provide better access to care for the Aboriginal community.

“We are trying to address those access barriers and what we would consider our preventable hospital admissions that can be prevented by timely access to appropriate primary health care,” he said.

Located in Lawson Street, Penrith, the establishment of the clinic was a result of funding provided by the Department of Health and the Ministry of Health in 2017.

“We want to acknowledge the support of NSW Ministry of Health and the local health district for providing $1.5 million in capital works funding,” Mr Stuart said.

2.2 NSW: Summer Hunt now in charge at Coomealla Health Aboriginal Corporation #becauseofherwecan 

Above :Incoming Coomealla Health Aboriginal Corporation CEO Summer Hunt, chairperson Jan Etrich and outgoing CEO Barry Stewart.

COOMEALLA Health Aboriginal Corporation (CHAC) has appointed Summer Hunt as its new chief executive officer.

Ms Hunt will transition to the role after three years working as deputy CEO to Barry Stewart.

Mr Stewart and Ms Hunt were appointed in 2015 in the roles of CEO and deputy CEO respectively, and at that time implemented a three-year plan for Mr Stewart to oversee a set of key changes required to stabilise and improve the organisation. Ms Hunt undertook an intensive on-the-job training program before moving into the CEO role.

3.1 NT : Congress Alice Springs : Blow Breathe Cough video activity in Western Arrernte 

Australian Hearing and Menzies School of Health Research have collaborated to create an animated version of this classroom favourite: the Blow Breathe Cough activity in Western Arrernte . Check it out!

View Video HERE 

3.2 NT Danila Dilba ACCHO Deadly Choices Building up a new generation of future leaders

Deadly Choices ran a session on Leadership at Moulden Primary School with the grade 5s, followed by playing a traditional Indigenous game called Edor. Our Deadly Choices team recently added Moulden Primary school, meaning we can now deliver education on healthy lifestyles to school kids of all ages. Building up a new generation of future leaders.

4.1 WA: AHCWA : Commencing the delivery of the Certificate II Family Well-being

With the Aboriginal Health Council of Western Australia – AHCWA commencing the delivery of the Certificate II Family Well-being, AHCWA Youth Committee members have taken the opportunity to participate and develop our skills. We have found it to be very beneficial not only for our professional careers in the Health Sector, but also our personal lives 💫

For more info on the Certificate II Family Well-Being, please contact AHCWA on 9227 1631.

5.1 QLD : Rapid Response Syphilis Testing at Wuchopperen Health Service

Wuchopperen Health Service Limited  rolled out rapid, point of care testing for syphilis on Monday 13 August.

The tests are part of an $8.8 million Australian government initiative to combat the syphilis outbreak in northern Australia.

Wuchopperen CEO Dania Ahwang said she welcomed the new tests.

‘These tests will make a difference to the health of Aboriginal and Torres Strait Islander people in northern Australia, and may even save lives.’

‘We welcome the Australian Government’s investment in this critically important public health issue.’

‘I urge Aboriginal and Torres Strait Islander people aged 15 – 39 to come in for a point of care test from Monday onwards. If you are outside that age group and have concerns, standard blood tests are always available.’

Wuchopperen Medical Director Dr Jacqueline Mein said the new tests offered a range of benefits.

‘The finger prick test takes 15 minutes to get a result compared to a standard blood test which can take a number of days to get processed,’ she explained.

‘This means that the client can get their results fast, and any follow up tests or treatment can be booked in on the spot.’

‘Point of care testing reduces the risk of the condition being passed on while clients are waiting for their results, or of not being able to get in touch with a client once the results are in.’

‘I
n the event of a positive test, it also makes it easier to find out who a client may have passed the condition on to.’

Wuchopperen has received 3000 tests, and will be offering them to all clients aged 15 – 39. The tests are available from the Manoora and Edmonton facilities from Monday 13 August.

Image: Registered Nurse Amon Nteziryayo conducting a rapid test

 

NACCHO Aboriginal Women’s Health #BreastCancerAwareness #getChecked : 1.Download #Indigenous Resources from @CancerAustralia and 2.NACCHO supports this Sundays #StandWithMeAtTheG #FieldOfWomen @bcnapinklady

If I hadn’t been diagnosed with breast cancer I wouldn’t be here today. People forget that Aboriginal women get breastcancer. We need Aboriginal women to get themselves checked because there is treatment available and it can save your life “

Aunty Pam Pedersen speaking at the Peter Maccallam Cancer Centre signing of a MOU with VACCHO August 9

Twenty years ago, breast cancer was not often talked about publicly. It was discussed in whispers, and many women spoke of a feeling of shame at diagnosis.

Women felt like a number, not an individual, and were subjected to radical surgery. They were given little information and even less support. They held little hope for a future.

Breast Cancer Network Australia (BCNA) began during this time, born out of one woman’s determination to make the breast cancer journey better.

Others soon joined her cause, and for 20 years, BCNA has worked tirelessly to ensure every Australian diagnosed with breast cancer receives the very best support, information, treatment and care.

Today, BCNA is the peak national organisation for Australians affected by breast cancer.”

#StandWithMeAtTheG this Sunday. This year, 18,235 Aussies will hear the words,‘You have breast cancer’. #FieldOfWomen brings these stats to life as women, men and children stand together on the @MCG in the shape of the @bcnapinklady.

View Video Here

Australia’s Lots to live for video on social media will start a conversation between Aboriginal and Torres Strait Islander people about breast cancer and how early detection can save lives.

If you are an Aboriginal and Torres Strait Islander women, it is vitally important you know the normal look and feel of your breasts, the symptoms to look out for and the importance of seeing their doctor if you find a change.

Breast cancer is the most common cancer among women in Australia, including among Aboriginal and Torres Strait Islander women, yet Indigenous women are 16 per cent less likely to survive than non-Indigenous women.”

Professor Jacinta Elston ( breast cancer survivor )  Chair of the Cancer Australia Leadership Group on Aboriginal and Torres Strait Islander Cancer Control : She is a descendent of both the Kalkadoon people of North-West Queensland and the South Sea Islander people.

See full report below

About 3 Aboriginal and Torres Strait Islander Australians are diagnosed with cancer every day. Indigenous Australians have a slightly lower rate of cancer diagnosis but are almost 30 per cent more likely to die from cancer than non-Indigenous Australians1.

Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to reduce the impact of cancer on Indigenous Australians.

Our work includes:

  • raising awareness of risk factors and promoting awareness and early detection for the community
  • developing evidence-based information and resources for Aboriginal and Torres Strait Islander people affected by cancer and health professionals
  • providing evidence-based cancer information and training resources to Aboriginal and Torres Strait Islander Health Workers
  • increasing understanding of best-practice health care and support, and
  • supporting research.

We have a range of resources which provide information to support you and the work you do:

 

See Key Facts Breast cancer in Aboriginal and Torres Strait Islander women or Part 2 Below

A new breast awareness video designed for Aboriginal and Torres Strait Islander women to share with family and friends on social media aims to increase early detection of breast cancer and improve survival.

Cancer Australia CEO, Dr Helen Zorbas, said the video, titled Lots to live for, had been produced to put vital knowledge about the importance of breast awareness and early detection of breast cancer in the hands of Aboriginal and Torres Strait Islander women and communities.

“Finding breast cancer early, while it is still confined to the breast, significantly increases the chances of survival,” Dr Zorbas said. “Early detection of breast cancer through breast awareness and increasing participation in mammographic screening are important ways to improve survival outcomes and address the disparity in breast cancer survival between Indigenous and non-Indigenous women.”

Professor Jacinta Elston, Chair of the Cancer Australia Leadership Group on Aboriginal and Torres Strait Islander Cancer Control, and an Aboriginal woman from Townsville, supported the video’s message and encouraged women to share it on social media.

“Studies have shown that social media has been used effectively in getting health messages out into our community,” Professor Elston said.

See opening message

“Aboriginal and Torres Strait Islander women aged between 50 and 74 years are also encouraged to have a free breast screen every two years. Mammographic screening is the best early detection test for reducing deaths from breast cancer.”

Professor Elston, who is herself a breast cancer survivor, acknowledged that some Indigenous women may be reluctant to discuss a breast change, due to shame, embarrassment, fear or stigma, but that this could seriously impact on their breast cancer outcomes.

“Changes in your breast may not be due to cancer, but if you find a change that is new or unusual, it’s important to see a doctor without delay,” Professor Elston said. “We need to look after our health – for ourselves and our families.”

The Lots to live for video, which features NITV’s Marngrook Footy Show presenter Leila Gurruwiwi, is designed to be easily accessible and shareable on social media platforms widely used by Aboriginal and Torres Strait Islander people.

“Cancer Australia is committed to improving cancer outcomes for Aboriginal and Torres Strait Islander peoples,” Dr Zorbas said.

Visit www.canceraustralia.gov.au/atsi for more information.

Part 2 Key Facts Breast cancer in Aboriginal and Torres Strait Islander women

Key statistics

Incidence

  • Breast cancer is the most common cancer among Aboriginal and Torres Strait Islander women.
  • The number of breast cancer diagnoses among Aboriginal and Torres Strait Islander women increased by over 60% between the years 2004-08 and 2008-12.

Survival

  • The breast cancer survival rate was 16% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women between 2006-2010.

Mortality

  • Breast cancer was the second leading cause of cancer death among Aboriginal and Torres Strait Islander women after lung cancer (between 2007 and 2011).
  • In 2010-2014, there were 154 deaths from breast cancer among Aboriginal and Torres Strait Islander women in Australia.

Factors affecting breast cancer outcomes among Aboriginal and Torres Strait Islander women

Aboriginal and Torres Strait Islander women:

  • are less likely than non-Indigenous women to have a screening mammogram
  • may choose not to visit a doctor when they notice changes in their breasts.
  • are less likely to undergo cancer treatment
  • are less likely to complete cancer treatment
  • are more likely to have 1 or more other health problems such as heart disease and/or diabetes.

As a result of these factors, breast cancer may be more advanced when diagnosed.

Key messages

Finding breast cancer early

  1. Breast awareness and early detection of breast cancer for Aboriginal and Torres Strait Islander women
  • Finding breast cancer early means there are more treatment options and the chances of survival are greatest.
  • More than half of breast cancers are diagnosed after a woman or her doctor notices a change in the breast.
  • This shows how important it is that women are aware of the normal look and feel of their breasts and are confident in reporting unusual breast changes.

How can Aboriginal and Torres Strait Islander women get to know the normal look and feel of their breasts?

  • Women of all ages, daughters, mothers, aunties and grandmothers, are encouraged to get to know the normal look and feel of their breast.
  • They don’t need to be an expert or know a special way to check their breasts. They can do this as part of everyday activities such as dressing, looking in the mirror, or showering.

Changes to look out for

There are a number of changes to look out for:

  • A new lump or lumpiness
  • A change in the size or shape of your breast
  • A change in the nipple
  • Discharge from the nipple
  • Any unusual pain
  • A change in the skin of your breast

What to do if women find a change?

While most breast changes are not due to cancer, if a woman finds a change in her breast that is new or unusual for her, it’s important to see a doctor without delay.

Screening mammograms

  • Aboriginal and Torres Strait Islander women aged between 50 and 74 years are encouraged to attend mammographic breast screening every two years. Mammographic screening is the best early detection test for reducing deaths from breast cancer.

Where to go to have a breast screen?

BreastScreen Australia provides free breast screening for women 50-74 years and has services in all states and territories. To find out more call 13 20 50.

Lots to Live For!

Cancer Australia’s new video Lots to Live For was developed to put vital knowledge about the importance of breast awareness and early detection of breast cancer in the hands of Aboriginal and Torres Strait Islander women and communities.

The Lots to Live For video, which features Marngrook Footy Show presenter Leila Gurruwiwi, is designed to be accessible and shareable on social media platforms widely used by Indigenous communities.

Visit https://www.facebook.com/canceraustralia/ or

https://twitter.com/CancerAustralia #LotsToLiveFor @CancerAustralia

For more information

Visihttp://www.canceraustralia.gov.au/atsi

 

 

NACCHO Aboriginal Health and #ClosetheGap #Cancer @CancerCouncilOz #WorldCancerday Why should the poor die young? Closing the gap in cancer outcomes : Unhealthy lifestyles that can increase cancer risk

 ” In Australia, the poorest among us are 30% more likely to die of cancer than the richest.

There is also a big gap in cancer outcomes for our Indigenous Australian population, where incident rates from cancer are 10% higher than non-Indigenous Australians and mortality rates are 30% higher.

Similarly, cancer incidence (particularly cancers with poorer prognoses) and mortality are significantly higher outside capital cities, with outcomes worsening in step with remoteness.

So why are money, cultural background, geographic location and cancer types leading to some Australians being left behind?

More research is required to definitively pinpoint why these trends are occurring, but several factors stand out. More needs to be done to promote healthy lifestyles and cancer prevention to some parts of our community.

As an example, we know that smoking rates are higher in Indigenous populations and among poorer Australians and also link to cancers with poorer prognosis such as lung cancer.

Continued investment in anti-smoking campaigns tailored to these communities is critical in reducing this disparity. Currently around 40% of Indigenous Australians smoke compared with 12.2% of the general Australian population. In remote communities, this rises to around 60%.

Other unhealthy lifestyles that can increase cancer risk, including excessive alcohol consumption, physical inactivity, an unhealthy diet and obesity, are also more prevalent among socio-economically disadvantaged populations

Professor Sanchia Aranda is the CEO of Cancer Council Australia

See Full Article Part 4 below

Part 1 resources for Aboriginal Health workers

This work can sometimes be challenging because of the complex medical terminology involved, and the different side effects that patients can experience during treatment.

This booklet has been developed in collaboration with Aboriginal Health Workers to provide important and practical information to help you support your patients during their cancer treatment.

The booklet will help you to:

  • understand safety issues for patients having chemotherapy
  • recognise some of the most common side effects of cancer treatment
  • understand how to manage these side effects
  • educate your patients about how to manage side effects
  • know when to seek help (call a doctor or other healthcare professional)
  • understand the effects of cancer on your patients’ social and emotional wellbeing

Resources and Download Booklet HERE

Part 2 Quit smoking this to reduce your risk of developing tobacco related cancers.

More Info Indigenous Support

Part 3 Here are some ways to reduce your risk. Let’s beat cancer!

 Part 4 Money, cultural background and geographic location are crucial in determining survival rates

From The Guardian

Last week Cancer Council released new data forecasting cancer survival trends into the future. The statistics, outlining an expected 72% increase in the number of Australians living with cancer or in remission by the year 2040, were startling – but even more concerning are the trends that show the gap between the haves and have-nots when it comes to cancer survival.

The new report, released in the lead up to World Cancer Day, held yesterday 4 February, show that when it comes to cancer, things just aren’t as equal as they should be.

In Australia, the poorest among us are 30% more likely to die of cancer than the richest.

There is also a big gap in cancer outcomes for our Indigenous Australian population, where incident rates from cancer are 10% higher than non-Indigenous Australians and mortality rates are 30% higher.

Similarly, cancer incidence (particularly cancers with poorer prognoses) and mortality are significantly higher outside capital cities, with outcomes worsening in step with remoteness.

On top of all of this, there are increasing differences in survival rates between different cancer types.

By the year 2040, the most common cancers Australians will have survived are breast, prostate, bowel and melanoma. These are all common cancer types where we have seen positive improvements in awareness, better early detection, and, ultimately, treatment (and even with those advances, thousands of Australians die from these cancers each year, often in ways that can be prevented).

However, another common cancer type, lung cancer, features a much lower survival rate and highlights the need for greater investment in early detection and treatment for this cancer. Rarer cancers with poorer overall survival, such as pancreatic cancer, make up an even smaller proportion of survivors.

We also know that some parts of our community are less likely to detect cancer early. Australia has world-leading screening programs for bowel, breast and cervical cancer, but participation rates remain low, and participation lags behind in communities where health literacy is lower.

For example, cervical cancer mortality in Indigenous women is more than four times that of non-Indigenous women, which largely reflects far lower screening rates.

Finally, we know that the financial impact of cancer, something we call “financial toxicity”, impacts diagnosis and treatment decisions and this is likely to be particularly the case for poorer Australians with less capacity to absorb the costs of undergoing cancer treatment.

Australia has a good health system by world standards, but it’s the additional out-of-pocket and indirect costs of cancer that seem to allow the poorest people in our community to fall behind.

It’s the cost of accommodation for those travelling to treatment and parking, it’s the cost of having to quit your job while having treatment, it’s the financial impact on carers who also leave their jobs to support their loved one. I was staggered by the $2,500 bill my niece received for radiology tests at diagnosis of cancer, none of which was reimbursable through Medicare.

These costs are often exaggerated for our regional and remote cancer patients who have greater travel requirements and often lose the capacity to work even part-time.

We also know that doctors working in the private system often fail to disclose expected medical costs or to inform patients of lower cost alternatives within the public health system.

This has sadly led to cancer patients mortgaging their homes and putting their finances on the line to pay excessive out-of-pocket costs that are simply not justifiable. Cancer Council continues to call for health practitioners to disclose financial costs of treatment alongside information about other treatment options.

This report highlights the importance of funding research aimed at closing the survival gap for those cancers that continue to have poorer survival rates. We also need to translate the learnings and advances gained in cancers like breast cancer to other types.

Cancer Council funds research across all cancer types, and projects like Forgotten Cancers put low-survival cancers in the spotlight, but there is always so much more to be done. There are lost opportunities in particular when it comes to using our existing health system to detect rare cancers sooner, in order to increase the chances of successful treatment. In the UK and Denmark for example, gains have been made through setting benchmarks for time to diagnosis that help to avoid delays and get people into treatment sooner.

As a charity, Cancer Council can only fund a tiny fraction of what could be achieved through enhanced use of Australia’s $170 billion total annual health budget, of which only around 3% goes to cancer and around 1% to disease prevention. But we can engage with everyone to help make things better and work towards reducing these unacceptable disparities in cancer outcomes.

  • Professor Sanchia Aranda is the CEO of Cancer Council Australia

 

NACCHO Aboriginal Health and #Smoking Research Report : ‘Deadly progress’: substantial drop in Indigenous smoking from 2004-2015

“The research is a positive news story in Indigenous health, and more should be done to understand what is working to reduce Indigenous smoking” 

Professor Tom Calma, lead advocate for Indigenous tobacco control and Chancellor of the University of Canberra

Read Paper HERE

Read over 118 NACCHO Aboriginal Health and Smoking published over the past 5 years

A paper led by ANU researcher Associate Professor Ray Lovett published in the journal Public Health Research & Practice today found a substantial drop in smoking among Aboriginal and Torres Strait Islander people over the last ten years.

The research highlights the positive downward trends in daily smoking prevalence for young Indigenous people and Indigenous people living in urban areas.

The majority of Aboriginal and Torres Strait Islander adults (around six in ten) do not smoke daily.

According to the study, the proportion of Indigenous people smoking daily dropped by 9%, from 50% in 2004 to 41% in 2014.

Lovett explains, ‘As a result, there are 35,000 fewer daily smokers today than there would have been if things had stayed the same since 2004. This will lead to thousands of lives saved’.

‘The way we communicate statistics matters. In our work we focus on the progress made within the Aboriginal and Torres Strait Islander population, and we find that substantial progress has been achieved.

In contrast, when reports focus on the gap in smoking prevalence compared to the total Australian population, this can have negative consequences and can actually contribute to widening the gap’, said Lovett.

The team used data from national surveys conducted by the Australian Bureau of Statistics to assess trends in Indigenous smoking over time.

Dr Lovett and his research team are now working with two Aboriginal organisations, Central Australian Aboriginal Congress and Institute for Urban Indigenous Health, to better understand how their work contributes to the decline in smoking rates.

The full article can be found here: http://www.phrp.com.au/?p=37127

Discussion

The prevalence of daily smoking among Aboriginal and Torres Strait Islander adults in Australia has decreased by 8.6 percentage points (95% CI 5.5, 11.8), from 50.0% in 2004–05 to 41.4% in 2014–15.

This corresponds to an estimated 35 000 fewer Aboriginal and Torres Strait Islander adult daily smokers in 2014–15, compared with if the smoking prevalence had remained stable since 2004–05. Our findings indicate that thousands of premature deaths in Aboriginal and Torres Strait Islander people have been prevented by the reduction in daily smoking prevalence over the past decade.

Accurately determining the number of deaths averted requires additional data, such as cause-specific mortality. Declines in daily smoking among Aboriginal and Torres Strait Islander people were observed among both males and females, and were most evident among those aged 18–44 years, and those living in urban/regional areas.

The absolute decrease in smoking prevalence observed in the Aboriginal and Torres Strait Islander population is comparable with the decrease of 6.8 percentage points (95% CI 5.6, 7.9) in the total Australian population over the same period, although the base smoking prevalence was substantially lower in the total Australian population (21.3% in 2004–05). These results demonstrate that considerable progress has been made in the Aboriginal and Torres Strait Islander population in the past decade, matching in absolute terms the extent of progress made in the total Australian population.

Given the similar absolute decrease in smoking prevalence in the Aboriginal and Torres Strait Islander and total Australian population, the gap in smoking prevalence has remained relatively stable. This may appear inconsistent with the Australian Institute for Health and Welfare’s midterm report for the National Tobacco Strategy 2012–20185, which reported that the gap in smoking between Aboriginal and Torres Strait Islander people and non-Indigenous Australians had increased between 2008 and 2015.

The discrepancy arises from different methods used to report trends in smoking inequalities.9-11 Our analysis emphasises change in the absolute prevalence of smoking within the population (50.0% – 41.4% = 8.6% absolute prevalence decrease), whereas the midpoint report emphasises smoking prevalence in the Aboriginal and Torres Strait Islander population relative to the non-Indigenous population.5

In relative terms, the ratio of Aboriginal and Torres Strait Islander to total Australian smoking prevalence increased from 2.4 (50.0%:21.3%) in 2004–05 to 2.9 (41.4%:14.5%) in 2014–15. This demonstrates that reporting change in absolute versus relative terms can lead to fundamentally different conclusions, which could affect support for programs and policies.9-12

Focusing on relative differences in isolation can obscure progress at the population level; that is, the absolute number of Aboriginal and Torres Strait Islander adults quitting or not taking up smoking.

Further, research from other populations demonstrates that communicating information about health inequity using a progress frame (as used in this paper) rather than a disparity frame (i.e. focusing on the persisting gap) is associated with more positive emotional responses and increased interest in engaging in health-promoting behaviours.14 Therefore, we consider it ethical to report absolute progress in smoking prevalence.

The ambitious target to halve Aboriginal and Torres Strait Islander adult daily smoking prevalence to 23.9% by 20186 will not be achieved if current trends continue. However, this target would be reached within the next two decades if smoking prevalence continues to decrease at the current rate. If the success in smoking reduction observed within the younger age groups and those living in urban/regional areas is echoed in older age groups and in remote areas, this target may be reached earlier.

We observed significant reductions (about 10%) in daily smoking prevalence among the youngest age groups (18–24, 25–34 and 35–44 years). Data from the 2004–05 NATSIHS indicates that two-thirds of current and past Aboriginal and Torres Strait Islander smokers had begun smoking by age 1817; therefore, our findings of reduced smoking prevalence among younger adults is promising.

The Aboriginal and Torres Strait Islander population has a younger age profile than the total population, and therefore the potential population-level benefit of reducing smoking among younger adults is important.18

We observed reductions in daily smoking prevalence among male and female Aboriginal and Torres Strait Islander adults living in urban/regional areas. Given that the majority of Aboriginal and Torres Strait Islander people live in urban/regional settings, this is another encouraging finding at the population level.

We did not detect a significant change between 2004–05 and 2014–15 in daily smoking prevalence among Aboriginal and Torres Strait Islander adults living in remote areas. The observed stability of smoking prevalence in remote areas from 2004 to 2015 is consistent with trends from 1994 to 2004.7 Despite being the largest available datasets, the number of survey participants in remote areas was relatively small, and is likely to be insufficient to detect changes in prevalence.

Given the enduring high smoking prevalence among older age groups and in remote settings, improved intensive effort will be required to change the normalisation of tobacco use and correct potential misperceptions of tobacco use, particularly as older people may have had longer and more intense exposure to tobacco marketing.19

This includes continued and concerted effort from targeted Aboriginal and Torres Strait Islander tobacco control programs, in addition to national strategies.4,20

The prevalence of smoking is reduced by increased numbers of people quitting and not taking up smoking. Since 2008, there has been a concerted effort in public health strategies, policies and programs to reduce tobacco smoking in Aboriginal and Torres Strait Islander people.

Australia’s approach to tobacco control is comprehensive, and it is difficult to attribute changes to one program; however, continuing support for both whole-of-population and targeted strategies is required.

For example, recent evidence indicates that the introduction of graphic warning labels on cigarette packages led to increased understanding of and concern about the harms associated with smoking among Aboriginal and Torres Strait Islander people19,21, and research has demonstrated that smokers’ knowledge of the effects of second-hand smoke is associated with desire and attempts to quit.22 Our findings may indicate that programs and policies have been particularly effective at reducing smoking among young people and those living in urban/regional areas. It is more difficult to assess the potential effectiveness of programs and policies in remote settings; finer regional estimates are required to assess policy and program impacts in this setting.23

Strengths and weaknesses

This paper analyses multiple cross-sectional data, which are the most comprehensive data available on Aboriginal and Torres Strait Islander smoking status. Limitations of our approach include that comparability between survey estimates may be affected by differences in scope, sample design, coverage, and potential changes in the age structure of the population over time. The use of weighting generates estimates that are representative of the in-scope population, which were similarly defined across the four surveys. However, we note that the 2004–05 and 2008 surveys represent a somewhat smaller percentage (82–90%) of the Aboriginal and Torres Strait Islander population compared with the other surveys (95%); this may result from issues related to survey scope.17

We have restricted our analysis to current daily smoking – rather than including weekly or less frequent smoking – to enable consistent measurement across surveys, and to enable direct comparison with national tobacco targets.5,6 It is important to note that our analysis focused on cigarette smoking. Recent ABS surveys provide data on the use of other tobacco products (e.g. chewing tobacco); data on e-cigarette use are not yet available.

Although we include a comparison with daily smoking prevalence in the total Australian population as a benchmark, this article focuses on variation in daily current smoking trends within the Aboriginal and Torres Strait Islander population. We have presented comparable estimates for the total Australian population, rather than the non-Indigenous Australian population, because of the data that were available, and we may therefore underestimate the gap in prevalence between the Aboriginal and Torres Strait Islander and non-Indigenous populations. However, this underestimation is likely to be very small; for example, in 2014, the difference between daily adult smoking prevalence in the non-Indigenous population (14.2%; 95% CI 13.4, 15.0)3 versus the total Australian population (14.5%; 95% CI 13.6, 15.4) was marginal.

Conclusions

Applying a progress frame rather than a disparity frame and reporting absolute changes in smoking prevalence provides clear evidence of the substantial and significant declines in daily smoking prevalence among Aboriginal and Torres Strait Islander adults, which will result in considerable health gain. Particular success has occurred among younger adults and those living in urban/regional areas.

Despite this progress, the smoking prevalence in the Aboriginal and Torres Strait Islander population remains high, with an estimated 165 000 current adult daily smokers. It will be critical to learn from the success among younger adults and those in urban areas to effect change among older age groups and those in remote areas. Continuation and enhancement of a suite of tobacco control efforts are required.

 

 

 

 

 

 

 

 

 

 

NACCHO Aboriginal Health @AHPC_VU #AusHealthTracker report outlines growing health divide between the have and have nots

 ” Australia’s Health Tracker by Socio-Economic Status, a new report from the Australian Health Policy Collaboration at Victoria University, shows close links between socio-economic disadvantage and poor health as the gap widens between the have and have not’s.

Ten million Australians in low socio-economic brackets are at high risk of dying early from chronic disease, an alarming snapshot of the nation’s health shows

Australians sitting in the lowest SES bracket are:

  • Four times more likely to die from diabetes
  • Three times more likely to die from a respiratory disease
  • Two and a half times more likely to die from cardiovascular disease
  • Seventy per cent more likely to suicide and
  • Sixty per cent more likely to die from cancer.

People in lower SES brackets have higher risks of diabetes, heart disease, cancer, and depression.  

AHPC Director Rosemary Calder said the health divide in relation to chronic disease and risk factors is stark.

Download the Report

australias-health-tracker-by-socioeconomic-status

Chronic disease claimed the lives of 49,227 people before the age of 75 in lower socio-economic groups in the past four years – more than the capacity of the Sydney Cricket Ground.

“This is the story here, we are seeing working families struggle due to skyrocketing costs of housing, utilities and food and this is having a significant effect on their health outcomes,” she said.

Those often referred to as the working poor are at much greater risk of poor health, more likely to be obese, less likely to do exercise and much more likely to smoke, Professor Calder said.

Australia’s Health Tracker by Socio-Economic Status is not just about the health of communities who are most disadvantaged it alarmingly shows that the health of 40 per cent of Australians with low incomes – the working poor – is in jeopardy.”

“Being socially and economically disadvantaged is not only bad for your health it’s also much more likely to kill you,” Professor Calder said. “Our report shows not everyone has a fair go at living a long, healthy and prosperous life.”

But it’s not just the disadvantaged at risk. Australia’s Health Tracker data also shows alcohol is being consumed at risky levels in higher socio-economic groups. High cholesterol is another risk factor that affects the advantaged while rates of high blood pressure is evenly spread across all socio-economic groups.

Part 2 Public Health Association of Australia (PHAA)

This week Public Health Association of Australia (PHAA) co-hosted the launch of Australia’s Health Tracker by Socio-Economic Status (SES), a new report by the Australian Health Policy Collaboration at Victoria University.

The report highlights the growing health disparities in Australia which correlate closely with socio-economic status. Those in the lowest SES bracket experience significantly poorer health compared to those in the middle and highest brackets.

Michael Moore, CEO of the PHAA said, “One of the key principles underpinning the work of the PHAA is the social determinants of health.

The Health Tracker is a clear illustration of these determinants at work. Those who experience social and economic disadvantage also experience a much higher risk of non-communicable disease such as diabetes, respiratory disease, heart disease and cancer. They are also much more likely to experience serious mental health issues.”

“These health conditions are often long-term and eventually result in an earlier death. This research illustrates that disadvantaged Australians are indeed more likely to die from one of these diseases. The report paints a stark picture of how one’s place on the social and economic ladder has a direct impact on life expectancy,” Mr Moore said.

The report shows that 40% of Australians on low incomes are currently experiencing decreased health.

Such poor health outcomes can be attributed to multiple factors including lack of access to healthcare, poor nutrition, high rates of obesity, and high smoking rates. The rising cost of living from the increasing prices of housing, utilities and food is also manifesting in poorer health outcomes in the population.

Mr Moore said, “Every year chronic disease is claiming the lives of thousands of Australians under 75 in lower socio-economic groups at an alarming rate. However, this is not adequately accounted for in our national health policy and programs. Instead of prioritising our most vulnerable, we are applying one-size-fits-all health policies.”

“Ultimately, the focus ought to be significantly increased funding in preventive health, as this is the simplest, most effective and economically sound solution. Currently, Australia invests a pathetic 1.5% of its health budget on preventive health measures and programs.

It really needs to be 5% of health spending as a bare minimum, and we are unlikely to see a meaningful reduction of chronic disease without this investment,” Mr Moore added.

“At present, one in two Australians have a chronic disease, and many have more than one condition. The good news is that almost a third of this could be entirely prevented with greater investment in public health initiatives designed to reduce obesity, smoking, and alcohol consumption as well as increasing physical activity,” Mr Moore concluded.

Part 3 Are we dooming our children to a darker health future?

Latest figures on the diet and lifestyle of Australia’s children signal a troubling future for their health unless governments implement an effective national response , the Consumers Health Forum says.

“The Australia’s Health Tracker statistics released today should disturb us all as they indicate that many children now have higher risk factors for poor health than their parents,” the CEO of the Consumers Health Forum, Leanne Wells, said. “In many instances the risk factors are even worse for Indigenous children.

“The danger signals for our children are showing that in crucial aspects children are already following less healthy lifestyles and diets than their parents, in areas like physical activity and consumption of junk food and too much sugar.

“For instance, 70.8 per cent of children aged 5 – 11 years are not meeting physical activity recommendations and that compares with 44.5 per cent of adults. A brighter feature in the otherwise bleak picture for Indigenous children is that fewer, 40.5 per cent, do not meet the physical activity target.  But when it comes to children who are overweight or obese, 32.8 per cent of Indigenous children are in this category compared to 25.6 per cent for children overall in this age group.

“More than 70 per cent of children aged 9 – 13 years consume too much sugar compared to 47.8 per cent of adults.

“Is Australian society dooming its children too shorter, less healthy lives by failing to take the steps now that we need to take to encourage more physical activity and discourage unhealthy food and drink consumption?

“The picture portrayed in the Health Tracker data compiled by the Australian Health Policy Collaboration highlights the need for a systemic national approach to focus on common risk factors, tackling health inequities and disparities.

“Both medical leader, Dr Mukesh Haikerwal, and financial guru Alan Kohler, told the National Press Club launch of the new report today that stronger preventive health measures would save our society billions in reducing illness and early death and avoidable hospital costs.  As Mr Kohler said, “sugar in my view needs to be more expensive” to reflect its cost to health care.

“Currently Australia dedicates only 1.5 per cent of its health expenditure to prevention which could help reduce the widespread incidence of chronic disease that afflicts one in every two Australians.  What is needed now would not bankrupt the budget. But it would represent a healthy investment in Australia’s future,” Ms Wells said.

“We need to rethink prevention and take a longer-term view about where we should be investing in health.”

 

 

 

NACCHO and @CancerAustralia Aboriginal Women’s Health and Breast Cancer #LotsToLiveFor video launch to share and educate

 ” Sharing Cancer Australia’s Lots to live for video on social media will start a conversation between Aboriginal and Torres Strait Islander people about breast cancer and how early detection can save lives.

If you are an Aboriginal and Torres Strait Islander women, it is vitally important you know the normal look and feel of your breasts, the symptoms to look out for and the importance of seeing their doctor if you find a change.

Breast cancer is the most common cancer among women in Australia, including among Aboriginal and Torres Strait Islander women, yet Indigenous women are 16 per cent less likely to survive than non-Indigenous women.”

Professor Jacinta Elston ( breast cancer survivor )  Chair of the Cancer Australia Leadership Group on Aboriginal and Torres Strait Islander Cancer Control : She is a descendent of both the Kalkadoon people of North-West Queensland and the South Sea Islander people.

See Key Facts Breast cancer in Aboriginal and Torres Strait Islander women or Part 2 Below

Part 1 Launch today of The Lots to live for video, which features NITV’s Marngrook Footy Show presenter Leila Gurruwiwi

VIEW HERE

A new breast awareness video designed for Aboriginal and Torres Strait Islander women to share with family and friends on social media aims to increase early detection of breast cancer and improve survival.

Cancer Australia CEO, Dr Helen Zorbas, said the video, titled Lots to live for, had been produced to put vital knowledge about the importance of breast awareness and early detection of breast cancer in the hands of Aboriginal and Torres Strait Islander women and communities.

“Finding breast cancer early, while it is still confined to the breast, significantly increases the chances of survival,” Dr Zorbas said. “Early detection of breast cancer through breast awareness and increasing participation in mammographic screening are important ways to improve survival outcomes and address the disparity in breast cancer survival between Indigenous and non-Indigenous women.”

Professor Jacinta Elston, Chair of the Cancer Australia Leadership Group on Aboriginal and Torres Strait Islander Cancer Control, and an Aboriginal woman from Townsville, supported the video’s message and encouraged women to share it on social media.

“Studies have shown that social media has been used effectively in getting health messages out into our community,” Professor Elston said.

See opening message

“Aboriginal and Torres Strait Islander women aged between 50 and 74 years are also encouraged to have a free breast screen every two years. Mammographic screening is the best early detection test for reducing deaths from breast cancer.”

Professor Elston, who is herself a breast cancer survivor, acknowledged that some Indigenous women may be reluctant to discuss a breast change, due to shame, embarrassment, fear or stigma, but that this could seriously impact on their breast cancer outcomes.

“Changes in your breast may not be due to cancer, but if you find a change that is new or unusual, it’s important to see a doctor without delay,” Professor Elston said. “We need to look after our health – for ourselves and our families.”

The Lots to live for video, which features NITV’s Marngrook Footy Show presenter Leila Gurruwiwi, is designed to be easily accessible and shareable on social media platforms widely used by Aboriginal and Torres Strait Islander people.

“Cancer Australia is committed to improving cancer outcomes for Aboriginal and Torres Strait Islander peoples,” Dr Zorbas said.

Visit www.canceraustralia.gov.au/atsi for more information.

Part 2 Key Facts Breast cancer in Aboriginal and Torres Strait Islander women

Key statistics

Incidence

• Breast cancer is the most common cancer among Aboriginal and Torres Strait Islander women.

• The number of breast cancer diagnoses among Aboriginal and Torres Strait Islander women increased by over 60% between the years 2004-08 and 2008-12.

Survival

• The breast cancer survival rate was 16% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women between 2006-2010.

Mortality

• Breast cancer was the second leading cause of cancer death among Aboriginal and Torres Strait Islander women after lung cancer (between 2007 and 2011).

• In 2010-2014, there were 154 deaths from breast cancer among Aboriginal and Torres Strait Islander women in Australia.

Factors affecting breast cancer outcomes among Aboriginal and Torres Strait Islander women

Aboriginal and Torres Strait Islander women:

are less likely than non-Indigenous women to have a screening mammogram

• may choose not to visit a doctor when they notice changes in their breasts.

• are less likely to undergo cancer treatment

• are less likely to complete cancer treatment

• are more likely to have 1 or more other health problems such as heart disease and/or diabetes.

As a result of these factors, breast cancer may be more advanced when diagnosed.

Key messages

Finding breast cancer early

1. Breast awareness and early detection of breast cancer for Aboriginal and Torres Strait Islander women

• Finding breast cancer early means there are more treatment options and the chances of survival are greatest.

• More than half of breast cancers are diagnosed after a woman or her doctor notices a change in the breast.

This shows how important it is that women are aware of the normal look and feel of their breasts and are confident in reporting unusual breast changes.

How can Aboriginal and Torres Strait Islander women get to know the normal look and feel of their breasts?

• Women of all ages, daughters, mothers, aunties and grandmothers, are encouraged to get to know the normal look and feel of their breast.

• They don’t need to be an expert or know a special way to check their breasts. They can do this as part of everyday activities such as dressing, looking in the mirror, or showering.

Changes to look out for

There are a number of changes to look out for:

• A new lump or lumpiness

• A change in the size or shape of your breast

• A change in the nipple

• Discharge from the nipple

• Any unusual pain

• A change in the skin of your breast

What to do if women find a change?

While most breast changes are not due to cancer, if a woman finds a change in her breast that is new or unusual for her, it’s important to see a doctor without delay.

Screening mammograms

• Aboriginal and Torres Strait Islander women aged between 50 and 74 years are encouraged to attend mammographic breast screening every two years. Mammographic screening is the best early detection test for reducing deaths from breast cancer.

Where to go to have a breast screen?

BreastScreen Australia provides free breast screening for women 50-74 years and has services in all states and territories. To find out more call 13 20 50.

Lots to Live For!

Cancer Australia’s new video Lots to Live For was developed to put vital knowledge about the importance of breast awareness and early detection of breast cancer in the hands of Aboriginal and Torres Strait Islander women and communities.

The Lots to Live For video, which features Marngrook Footy Show presenter Leila Gurruwiwi, is designed to be accessible and shareable on social media platforms widely used by Indigenous communities.

Visit https://www.facebook.com/canceraustralia/ or

https://twitter.com/CancerAustralia #LotsToLiveFor @CancerAustralia

For more information

Visit http://www.canceraustralia.gov.au/atsi

NACCHO Aboriginal Health and #Obesity : Download #TippingtheScales Report Leading health orgs set out 8 urgent actions for Federal Government

“Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese.

This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult.

The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 “

 OPC Executive Manager Jane Martin 

Download the report HERE  tipping-the-scales

Read over 30 + NACCHO Obesity articles published last 5 years

Read over 30+ NACCHO Nutrition and Healthy foods published last 5 years

Thirty-four leading community, public health, medical and academic groups have today united for the first time to call for urgent Federal Government action to address Australia’s serious obesity problem.

In the ground-breaking new action plan, Tipping the Scales, the agencies identify eight clear, practical, evidence-based actions the Australian Federal Government must take to reduce the enormous strain excess weight and poor diets are having on the nation’s physical and economic health.

Led by the Obesity Policy Coalition (OPC) and Deakin University’s Global Obesity Centre (GLOBE), Tipping the Scales draws on national and international recommendations to highlight where action is required. Areas include:

  1. Time-based restrictions on TV junk food advertising to kids
  2. Set clear food reformulation targets
  3. Make the Health Star Rating mandatory by July 2019
  4. Develop a national active transport strategy
  5. Fund weight-related public education campaigns
  6. Introduce a 20% health levy on sugary drinks
  7. Establish a national obesity taskforce
  8. Develop and monitor national diet, physical activity and weight guidelines.

OPC Executive Manager Jane Martin said the eight definitive policy actions in Tipping the Scales addressed the elements of Australia’s environment which set individuals and families up for unhealthy lifestyles, rather than just focusing on treating the poor health outcomes associated with obesity.

Watch video HERE : How does junk food marketing influence kids

“Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese. This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult,” Ms Martin said.

“The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 But Australia still has no strategy to tackle our obesity problem. It just doesn’t make sense.

“Without action, the costs of obesity and poor diet to society will only continue to spiral upwards. The policies we have set out to tackle obesity therefore aim to not only reduce morbidity and mortality, but also improve wellbeing, bring vital benefits to the economy and set Australians up for a healthier future.”

Professor of Epidemiology and Equity in Public Health at Deakin University, Anna Peeters, said the 34 groups behind the report were refusing to let governments simply sit back and watch as growing numbers of Australians developed life-threatening weight and diet-related health problems.

“For too long we have been sitting and waiting for obesity to somehow fix itself. In the obesogenic environment in which we live, this is not going to happen. In fact, if current trends continue, there will be approximately 1.75 million deaths in people over the age of 20 years caused by diseases linked to overweight and obesity, such as type 2 diabetes, cancer heart disease, between 2011-20501,” Professor Peeters said.

“Obesity poses such an immense threat to Australia’s physical and economic health that it needs its own, standalone prevention strategy if progress is to be made. There are policies which have been proven to work in other parts of the world and have the potential to work here, but they need to be implemented as part of a comprehensive approach by governments. And they need to be implemented now.

“More than thirty leading organisations have agreed on eight priorities needed to tackle obesity in Australia. We would like to work with the Federal Government to tackle this urgent issue and integrate these actions as part of a long-term coordinated approach.”

In addition to the costs to society, the burden of obesity is felt acutely by individuals and their families.

As a Professor of Women’s Health at Monash University and a physician, Professor Helena Teede sees mothers struggle daily with trying to achieve and sustain healthy lifestyles for themselves and their families, while having to deal with the adverse impact of unhealthy weight, especially during pregnancy.

“As a mother’s weight before pregnancy increases, so does the substantive health risk to both the mother and baby. Excess weight gain during pregnancy further adds to these risks and is a key driver of infertility, long-term obesity, heart disease and type 2 diabetes, while for the child, their risk of becoming overweight or obese and developing chronic diseases in later life greatly increases,” Professor Teede said.

“The women I see are generally desperate for help to improve their lifestyle and that of their families. They want to set themselves and their families up for healthy, long lives.

“Currently, there is a lot of blame placed on individuals with unhealthy diets and lifestyles seen as being due to individual and family discipline. Women from all backgrounds and walks of life struggle with little or no support to achieve this. It is vital that we as a community progress beyond placing all responsibility on the individual and work towards creating a policy context and a society that supports healthy choices and tips the scales towards obesity prevention to give Australian families a healthy start to life.”

The calls to action outlined in Tipping the Scales are endorsed by the following organisations: Australian Chronic Disease Prevention Alliance (which includes the Heart Foundation, Cancer Council Australia, Kidney Health Australia, Diabetes Australia and the Stroke Foundation), Australian Health Policy Collaboration (AHPC), Australian Medical Students’ Association (AMSA), Australian & New Zealand Obesity Society (ANZOS), Australasian Society of Lifestyle Medicine, Baker Heart & Diabetes Institute, CHOICE, Consumers Health Forum of Australia, Deakin University’s Global Obesity Centre (GLOBE), Institute For Physical Activity and Nutrition (IPAN), Monash Centre for Health, Research and Implementation (MCHRI), LiveLighter, Menzies School of Health Research, The University of Melbourne’s Melbourne School of Population & Global Health, Melbourne Children’s (which includes The Royal Children’s Hospital Melbourne, Murdoch Children’s Research Institute and the University of Melbourne), the National Rural Health Alliance Inc, Nutrition Australia, Obesity Australia, Obesity Policy Coalition, Obesity Surgery Society of Australia & New Zealand, Parents’ Voice, Public Health Association of Australia and Sugar By Half.

Download the Tipping the Scales action plan and snapshot at opc.org.au/tippingthescales


1. Obesity Australia. Obesity: Its impact on Australia and a case for action. No time to Weight 2. Sydney, 2015.