Equity in Cancer Care and Outcomes

As part of the EnRICH Program within the Sydney Catalyst Translational Cancer Research Centre, the team is investigating variations in the timeliness and nature of diagnostic pathways for people with suspected lung cancer across NSW. In collaboration with clinical teams at the Chris O’Brien Lifehouse, we are comparing the time to diagnosis and treatment for people in regional and rural New South Wales with their Sydney-based counterparts.

The team is investigating whether it is possible to categorise treatment variation as ‘warranted’ or ‘unwarranted’ through the development of a novel questionnaire. This is being tested in a study of clinicians’ perspectives on the issue of apparent under-use of neoadjuvant radiotherapy for rectal cancer, in which both the size of variation between Local Health Districts, and the reasons for this variation are being examined. A second study is examining unwarranted variations in, and departures from Optimal Care Pathways for, lung cancer care across NSW hospitals in the EnRICH Program (both studies are Cancer Institute NSW funded projects). The team is investigating whether improved cancer care coordination can reduce outcome disparities, with the development of a novel measure of patient experience of cancer care coordination underpinning several randomised trials of care coordination interventions in collaboration with the Surgical Outcomes Research Centre (SOuRCe), the EnRICH Program and other research groups across Australia. With a focus on reducing the high complication rate following major exenterative surgery for pelvic cancer, we are collaborating with SOuRCe in an NHMRC-funded randomised trial of an intensive, pre-operative exercise intervention that is recruiting patients in NSW and Victoria.