Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Colon Cancer Stage and Treatment Patterns in relation to culturally and linguistically diverse (CALD) Status, in South West Sydney Local Health District (SWSLHD). (#154)

Kirsten J Duggan 1 2 , Amrita Chandra 1 2 , Angela Berthelsen 1 2 , Mahbuba Sharmin 1 2 , Nasreen Kaadan 1 2 , Varsha Deshmukh 1 2 , Weng Ng 3 , Despina Seccombe 4 , Meredith Johnston 5 , Joseph Descallar 1
  1. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  2. SWSLHD Clinical Cancer Registry, Liverpool, NSW, Australia
  3. Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool and Campbelltown, NSW, Australia
  4. Palliative Care, South West Sydney Local Health District, Liverpool, NSW, Australia
  5. Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool and Campbelltown, NSW, Australia


CALD communities may experience higher incidence and prevalence of risk factors for certain cancers, and vary in knowledge, awareness and beliefs about cancer causes and treatments. These factors may impact on overall patient management and outcome. Our aim was to investigate patients diagnosed and/or treated for colon cancer in SWSLHD, to identify any disparities in relation to CALD status.


A retrospective cohort of rectal cancer cases, newly diagnosed in 2006-2012, and residing in SWS suburbs were identified from the SWSLHD Clinical Cancer Registry. CALD status was determined from Country of Birth and Preferred Language, and patients were classified: Non-CALD, CALD – English Speaking, and CALD – Non-English Speaking. Univariate testing and multiple multivariate models were used to identify associations with stage at diagnosis and treatment utilisation outcomes.


1596 colon cases were identified.  56% of patients were Male. Median age was 70. 41% of patients were from CALD backgrounds and of these 60% preferred a language other than English. The top three other languages were Italian (15%), Vietnamese (15%), Arabic (15%). Breakdown of analysis groups were CALD-English (16%), CALD-Non-English (25%) and Non-CALD (59%). 26% had distant metastases. The odds of distant metastases at diagnosis were significantly decreased for the CALD-Non-English group (OR 0.574, 0.427-0.771, p<0.001). Utilisation of Surgery was 82% and Systemic therapy was 40%. Surgery utilisation was significantly associated with females (OR 1.364, 1.014-1.835, p=0.04), those of lower socioeconomic residence (OR 1.4, 1.035-1.893, p=0.029) and Stage group (p<0.001). Patients aged 70 years and older had decreased odds of Systemic therapy (OR 0.304, 0.205-0.451, p<0.001). There was no significant differences in modality utilisation identified between the CALD groups.


Patients in the CALD-Non-English speaking group had significantly decreased odds of metastases at diagnosis, compared to the Non-CALD group. We found no difference in treatment modality utilisation related specifically to CALD status.