Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Rectal Cancer Stage and Treatment Patterns in relation to patient’s culturally and linguistically diverse (CALD) Status, in South West Sydney Local Health District (SWSLHD).   (#155)

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 some cancers, and vary in knowledge, awareness and beliefs about cancer, its causes and treatments. These factors may impact on patient management and outcome. We aim to investigate patients diagnosed and/or treated for rectal cancer in SWSLHD facilities, to identify any disparity in stage at diagnosis and treatment patterns 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 factors associated with stage at diagnosis and treatment utilisation outcomes.


648 rectal cancers were identified. 67% were male. The median age was 65. 46% were from CALD backgrounds and of these 54% preferred a language other than English. The top three other languages were Vietnamese (18%), Italian (13%), and Arabic (9%). The analysis groups were Non-CALD (54%), CALD-English (21%) and CALD-non-English (25%). 20% had distant metastases at diagnosis. Treatment modality utilisation was Surgery – 82%, Radiotherapy – 45% and Systemic – 59%. No treatment was recorded for 3% of patients. Patients with higher socioeconomic status had increased odds of Surgery (OR .571 0.373-0.876, p=0.01), and those aged over 70 years had decreased odds of Systemic therapy use (OR 0.194, 0.109-0.348, p<0.001). There were no significant differences in extent of disease at diagnosis or overall modality utilisation identified between the CALD groups.


There was no significant disparity in extent of disease at diagnosis, or treatment modality utilisation specifically related to patient CALD status for rectal cancer patients in SWSLHD.