Background
Gastric and oesophageal cancers cause significant cancer-related morbidity and mortality in Australia. Multimodality treatment remains the cornerstone for curative intent treatment for locally advanced disease. Culturally and linguistically diverse (CALD) populations affected by cancer often have poorer health outcomes compared to non-CALD populations which may be due to poorer health literacy and unequal access to healthcare, resources and support networks.
Aim
We compared the differences in tumour characteristics and outcomes in patients treated with curative intent multimodality therapy for gastric and oesophageal cancers across different cultural backgrounds in South Western Sydney Local Health District (SWSLHD).
Methods
All patients treated with chemotherapy between 2010-2020 for non-metastatic gastric and oesophageal cancer across four institutions in SWSLHD were identified from an electronic database. CALD patients were defined as those born in a predominantly non-English speaking country or whose preferred language was not English. SPSS was used to perform the statistical analyses.
Results
212 patients (94 CALD and 118 non-CALD respectively) were identified. A greater proportion (28.7% vs 14.4%, p=0.01) of CALD patients were female. CALD patients had a predominance of gastric cancers (70.2% vs 21.1%, p<0.001). Only 7% of all CALD patients had oesophageal cancer vs 45% of non-CALD patients (p<0.001). CALD patients also presented with earlier stage disease when compared to non-CALD patients (41.9 vs 57.4%, p=0.01). Median overall survival was not statistically different between CALD and non-CALD population (42.8 vs 43.8 months, p=0.76). No specific differences were highlighted when analysed by tumour location or histology.
Conclusions
CALD patients were more likely to present with gastric cancers and receive perioperative chemotherapy than non-CALD patients who had a predominance of oesophageal cancers and treatment with neoadjuvant chemo-radiation. This may reflect genetic and etiological difference in gastric and oesophageal cancers in CALD patients. Despite this, survival of CALD and non-CALD populations was similar.