2042P - Improving breast cancer outcomes for indigenous women

Background

Breast cancer is the most diagnosed cancer affecting Australian women. While the incidence rate of breast cancer is lower in indigenous women than non-indigenous women the mortality rate is higher, with indigenous women 1.2 times more likely to die from the disease. The are many factors that contribute to this and if we want outcomes to improve for indigenous women with breast cancer, we must identify where practice and policy can change and improve. These findings may inform approaches for indigenous women in other high-income countries who experience similarly poor breast cancer outcomes.

Methods

This research employed the Context-Mechanism-Outcome (CMO) framework to reveal potential mechanisms and contextual factors that influence breast cancer outcomes for indigenous women. The framework explains generative causation, which helps to highlight the relationship between a context, mechanism, and outcome of a program or policy. The mechanisms and contextual factors were stratified into multiple levels; micro (interpersonal), meso (systemic), and macro (policy) levels. “If-Then-Because” statements were used to represent (broadly) the elements of CMO.

Results

The CMO framework allowed us to interpret evidence regarding indigenous women and breast cancer and provided nine practical ways to improve health outcomes and survival rates: 1. Improved health literacy regarding the importance of screening and early detection, delivered in a culturally safe way 2. Increased cultural safety and access to screening services 3. Presence of indigenous health service providers 4. Ensuring health service provider is local and/or familiar with indigenous culture and community 5. Culturally safe screening, diagnosis, treatment and follow-up settings 6. Local indigenous screening champions in the community 7. Protocols for abnormal results are tailored to local setting and community 8. Culturally safe support available for people who receive diagnoses 9. Policy is re-written in consultation with indigenous people and provides solutions to improve health outcomes.

Conclusions

Using the CMO framework, this study has provided nine practical measures to assist in improving the health outcomes for Australian indigenous women with breast cancer.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

V. Christie.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.