Patterns of Cancer Care for Aboriginal People in NSW (APOCC)

Cancer Council NSW is investigating the cancer experiences of Aboriginal people in NSW through the Aboriginal Patterns of Cancer Care project (APOCC).

This project is being funded by the National Health and Medical Research Council (NHMRC) through a Health Services Research Grant and Cancer Institute NSW through a Cancer Epidemiology Linkage Grant.

Although it is well documented that cancer is the second most common cause of death for Aboriginal people, very little is known about the cancer experiences of Aboriginal people in NSW


APOCC Artwork – Georgia Altona , Kamilaroi artist, (1959-2008)


Latest News from APOCC

Prostate Cancer

The APOCC team has just published research findings on Aboriginal men with prostate cancer, in the British Journal of Urology International. 

Prostate cancer is the number one cancer for Aboriginal men. APOCC has shown that Aboriginal men are 50 percent more likely to die after a prostate cancer diagnosis compared to non-Aboriginal men.

Findings have revealed that although the age and spread of disease at diagnosis were similar for Aboriginal and non-Aboriginal men, prostate cancer mortality five years after diagnosis was significantly higher for Aboriginal men.

It was also found that Aboriginal men are less likely to have surgery for their prostate cancer than non-Aboriginal men.  APOCC researchers suggest that timing of diagnosis, cultural differences and reduced access to treatment may be contributing factors for Aboriginal men to have poorer prostate cancer survival compared to non-Aboriginal men.

These findings identify an urgent need for:

  • More research on the prostate cancer journey for Aboriginal men, and their access to treatment services, to better understand the poorer survival after a prostate cancer diagnosis among Aboriginal men.
  • Increased health professional and Aboriginal community awareness of prostate cancer, which could see more Aboriginal men actively seeking advice and making better informed decisions around prostate health issues.
  • Specific Aboriginal cancer information resources which could create greater community understanding of prostate health issues and see more active monitoring of prostate issues among Aboriginal men.

You can read the abstract of this publication here:


Breast Cancer

The APOCC team has just published findings on Aboriginal women with breast cancer, in the journal BMC Cancer. 

Aboriginal women were found to be 30 percent more likely to die from their breast cancer than non-Aboriginal women. At the time of diagnosis, Aboriginal women were more likely to:

  • be younger than non-Aboriginal women being diagnosed, 
  • have a breast cancer that has spread beyond the breast and 
  • have another chronic condition, such as diabetes or heart complications.

These findings identify an urgent need to encourage actions that increases: 

  1. the chance of early diagnosis of breast cancer in for NSW Aboriginal women, 
  2. the prevention of other chronic diseases in for NSW Aboriginal women and 
  3. the rates of surgical treatment to improve breast cancer survival for NSW Aboriginal women.

You can read the abstract of this publication here:


Cancer Treatment for Aboriginal People

Findings from the APOCC & University of New South Wales Qualitative Interview Study suggest that Aboriginal people may be reluctant to undergo cancer treatment due to fear and confusion about the health system in addition to practical barriers such as lack of transport and accommodation.  This highlights the need for health services and organisations like Cancer Council NSW to work with Aboriginal communities to overcome these barriers.


 Stay up-to-date with all the latest news from the APOCC Study delivered to your inbox in our quarterly e-newsletter. To join the mailing list, contact us at or call us on 1800 1800 247 029.

 APOCC Newsletter No 16 May 2014 V2


About The APOCC Study

APOCC Project Team

Chief Investigators

Professor Dianne O’Connell
Cancer Research Division, Cancer Council NSW

Professor Phyllis Butow
School of Psychology, University of Sydney

Professor Bruce Armstrong
Public Health and Community Medicine, University of Sydney

Professor Carla Treloar
National Centre in HIV Social Research, University of New South Wales

Mr Anthony Dillon
School of Indigenous Health Studies, University of Sydney

Dr. Christy Newman
National Centre in HIV Social Research, University of New South Wales

Mr. Rajah Supramaniam
Cancer Research Division, Cancer Council NSW

Cancer Research Division Team

Jennifer Rodger
Project Coordinator

Joanna Jarrald
Communications Coordinator

Erin Dooley
Aboriginal Communications Assistant

APOCC2 DOC choiceSMLL to R: Kristie Weir, Dianne O’Connell, Jenny Rodger, Jo Jarrald, Raj Supramaniam 

Aims of the APOCC project

This project aims to explore the reasons for the increased death rate from cancer for Aboriginal people in NSW. Is it due to: later diagnosis of cancer, different treatments received, or a combination of both?

The aims of this project are to:

  • Determine whether Aboriginal people are being diagnosed with cancer at later stages;
  • Describe any barriers to Aboriginal people being diagnosed earlier and accessing cancer care;
  • Describe the care that Aboriginal people with cancer are currently receiving; and
  • Compare the level and types of care with that received by non-Aboriginal people.


Phases of the APOCC project

The APOCC Project consists of 5 phases:

Phase 1: An analysis of a linked dataset of cancers and hospital treatment records

Phase 2: Qualitative Interviews with Aboriginal Health Workers, Aboriginal people with cancer and carers for Aboriginal people with cancer about perceptions of cancer diagnosis and care.

The qualitative arm aims to explore and understand Aboriginal people’s cancer journeys using culturally appropriate qualitative research tools

The Centre for Social Research in Health at the University of NSW, conducted these interviews. 
For more information about the Centre for Social Research in Health team and their APOCC work, click here.


Treloar, C., Gray, R., Brener, L., Jackson, C., Saunders, V., Johnson, P., Harris, M., Butow, P., & Newman, C. E. (2013).  “I can’t do this, it’s too much”: Building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers.International Journal of Public Health. Advance online publication. View article here

 Treloar, C., Gray, R., Brener, L., Jackson, C., Saunders, V., Johnson, P., Harris, M., Butow, P., & Newman, C. E. (2013). Health literacy in relation to cancer: addressing the silence about and absence of cancer discussion among Aboriginal people, communities and health services. Health and Social Care in the Community, 21(6), 655-664. View article here

 Newman, C. E., Gray, R., Brener, L., Jackson, L. C., Saunders, V., Johnson, P., Harris, M., Butow, P., & Treloar, C. (2013). One size fits all? The discursive framing of cultural difference in health professional accounts of providing cancer care to Aboriginal people. Ethnicity and Health, 18(4), 433-447. View article here

Other publications of interest

Newman, C., Treloar, C., Brener, L., Ellard, J., O’Connell, D., Butow, P., Supramaniam, R., & Dillon, A. (2008). Aboriginal Patterns of Cancer Care: a five-year study in New South Wales. Aboriginal & Islander Health Worker Journal, 32(3), May/June: 6-7

Phase 3: A Patterns of Care study examining treatment received by Aboriginal people with cancer

The Patterns of Care study describes patterns of cancer treatment given to Aboriginal hospital in-patients, using linked data from the New South Wales Central Cancer Registry and the Admitted Patient Data Collection comprising records of hospital admissions in New South Wales.Papers with results for lung and colorectal cancers are being written. 


Supramaniam R, Gibberd A, Dillon A, Goldsbury DE, O Connell DL.  Increasing rates of surgical treatment and preventing comorbidities may increase breast cancer survival for Aboriginal women. BMC Cancer 2014, 14:163. View publication here

Rodger JC,  Supramaniam R, Gibberd AJ, Smith DP, Armstrong BK, Dillon A and O’Connell DL. Prostate cancer mortality outcomes and patterns of primary treatment for Aboriginal men in New South Wales, Australia.  BJU International, Supplement Article

Phase 4: A Pathways to Diagnosis study examining the barriers to timely cancer diagnosis for Aboriginal people with cancer

Pathways to Diagnosis study started in 2011 and aims to identify barriers to diagnosis and treatment for Aboriginal people faced with a cancer diagnosis. 112 Aboriginal cancer patients were recruited from hospitals and Cancer Registries and interviewed by Aboriginal research staff. Extensive work had been done on developing a culturally appropriate questionnaire.


Publications for this arm of the study are being written.

Phase 5: A dissemination phase to ensure that the results of the project reach all stakeholders and recommendations can be made at local and state health and government levels.


Contact us

For further information, please contact us at or call us on 1800 1800 247 029.

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