Factors influencing lung cancer outcomes in culturally and linguistically diverse (CALD) populations

Background

Lung cancer remains the leading cause of cancer-related mortality globally and in Australia, with 8,691 deaths recorded nationally in 2023. People from culturally and linguistically diverse (CALD) backgrounds experience disproportionately poorer outcomes, yet the reasons behind these disparities are not fully understood. Given that nearly one-third of Australia's population is born overseas, and a significant proportion come from CALD backgrounds, understanding and addressing these inequities is crucial.

CALD patients often face barriers such as language difficulties, cultural insensitivity, stigma, and limited health literacy, which can hinder access to timely diagnosis and treatment. About one-third of lung cancer patients in NSW present through emergency departments, often due to delays in care or lack of continuity. Bulk-billing practices, while more accessible, can be time-constrained and less conducive to preventive care discussions, particularly for patients requiring longer consultations. The upcoming National Lung Cancer Screening Program (NLCSP) relies heavily on GP referrals, highlighting the urgent need to understand and address CALD-specific challenges to ensure equitable access and outcomes.

Aim

This project aims to explore the factors contributing to disparities in lung cancer outcomes between CALD and non-CALD populations by analysing large health datasets. It will investigate whether CALD patients are more frequently diagnosed through late hospital admissions rather than early GP visits, compare waiting times for treatment across public and private care, and examine GP consultation types, bulk-billing rates, and continuity of care. By identifying the most affected CALD communities and the barriers they face—such as language, migration history, or visa status—the project will inform targeted strategies to improve access to timely diagnosis and treatment, including equitable participation in the National Lung Cancer Screening Program.

Research Methodology

Existing national and NSW-based datasets will be linked for a retrospective cohort status which will capture linguistic, ethnic, cultural and migration factors. Statistical analysis will be conducted to investigate the aims of the project. This study will generate a data-driven, prioritised list of factors impacting access and outcomes for CALD lung cancer patients, relevant to the NLCSP. The study will be conducted in collaboration across hospital networks, medical research institutes and 6 UNSW sites, ensuring strong clinical and consumer engagement throughout.

Current Status

The protocol and data analysis plan for the project have been finalised. Currently, data curation is underway, with ongoing efforts to clean and organise the relevant datasets. In the coming months, the team will continue with data analysis, refine findings, and begin drafting strategies for improving care pathways.