Communicating Cancer-Related Information with Aboriginal and Torres Strait Islander Peoples: A Systematic Review and Meta-Synthesis

Abstract

Australian Aboriginal and Torres Strait Islander peoples are more likely to have poorer health outcomes than non-Aboriginal people. Reasons for the health disparity include the ongoing impacts of colonisation, a lack of access to culturally appropriate health services, and language and communication barriers. Cancer is the second biggest killer of Aboriginal and Torres Strait Islander peoples, with the mortality rate for some cancers more than three times higher for Aboriginal and Torres Strait Islander than non-Aboriginal Australians. Many factors contribute to the mortality rate of Aboriginal and Torres Strait Islander peoples with cancer, including lower screening participation, a mistrust for ‘Western’ medical systems and later presentation, meaning the cancer is more advanced when accessing health services. This meta-synthesis aimed to explore how health professionals communicate cancer-related information with Aboriginal and Torres Strait Islander peoples, including people with cancer, their families, and communities, to identify ways to improve this communication and, in turn, improve cancer health outcomes. A systematic search of eight electronic databases, following PRISMA guidelines, was undertaken to identify eligible studies. Studies were included if they were full articles published in English in peer-reviewed journals and reported qualitative data that contained data regarding communication of cancer-related information with Aboriginal people. Communication of cancer-related information was defined as encompassing verbal and nonverbal communication, discussion of cancer risk factors and screening, explaining diagnosis and treatment options. Following screening and appraisal for methodological quality 42 studies were synthesised using a meta-aggressive approach. Findings are described and implications including suggestions for how to improve communication and suggestions for future research are also provided.