Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Unwarranted variation in cancer care for culturally and linguistically diverse populations in Victoria: implications for equitable and optimal care (144479)

Frances F Graham 1 , Helena Rodi 1 , Phillip Parente 2 , Beverley Woon 3 , Ella Stuart 4 , Tommy Wong 4 , Linda Nolte 1
  1. North Eastern Melbourne Integrated Cancer Service, Heidelberg, Melbourne, Victoria, Australia
  2. Director of Cancer Services, Medical Oncologist, Monash University; Eastern Health, Melbourne, Victoria, Australia
  3. Sir Peter MacCallum Department of Oncology, University of Melbourne; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  4. Cancer and Specialist Therapies | Aged Care and Systems Priorities Branch, Victorian Department of Health; Cancer Council Victoria, Melbourne, Victoria, Australia

Background

Culturally and linguistically diverse (CALD) populations experience inequities across the cancer care continuum, relating to diagnosis, access, and outcomes. Unwarranted variation (UWV) - differences in care not explained by clinical need or patient preference provides a framework to identify avoidable inequities.

Aim

This study examined UWV in cancer care for Victorian CALD populations diagnosed with breast, colorectal, lung and prostate cancer, with a focus on identifying health service priority improvements to promote equity in optimal care.

Methods

A retrospective cohort analysis (2019-2023) was conducted using linked administrative datasets to examine patterns of care for CALD adults with breast, colorectal, lung or prostate cancer, with findings informing a 2026 summit event. It included extensive consultation with clinicians, consumers and community representatives. CALD populations were identified using country of birth, with language used to refine classification. Analysis focused on key stages of the care continuum, including screening, diagnosis, treatment and post-treatment care.

Results

While treatment delivery was broadly comparable once patients entered care pathways, substantial access inequities were identified. Priority UWVs identified for statewide action included (1) longer time to first treatment with CALD patients more likely to experience delays; (2) lower likelihood of receiving any cancer treatment within one year of diagnosis; and (3) higher emergency department utilisation following diagnosis. Additional gaps were observed in screening participation and follow-up supportive care access and navigation, with pronounced disparities in some groups including Arabic and Vietnamese-speaking populations. Lung cancer outcomes were particularly influenced by delayed diagnosis and limited access to early detection pathways.

Conclusions 

These findings highlight persistent, system-level inequities in cancer care for CALD populations in Victoria. Addressing UWV requires targeted, culturally responsive interventions to strengthen early detection, improve navigation and ensure timely access to treatment. Embedding equity-focused system redesign is critical to delivering more coordinated and optimal cancer care.