Brisbane-based Associate Professor Gail Garvey brings a wealth of research and leadership experience to her new role as Program Leader for the CRC for Aboriginal and Torres Strait Islander Health’s Program 1. A Kamilaroi woman whose family originated from Moree in western New South Wales, Gail has held positions as Assistant Dean of Indigenous Health and Education at Newcastle University and Head of the Indigenous Health Research Program at Queensland Institute of Medical Research (QIMR). She was also a past Link person for QIMR at both the CRC for Aboriginal Health and the CRCATSIH. In October Gail moved across to the Menzies School of Health Research with her team of researchers to head up Menzies’ Cancer Epidemiology group, and this month she takes over the leadership of Menzies’ Epidemiology and Health Systems Division – the most senior research role held by an Aboriginal or Torres Strait Islander at Menzies.
Cancer is the second largest killer of Aboriginal and Torres Strait Islander people, accounting for 19 per cent of deaths, but until recently it has not loomed large on the radars of most health professionals and policymakers. That is because, unlike a number of other conditions that affect Aboriginal people disproportionately (such as diabetes), Aboriginal and Torres Strait Islander people experience cancer at a lower rate than other Australians.
However, these statistics mask the real problem – that the mortality rate for Aboriginal and Torres Strait Islander people with cancer is up to 45 per cent higher than for other Australians. In other words, when Aboriginal and Torres Strait Islander people get cancer, they are much more likely to die from it. The goal of our team’s cancer research is to understand why this is the case, what support arrangements could help Aboriginal and Torres Strait Islander cancer patients, and to ensure that our research findings are taken up and used by health professionals working in the cancer area.
For instance, we know that Aboriginal women suffer from much higher rates of cervical cancer than other Australian women. Is this because cancer-screening services are less available in regional and remote areas? Is it because Aboriginal women feel uncomfortable with screening procedures, and in visiting screening clinics? Are there cost factors involved? We can make educated guesses, but until we have the evidence base we just won’t know.
Lack of data is a key impediment to our research effort. There are currently no national data on cancer incidence in Aboriginal and Torres Strait Islander Australians due to poor data quality in several jurisdictions. Also, for those patients who are registered, there is concern that not all are correctly identified as Aboriginal and Torres Strait Islander. There have been pockets of research done around cancer registries and other datasets but it’s been disjointed. We need to start connecting up the dots at a national level and that’s where Menzies and the Lowitja Institute can make a real difference.
My recent move across to Menzies’ Brisbane base with my research team is partly aimed at encouraging greater collaboration across disciplines and between mainstream and Aboriginal health researchers in this challenging area. Menzies has had 25 years’ experience in Aboriginal and Torres Strait Islander health research and has built up a good reputation in our communities. We thought that was really where our research was best placed.
It was also important to me when making my decision to move from QIMR that I remained involved with the Lowitja Institute. The links between Menzies and the Institute are very strong due to Menzies’ prior relationship with the CRC for Aboriginal Health and the CRC for Aboriginal and Tropical Health, and it’s the sort of collaborative working relationship that is so important to making progress in Aboriginal and Torres Strait Islander health. In Brisbane we are now co-located with both the Lowitja Institute’s Program 1 team and the One21seventy National Centre for Quality Improvement in Indigenous Primary Health Care (which emerged out of the CRCAH’s ABCD project), so from my perspective it’s a perfect match.
At the moment our cancer research is focused on investigating the supportive care needs of Aboriginal and Torres Strait Islander adults with cancer. We’ve developed a culturally appropriate tool to help patients assess their needs, and we intend to adapt the tool so it can be used no matter which State or Territory patients live in. We’re currently validating the tool in Queensland to make sure it is answering the questions we want it to, and once we’ve done that we’ll be able to take it to other community groups around Australia.
There is a strong degree of overlap between my roles at Menzies and the Lowitja Institute, and some of the work that we’re doing at Menzies will help the Institute achieve the cancer research milestones agreed with the Commonwealth under the CRC funding package. For instance, we will be submitting a proposal by the end of January 2012 to establish a Centre of Research Excellence (CRE) for Aboriginal Cancer that emerged out of a Lowitja Institute-organised Roundtable. If we are successful, CRE funding is worth $2.5 million over five years, which would give us about $500,000 a year to devote purely to Aboriginal and Torres Strait Islander cancer research.
Among the issues the CRE would examine is the disparity in cancer survival rates between people living in metropolitan areas and those living in more remote locations. We already know that Aboriginal and Torres Strait Islander people don’t get the same access to treatment as other Australians, and certainly it takes longer to get surgery. Under our proposal the CRE will have chief investigators in different States and Territories, all running separate projects. We’ll be investigating the best way to provide services to Aboriginal and Torres Strait Islander people living in different locations, what services they are more likely to take up and how best they can be supported.
The Lowitja Institute will also be supporting Menzies and our team to establish a national network of people who are interested in cancer research among Aboriginal and Torres Strait Islander populations. As part of this it is our intention to hold further roundtables to keep everyone engaged in the research effort.
We all need to work together on Aboriginal and Torres Strait Islander cancer more effectively than we have in the past. The first Cancer Roundtable was wonderful in this regard, with the presence of Professor Ian Olver, Chief Executive of the Cancer Council of Australia, to ensure that we had good representation from health professionals across the entire spectrum of cancer care and research, including clinicians.
The truth is, it’s one thing to do the research, but quite another to engage with clinicians at the coal face and get them to change practice in the care of Aboriginal and Torres Strait Islander people with cancer. This is why building collaborations between communities, clinicians and researchers is the vital ingredient in all we do.