NRSG371: Improving Cancer Screening in Indigenous Communities

This report examines cancer screening practices and challenges within Indigenous communities in Australia, focusing on the disparities in cancer rates and survival compared to non-Indigenous populations. It highlights the critical role of nurses in improving early detection and secondary prevention through patient education, coordination of care, and culturally sensitive communication. The report discusses factors contributing to higher cancer risk among Indigenous Australians, including lifestyle factors, limited access to healthcare, and lower participation in screening programs. It also explores strategies to enhance screening rates and improve health outcomes, emphasizing the importance of culturally appropriate approaches and community engagement. The report concludes by underscoring the need for multidisciplinary collaboration and the empowerment of Indigenous communities in cancer prevention and management.

Building healthy communities

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Indigenous community of Australia in rural area ..................................................................1
Rationale for selection of indigenous community of Australia..............................................2
Role and responsibilities of nurses in cancer screenings........................................................3
Role of nurse in cancer screening in indigenous community community of Australia..........4
CONCLUSION................................................................................................................................5
REFERENCES ...............................................................................................................................6

INTRODUCTION
Cancer screening is referred to as a process that is used for examining the symptoms for
presence of cancer in the body. Screening tests are extremely useful as it helps detect cancer in
its early stage and reduce chances of cancer related deaths. Tests included in screenings are urine
tests, blood tests, DNA tests etc. and medical imaging. It is easier to cure abnormal cancerous
growth in cells, if it is detected at an early stage because by the time symptoms appear in the
body the cancer can maliciously grow and spread rapidly (Hendryx, 2018). This makes the
cancer even harder to cure. The accuracy rate of cancer screening is found to be 93% making it a
reliable indicator for presence of cancer in the body. The two most critical screenings are
colonoscopy (colorectal cancer) and mammography (breast cancer). As of now, there are still
some types of cancers that do not have an effective screening method. Development of new
cancer screening techniques is still under active research (Hertzum-Larsen and et. al., 2019).
Screening of cancer may improve chances of survival yet there are a number of risk associated
with cancer screening such as false positives, overdiagnosis and false reassurances.
MAIN BODY
Indigenous community of Australia in rural area
In Australia, indigenous community is divided on the basis of culture into two groups made up of
Aboriginals and Torres strait islander people. But there is a great diversity among these two
groups. Many indigenous people keep the knowledge of their unique language, culture and belief
in their traditional knowledge and natural resources(Building Community in an Online Graduate
Program: Exploring the Role of an In-Person Orientation, 2018). In their physical and cultural
survival ancestral land, water and territories have fundamental importance. There are 5%
indigenous people in the world but more then 15% are belonging to extremely poor of the
world's population. In 2004-2008, the prevalence of new cancer in indigenous people is very
high then the non indigenous people in Australia (Taylor, & Guerin, 2019). Mostly Lungs cancer
are diagnosed in Australian indigenous people. In 2007-2011 the mortality rate due to the cancer
is high in indigenous people than the non indigenous people in Australia(Building community
resilience on social media to help recover from the COVID-19 pandemic, 2022). Most of the
indigenous people in Australia is died due the lungs cancer. From 1999 to 2007 most of the
indigenous people who diagnosed for cancer had 40% chance of survival for 5 years where as it
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was higher in non indigenous people with 52% chances of survival(An investigation of
efficient nursing interventions in early diagnosis of cancer A systematic review and meta-
analysis, 2021).
Rationale for selection of indigenous community of Australia
There are several reason due to which indigenous people have higher risk factor for
different types cancer in their community. Which are following:
 liver cancer: In these communities, there are more risky alcohol consumption more
prevalence of hepatitis b diseases may be becoming the reason of higher rates of cancer
and mortality (Rosales, et. al., 2020).
 Lungs cancer: there are higher prevalence of smoking in indigenous people than non
indigenous,which is 38% in indigenous and 18% in non indigenous people in Australia. Cervical cancer: Australian non indigenous women doing lower screening of cervical
than the non indigenous Australian women therefore they had more rate of cervical
cancer(The workings of an action learning program for building mental health promotion
capacity – A realist evaluation, 2022)
 Breast cancer in female: due to the least participation in screening of breast cancer,
indigenous women are more suffering than non indigenous and 100% dying rate from this
type of cancer (De Jager, Gunnarsson, & Ho, 2021).
Indigenous people is diagnosed 1.1% times more no of cases of cancer than non indigenous
people from year 2009-2013. There are many factors which contribute in the gap between the
health of indigenous and non indigenous people such as:
 lower education rates
 lower employment rates
 higher smoking rates
 poor nutrition
 physical inactivity
 poor access to health services
Due to less participating in bowel, breast, cervical screening program, indigenous people face
more chances to suffering from cancers related to these organs. Prevalence rate of cancers in
indigenous people are lower than non indigenous people due to the lower survival rate(Primary
health care clinics as catalyst to community building and health among residents in low income
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housing units, 2021). Prostrate cancer is most common in indigenous people which is very less in
non indigenous due to their living style which is more advanced and well hygienic than
Aboriginal and Torres strait. There are less surviving rate of indigenous than non indigenous
from all these types of cancer(Building community resilience beyond COVID-19: The Singapore
way 2021).
Role and responsibilities of nurses in cancer screenings
Nurses play a central role in early detection and secondary cancer prevention. It is
important for them to carry out follow ups with the patients, coordinating the tests prescribed to
them and ensuring continuity of the treatment after diagnosis(Fornes-Vives and et. al., 2019). For
the known community of Aboriginal and Torres strait islanders, who were the first inhabitants in
Australia, providing up to date information to facilitate patient knowledge and ensuring
coordination among different levels of care is a prime role that nurses play in helping smooth the
path for cancer screening process. Carrying out diagnostic tests and management of records of
the patients is an integral part of duty(Abu Yahya and et. al., 2019). The role requires them to
plan and document group meetings and maintaining appropriate nursing records for future
references (Marcus and et. al., 2021). Nurses in cancer care can provide fundamental education
for cancer prevention including the ways for successful prevention. Compared to doctors, nurses
are more easily accessible to the general public and can educate people in context of cultural
background of the individuals, their families and communities(Woo and et. al., 2020). They
monitor the process from the beginning. For example, if screening for colon cancer is to take
place which includes insertion of a flexible tube inside the rectum, many won't feel comfortable
having that procedure done but a nurse can make the patient feel comfortable, make him aware
about the procedure, obtain an informed consent, recording procedures and ultimately carry out
the diagnostic test procedure (An investigation of efficient nursing interventions in early
diagnosis of cancer A systematic review and meta-analysis, 2021). They can help identify
symptoms of colon cancer such as gastrointestinal bleeding, change in stools, unexplained
weight loss(Swoboda and et. al., 2020). Even after the procedure has been done, the nurse
remains in contact with the patient carrying out routine follow ups, check-ups.
According to WHO, in recent years cancer is the second most leading cause of death all
over the world, therefore, early detection is essential. Early diagnosis can be hindered by poor
knowledge and lack of resources. Henceforth, one of the main areas of a nurses' responsibilities
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includes implementing and evaluating that all stakeholders have access to cancer prevention
education(Stenzel and et. al., 2022). Informing the people about the management of risk of
developing cancer and its screenings. The central component for nurses is coordination and
collaboration with other team members of the health team. They can help advocate for the patient
and their families and not just treat the cancer. Nurses also enforce safe and effective
administration of cancer therapy medications (chemotherapy, target-based therapy, medicinal
therapy) according to the national standard polices and local policy. It is important for them to
explain the process of chemotherapy, its procedures, side effects and management of side
effects(Wender an et. al., 2019). Management of cases and enforcing patient's rights aids in
providing better quality of care. For providing optimal care to patients inclusion of nurses in
population based screenings should be promoted.
Role of nurse in cancer screening in indigenous community community of Australia
Australia's indigenous people are the two main distinct cultural groups made up of
Aboriginal and Torres Strait Islander peoples. But there is great diversity within these two
broadly described groups exemplified by the over 250 different language groups spread across
the nation. Cervical cancer incidence and mortality rates have halved in Australia since the
introduction of the National Cervical Screening Program (NCSP) in 1991 (Anderson and et. al.,
2021). although Australia could be one of the first countries in the world to eliminate cervical
cancer, incidence rates among Aboriginal and Torres Islander women remain more than twice
those of non- indigenous women and mortality is three times higher(Perera andet. al., 2018). This
is partly because participation is cervical screening among Aboriginal and Torres Strait Islander
women is approximately20 percent points lower than other Australian women. The disparities in
cervical cancer outcomes and screening participation rates indicate that the NCSP is not meeting
the needs of Aboriginal and Torres Strait Islander women(Hamama and et. al., 2019). Nurses are
expected to engage with all the people as individuals in a culturally safe and respectful way so
that they do not feel disregarded, honest and compassionate professional relationships, and
adhere to their obligations about privacy and their confidentiality (Ivers and et. al., 2019). In
Australia, there are some national population based screening programs for breast cancer,
cervical cancer and bowel cancer. Indigenous Australians do participate in breast screen
Australia and the National Bowel Cancer Screening Program (NBCSP) at a lower rate than non-
indigenous Australians. Informations are not available on indigenous participation in the
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National Cervical Screening Program, although there is an evidence that indigenous Australians
also participate in cervical screening at a lower rate. The pilot program aimed to encourage
Aboriginal and Torres Strait Islander people to do this bowel screening test(Salvador and et. al.,
2022). That provided resources for families and communities, and primary health care
professionals participating in the pilot program. The pilot shows higher participation in screening
for those who were handed kits through the alternate pathway; similar participation rates to non
indigenous Australians who screened through the usual mail model pathway;increased screening
among those who had been previously invited, but never screened; increased screening among
those who are lived in areas of low socio economic status or remote areas. Aboriginal and Torres
Strait Islander women experience a higher burden of cervical cancer than the other women too
(Meiklejohn and et. al., 2019). The reasons that some women in this population starts and
continue to screen remain unheard but could provide insights to support women who currently do
not participate. Australian women aged 25-70 years who had completed cervical screening in the
past five years, recruited via Primary Health Care Centers (PHCC) from three jurisdictions.
This approach basically recognises that an individual live within families, communities
and their culture that also have the strengths and resource material that will contribute and
provide with well-being. Strengths based approaches to research and discovery have their
specific relevance and link to understanding and promoting health and well being in indigenous
contexts. The more of attention is given to social, cultural and ecological factors of living which
is highlighted in these approaches and they are consistent with philosophies of living a sound and
good life found in many indigenous cultures of Australia(Betz and et. al., 2022). For these
communities cultural strengths can be enabled through traditional cultural practices and beliefs,
kinship ties, connection to their land and country, their art,song, and ceremonies, dance healing
and their spirituality and also the empowerment, their ancestry, belongings and self
determination.
CONCLUSION
By analysing the above information, it can be concluded that the position of the most
cancer screening nurses is better understood within side the context of a multidisciplinary team.
Nurses taking part in nursing interventions make independent decisions about personalized
patient care. Nursing interventions improve service accessibility which can lead to increased
opportunity for early detection of cancer. It is important for them to make sure a patient's legal
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responsibilities in terms of administration of medications are met accurately. Specially trained
nurses for cancer care called oncology nurses specialize in assessing a person's needs in both
hospitals and outpatient practices. Independent verification of medication obtained by the
pharmacy is done by nurses. Primary care by nurses includes health education, elimination of
risk factors and promotion of physical activity whereas secondary care includes undertaking
measures to cure cancer. One of the most valuable tools that nurses have is their extraordinary
ability to form professional connections with their patients and their families. A variety of
nursing assessment along with appropriate guidance and knowledge can lead to effective
treatments after early detection of cancers.
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REFERENCES
Books and Journals
Abu Yahya and et. al.,(2019, January). Correlates of nurses’ motivation and their demographic
characteristics. In Nursing forum (Vol. 54, No. 1, pp. 7-15).
Anderson, K., Diaz, A., Parikh, D.R. and Garvey, G., 2021. Accessibility of cancer treatment
services for Indigenous Australians in the Northern Territory: perspectives of patients and
care providers. BMC Health Services Research, 21(1), pp.1-13.
Betz and et. al., (2022). Health care transition planning: A potpourri of perspectives from
nurses. Journal for Specialists in Pediatric Nursing, e12373.
De Jager, E., Gunnarsson, R., & Ho, Y. H. (2021). Surgical services for breast cancer patients in
Australia, is there a gap for aboriginal and/or torres strait islander women?. World journal
of surgery, 1-10.
Fornes-Vives and et. al., (2019). Longitudinal study predicting burnout in Spanish nurses: The
role of neuroticism and emotional coping. Personality and Individual Differences, 138,
286-291.
Hamama and et. al., (2019). Burnout and perceived social support: The mediating role of
secondary traumatization in nurses vs. physicians. Journal of advanced nursing, 75(11),
2742-2752.
Hendryx, M., & Luo, J. (2018). Increased cancer screening for low-income adults under the
Affordable Care Act Medicaid expansion. Medical care, 56(11), 944-949.
Hertzum-Larsen and et. al., (2019). Participation in cervical cancer screening among immigrants
and Danish-born women in Denmark. Preventive medicine, 123, 55-64.
Ivers, R., Jackson, B., Levett, T., Wallace, K. and Winch, S., 2019. Home to health care to
hospital: Evaluation of a cancer care team based in Australian Aboriginal primary
care. Australian Journal of Rural Health, 27(1), pp.88-92.
Marcus and et. al.,(2021). The ASCCP cervical cancer screening task force endorsement and
opinion on the American Cancer society updated cervical cancer screening
guidelines. Journal of lower genital tract disease, 25(3), 187-191.
Meiklejohn, J.A., Arley, B.D., Pratt, G., Valery, P.C. and Bernardes, C.M., 2019. 'We just don't
talk about it': Aboriginal and Torres Strait Islander people'perceptions of cancer in
regional Queensland. Rural and Remote Health, 19(2), pp.20-28.
Perera, C. K., Pandey, R., & Srivastava, A. K. (2018). Role of religion and spirituality in stress
management among nurses. Psychological Studies, 63(2), 187-199.
Rosales, B. M., et. al., (2020). Cancer mortality in kidney transplant recipients: An Australian
and New Zealand population‐based cohort study, 2013. International Journal of
Cancer, 146(10), 2703-2711.
Salvador and et. al., (2022). Revisiting the roles of neonatal intensive care unit nurses towards
vision 2030 of Saudi Arabia: A descriptive phenomenological study. Journal of Nursing
Management.
Stenzel and et. al., (2022). The intersection of sexual orientation with race and ethnicity in
cervical cancer screening. Cancer.
Swoboda, N. L., Dahlke, S., & Hunter, K. F. (2020). Nurses’ perceptions of their role in
functional focused care in hospitalised older people: An integrated review. International
Journal of Older People Nursing, 15(4), e12337.
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Taylor, K., & Guerin, P. T. (2019). Health care and Indigenous Australians: cultural safety in
practice. Macmillan International Higher Education.
Wender an et. al., (2019). A blueprint for cancer screening and early detection: Advancing
screening’s contribution to cancer control. CA: a cancer journal for clinicians, 69(1), 50-
79.
Woo and et. al., (2020). Global prevalence of burnout symptoms among nurses: A systematic
review and meta-analysis. Journal of psychiatric research, 123, 9-20.
Online
Building Community in an Online Graduate Program: Exploring the Role of an In-Person
Orientation, 2018 [online] available through:
<https://www.proquest.com/openview/3f5b2a81f107aa13e66b8aa2e9e32940/1?pq-
origsite=gscholar&cbl=55152 >
Building community resilience beyond COVID-19: The Singapore way 2021
< https://www.sciencedirect.com/science/article/pii/S2666606520300912 >
Building community resilience on social media to help recover from the COVID-19 pandemic,
2022 [online] available through:
< https://www.sciencedirect.com/science/article/pii/S0747563222001169 >
Primary health care clinics as catalyst to community building and health among residents in low
income housing units, 2021 [online] available through:
< https://www.sciencedirect.com/science/article/pii/S0897189721000021 >
The workings of an action learning program for building mental health promotion capacity – A
realist evaluation, 2022 [online] available through:
< https://www.sciencedirect.com/science/article/abs/pii/S0149718922000349 >
An investigation of efficient nursing interventions in early diagnosis of cancer A systematic
review and meta-analysis, 2021 [Online], Available through; <
https://journals.lww.com/jfmpc/Fulltext/2021/10080/An_investigation_of_efficient_nursin
g.38.aspx>
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