Multicultural communities

The NSW Cancer Plan aims to lessen the burden of cancer in NSW. It recognises that some people and communities have a higher risk of cancers and experience poorer cancer-related health outcomes. This includes some multicultural (or culturally and linguistically diverse (CALD)) communities.

How cancer affects multicultural communities differently

The NSW Cancer Plan acknowledges that some multicultural communities:

  • have a higher incidence of cancer
  • have a higher prevalence of cancer-related risk factors (e.g. smoking)
  • are less likely to use screening or cancer support services, so they may experience poorer outcomes during and after cancer treatment
  • vary in their knowledge, awareness and beliefs about cancer, its causes and treatments.
Biennial breast screening participation trends for women aged 50-74 by population type – by Calendar year

Biennial breast screening participation trends for women aged 50–to74 by population type – by Calendar year

Data source: BreastScreen NSW (population data are sourced from SAPHARI, Centre for Epidemiology and Evidence, NSW Ministry of Health and Australian Bureau of Statistics).

The focus cancers outlined in the NSW Cancer Plan have a significant impact on multicultural communities for the following reasons:

  • Lung cancer numbers are expected to increase based on smoking trends.
  • Primary liver cancer numbers are high due to the prevalence of hepatitis B or C viruses in some multicultural communities, which is one cause of this cancer.
  • Bowel, breast and cervical cancer outcomes are often poorer than the general population, due to low participation in the national screening programs for these cancers (see above).

What we are achieving for multicultural communities

The Cancer Institute NSW is working across cancer prevention, diagnosis and treatment initiatives and programs to improve cancer outcomes for multicultural communities.

This is guided by our Multicultural Equity Framework which embeds multicultural principles in service planning and delivery, and aligns to the NSW Plan for Healthy Culturally and Linguistically Diverse Communities 2019-2023.

Multicultural Equity Framework
NSW Plan for Healthy Culturally and Linguistically Diverse Communities 2019–to2023

Over the past 12 months, we have achieved the following:

Supporting activities to prevent tobacco use
  • We funded social marketing and community engagement projects in high-risk multicultural communities, such as Shisha No Thanks. This is project aims to raise awareness of the harms of waterpipe smoking among young people from Arabic-speaking backgrounds. This is managed by South Eastern Sydney Local Health District in partnership with the Lebanese Muslim Association, NSW Multicultural Health Communication Service, Sydney Local Health District, South Western Sydney Local Health District and the South Eastern Sydney Research Collaboration Hub.



Funding projects to improve the experience of people from multicultural backgrounds affected by cancer

Through the Innovation in Cancer Control Grants, we have funded a number of projects that will support improvements in cancer care for multicultural communities:

  • The Diversity in Cancer Care project, delivered by Metro Assist Inc, addresses equity issues around access to information and engagement with primary care sector, to improve the role of GPs in cancer care. This project is focusing on Arabic and Chinese communities.
  • The Redressing equity in healthcare: Utilising patient-reported outcomes to support Chinese and Vietnamese patients to self-manage their cancer-related challenges project is addressing current gaps in care, by providing patients with self-management resources in their preferred languages. The project will also develop a range of self-management resources for broader use in Australia and internationally.
  • We funded new culturally-sensitive support groups that bring together women from Arabic and Vietnamese backgrounds in south western Sydney to help each other through their cancer journeys.


Funding bowel screening community education grants

As a focus cancer, we continue to provide grants to organisations to implement local initiatives that aim to improve bowel screening participation rates. Successful grant recipients in 2019 include:

  • Liverpool Women's Health Centre
  • South Western Sydney Local Health District
  • Sydney Local Health District
  • Sydney North Primary Health Network
  • Vietnamese Community in Australia: NSW Chapter Inc

Read more about these projects.

Translating resources for multiculutral communities

Resources to encourage screening

Macedonian Bowel screening flipchart
Korean Breast screening flipchar3
  • Developed the bowel and breast screening in-language education resources. The Bowel Health and Screening Flipchart and Facilitator Manual and the Breast Health and Screening Flipchart and Facilitator Manual contain essential information about cancer, cancer screening and the national cancer screening programs for bowel and breast cancer, respectively.
    The resources are communication aids to support health and community organisations and workers, including the Bilingual Community Education (BCE) program, to deliver bowel and breast screening education to multicultural communities.
    The flipchart is currently available in English, simplified and traditional Chinese, Arabic, Italian, Greek and Vietnamese (and also Spanish for breast health).
  • We supported uptake of the Bowel Health and Screening Flipchart and Facilitator Manual among multicultural health and community organisations. In 2019,
    • almost 100 bilingual educators and other health and community workers were trained to use the resources
    • 56 stakeholder-led community education sessions were run, reaching 1,500 community members from 15 different language and cultural backgrounds.
  • To encourage culturally and linguistically diverse people to take up appropriate screening and reduce the incidence of cancer, we developed fact sheets and brochures about What is cancer screening? and translated them into 15 languages.
Vietnames resource for screening programs

Resources to help people understand cancer and cancer treatments

  • Patient information sheets on eviQ, such as Understanding chemotherapy (pictured below), are now available in several languages, including Arabic, Vietnamese, simplified and traditional Chinese, French, Greek, Italian, Korean, Spanish, Vietnamese, Macedonian and Thai.
Thai Patient Information sheets
  • The T.I.P.S. education resource has been translated into Arabic, Vietnamese, Mandarin and Cantonese. This is a four-point guide to help people who have been diagnosed with cancer to have conversations with their doctor. It focuses on Team, Involvement, Planning and Support. The resources are available in audio, video and web formats on the Cancer Institute NSW website.
T.I.P.S. in-language
Engaging with the primary care sector to improve cancer outcomes for multicultural communities

Multicultural Primary Care Cancer Forum

We held a Forum in June 2019 to improve the capacity of the sector to respond to the cancer needs of culturally diverse communities. Sessions focused on self-collection in cervical screening; discussions on tobacco harm and strategies to minimise this; and in-language resoucres that are designed to assist people living with cancer.

Speakers on the day delivered strong messages regarding the crucial role GPs play in improving cancer outcomes for multicultural communities who experience access and equity issues.

An outcome of the Forum was the establishment of a clinical primary care network which will guide and inform the Institute's work in the future.

NSW Cancer Plan initiatives for multicultural communities

Across each goal of the NSW Cancer Plan, specific initiatives have been developed to support multicultural communities, including:

  • public education campaigns and support services to reduce smoking
  • strategies to encourage participation in the national cancer screening programs
  • strategies to facilitate the provision of advice and support by primary health care professionals
  • early assessment, diagnosis, surveillance and treatment pathways
  • culturally-appropriate tools and resources (including 'in language' information)
  • initiatives to engage multicultural people in service planning and delivery
  • culturally-appropriate methods of collecting patient-reported outcomes.

Progress of the NSW Cancer Plan is regularly monitored and evaluated. Find more information on the indicators used to track against the Plan's objectives.