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.
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.
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.
Biennial breast screening participation trends for women aged 50-74 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).
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.
Over the past 12 months, we have achieved the following:
Partnering with community-based organisations
Women’s Health NSW
- We collaborated with Women’s Health NSW to deliver the first Multicultural Women’s Cancer Summit. The event was a great opportunity to learn and share insights with women’s health centres across the state to improve cancer outcomes for women in NSW.
- The summit focused on the needs of women in multicultural communities and strategies to best support accessible and women-centred cancer care. Topics of discussion included bowel, breast and cervical cancer screening, tobacco cessation, and equity-based care for women with cancer.
Bilingual Community Education and Cultural Support Programs
- In partnership with Bilingual Community Education and Cultural Support Programs, we continued the series of ‘train the trainer’ workshops for bilingual community educators and cultural support workers from four local health districts for the cervical screening flipchart and the bowel and breast screening programs.
- Fifty-four educators representing several language groups joined us for the workshop. They received copies of the flipchart to use within their community program. This also marked the launch of the cervical screening flipcharts and manuals, which are new additions to the suite of Institute’s multilingual resources.
Developing resources for multicultural communities
- Language barriers play a significant role in the poor health processes and outcomes for multicultural communities, including reduced access to preventive cancer screening services and information about cancer treatments.
- We invested significant efforts in making cancer information available in diverse languages. The process included rigorous testing with key stakeholders, and key principles of health literacy were incorporated through the development and translation phases.
Resources to encourage screening
- The What is Cancer Screening? brochures and fact sheets are now available in 23 languages, with the additional of Serbian, Croatian, Turkish, Khmer, Mongolian, Portuguese, Tibetan and Russian. They encourage culturally and linguistically diverse people to take up appropriate screening, to reduce the incidence of cancer in their communities.
- Multicultural Units from Western Sydney, Hunter New England, Murrumbidgee and Illawarra Shoalhaven Local Health Districts, Pink Sari Inc and the Cancer Institute NSW Community and Consumer Advisory Panel all contributed to the development of these resources.
- Cervical screening – taking care of your health is now available in six languages (Arabic, Simplified and Traditional Chinese, Korean, Thai and Vietnamese). The resources developed with assistance from Family Planning NSW, are for use by bilingual community educators in linguistically diverse communities.
- 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 flipchart is currently available in English, simplified and traditional Chinese, Arabic, Italian, Greek and Vietnamese (and also Spanish for breast health).
- The resources are communication aids to support health and community organisations and workers, including the Bilingual Community Education programs, to deliver bowel and breast screening education to multicultural communities.
- We continue to support uptake of these resources among multicultural health and community organisations. In 2020, small grants were offered to organisations to deliver cervical and breast screening community education sessions to CALD communities using the flipcharts, with a focus on women in south western and western Sydney areas where cervical screening participation rates are low.
Resources to help people understand cancer and treatments
- In March 2020, we launched a series of new Patient Information content in Arabic, Spanish, Italian, Korean, Greek, Vietnamese, simplified Chinese and traditional Chinese. These pages bring together multicultural resources from across NSW and Australia, supporting patients, carers and service providers to better understand cancer care.
- The latest eviQ factsheet, Chemotherapy Safety at Home, was launched during the 2020 Multicultural Health Week and is now available in several languages, including Arabic, Vietnamese, simplified and traditional Chinese, French, Greek, Italian, Korean, Spanish, Macedonian and Thai.
- Our four-point guide on Team, Involvement, Planning and Support (T.I.P.S.) to help people who have been diagnosed with cancer have conversations with their doctor is now available in Greek, Italian, Spanish and Korean. The resource is available in web, audio and video formats .
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.
We continue to provide grants to organisations so they can implement local initiatives aimed at improving breast and cervical screening participation rates. Successful grant recipients in 2020 include:
- Liverpool Women's Health Centre
- Boronia Multicultural Services
- Arabic Council of NSW
- Cancer Council NSW
- Pink Sari Inc
- Vietnamese Community in Australia
New models of care
- We completed a patient-reported measures (PRMs) pilot project for Arabic-speaking patients at the Bankstown Cancer Care Centre. PRMs enable patients to provide direct, timely feedback about their health care.
- The project had high completion rates, with 9 in 10 people completing the Arabic language Edmonton Symptom Assessment Scale tool (ESAS-r) validated tool.
- This initiative demonstrated the benefit of an in-language PRMs tool to empower patients and improve shared decision- making between the clinician and the patient.
Engaging with the primary care sector to improve cancer outcomes for multicultural communities
- We acknowledge the important role GPs play in enhancing screening partnerships and improving patient outcomes of those diagnosed with cancer. We have developed resources for GPs to support them in providing care to patients from diverse backgrounds.
- We developed a module in the Primary Care Quality Improvement Toolkit to build the capacity of the primary care sector to promote and support participation of culturally and linguistically diverse communities in national cancer screening programs.
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.