Case study: Innovative collaboration to connect Aboriginal women from rural New South Wales to world-class cancer treatment for cervical cancer.
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Aboriginal and Torres Strait Islander women experience notably higher cervical cancer incidence (19.5 vs 8.7 per 100,000) and mortality rates (7.7 vs 1.9 per 100,000) compared to non-Aboriginal and non-Torres Strait Islander women, primarily due to healthcare access barriers and cultural factors. This case study examines a multidisciplinary, culturally responsive approach for a 42-year-old Aboriginal woman from rural New South Wales (NSW) Australia, diagnosed with International Federation of Gynaecology and Obstetrics (FIGO) Stage IIIC2 squamous cell carcinoma. Living 140 km from the nearest rural cancer centre and caring for six children, the patient faced substantial logistical challenges in accessing the recommended treatment of 25 fractions of external beam radiotherapy (EBRT) and 4 fractions of intracavitary brachytherapy (ICBT) within the critical 50-day timeframe. The care model incorporated Aboriginal Care Coordinators, inter-institutional data sharing between rural and metropolitan centres, and flexible scheduling addressing logistical and cultural barriers. Due to treatment interruptions, the patient completed only 17 EBRT fractions locally. However, innovative collaboration enabled immediate treatment continuation at the metropolitan centre using shared planning data and optimised treatment plans. The patient completed her full treatment within the recommended timeframe through bi-daily EBRT sessions coordinated with ICBT, supported by culturally appropriate handover between Aboriginal support staff. This collaborative patient centred model overcame systemic barriers to achieve optimal clinical outcomes, leading to the development of a comprehensive gynaecological radiation oncology framework for Aboriginal women now integrated into clinical practice. These findings demonstrate how culturally tailored, inter-institutional collaboration can enhance cancer care delivery for Aboriginal populations, supporting broader application across diverse healthcare settings to address health disparities. Plain Language Summary: Some Aboriginal and Torres Strait Islander women face higher rates of cervical cancer and more challenges in accessing care. This study explains how one patient was supported through cancer treatment using a coordinated care plan, shared hospital information, and culturally appropriate support. This study found that this approach helped her complete treatment on time despite travel and family challenges. This matters because it shows how culturally responsive care and better coordination can improve access and outcomes for people who face barriers to cancer treatment.