Strategic Objective 4: Strong and dynamic foundations

10-year ambition

A modern, fit for purpose cancer control infrastructure, advanced by the innovative application of technology, research and data to improve Australia’s cancer outcomes.

Current status

Priority areas for action in the Australian Cancer Plan (the Plan) to ensure strong and dynamic foundations in cancer control include:

  • technology innovations that support improvements across the cancer care continuum, including:
    • in platform technologies such as artificial intelligence, ‘omic’ technologies, robotics, and digital technologies supporting virtual care
    • advanced treatments such as targeted therapies and immunotherapies[139][140][141]
    • virtual delivery of care and digital enablement to integrate care across the system, linking health information and records and supporting patient navigation[90][142][143][144][145][146][147]
    • application of technology to ensure equitable access to, and increasing uptake of, quality care[142][143] and the ability to monitor cancer care and cancer outcomes over time, between health providers and across health systems.[90]
  • research which addresses areas of unmet and emerging need through coordinated investment strategies and collaborative partnerships, and includes an improved clinical trials landscape to support all Australians with cancer to participate in trials[144]
  • data that informs patient-centred care and health system improvements and planning across the cancer continuum through better collection, linkage and sharing across sectors.[139][141] Necessary data includes patient experiences and quality of clinical care, stage at diagnosis and other prognostic indicators, co-morbidities, treatments, biobanking, and survivorship across population groups. Aboriginal and Torres Strait Islander-led initiatives which strengthen Indigenous Data Sovereignty will be a key consideration with approaches to ensure equitable outcomes for all Australians.[146]

Ambitions, Goals & Actions

10-year ambition

A modern, fit for purpose cancer control infrastructure, advanced by the innovative application of technology, research and data to improve Australia’s cancer outcomes.

In achieving this ambition, Australia will ensure that provision of equitable cancer care across the continuum is supported by the best available health intelligence from research, clinical trials, and meaningful, connected data.

Indigenous Data Sovereignty and equitable access to clinical trials and cancer care will ensure improved outcomes for Aboriginal and Torres Strait Islander people and other priority population groups across the cancer care continuum.

2 Years
5 Years

Goal

Nationally agreed frameworks for collection and reporting of comprehensive cancer data, and implementation of new technologies into routine cancer care, with a focus on research priorities that drive innovation and fast-track opening of cancer clinical trials in Australia.

In achieving this 2-year goal, the necessary agreements and frameworks will be in place to support national data accessibility, research in identified areas of need, and improved equitable cancer clinical trial access and care.

Actions

4.2.1
Develop an agreed national cancer data framework to improve accessibility, consistency and comprehensiveness of integrated data assets.
4.2.2
Ensure targeted and innovative research investment into areas of unmet and emerging need; and improve clinical trial design and equitable access.
4.2.3
Identify opportunities to improve equitable cancer care through the digital health ecosystem.
4.2.4
Establish Aboriginal and Torres Strait Islander-led initiatives which strengthen Indigenous Data Sovereignty and governance of cancer data.

2 Years

Goal

Nationally agreed frameworks for collection and reporting of comprehensive cancer data, and implementation of new technologies into routine cancer care, with a focus on research priorities that drive innovation and fast-track opening of cancer clinical trials in Australia.

In achieving this 2-year goal, the necessary agreements and frameworks will be in place to support national data accessibility, research in identified areas of need, and improved equitable cancer clinical trial access and care.

Actions

4.2.1
Develop an agreed national cancer data framework to improve accessibility, consistency and comprehensiveness of integrated data assets.
4.2.2
Ensure targeted and innovative research investment into areas of unmet and emerging need; and improve clinical trial design and equitable access.
4.2.3
Identify opportunities to improve equitable cancer care through the digital health ecosystem.
4.2.4
Establish Aboriginal and Torres Strait Islander-led initiatives which strengthen Indigenous Data Sovereignty and governance of cancer data.

5 Years

Goal

A national cancer data ecosystem supporting evidence-based, innovative models of care which incorporate national uptake of advanced technology and infrastructure, underpinned by world-class research and a clinical trials landscape in which all Australians have equal access.

In achieving this 5-year goal, cancer data systems which support innovative models of care and assist improved and equitable cancer outcomes are developed.

Targeted research in priority areas and improved identification of priority patient groups in data will inform cancer care and all Australians with cancer will have access to clinical trials.

Access to care for Aboriginal and Torres Strait Islander people will be increased with equitable access to digitally enabled care improved for all Australians including those in regional, rural and remote areas.

Actions

4.5.1
Design and embed patient reported experience and patient reported outcomes into national performance monitoring and reporting for all providers, to assess services for all population groups and establish an evidence base.
4.5.2
Expand access to digitally enabled cancer care to improve equity and access to quality cancer care, particularly in regional, rural and remote areas.
4.5.3
Explore and test innovative approaches to health service funding models to address areas of need, and system improvement, in cancer care.
4.5.4
Expand the use of technology and virtual care to increase access for Aboriginal and Torres Strait Islander people and to support communities across the cancer care continuum.

Stakeholder quotes

We could be so much further ahead in addressing social determinants of health if we had access to data out there. The real key challenge is that data is captured in states, it is very difficult to get a national picture
Public Consultation Submission
We could be so much further ahead in addressing social determinants of health if we had access to data out there. The real key challenge is that data is captured in states, it is very difficult to get a national picture
Public Consultation Submission
Research plays a pivotal role to establish the efficacy and safety of new treatments. There are limits to the current level of research translation into clinical practice
Public Consultation Submission
One thing that holds up progress is there is a data custodian for each dataset...I think covid has created a new platform to move forward to addressing data issues
Public Consultation Submission

Stakeholder input

Stakeholders emphasised the importance of improving data linkage across jurisdictions. It was noted that improving the availability of real-time data has the potential to inform system accountability, performance, quality, and improvement. A lack of inclusive data has been a significant barrier to understanding and improving levels of cancer care across Australia, such as aspects of cancer screening.

The critical role that cancer research plays in cancer control was highlighted. There are opportunities for the Plan to facilitate growth, investment, and commercialisation of cancer research in Australia, as well as facilitating greater access to cancer clinical trials.

Stakeholders raised the importance of a future-focused cancer control system in Australia, underpinned by investment in emerging and innovative research and technologies. The importance of technologies such as telehealth and other digital tools in reducing barriers to cancer screening, treatment, and ongoing cancer care, along with the need to improve cancer research funding and access to clinical trials for all priority population groups, was emphasised.

Aboriginal and Torres Strait Islander people
People Living in Rural and Remote Areas
Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Asexual (LGBTIQA+) People
People from Culturally and Linguistically Diverse (CALD) Backgrounds
People living with Disability
People in Lower Socioeconomic Groups
People Living with a Mental Illness
Older Australians
Adolescents and Young Adults
Children

Stakeholders highlighted the need to implement consistent approaches to identify Aboriginal and Torres Strait Islander people in data and health systems, and nationally consistent legislation on health data privacy and health information law. The need to ensure Indigenous Data Sovereignty by implementing Aboriginal and Torres Strait Islander governance of the collection and use of cancer data and research was emphasised.

Barriers to closing the gap in outcomes for Aboriginal and Torres Strait Islander people include the lack of Indigenous Data Sovereignty and access to cancer clinical trials.

Stakeholders also noted the need to invest in cancer research seeking to understand health inequities in Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander people

Stakeholders highlighted the need to implement consistent approaches to identify Aboriginal and Torres Strait Islander people in data and health systems, and nationally consistent legislation on health data privacy and health information law. The need to ensure Indigenous Data Sovereignty by implementing Aboriginal and Torres Strait Islander governance of the collection and use of cancer data and research was emphasised.

Barriers to closing the gap in outcomes for Aboriginal and Torres Strait Islander people include the lack of Indigenous Data Sovereignty and access to cancer clinical trials.

Stakeholders also noted the need to invest in cancer research seeking to understand health inequities in Aboriginal and Torres Strait Islander people.

People Living in Rural and Remote Areas

The limited availability of clinical trials in rural and remote areas was raised. New approaches to expand access to services and clinical trials for people living in rural and remote areas should be considered to increase cancer treatment and care opportunities for this population group.

Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Asexual (LGBTIQA+) People

Increased data collection regarding sexuality and gender inclusivity, including in health surveys, registries, and patient records would improve understanding of the cancer care needs and lifestyle behaviours of this priority population group. Collection of this data would improve the measurement of cancer risk factors, cancer incidence, and cancer experiences among LGBTIQA+ people.

Stakeholders also pointed to the need to invest in research to better understand cancer risks and experiences of LGBTIQA+ people.


People from Culturally and Linguistically Diverse (CALD) Backgrounds

People from diverse backgrounds can be underrepresented in clinical trials, which may lead to members of this priority population group not being able to access the latest cutting-edge treatment. The importance of increasing engagement and participation of people from diverse communities in research and clinical trials was identified.

Stakeholders also expressed the need to improve data collection and linkage to better identify people from diverse communities that are at greatest risk of poorer cancer outcomes.


People living with Disability

Consistent and high-quality data collection approaches are required to identify people living with disability who are navigating the cancer care system.

People in Lower Socioeconomic Groups

Digital technologies such as telehealth and other digital interventions were identified as cost-effective ways to support consumers with limited ability to afford ongoing costs associated with their care.

Stakeholders emphasised the need to provide infrastructure and support so that people in lower socioeconomic groups have consistent access to digital technologies such as telehealth, virtual care, and digital therapeutics.

People Living with a Mental Illness

The lack of consumer voices both in research findings and research production was raised. Also highlighted was the rarity of cancer and diagnosed mental illness being reported in the same dataset e.g., cancer registries. In addition, when co-reported data are available, it can be hard to identify which diagnosis came first.

Older Australians

There exist gaps in knowledge about how cancer progresses in older Australians with comorbid conditions. It was emphasised that sustained research is needed to improve understanding of how to treat older people with cancer, together with greater investment in clinical trials that directly improves their cancer care.

Adolescents and Young Adults

Stakeholders are concerned by the fertility risks of cancer treatments for adolescents and young adults and highlighted a need for increased research to better understand the relationship between cancer treatments and infertility.

There is also demand for a national data registry of newly diagnosed adolescent and young adult cancers to facilitate monitoring of cancer information and trends to promote improved outcomes.

Children

Resources allocated to childhood cancers need to be increased as part of sustainable funding arrangements, to allow for improvements in early access to new therapies for children. Increased investment into childhood cancer research across the continuum of care is needed, particularly into a new generation of molecularly targeted anti-cancer therapies. The exploration of genomic, functional, biological, and clinical data to drive improved understanding of the growth of childhood cancers was also highly supported.

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