VICS Optimal Care Summits CALD consultation 2025–26

The VICS Optimal Care Summits program is examining cancer care and outcomes for culturally and linguistically diverse (CALD) Victorians.

This is the program’s first consultation to focus on a priority population, rather than a single tumour type. Guided by the expert advisory group below, we have identified 16 unwarranted variations in care and outcomes for people born in non-English speaking countries and treated for cancer in Victoria. We prioritised 3 of these variations for discussion at a live summit event on 27 February 2026.

Rapid literature review

A rapid literature search by the VICS Optimal Care Summits team in August 2025 focused on CALD adult populations in Australia with breast, colorectal, lung or prostate cancer. 29 studies met our inclusion criteria, including 2 from ‘grey literature’ and 2 found by hand-searching.

While existing studies describe patterns of care and highlight variation by clinical factors, few explicitly define or categorise such variation as unwarranted. The absence of a CALD-specific Optimal Care Pathway (OCP), or CALD considerations in existing OCPs and a consistent framework for identifying unwarranted variation, constrains the ability to distinguish acceptable differences from those requiring intervention. Notably, no studies examined end-of-life care or evaluated the effectiveness of strategies aimed at reducing variation for CALD communities. Closing these gaps is vital to inform equity-focused improvements in cancer care for CALD communities and to guide the development of targeted, data-driven quality improvement initiatives within the Australian health system.

• Read the literature review report (PDF)

Patient experiences

The VICS Optimal Care Summits team analysed data from the 2023 Victorian Cancer Patient Experience Survey and conducted focus group discussions with 12 CALD patients and carers between November 2025 and January 2026. Discussions were structured around the 7 steps of Optimal Care Pathways – from prevention and early detection through to survivorship and end-of-life care.

• Read the patient experience data report (PDF)

Unwarranted variations

The VICS, our expert advisory group below, and the Victorian Department of Health’s Analysis of Linked Information in Cancer (ALIC) data unit identified the following unwarranted variations in care and outcomes for people born in non-English-speaking countries and treated for cancer in Victoria. A 3-round survey process prioritised the 3 variations in bold below for discussion at our CALD cancer care summit on 27 February 2026.

• See more detail of these variations and how they were prioritised (PDF)

In 2019–2023:

System issues

1. 22% of patients had multiple countries of birth documented in their medical record.

OCP Step 2 – Presentation, initial investigation and referral

2. Patients from Arabic-speaking countries, Southeastern European and Southern European countries, and Vietnam had statistically significantly more presentations to an emergency department (ED) 28 days before their cancer diagnosis, compared with those from English-speaking countries.
3. CALD patients were statistically significantly more likely to present to a public hospital ED 28 days before their cancer diagnosis, compared with those from English-speaking countries.

OCP Step 3 – Diagnosis, staging and treatment planning

4. CALD patients had statistically significantly more public hospital ED presentations in the first 3 months following diagnosis, compared with those from English-speaking countries.
5. CALD patients had statistically significant differences in stage at diagnosis, compared with those from English-speaking countries.

OCP Step 4 – Treatment

6. CALD patients were statistically significantly less likely to have any treatment (surgery, systemic therapy, radiotherapy) within a year of diagnosis, compared with patients from English-speaking countries.
7. A statistically significantly higher proportion of prostate cancer patients from Arabic-speaking countries had an emergency readmission to hospital within 30 days of discharge from surgery, compared with the average (18% vs 8%).
8. For stage 3 colorectal cancer, patients from English-speaking countries and Chinese-speaking countries had significantly higher use of adjuvant systemic therapy compared with the average.
9. CALD patients were statistically significantly more likely to have a longer time to first treatment, compared with the statewide average.
10. Colorectal cancer patients (stages 1, 2 and 3) from Southern European countries were less likely to receive surgery within 7 weeks of diagnosis at a private hospital, compared with the average.

OCP Step 5 – Care after initial treatment and recovery

11. CALD patients were less likely to see a dietitian during their admission within 6 months of diagnosis, compared with the average.
12. CALD patients were less likely to see a physiotherapist during their admission within 6 months of diagnosis, compared with the average.
13. CALD patients were less likely to see a psychologist during their admission within 6 months of diagnosis, compared with the average.
14. CALD patients were less likely to see a social worker during their admission within 6 months of diagnosis, compared with the average.

OCP Step 7 – End-of-Life care

15. CALD patients were statistically significantly more likely to have an ED admission within 30 days of death, compared with patients from English-speaking countries.
16. CALD patients were statistically significantly more likely to have 2 or more emergency presentations to public hospitals within 30 days of death, compared with patients from English-speaking countries.

Expert advisory group

• Prof. Phillip Parente (Co-chair) – Director of Cancer Services, Eastern Health; Professor, Monash University; Medical oncologist, Epworth Hospital
• Dr Beverley Woon (Co-chair) – Radiologist, Peter MacCallum Cancer Centre, St Vincent’s BreastScreen, and Eastern Health
• Sarah Davies – Cancer care coordinator, Mildura Base Public Hospital
• Dr Jazmin Eckhaus – Cardiothoracic surgeon, St Vincent’s Hospital and Eastern Health
• Miss Christina Foley – Breast and endocrine surgeon, St Vincent’s Hospital
• Dr Umbreen Hafeez – Medical oncologist, Austin Health
• Ms Yue Hu – Director, Transcultural & Language Services (TALS) | Narrun Wilip-giin Aboriginal Support Unit, Northern Health
• Dr Adeline Lim – Radiation oncologist, Austin Health
• Abbie Lockwood – Cultural Strategic Project Lead, Bendigo Community Health Services
• Stacey McDermott – Oncology clinic nurse, GV Health
• Dr Amanda Ormerod – Clinical lead (haematology), Latrobe Regional Health
• Rowena Paton – Clinical nurse specialist (oncology), Mornington Peninsula
• Ms Meron Pitcher – Head of surgery, Western Health
• Ms Peita Roberts – Clinical Nurse Consultant (lung), Northern Health
• June Savva – Senior dietitian, Monash Health
• Prof. Shomik Sengupta – Head of surgery, Eastern Health
• Dr Alesha Thai – Medical oncologist, Peter MacCallum Cancer Centre
• A/Prof. Justin Tse – General practitioner, Ivanhoe; Associate Professor, University of Melbourne
• A/Prof. Zee Wan Wong – Director of Oncology Unit, Monash Health
• Prof. Justin Yeung – Colorectal surgeon, Western Health.