Around the world the changing face of oncology is being driven by scientific inquiry helping to deliver personalised medicine and care. Despite cancer mortality decreasing in the last decade for non-Indigenous Australians, cancer mortality has increased for Indigenous Australians. Understanding the multifactorial reasons for these diverging mortality trajectories requires examining the epidemiological understanding of both age, gender and cancer type, but also demands close examination and dismantling of our understanding of race and racism and how it is operationalised in the Australian health care system. Understanding culturally safe care is critical in delivering personalised care at the population level for Indigenous Australians and will allow us the paradigm shift so urgently required.