ORCID Profile
0000-0001-6442-4409
Current Organisations
The University of Auckland
,
Cancer Council SA
,
University of South Australia
,
Cancer Institute NSW
,
South Australian Health and Medical Research Institute
,
Cancer Australia
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Publications
Case‐survival rates for infiltrating ductal carcinomas by category of hospital at diagnosis in South Australia
Publisher: AMPCo
Date: 05-1991
DOI: 10.5694/J.1326-5377.1991.TB121265.X
Abstract: To determine whether case-survival rates for infiltrating ductal carcinomas diagnosed in South Australia during 1980-1986 have varied by hospital of attendance at diagnosis. A null hypothesis was tested. All 2589 cases notified to the State Cancer Registry were included. The date of censoring for survival analyses was June 30, 1989. Multivariate analyses were undertaken adjusting for age at diagnosis, diameter of tumour, and extent of nodal involvement. After adjusting for differences in age, diameter and nodal status, there was not a significant difference in case outcome between large public hospitals, large private hospitals and smaller hospitals (P greater than 0.05). Although protocols for treatment of breast cancer are in a transitional phase and differences exist, case-survival rates have not shown a substantial variation by hospital of attendance at diagnosis.
Measuring psychosocial outcomes of men living with prostate cancer: feasibility of regular assessment of patient-reported outcomes
Publisher: Hindawi Limited
Date: 26-12-2021
DOI: 10.1111/ECC.13393
Proximate determinants of particulate matter (PM2.5) emission, mortality and life expectancy in Europe, Central Asia, Australia, Canada and the US
Publisher: Elsevier BV
Date: 09-2201
DOI: 10.1016/J.SCITOTENV.2019.05.278
Abstract: The growing concern with environmental related impacts on mortality and morbidity means that the conceptual framework of environment-health-economic policy nexus is salient in the global debate on air pollution. With time series data spanning 2000-2016, this study explored the proximate determinants of ambient air pollution, mortality, and life expectancy in North America, Europe & Central Asia, and East Asia & Pacific regions. The study applied historical data on urban population, total pollution, energy consumption, GDP per capita, life expectancy, mortality rate and industrial PM An increase in income level by 1% declined mortality rate by 0.01% and increased longevity by ~0.02% (95% Confidence Interval [CI]) in the long-run. An increase in industrial PM Ambient air pollution contributes significantly in reducing life expectancy and increasing mortality. However, sustained economic development, along with energy efficiency, and sustainable urban settlement planning and management are potential options for reducing ambient air pollution while improving quality of life and environmental sustainability.
Residential area sociodemographic and breast cancer screening venue location built environmental features associated with women's use of closest venue in greater Sydney, Australia
Publisher: MDPI AG
Date: 27-10-2021
Abstract: Understanding environmental predictors of women’s use of closest breast screening venue versus other site(s) may assist optimal venue placement. This study assessed relationships between residential-area sociodemographic measures, venue location features, and women’s use of closest versus other venues. Data of 320,672 Greater Sydney screening attendees were spatially joined to residential state suburbs (SSCs) (n = 799). SSC-level sociodemographic measures included proportions of: women speaking English at home university-educated full-time employed and dwellings with motor-vehicles. A geographic information system identified each woman’s closest venue to home, and venue co-location with bus-stop, train-station, hospital, general practitioner, and shop(s). Multilevel logistic models estimated associations between environmental measures and closest venue attendance. Attendance at closest venue was 59.4%. Closest venue attendance was positively associated with SSC-level women speaking English but inversely associated with SSC-level women university-educated, full-time employed, and dwellings with motor-vehicles. Mobile venue co-location with general practitioner and shop was positively, but co-location with bus-stop and hospital was inversely associated with attendance. Attendance was positively associated with fixed venue co-location with train-station and hospital but inversely associated with venue co-location with bus-stop, general practitioner, and shop. Program planners should consider these features when optimising service locations to enhance utilisation. Some counterintuitive results necessitate additional investigation.
Reply to 'Comment on 'Effect of population breast screening on breast cancer mortality up to 2005 in England and Wales: An individual-level cohort study'
Publisher: Springer Science and Business Media LLC
Date: 21-09-2017
DOI: 10.1038/BJC.2017.328
Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages
Publisher: BMJ
Date: 06-2019
DOI: 10.1136/BMJOPEN-2018-027962
Abstract: To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption. A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2). Study 1: South Australians, 15+ years (n=2732) study 2: Australians, 18+ years (n=3430). Primary outcome measures: levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses. In 2017, all 10 potential policy initiatives received majority support (60%–88% either ‘somewhat’ or ‘strongly’ in favour). Initiatives with educative elements or focused on children received high support ( %), with highest support observed for text warning labels on drink containers (88%) and government c aigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%–18% absolute difference) and/or in children (8%–26% absolute difference) and lower among SSB high consumers (7+ drinks per week 9%–29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55% χ 2 =15.7, p .001) and graphic health warnings (52%vs68% χ 2 =23.4. p .001). There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.
On‐Resin Preparation of Allenamidyl Peptides: A Versatile Chemoselective Conjugation and Intramolecular Cyclisation Tool
Publisher: Wiley
Date: 03-09-2020
The effects of comorbidity on colorectal cancer mortality in an Australian cancer population
Publisher: Springer Science and Business Media LLC
Date: 12-06-2019
DOI: 10.1038/S41598-019-44969-8
Abstract: This study estimated the absolute risk of colorectal cancer (CRC) specific and other-cause mortality using data from the population-based South Australian Cancer Registry. The impact of competing risks on the absolute and relative risks of mortality in cases with and without comorbidity was also investigated. The study included 7115 staged, primary CRC cases diagnosed between 2003 and 2012 with at least one year of follow-up. Comorbidities were classified according to Charlson, Elixhauser and C3 comorbidity indices, using hospital inpatient diagnoses occurring five years before CRC diagnosis. To estimate the differences in measures of association, the subdistribution hazard ratios (sHR) for the effect of comorbidity on mortality from the Fine and Gray model were compared to the cause-specific hazards (HR) from Cox regression model. CRC was most commonly diagnosed in people aged ≧ 70 years. In cases without comorbidity, the 10-year cumulative probability of CRC and other cause mortality were 37.1% and 17.2% respectively. In cases with Charlson comorbidity scores ≥2, the 10-year cumulative probability of CRC-specific and other cause mortality was 45.5% and 32.2%, respectively. Comorbidity was associated with increased CRC-specific and other cause mortality and the effect differed only marginally based on comorbidity index used.
Radon daughter exposures at the Radium Hill uranium mine and lung cancer rates among former workers, 1952-87
Publisher: Springer Science and Business Media LLC
Date: 07-1991
DOI: 10.1007/BF00052136
Performance Analysis of the Idle Mode Capability in a Dense Heterogeneous Cellular Network
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2018
Performance impact of idle mode capability on dense small cell networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2017
Clinical and socio-demographic profile of an Australian multi-institutional prostate cancer cohort
Publisher: Wiley
Date: 12-2009
Challenges for ethics committees in biomedical research governance: illustrations from China and Australia
Publisher: Knowledge E
Date: 08-01-2021
DOI: 10.18502/JMEHM.V14I25.8279
Abstract: In this paper, the evolution of the ethics committees for health research, their history, membership, and function in China and Australia is described. Investigators in each country compared the history and governance of their ethical systems based on the published evidence rather than personal opinions. Similarly, ex les of challenges were selected from the literature. In both countries, the aim was to maximize the social benefits of research and minimize the risk imposed on the participants. Common challenges include maintaining independence, funding and delivering timely ethical reviews of the research projects. These challenges can be difficult where research ethics committees rely on voluntary contributions and lack a strong resource base. They must adapt to the increasingly rapid pace of research as well as the technological sophistication. Population health research can challenge the conventional views of consent and privacy. The principles of the sound ethical review are common in both countries governance arrangements and operational procedures, however, can differ, reflecting the cultural values and norms of their host countries and in respect of legal environments. By studying the evolution and function of ethics committees in the two countries, we established the differences in the governance and health systems, while similar ethical objectives helped sustain collaborative research.
Cancers of the corpus uteri treated in South Australian public hospitals: Trends in clinical management and survival across three decades
Publisher: Hindawi Limited
Date: 08-07-2020
DOI: 10.1111/ECC.13281
Interval cancers as related to frequency of recall to assessment in the South Australian population-based breast screening program: An exploratory study
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.CANEP.2022.102183
Abstract: Australian accreditation standards specify upper limits for percentages of women recalled for further assessment following screening mammography. These limits have been unchanged since national screening commenced circa 1990, although screening target ages have changed, and technology from analogue to digital mammography. This study compared 2804 women with interval cancers diagnosed since national screening began (cases) with 14,020 cancer-free controls (5 controls per case), randomly selected after matching by age, round, screen type and calendar year of screening episode, to determine the odds of interval cancer by differences in clinic recall to assessment percentages. Within low numbers of recalls that were within accepted accreditation ranges, results did not indicate more frequent recalls to assessment to be associated with fewer interval cancers in the analogue era. However, more frequent recalls were associated with reduced interval cancers for digital screens. These results are not conclusive, requiring confirmation in other screening environments, especially those with larger numbers of digital screens. If confirmed, frequency of recalls to assessment may need adjustment to get the best trade-offs in the digital era between reduced odds of interval cancers from more recalls and increases in financial and non-financial costs, including increased potential for overdiagnosis.
Uplink Performance Analysis of Dense Cellular Networks with LoS and NLoS Transmissions
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2017
HPV and Oropharyngeal Cancer among Indigenous Australians: Study Protocol
Publisher: JMIR Publications Inc.
Date: 25-03-2018
Has cancer survival improved for older people as for younger people? New South Wales, 1980-2012
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.CANEP.2018.04.014
Abstract: Cancer survival has improved markedly in Australia for all ages but it is still lower in older patients. We hypothesize that the survival gap by age has increased. Our rationale is that treatment constraints in older people and potentially their limited participation in trials may have limited opportunities for survival gain. Post-diagnostic five-year cancer-specific mortality rates were analysed by age group for cancers recorded on the NSW Cancer Registry. Live cases were censored on December 31st, 2012. Hazards ratios (HRs) were obtained from proportional hazards regression for 1990-99 and 2000-12 diagnostic periods, using 1980-89 as the reference, adjusting for socio-demographic factors, degree of cancer spread, and for all cancers combined, for cancer sites. Five-year mortality reduced by diagnostic period for all cancers collectively from 53% in 1980-89 to 33% in 2000-12, with decreases for separate cancer sites. Adjusted HRs (95% confidence intervals) were 0.78 (0.77, 0.80) for 1990-99 and 0.61 (0.58, 0.63) for 2000-12 for all cancers combined. The downward trend in HRs was smaller for the 80+ year age group, leading to significantly higher HRs of 0.83 (0.81, 0.87) and 0.73 (0.70, 0.76) for 1990-99 and 2000-12 respectively. Results were similar using competing risk regression and 5-year rather than 10-year age strata. The reduction in cancer mortality was smaller in older people, as seen in the USA. Research is needed to achieve the best trade-offs between cancer control and harm avoidance in older people. Multidisciplinary teams have an important contribution to make.
Analysis of Underlaid D2D-Enhanced Cellular Networks: Interference Management and Proportional Fair Scheduler
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
Treatment and Survival from Colorectal Cancer: The Experience of Patients at South Australian Teaching Hospitals Between 1980 and 2002
Publisher: Elsevier BV
Date: 08-2005
DOI: 10.1016/J.CLON.2005.04.005
Abstract: To evaluate trends in colorectal cancer survival and treatment at South Australian teaching hospitals and degree of adherence to treatment guidelines which recommend adjuvant chemotherapy for Dukes' C colon cancers and combined chemotherapy and radiotherapy for high-risk rectal cancers. Trends in disease specific survival and primary treatment were analysed, and comparisons drawn between diagnostic epochs, using cancer registry data from South Australian teaching hospitals. Statistical methods included univariate and multivariable disease specific survival analyses. Five-year survival increased from 48% in 1980-1986 to 56% in 1995-2002. Largest gains were for stage C, where survivals were higher when chemotherapy was part of the primary treatment. By comparison, gains in 1-year survival were largest for stage D. Chemotherapy was provided for 4% of patients with colorectal cancers in 1980-1986, increasing to 32% in 1995-2002. Among stage C cases below 70 years at diagnosis, the proportion having chemotherapy increased to 83% in 1995-2002. The most common chemotherapy was fluorouracil (5FU) as a single agent in 1980-1986 and 5FU with leucovorin in 1995-2002. As expected, radiotherapy was used more frequently for rectal than colon cancers, and particularly for stage C. Among stage C rectal cases below 70 years, the proportion having radiotherapy increased from 10% in 1980-1986 to 57% in 1995-2002. Approximately 93% of colorectal cancers were treated surgically. Patients not treated surgically tended to be aged 80 years or more and to present with distant metastases. Trends in chemotherapy and radiotherapy accord with evidence-based recommendations. There have been reassuring gains in survivals after adjusting for stage, grade and other prognostic indicators. The data show survival gains and treatment patterns that in idual hospitals can use as benchmarks when evaluating their own experience.
Benchmarking epidemiological characteristics of cervical cancer in advance of change in screening practice and commencement of vaccination
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1111/J.1753-6405.2007.00033.X
Abstract: To investigate trends in cervical cancer incidence, mortality and survival by histology for benchmarking purposes ahead of practice change and the introduction of Human Papilloma Virus (HPV) vaccine. Using data from the South Australian Cancer Registry, age-standardised rates are presented for four-year periods from 1977 to 2004. Socio-demographic and secular predictors of glandular as opposed to squamous cancers are investigated, using multivariable logistic regression. Disease-specific survivals are analysed using Kaplan-Meier product-limit estimates and Cox proportional hazards regression. Incidence and mortality rates reduced by 55.1% and 59.3% respectively between 1977-80 and 2001-04, with larger reductions for squamous than glandular cancers. The ratio of squamous to glandular cancer incidence reduced from 5.4:1 in 1977-88 to 2.8:1 in 1993-2004, with a corresponding reduction from 5.2:1 to 3.0:1 for mortality. Compared with squamous cancers, glandular lesions were more common in patients from higher socio-economic areas, but less common in those over 70 years of age, Aboriginal patients, and those born in Southern Europe. The proportion of cancers comprising glandular lesions has increased, possibly reflecting prevention of squamous cancers through treatment of screen-detected preinvasive lesions. Additional mortality reductions from screening may be limited where the proportion of glandular lesions is high, with vaccination offering the best prospects for gains in the long term. Priority should be given to Aboriginal and Torres Strait Islander women in vaccination programs in view of their high death rate from cervical cancer.
Variation in the management of early breast cancer in rural and metropolitan centres: Implications for the organisation of rural cancer services
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.BREAST.2010.03.032
Abstract: The study examines the management and outcomes of women with early invasive breast cancer treated in rural and metropolitan centres over a nine-year observation period. A prospective audit of the treatment and outcomes of 2081 women with early breast cancer who underwent potentially curative surgery between 1997 and 2006 in metropolitan Canberra or in the surrounding rural region was completed. Overall, there was good agreement between published guidelines and the treatment received by the women in the study. However, women treated in rural centres were less likely to receive postoperative radiotherapy after breast-conserving surgery, or to undergo axillary lymph node surgery or sentinel lymph node biopsy compared with women treated in metropolitan centres. Surgery in a rural centre was associated with increased breast cancer recurrence (HR = 1.54, p < 0.001) and increased breast cancer mortality (HR = 1.84, p < 0.001), after adjustment for age and tumour characteristics. Non-cancer related mortality was increased in women treated in rural centres compared with women travelling to a metropolitan centre for surgery (HR = 2.08 p = 0.005). There were differences in both the care provided and treatment outcomes between women treated in rural centres and women treated in metropolitan centres. However, the increased non-cancer related mortality in women treated in rural centres suggests an increased medical comorbidity in this group. Initiatives supporting rural-based surgeons to adopt new procedures such as sentinel node biopsy may help to optimise rural breast cancer treatment.
Short-term outcomes after surgical resection for colorectal cancer in South Australia
Publisher: Wiley
Date: 02-08-2017
DOI: 10.1111/JEP.12612
Abstract: Short-term outcomes (unplanned readmission, post-surgical complication rates, 30-day and 90-day post-surgical mortality) are often used as indicators of quality of surgical care for colorectal cancer (CRC). Differences in these immediate outcomes can highlight disparities in care across patient subpopulations. This study aimed to document short-term outcomes following major surgery for CRC and to identify whether there were any sociodemographic differences across South Australia (SA). This population-based study included all CRC resections among SA residents diagnosed with CRC aged 50-79 years in 2003-2008 (n = 3940). Clinical, treatment, comorbidity and outcomes data were compiled through linkage of administrative and surveillance datasets across SA. A retrospective cohort design was used to examine short-term outcomes including post-operative complications, 28-day emergency readmission and 30-day and 90-day mortality. We used multivariable logistic regression to identify factors associated with each outcome. Post-operative complications occurred in 28% of cases. Thirty-day and ninety-day mortality were 1.3% and 3%, respectively. Later stage, older age, multiple comorbidities and emergency admissions were associated with poorer short-term outcomes. Risk of complications was lower among patients from higher socio-economic areas (OR = 0.77, 95%CI 0.62-0.98). Risk of 30-day mortality was higher among non-metropolitan patients (OR = 2.33, 95%CI 1.22-4.46). Post-operative complications increased the risk of emergency readmission and short-term mortality. Short-term outcomes following CRC surgery may be improved through strategies to increase earlier detection and reduce emergency admissions. Socioeconomic and regional disparities require further examination of health system factors.
Rising incidence of early-onset colorectal cancer in Australia over two decades: Report and review
Publisher: Wiley
Date: 23-12-2015
DOI: 10.1111/JGH.12792
Abstract: The average age at diagnosis for colorectal cancer (CRC) in Australia is 69, and the age-specific incidence rises rapidly after age 50 years. The incidence has stabilized or is declining in older age groups in Australia during recent decades, possibly related to the increased uptake of screening and high-risk surveillance. In the same time frame, a rising incidence of CRC in younger adults has been well-documented in the United States. This rise in incidence in the young has not been reported from other countries that share long-term exposure to westernised urban lifestyles. Using data from the Australian Institute of Health and Welfare, we examined trends in national incidence rates for CRC under age 50 years and observed that rates in people under age 40 years have been rising for the last two decades. We further performed a review of the literature regarding CRC in young adults to outline the extent of current understanding, explore potential risk factors such as obesity, alcohol, and sedentary lifestyles, and to identify the questions remaining to be addressed. Although absolute numbers might not justify a population screening approach, the dispersal of young adults with CRC across the primary health-care system decreases probability of their recognition. Patient and physician awareness, aided by stool and emerging blood-screening tests and risk profiling tools, have the potential to aid in identification of those young adults who would most benefit from a colonoscopy through early detection of CRCs or by removal of advanced polyps.
Metastatic Colorectal Cancer in Young Adults: A Study from the South Australian Population-Based Registry
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.CLCC.2015.07.005
Abstract: Colorectal cancer (CRC) is a common malignancy. There is growing evidence that CRC incidence is increasing in the younger population. There is controversy surrounding the prognosis of young patients with CRC. In this study we reviewed Australian patients with metastatic CRC (mCRC) who were younger than 40 years of age at the time of diagnosis of metastatic disease. To our knowledge this is the first study to focus on this age group with mCRC. This was a retrospective study using data from the South Australian Metastatic Colorectal Cancer database. We compared patient and disease characteristics, management approaches, and outcomes for age groups < 40 and ≥ 40. A multivariate Cox proportional hazards model was fitted to compare the survival outcomes (death from all causes) between the 2 groups. From 3318 patients, 46 (1.4%) were younger than 40 years of age. In a comparison of patients in the younger than 40-year-old group with the older group, a greater proportion had synchronous metastatic disease (80.4% vs. 64.4%, respectively P = .04) and disease originating from the left colon (71.7% vs. 61.7%, respectively P = .035) also a larger proportion in the younger than 40-year-old group received chemotherapy compared with the older group (82.6% vs. 58.7%, respectively P < .01). In the adjusted multivariate model, survival was not significantly different between the 2 groups (hazard ratio, 0.81 95% confidence interval, 0.56-1.16 log rank P = .25). Young-onset mCRC patients, when defined as aged younger than 40 years, have equivalent survival compared with their older counterparts. This is despite differences in disease characteristics and management approach between the 2 groups.
Survival of South Australian cancer patients
Publisher: AMPCo
Date: 06-1982
DOI: 10.5694/J.1326-5377.1982.TB124172.X
Abstract: Survival rates for cancer patients derived from population-based data are a fundamental means of monitoring the effectiveness of treatment for the community at large. We used South Australian Cancer Registry data to study survival by cancer site from date of diagnosis in 1977-79 to August 1980. One-year and two-year cumulative percentage survival rates for all types of invasive cancer were 64% (+/- 0.5%) and 54% (+/- 0.5%) respectively. We anticipate that these findings will provide a yardstick for intra-hospital survival analyses.
Analysis of Rateless Multiple Access Scheme with Maximum Likelihood Decoding in an AWGN Channel
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2023
Sugar-sweetened beverage consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: A scoping review protocol
Publisher: BMJ
Date: 07-2017
Outcomes for metastatic colorectal cancer (mCRC) based on microsatellite instability.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2018
DOI: 10.1200/JCO.2018.36.4_SUPPL.759
Abstract: 759 Background: Microsatellite instability (MSI) has been associated with improved survival outcomes in early stage CRC. In stage IV disease, MSI represents only 3-5% of cases and currently the prognostic implications are less clear. There is however evolving evidence that treatment pathways should include anti-PD-1 antibodies given the encouraging results in heavily pre-treated MSI mCRC patients. We undertook an analysis of the South Australian mCRC population based registry to explore the relevance of MSI status in this population based registry. Methods: The registry was analysed to assess patient characteristics and survival outcomes comparing patients with MSI or microsatellite stable (MSS) disease. K-M survival analysis was used to assess OS. Results: 4359 patients are registered on the data base. 598 (14%) patients had been tested for MSI. 62 (10.1%) of these patients had demonstrable MSI. Patient characteristics and outcomes are summarized in the table. There are statistically higher rates of right sided primary, poorly differentiated pathology and BRAF mutation in the MSI group associated with a trend to reduced survival. Chemotherapy and biological therapy received in the MSI v MSS groups was as follows 5FU 31% v 25%, 5FU/irinotecan 17% v 12%, 5FU/oxaliplatin 52% v 58%, bevacizumab 31% v 42%, anti-EGFR 0 v 4.6%. Conclusions: The patient characteristics of MSI mCRC are in keeping with those previously reported. MSI in this population based mCRC registry is not associated with a favorable outcome as seen in earlier stage disease compared to patients with MSS disease. The trend to poorer outcomes may support routine testing and potentially an alternate treatment pathway, which may include PD-1 inhibitors.[Table: see text]
Estimating over-diagnosis of breast cancer (Authors' Reply)
Publisher: Wiley
Date: 18-11-2015
DOI: 10.1002/IJC.29271
Microscopic Analysis of the Uplink Interference in FDMA Small Cell Networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2016
Degree of cancer spread at presentation and survival among adolescents and young adults in New South Wales, Australia
Publisher: Mary Ann Liebert Inc
Date: 04-2021
Multiple primary cancers of separate organ sites: implications for research and cancer control (Australia)
Publisher: Springer Science and Business Media LLC
Date: 06-2005
Primary, allied health, geriatric, pain and palliative healthcare service utilisation by aged care residents, 2012-2017
Publisher: Wiley
Date: 17-04-2023
DOI: 10.1111/AJAG.13199
Abstract: To examine the incidence and trends in primary care, allied health, geriatric, pain and palliative care service use by permanent residential aged care (PRAC) residents and the older Australian population. Repeated cross‐sectional analyses on PRAC residents ( N = 318,484) and the older (≥65 years) Australian population ( N ~ 3.5 million). Outcomes were Medicare Benefits Schedule (MBS) subsidised primary care, allied health, geriatric, pain and palliative services between 2012–13 and 2016–17. GEE Poisson models estimated incidence rates and incidence rate ratios (IRR). In 2016–17, PRAC residents had a median of 13 (interquartile range [IQR] 5–19) regular general medical practitioner (GP) attendances, 3 (IQR 1–6) after‐hours attendances and 5% saw a geriatrician. Highlights of utilisation changes from 2012–13 to 2016–17 include the following: GP attendances increased by 5%/year (IRR = 1.05, 95% confidence interval [CI] 1.05–1.05) for residents compared to 1%/year (IRR = 1.01, 95%CI 1.01–1.01) for the general population. GP after‐hours attendances increased by 15%/year (IRR = 1.15, 95%CI 1.14–1.15) for residents and 9%/year (IRR = 1.08, 95%CI 1.07–1.20) for the general population. GP management plans increased by 12%/year (IRR = 1.12, 95%CI 1.11–1.12) for residents and 10%/year (IRR = 1.10, 95%CI 1.09–1.11) for the general population. Geriatrician consultations increased by 28%/year (IRR = 1.28, 95%CI 1.27–1.29) for residents compared to 14%/year (IRR = 1.14, 95%CI 1.14–1.15) in the general population. The utilisation of most examined services increased in both cohorts over time. Preventive and management care, by primary care and allied health care providers, was low and likely influences the utilisation of other attendances. PRAC residents' access to pain, palliative and geriatric medicine services is low and may not address the residents' needs.
Female breast cancer management and survival: The experience of major public hospitals in South Australia over 3 decades—trends by age and in the elderly
Publisher: Wiley
Date: 08-10-2017
DOI: 10.1111/JEP.12819
Abstract: Clinical registry data from major South Australian public hospitals were used to investigate trends in invasive breast‐cancer treatment and survival by age. Disease‐specific survival was calculated for the 1980 to 2013 diagnostic period using Kaplan‐Meier product‐limit estimates, with a censoring of live cases on December 31, 2014. Cox proportional hazards regression was used to examine differences in survival by age and tumour characteristic. First‐round treatments following diagnosis were analysed, using multiple logistic regression to adjust for confounding. Five‐year survival increased from 75% in the 1980s to 87% in 2000 to 2013, consistent with national trends, and with increases occurring irrespective of age. There was an increased use of breast conserving surgery, radiotherapy, chemotherapy, and hormone treatments. Five‐year survival was lower for women aged 80+ years, increasing from 65% in the 1980s to 74% in 2000 to 2013. Lower survival in these older women persisted after adjusting for TNM stage, other clinical variables, and diagnostic year, without evidence of a reduced disparity over time. Older women were less likely to have surgery, radiotherapy, and chemotherapy throughout 1980 to 2013. By comparison, their use of hormone therapy was elevated. The adjusted relative odds of mastectomy (as opposed to breast conserving surgery) were lower for the 80+ year age range. Breast‐cancer survival increases applied to all ages, including 80+ years, but poorer outcomes persisted in this older group and the gap did not reduce. A key question is whether the best trade‐off now exists between optimally therapeutic cancer treatment and accommodations for frailty and co‐morbidity in the aged, or whether opportunities exist for better trade‐offs and better survival. Local registry data are important for describing local service activity and outcomes by age for local service providers, health administrations and consumer groups monitoring disparities and indicating effects of local initiatives.
Epidemiological characteristics of Legionella infection in South Australia: implications for disease control
Publisher: Wiley
Date: 02-1991
DOI: 10.1111/J.1445-5994.1991.TB03007.X
Abstract: About one third of adults surveyed in South Australia have shown evidence of past silent infection with Legionella pneumophila serogroup 1. However, the annual notification rate for symptomatic disease is only about 0.5 per 100,000 residents in non-epidemic years. The male to female ratio is 2.5 to one and approximately 50% of the cases are at least 60 years of age. Cases have presented more in summer and in the metropolitan areas. Twenty cases of Legionnaires' disease occurred during the summer of 1985-86. A cooling tower was held to be the principal source with aerosols being dispersed up to three kilometers away during an atmospheric thermal inversion. A subsequent outbreak of 22 L. longbeachae serogroup 1 infections had no marked geographic clustering. The outbreak commenced in spring and cases were distinguished as active gardeners. L. longbeachae was found in garden soil and it is hypothesised that this soil inhabitant can become aerosolised and inhaled during gardening. The potential for primary prevention of Legionnaires' disease is discussed in relation to water-handling equipment and the need for early precautionary treatment of all community-acquired pneumonia as suspect Legionnaires' disease is emphasised.
Australian validation of the Cancer of the Prostate Risk Assessment Post-Surgical score to predict biochemical recurrence after radical prostatectomy
Publisher: Wiley
Date: 04-05-2018
DOI: 10.1111/ANS.13954
Abstract: The Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) score is a simple post-operative risk assessment tool predicting disease recurrence after radical prostatectomy, which is easily calculated using available clinical data. To be widely useful, risk tools require multiple external validations. We aimed to validate the CAPRA-S score in an Australian multi-institutional population, including private and public settings and reflecting community practice. The study population were all men on the South Australian Prostate Cancer Clinical Outcomes Collaborative Database with localized prostate cancer diagnosed during 1998-2013, who underwent radical prostatectomy without adjuvant therapy (n = 1664). Predictive performance was assessed via Kaplan-Meier and Cox proportional regression analyses, Harrell's Concordance index, calibration plots and decision curve analysis. Biochemical recurrence occurred in 342 (21%) cases. Five-year recurrence-free probabilities for CAPRA-S scores indicating low (0-2), intermediate (3-5) and high risk were 95, 79 and 46%, respectively. The hazard ratio for CAPRA-S score increments was 1.56 (95% confidence interval 1.49-1.64). The Concordance index for 5-year recurrence-free survival was 0.77. The calibration plot showed good correlation between predicted and observed recurrence-free survival across scores. Limitations include the retrospective nature and small numbers with higher CAPRA-S scores. The CAPRA-S score is an accurate predictor of recurrence after radical prostatectomy in our cohort, supporting its utility in the Australian setting. This simple tool can assist in post-surgical selection of patients who would benefit from adjuvant therapy while avoiding morbidity among those less likely to benefit.
Warning labels and interpretive nutrition labels: impact on substitution between sugar and artificially sweetened beverages, juice and water in a real-world selection task
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.APPET.2021.105818
Abstract: Effective strategies to reduce free sugar intake are needed. This study examined exposure to a warning label, independently and in conjunction with a Health Star Rating (HSR) label, on the selection of commercially available cold beverages with real decision-making stakes. Participants (N = 511, 47.9% female, mean = 21.7 (SD = 6.1) years) accessed an online convenience store app via an on-c us laptop to select one of 10 beverages (5 sugar-sweetened beverages [SSBs], 1100% fruit juice, 2 artificially sweetened beverages [ASBs] and 2 waters). The task was repeated with the addition of a warning label on high-sugar drinks in Round 2, and the addition of an HSR label on all drinks in Round 3. Participants were informed that they would receive a complementary drink (valued at <$5AUD) based on their selections following the completion of a brief questionnaire. Baseline results indicated that SSBs and waters were the most and least popular choices, respectively. For both males and females, there was a significant decrease in SSB selection (p < 0.001) and significant increase in ASB and water selection (p < 0.001) following the addition of warning labels to high-sugar drinks. The decreased selection of SSBs and increased selection of waters was maintained in Round 3 when HSR labels were added to all drinks. 100% fruit juice selection decreased with the addition of a warning label for females only (p < 0.01), but increased following the addition of a 4-star HSR label, for both males (p < 0.05) and females (p < 0.001). Warning labels reduced young adults' selection of SSBs and promoted substitution to water. The HSR reinforced this effect for the least healthy drinks. Increased water selection may be further enhanced by ensuring that warning label thresholds and HSR algorithms align to present consistent messaging.
Residential area and screening venue location features associated with spatial variation in breast cancer screening invitation response rates: an observational study in Greater Sydney, Australia
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-043853
Abstract: Participation in breast cancer screening (BCS) varies at the small-area level, which may reflect environmental influences. This study assessed small-area variation in BCS invitation response rates (IRRs) and associations between small-area BCS IRR, sociodemographic factors, BCS venue distance and venue location features in Greater Sydney, Australia. BCS IRR data for 2011–2012 were compiled for 9528 Australian Bureau of Statistics Statistical Area Level 1 (SA1) units (n=227 474 women). A geographial information system was used to extract SA1-level sociodemographic features (proportions of women speaking English at home, full-time employed and university educated, and proportion of dwellings with motor vehicles), SA1-level distance to closest venue(s) (expressed as quartiles), and closest venue(s) colocated with bus stops, train station, hospital, general practitioner and shops. Associations between area-level features, BCS venue distance, venue location features and IRR were estimated using ordinary least square-type spatial lag models including area education as a covariate. BCS IRR varied across SA1s (mean=59.8%, range: 0%–100%), with notable spatial autocorrelation (Moran’s I=0.803). BCS IRR was positively associated with greater SA1-level proportion of women speaking English at home (β=2.283, 95% CI 2.024 to 2.543), women’s education (in the model including speaking English at home β=0.454, 95% CI 0.211 to 0.697), dwellings with motor vehicles (β=1.836, 95% CI 1.594 to 2.078), greater distance to venue (eg, most distant quartile compared with closest: β=6.249, 95% CI 5.489 to 7.008), and BCS venue colocated with shops (β=0.762, 95% CI 0.273 to 1.251). Greater SA1-level women employment (β=−0.613, 95% CI −0.898 to −0.328) and venue colocated with train station (β=−1.889, 95% CI −2.376 to −1.402) or hospital (β=−0.677, 95% CI −1.164 to −0.189) were inversely related to BCS IRR. Small-area variation in BCS IRR exists for Greater Sydney and is strongly related to sociodemographic factors that, together with BCS venue location features, could inform targeted attempts to improve IRR.
Equivalence of outcomes for rural and metropolitan patients with metastatic colorectal cancer in South Australia
Publisher: AMPCo
Date: 10-2014
DOI: 10.5694/MJA14.00046
Abstract: To compare the management and outcome of rural and metropolitan patients with metastatic colorectal cancer (mCRC) in South Australia. Retrospective cohort study of patients with mCRC submitted to the South Australian mCRC registry between 2 February 2006 and a cut-off date of 28 May 2012. Differences in oncological and surgical management and overall survival (calculated using the Kaplan-Meier method) between city and rural patients. Of 2289 patients, 624 (27.3%) were rural. There was a higher proportion of male patients in the rural cohort, but other patient characteristics did not significantly differ between the cohorts. Equivalent rates of chemotherapy administration between city and rural patients were observed across each line of treatment (first line: 56.0% v 58.3%, P = 0.32 second line: 23.3% v 22.5%, P = 0.78 and third line: 10.1% v 9.3%, P = 0.69). A higher proportion of city patients received combination chemotherapy in the first-line setting (67.4% v 59.9% P = 0.01). When an oxaliplatin combination was prescribed, oral capecitabine was used more frequently in rural patients (22.9% v 8.4% P < 0.001). No significant difference was seen in rates of hepatic resection or other non-chemotherapy treatments between cohorts. Median overall survival was equivalent between city and rural patients (14.6 v 14.9 months, P = 0.18). Patterns of chemotherapy and surgical management of rural patients with mCRC in SA are equivalent to their metropolitan counterparts and lead to comparable overall survival. The centralised model of oncological care in SA may ensure rural patients gain access to optimal care.
Cancer survival for Aboriginal and Torres Strait Islander Australians: A national study of survival rates and excess mortality
Publisher: Springer Science and Business Media LLC
Date: 31-01-2014
Do we know what to do with our nonagenarian and centenarian patients with metastatic colorectal cancer (mCRC)? Results from the South Australian mCRC registry
Publisher: Informa UK Limited
Date: 18-05-2018
Differences in breast cancer treatment pathways for women participating in screening through BreastScreen New South Wales
Publisher: Allied Academies
Date: 2020
Characteristics of near‐fatal asthma in childhood
Publisher: Wiley
Date: 07-1995
Abstract: As part of the South Australian asthma mortality survey, we examined 30 cases of near-fatal asthma attacks in children under 15 years of age who were seen over a 3-year period from May 1988 to June 1991. Subjects presented with asthma and either respiratory arrest, PaCO2 above 50 mm Hg, and/or an altered state of consciousness or inability to speak on presentation at a metropolitan Adelaide teaching hospital. A standardized interview and questionnaire was completed with subjects arents and medical practitioners. Data were reviewed by the assessment panel which made collective judgments based on predetermined criteria. Seventeen patients (57%) were male, 20% were less than 7 years of age, and the majority (53%) were aged between 12 and 15 years. The majority (83%) had severe asthma and only one case (3.3%) had mild asthma. Half of the subjects were waking every night due to asthma and 79% had significant exercise limitation. A quarter of the subjects had a previous ICU admission and 70% had a hospital admission in the last 12 months. Primary care was carried out by a general practitioner in 57% of cases, and 70% of subjects had a crisis plan. Only 46% of those older than 7 years of age had ever used a peak-flow meter. Eighty percent of subjects or their families had high denial scores, and in 73% of cases psychosocial factors were considered to be significant. Eighty percent of cases experienced acute progressive respiratory distress, and 63% of cases delayed seeking medical care.(ABSTRACT TRUNCATED AT 250 WORDS)
Metastatic colorectal cancer treatment and survival: the experience of major public hospitals in South Australia over three decades
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 02-09-2015
DOI: 10.7314/APJCP.2015.16.14.5923
Abstract: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (and RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively radiotherapy were 24%, 10% and 46% respectively and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (and RS) cases, about 63% would have been offered radiotherapy. Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.
Trends in migrant mortality rates in Australia 1981–2007: a focus on the National Health Priority Areas other than cancer
Publisher: Informa UK Limited
Date: 06-02-2014
DOI: 10.1080/13557858.2014.883368
Abstract: Migrants generally have more favourable mortality outcomes than the Australian-born population. The aim of this study is to update knowledge and inform future research in this field by examining mortality from musculoskeletal conditions, asthma, cardiovascular disease, diabetes mellitus, injuries and mental conditions between 1981 and 2007 among migrants in Australia. Average annual sex- and age-standardised mortality rates were calculated for each migrant group, period of death registration and cause of death. Mortality rates decreased among most groups for asthma, cardiovascular disease and motor vehicle accidents, with rates erging in the later time periods. The reverse was true for mental disorders, where Australian-born in iduals experienced the greatest increase in mortality. Migrants generally displayed more favourable mortality outcomes than their Australian-born counterparts. Migrants from Southern Europe appeared to have the greatest advantage. However, some migrants appeared to be over-represented in the areas of diabetes, suicide and mental health.
Survival and degree of spread for female breast cancers in New South Wales from 1980 to 2003: implications for cancer control
Publisher: Springer Science and Business Media LLC
Date: 03-06-2008
DOI: 10.1007/S10552-008-9177-Y
Abstract: This study investigated associations of degree of spread at diagnosis of breast cancer and socio-demographic factors with the risk of death among NSW females diagnosed in 1980-2003. Trends by diagnostic period, socio-demographic differences, and the implications for cancer control were considered. NSW Central Cancer Registry data were analyzed using regression and rank-order tests to show predictors of death from breast cancer and trends in degree of spread. Compared with localized disease, case fatality was thrice and 14 times higher for cancers with regional spread and distant metastases, respectively. After adjusting for degree of spread and socio-demographic differences, the relative risk of death from breast cancer has declined in recent diagnostic periods compared with the 1980-1983 baseline, reaching a low of 0.38 (0.35, 0.40) for 1999-2003. Age-specific analyses indicated that relative risks were lower in 1999-2003 for 50-69 year olds (RR = 0.31) than younger (RR = 0.40), or older (RR = 0.46) females. Regional or distant disease at diagnosis was lowest in the older age groups, the highest socio-economic stratum and in more recent periods. Females born in non-English speaking countries presented with more advanced disease, as did metropolitan women with the highest access to health services. Degree of spread of cancer at diagnosis is a powerful predictor of case fatality. Case fatalities from breast cancer have declined by diagnostic period, after adjusting for degree of spread, which may reflect treatment and screening advances. Attention should be directed at reducing disparities by socio-economic status and encouraging migrant women to present earlier.
Pregnancy and perinatal factors associated with persistently low apgar scores: An analysis of the birth records of infants born in South Australia
Publisher: Springer Science and Business Media LLC
Date: 06-1990
DOI: 10.1007/BF00145785
Abstract: Adjuvant endocrine therapy improves recurrence and survival rates, but has side effects and is inconvenient. The aim of this study was to determine the preferences of premenopausal women who had adjuvant endocrine therapy in a randomised trial. In all, 85 (or eighty-five) women completed semistructured interviews 6-30 months after finishing adjuvant endocrine therapy. Hypothetical scenarios based on known potential survival times (5 or 15 years) and rates (60% or 80% at 5 years) without adjuvant endocrine therapy were used to determine the smallest gains women judged necessary to make their adjuvant endocrine therapy worthwhile. Although a third of the women considered gains of 1% in survival rates or 6 months in survival times sufficient to make their adjuvant endocrine therapy worthwhile, more than half the women required gains of at least 5% in survival rates or 3 years in survival time as necessary to make adjuvant endocrine therapy worthwhile. Larger benefits were required by women who had longer treatment, worse side effects, and by those who were treated with goserelin alone. The route of administration (tablet vs injection) did not affect preferences and some women judged small benefits sufficient to make their adjuvant endocrine therapy worthwhile, but many women required larger benefits than their counterparts in similar studies of preferences for adjuvant chemotherapy.
Novel nested convolutional lattice codes for multi-way relaying systems over fading channels
Publisher: IEEE
Date: 04-2013
Development of Indicators to Assess Quality of Care for Prostate Cancer
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.EUF.2016.01.016
Abstract: The development, monitoring, and reporting of indicator measures that describe standard of care provide the gold standard for assessing quality of care and patient outcomes. Although indicator measures have been reported, little evidence of their use in measuring and benchmarking performance is available. A standard set, defining numerator, denominator, and risk adjustments, will enable global benchmarking of quality of care. To develop a set of indicators to enable assessment and reporting of quality of care for men with localised prostate cancer (PCa). Candidate indicators were identified from the literature. An international panel was invited to participate in a modified Delphi process. Teleconferences were held before and after each voting round to provide instruction and to review results. Panellists were asked to rate each proposed indicator on a Likert scale of 1-9 in a two-round iterative process. Calculations required to report on the endorsed indicators were evaluated and modified to reflect the data capture of the Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ). A total of 97 candidate indicators were identified, of which 12 were endorsed. The set includes indicators covering pre-, intra-, and post-treatment of PCa care, within the limits of the data captured by PCOR-ANZ. The 12 endorsed quality measures enable international benchmarking on the quality of care of men with localised PCa. Reporting on these indicators enhances safety and efficacy of treatment, reduces variation in care, and can improve patient outcomes. PCa has the highest incidence of all cancers in men. Early diagnosis and relatively high survival rates mean issues of quality of care and best possible health outcomes for patients are important. This paper identifies 12 important measurable quality indicators in PCa care.
Colorectal cancer treatment and survival: The experience of major public hospitals in south australia over three decades
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 03-04-0011
DOI: 10.7314/APJCP.2015.16.6.2431
Abstract: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Kaplan-Meier product- limit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.
Impact of relational continuity of primary care in aged care: a systematic review
Publisher: Springer Science and Business Media LLC
Date: 14-07-2022
DOI: 10.1186/S12877-022-03131-2
Abstract: Greater continuity of care has been associated with lower hospital admissions and patient mortality. This systematic review aims to examine the impact of relational continuity between primary care professionals and older people receiving aged care services, in residential or home care settings, on health care resource use and person-centred outcomes. Systematic review of five databases, four trial registries and three grey literature sources to October 2020. Included studies (a) aimed to increase relational continuity with a primary care professional, (b) focused on older people receiving aged care services (c) included a comparator and (d) reported outcomes of health care resource use, quality of life, activities of daily living, mortality, falls or satisfaction. Cochrane Collaboration or Joanna Briggs Institute criteria were used to assess risk of bias and GRADE criteria to rate confidence in evidence and conclusions. Heterogeneity in study cohorts, settings and outcome measurement in the five included studies (one randomised) precluded meta-analysis. None examined relational continuity exclusively with non-physician providers. Higher relational continuity with a primary care physician probably reduces hospital admissions (moderate certainty evidence high versus low continuity hazard ratio (HR) 0.94 95% confidence interval (CI) 0.92–0.96, n = 178,686 incidence rate ratio (IRR) 0.99, 95%CI 0.76–1.27, n = 246) and emergency department (ED) presentations (moderate certainty evidence high versus low continuity HR 0.90, 95%CI 0.89–0.92, n = 178,686 IRR 0.91, 95%CI 0.72–1.15, n = 246) for older community-dwelling aged care recipients. The benefit of providing on-site primary care for relational continuity in residential settings is uncertain (low certainty evidence, 2 studies, n = 2,468 plus 15 care homes) whilst there are probably lower hospitalisations and may be fewer ED presentations, there may also be an increase in reported mortality and falls. The benefit of general practitioners’ visits during hospital admission is uncertain (very low certainty evidence, 1 study, n = 335). Greater relational continuity with a primary care physician probably reduces hospitalisations and ED presentations for community-dwelling aged care recipients, thus policy initiatives that increase continuity may have cost offsets. Further studies of approaches to increase relational continuity of primary care within aged care, particularly in residential settings, are needed. CRD42021215698.
Breast cancer survival in New Zealand women
Publisher: Wiley
Date: 29-09-2015
DOI: 10.1111/ANS.12851
Abstract: The Quality Audit (BQA) of Breast Surgeons of Australia and New Zealand includes a broad range of data and is the largest New Zealand (NZ) breast cancer (BC) database outside the NZ Cancer Registry. We used BQA data to compare BC survival by ethnicity, deprivation, remoteness, clinical characteristic and case load. BQA and death data were linked using the National Health Index. Disease-specific survival for invasive cases was benchmarked against Australian BQA data and NZ population-based survivals. Validity was explored by comparison with expected survival by risk factor. Compared with 93% for Australian audit cases, 5-year survival was 90% for NZ audit cases overall, 87% for Maori, 84% for Pacific and 91% for other. BC survival in NZ appears lower than in Australia, with inequities by ethnicity. Differences may be due to access, timeliness and quality of health services, patient risk profiles, BQA coverage and death-record methodology.
Clinical and pathological factors predictive of lymph node status in women with screen-detected breast cancer
Publisher: Elsevier BV
Date: 10-2006
DOI: 10.1016/J.BREAST.2006.01.009
Abstract: Two thousand one hundred and thirty five asymptomatic invasive breast cancers detected through screening mammography were analysed to identify predictors of lymph node involvement. Multivariable analysis indicated that predictors included larger tumour diameter, an infiltrating ductal or lobular histological type, multifocal disease, a palpable lesion, and a younger age at diagnosis. An association also was found between nodal involvement and the presence of an extensive in situ component (EIC). Grade was associated with nodal involvement as a univariate predictor. It would be more accurate for screening assessment clinics to use models for predicting nodal status that were customised to their own experience rather than generic models developed in other settings that related predominantly to symptomatic cancer. These models could assist clinical decision-making on axillary node dissection and give guidance to pathologists on numbers of tissue sections to examine.
Prevalence of oral human papillomavirus infection among Australian indigenous adults
Publisher: American Medical Association (AMA)
Date: 08-06-2020
Disparities in breast screening, stage at diagnosis, cancer treatment and the subsequent risk of cancer death
Publisher: Springer Science and Business Media LLC
Date: 14-06-2019
Cancer Profiles, Times to Treatment, and Survival for Adolescents and Young Adults: Comparisons with Children and Older Adults in New South Wales, Australia
Publisher: Mary Ann Liebert Inc
Date: 10-2022
Evaluation of an intervention to train health professionals working with Aboriginal and Torres Strait Islander people to provide smoking cessation advice
Publisher: Elsevier BV
Date: 04-2019
Abstract: To investigate the effectiveness and cultural relevance of Quitskills training tailored for health professionals working with Aboriginal and Torres Strait Islander people who smoke. A retrospective analysis was conducted with data collected from 860 participants (54% Aboriginal and Torres Strait Islander participants) in tailored Quitskills training from 2012 to 2016. Course participants took part in a survey at pre-training, post-training and four-six weeks post-training to assess confidence in skills to address tobacco, and perceptions of the strengths, areas for improvement and cultural relevance of the training. Confidence in skills and knowledge to address tobacco increased significantly from pre- to post-training (all indicators of confidence in skills increased p<0.001) and remained high at follow-up. Tailored Quitskills training was perceived as being culturally relevant by Aboriginal and Torres Strait Islander participants, and the training facilitators were the most commonly cited strength of the training. Quitskills is an appropriate course for increasing skills and confidence among health professionals working with Aboriginal and Torres Strait Islander people who smoke. Implications for public health: Training courses that are tailored for Aboriginal and Torres Strait Islander people can build the capacity of the health workforce in a culturally relevant manner.
Sharing Government Health Data With the Private Sector: Community Attitudes Survey
Publisher: JMIR Publications Inc.
Date: 10-2021
DOI: 10.2196/24200
Abstract: The use of government health data for secondary purposes, such as monitoring the quality of hospital services, researching the health needs of populations, and testing how well new treatments work, is increasing. This increase in the secondary uses of health data has led to increased interest in what the public thinks about data sharing, in particular, the possibilities of sharing with the private sector for research and development. Although international evidence demonstrates broad public support for the secondary use of health data, this support does not extend to sharing health data with the private sector. If governments intend to share health data with the private sector, knowing what the public thinks will be important. This paper reports a national survey to explore public attitudes in Australia toward sharing health data with private companies for research on and development of therapeutic drugs and medical devices. This study aims to explore public attitudes in Australia toward sharing government health data with the private sector. A web-based survey tool was developed to assess attitudes about sharing government health data with the private sector. A market research company was employed to administer the web-based survey in June 2019. The survey was completed by 2537 in iduals residing in Australia. Between 51.8% and 57.98% of all participants were willing to share their data, with slightly fewer in favor of sharing to improve health services (51.99%) and a slightly higher proportion in favor of sharing for research and development (57.98%). There was a preference for opt-in consent (53.44%) and broad support for placing conditions on sharing health information with private companies (62% to 91.99%). Wide variability was also observed in participants’ views about the extent to which the private sector could be trusted and how well they would behave if entrusted with people’s health information. In their qualitative responses, the participants noted concerns about private sector corporate interests, corruption, and profit making and expressed doubt about the Australian government’s capacity to manage data sharing safely. The percentages presented are adjusted against the Australian population. This nationally representative survey provides preliminary evidence that Australians are uncertain about sharing their health data with the private sector. Although just over half of all the respondents supported sharing health data with the private sector, there was also strong support for strict conditions on sharing data and for opt-in consent and significant concerns about how well the private sector would manage government health data. Addressing public concern about sharing government health data with the private sector will require more and better engagement to build community understanding about how agencies can collect, share, protect, and use their personal data.
The premature mortality to incidence ratio (PREMIER): a person-centred measure of cancer burden
Publisher: Cold Spring Harbor Laboratory
Date: 18-10-2021
DOI: 10.1101/2021.10.17.21265122
Abstract: Cancer control initiatives are informed by quantifying the capacity to reduce cancer burden through effective interventions. Burden measures using health administrative data are a sustainable way to support monitoring and evaluating of outcomes among patients and populations. The PREmature Mortality to IncidencE Ratio (PREMIER) is one such burden measure. We use data on Aboriginal and non-Aboriginal South Australians from 1990 to 2010 to show how PREMIER quantifies disparities in cancer burden: between populations between sub-population cohorts where stage at diagnosis is available and when follow-up is constrained to 24-months after diagnosis. PREMIER cancer is the ratio of years of life expectancy lost due to cancer (YLL cancer ) to life expectancy years at risk at time of cancer diagnosis (LYAR) for each person. The Global Burden of Disease standard life table provides referent life expectancies. PREMIER cancer was estimated for the population of cancer cases diagnosed in South Australia from 1990 to 2010. Cancer stage at diagnosis was also available for cancers diagnosed in Aboriginal people and a cohort of non-Aboriginal people matched by sex, year of birth, primary cancer site and year of diagnosis. Cancers diagnoses (N=144,891) included 777 among Aboriginal people. Cancer burden described by PREMIER cancer was higher among Aboriginal than non-Aboriginal (0.55, 95%CIs 0.52-0.59 versus 0.39, 95%CIs 0.39-0.40). Diagnoses at younger ages among Aboriginal people, 7 year higher LYAR (31.0, 95%CIs 30.0-32.0 versus 24.1, 95%CIs 24.1-24.2) and higher premature cancer mortality (YLL cancer = 16.3, 95%CIs 15.1-17.5 versus YLL cancer = 8.2, 95%CIs 8.2-8.3) influenced this. Disparities in cancer burden between the matched Aboriginal and non-Aboriginal cohorts manifested 24-months after diagnosis with PREMIER cancer 0.44, 95%CIs 0.40-0.47 and 0.28, 95%CIs 0.25-0.31 respectively. PREMIER described disproportionately higher cancer burden among Aboriginal people in comparisons involving: all people diagnosed with cancer the matched cohorts and, within groups diagnosed with same staged disease. The extent of disparities were evident 24-months after diagnosis. This is evidence of Aboriginal peoples’ substantial capacity to benefit from cancer control initiatives, particularly those leading to earlier detection and treatment of cancers. PREMIER’s use of readily available, person-level administrative records can help evaluate health care initiatives addressing this need.
Effect of mammography screening and sociodemographic factors on stage of female breast cancer at diagnosis in New South Wales
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH19124
Abstract: ObjectiveThe aims of this study were to assess the effects of screening through BreastScreen NSW on the stage of cancer at diagnosis, and differences in cancer stage at diagnosis according to sociodemographic factors. MethodsUsing linked BreastScreen NSW screening attendance records and NSW Cancer Registry data, the effects of screening participation and sociodemographic characteristics on stage at diagnosis were investigated using Kruskal–Wallis analysis of variance or the Mann–Whitney U-test for the 2002–13 diagnostic period. Multivariate logistic regression was used to investigate predictors of stage at diagnosis. ResultsThe association between BreastScreen NSW participation and earlier stage at diagnosis was strongest when the last screening episode occurred within 24 months of the cancer diagnosis, with an odds ratio of localised versus non-localised cancer of 1.61 (95% confidence interval 1.51–1.72). Women aged ≥70 years, Aboriginal women, residents of major cities and women living in areas of socioeconomic disadvantage were more likely to have distant than non-distant stage at diagnosis. A trend towards more distant stage in more recent diagnostic years was evident after adjusting for screening participation. ConclusionsThe strongest and most consistent predictor of earlier stage at diagnosis was BreastScreen NSW participation. Continued efforts to increase screening participation are important to achieve earlier stage at diagnosis, particularly for sociodemographic groups with more advanced disease. What is known about the topic?Earlier cancer stage at diagnosis is a prerequisite for mortality reduction from screening. Past research indicated that screening participation in New South Wales (NSW) was strongly associated with early stage at diagnosis and mortality reduction. More contemporary data are needed to monitor screening performance in NSW and assess differences in cancer stage across sociodemographic subgroups. What does this paper add?Using data linkage, this paper indicates associations between screening, sociodemographic factors and stage at diagnosis for the NSW population in 2002–13. Contrary to expectations, major city residents tended to have a lower proportion of early stage breast cancer at diagnosis, which may be indicative of lower screening coverage and barriers to screening. Compared with past research, similar effects of screening and other sociodemographic factors on the stage of breast cancer at diagnosis were observed. This paper compares screening histories across sociodemographic groups, indicating statistically significant differences. What are the implications for practitioners?Increasing screening participation is particularly important for sociodemographic groups who are diagnosed at more advanced stages, including women from lower socioeconomic areas, Aboriginal and Torres Strait Islander women and residents of major cities. In particular, the results reinforce the need to further develop targeted strategies to increase screening participation among NSW women from lower socioeconomic areas and Aboriginal and Torres Strait Islander women. Further investigation into screening coverage and barriers to screening for residents in major cities is needed.
Performance Analysis of Reconfigurable Intelligent Surface Assisted Wireless System With Low-Density Parity-Check Code
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2021
Interrelationship of microplastic pollution in sediments and oysters in a seaport environment of the eastern coast of Australia
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.SCITOTENV.2019.133924
Abstract: Since the middle of the twentieth century, microplastics have emerged as a pollutant of concern. Sea ports are recipients of large amount of discharges through ballast water, ship traffic and other commercial activities, which may additionally add to the overall marine microplastic pollution. The aim of this study was to determine the interrelationship of microplastic pollution in the sediments and oysters at six major seaports (Port Jackson, Botany, Kembla, Newcastle, Yamba and Eden) of New South Wales (NSW). The results revealed the significant abundance of microplastic particles both in sediments and oysters in all the studied seaports which were estimated to be around 83-350 particles/kg dry weight in the sediments and 0.15-0.83 particles/g wet weight in the oysters. Although, the abundance of microplastics showed similar pattern in the sediments and oysters of the studied seaports, oysters had higher number of microplastics than sediments in all sea ports. Moreover, the results showed that the shapes, size and colours in the oysters did not necessarily match the main components in the sediments, although the polymer types matched well between each other. Black fibres between 0.1mm-0.5mm in size were the most abundant microplastics in oysters, whereas white spherules between 0.5mm-1mm in size were dominant in the sediments of NSW seaports. Moreover, the analysis of variance between microplastic abundance in sediment and oysters showed a non-significant positive linear relationship. Fourier Transform Infrared analysis further indicated that both sediments and oysters contained microplastics with two main polymers, polyethylene terephthalate and nylon, which suggests that the abundance of microplastics in the study ports was highly influenced by the port activities, mainly the intensive commercial fishing and fish processing activities along with intensive anthropogenic and industrial activities inside and surroundings the port environments.
Prognostic importance of palpability as a feature of screen-detected breast cancers
Publisher: SAGE Publications
Date: 06-2006
DOI: 10.1258/096914106777589560
Abstract: Objectives: To determine epidemiological characteristics of palpability as a feature of asymptomatic invasive breast cancers detected through screening mammography, and to determine whether palpability is predictive of case survival after adjusting for conventional prognostic indicators such as diameter, grade and nodal status. Setting: The University of Adelaide, South Australian Department of Health, and The Cancer Council South Australia, Adelaide, South Australia. Methods: Sociodemographic and clinical characteristics of 2108 screen-detected invasive breast cancers were compared by tumour palpability using univariate and multiple logistic regression analysis. Survival outcomes from breast cancer were compared using Kaplan–Meier product-limit estimates. Multivariable proportional hazard regression was employed to assess the association of palpability with survival after adjusting for conventional prognostic indicators. Results: Palpability was associated with year of diagnosis, ductal histology type, and unfavourable prognostic indicators such as larger tumour diameter, higher grade and nodal involvement. After adjusting for these variables, no associations were found with age at diagnosis, place of residence or socioeconomic status, or with presence of multifocal disease or presence of an extensive in situ component. Palpability was predictive of death from breast cancer in an unadjusted analysis, the relative risk (95% confidence limits) being 1.75 (1.12, 2.74). After adjusting for nodal involvement and larger tumour size, the relative risk no longer was elevated, reducing to 0.99 (0.60, 1.64). Discussion: Palpability is associated with unfavourable prognostic indicators, such as larger diameter, higher grade and nodal involvement, and is not an independent indicator of survival outcome for screen-detected female-breast cancers after accounting for nodal involvement and diameter.
Human papillomavirus infection and intrauterine growth restriction: a data-linkage study
Publisher: Informa UK Limited
Date: 22-09-2017
DOI: 10.1080/14767058.2017.1378330
Abstract: Using unbiased population data, to examine whether having a positive Pap smear, and thus a high probability of Human Papilloma Virus (HPV) infection, is a significant risk factor for intrauterine growth restriction (IUGR) in a subsequent pregnancy. Two independent population-based databases, namely the South Australian Perinatal Statistics Collection and the South Australian Cervical Screening Database, were deidentified and linked by the SANT Datalinkage Service. Analyses were performed on cases where Pap smear screening data was available for up to 2 years prior to a singleton live birth. Population characteristics and pregnancy related data were compared statistically by normal birth weight versus IUGR (10th percentile - known as small for gestational age (SGA), small for gestational age) and (3rd percentile birth weight - known as VLBW, very low birth weight). The association between cervical screening results and IUGR was assessed using generalized linear log binomial regression models. A total of 31,827 women met the criteria. Of these, 1311 women (4.1%) had a positive Pap smear within 2 years of the current pregnancy. Those having a positive Pap smear were more likely to have a baby with IUGR than those with negative smear results. For SGA, 5.8% babies were from mothers with positive Pap smears compared to 4.0% with negative smears indicating a 40% higher risk of having an SGA baby (95%CI 20-70%) among women with positive Pap smears. For VLBW, 7.6% mothers had positive Pap smears compared with 4.0% with negative smears (p < .001), which reflects a 90% increased risk (95%CI 40-150%). These associations reduced to 20% (95%CI 1-40%) and 50% (95%CI 10-100%) for SGA and VLBW, respectively, after adjusting for all other significant covariates including maternal age, ethnicity, marital status, occupation, smoking, pregnancy history, and maternal health during pregnancy. Mothers with a positive Pap smear have an increased risk of IUGR, especially for VLBW, which is independent of other risk factors. The results confirm previous findings in a small study and emphasise the need to consider the risks of both cancer and IUGR in all HPV vaccination programs.
Barriers and facilitators for health professionals referring Aboriginal and Torres Strait Islander tobacco smokers to the Quitline
Publisher: Elsevier BV
Date: 12-2017
Abstract: To examine the barriers and facilitators among health professionals to providing referrals to Quitline for Aboriginal and Torres Strait Islander clients who smoke. A brief online survey, based on the Theoretical Domains Framework, was completed by 34 health professionals who work with Aboriginal and Torres Strait Islander people in South Australia and the Northern Territory. Respondents who frequently made referrals had higher domain scores than less frequent referrers for 'Skills and knowledge' (M=4.44 SD=0.39 vs. M=4.09 SD=0.47, p<0.05) and 'beliefs about capabilities' (M=4.33 SD=0.44 vs. M=3.88 SD=0.42, p<0.01). Barriers to providing referrals to Quitline were lack of client access to a phone, cost of a phone call, preference for face-to-face interventions, and low client motivation to quit. Health professionals working with Aboriginal and Torres Strait Islander clients should be supported to build their skills and confidence to provide referrals to Quitline and other brief cessation interventions. Building capacity for face-to-face support locally would be beneficial where phone support is not preferable. Implications for public health: Engaging with health professionals who work with Aboriginal and Torres Strait Islander people to increase referrals to Quitline is strategic as it builds on their existing capacity to provide cessation support.
Exploring contrary trends in bladder cancer incidence, mortality and survival: implications for research and cancer control
Publisher: Wiley
Date: 05-2010
DOI: 10.1111/J.1445-5994.2009.01980.X
Abstract: To investigate trends in bladder cancer incidence, mortality and survival, and cancer-control implications. South Australian Registry data were used to calculate age-standardized incidence and mortality rates from 1980 to 2004. Sociodemographic predictors of invasive as opposed to in situ disease were examined. Determinants of disease-specific survival were investigated using Kaplan-Meier estimates and proportional hazards regression. Incidence rates for invasive cancers decreased by 21% between 1980-84 and 2000-04, similarly affecting men and women. Meanwhile increases occurred for combined in situ and invasive disease. While mortality rates decreased by approximately a third in men and women less than 70 years of age after the early 1990 s, no changes were evident for older residents. The proportion of cancers found at an in situ stage was higher in younger ages and more recent diagnostic periods. Five-year survivals of invasive cases decreased from 64% for 1980-84 diagnoses to 58% for 1995-2004. Multivariable analysis showed that diagnostic period was not predictive of survival after age adjustment (P= 0.719), with lower survival relating to older age, transitional compared with papillary transitional cancers, female sex, indigenous status and a country as opposed to metropolitan residence. Reductions in invasive disease incidence may be due to increased detection at an in situ stage. The decline in survival from invasive disease in more recent periods is explained by increased age at diagnosis. Poorer outcomes of invasive cases remain for women after adjusting for age, histology, indigenous status and residential location.
The dental health and treatment needs of middle‐aged and older patients attending 21 general dental practitioners in South Australia
Publisher: Wiley
Date: 06-1987
DOI: 10.1111/J.1834-7819.1987.TB01849.X
Abstract: The reversible phosphorylation of the alpha-subunit of eukaryotic translation initiation factor 2 (eIF2alpha) is a well-characterized mechanism of translational control in response to a wide variety of cellular stresses, including viral infection. Beside PKR, the eIF2alpha kinase GCN2 participates in the cellular response against viral infection by RNA viruses with central nervous system tropism. PKR has also been involved in the antiviral response against HIV-1, although this antiviral effect is very limited due to the distinct mechanisms evolved by the virus to counteract PKR action. Here we report that infection of human cells with HIV-1 conveys the proteolytic cleavage of GCN2 and that purified HIV-1 and HIV-2 proteases produce direct proteolysis of GCN2 in vitro, abrogating the activation of GCN2 by HIV-1 RNA. Transfection of distinct cell lines with a plasmid encoding an HIV-1 cDNA clone competent for a single round of replication resulted in the activation of GCN2 and the subsequent eIF2alpha phosphorylation. Moreover, transfection of GCN2 knockout cells or cells with low levels of phosphorylated eIF2alpha with the same HIV-1 cDNA clone resulted in a marked increase of HIV-1 protein synthesis. Also, the over-expression of GCN2 in cells led to a diminished viral protein synthesis. These findings suggest that viral RNA produced during HIV-1 infection activates GCN2 leading to inhibition of viral RNA translation, and that HIV-1 protease cleaves GCN2 to overcome its antiviral effect.
The impact of geographic unit of analysis on socioeconomic inequalities in cancer survival and distant summary stage - a population-based study
Publisher: Elsevier BV
Date: 04-2017
Abstract: When using area-level disadvantage measures, size of geographic unit can have major effects on recorded socioeconomic cancer disparities. This study examined the extent of changes in recorded socioeconomic inequalities in cancer survival and distant stage when the measure of socioeconomic disadvantage was based on smaller Census Collection Districts (CDs) instead of Statistical Local Areas (SLAs). Population-based New South Wales Cancer Registry data were used to identify cases diagnosed with primary invasive cancer in 2000-2008 (n=264,236). Logistic regression and competing risk regression modelling were performed to examine socioeconomic differences in odds of distant stage and hazard of cancer death for all sites combined and separately for breast, prostate, colorectal and lung cancers. For all sites collectively, associations between socioeconomic disadvantage and cancer survival and distant stage were stronger when the CD-based socioeconomic disadvantage measure was used compared with the SLA-based measure. The CD-based measure showed a more consistent socioeconomic gradient with a linear upward trend of risk of cancer death/distant stage with increasing socioeconomic disadvantage. Site-specific analyses provided similar findings for the risk of death but less consistent results for the likelihood of distant stage. The use of socioeconomic disadvantage measure based on the smallest available spatial unit should be encouraged in the future. Implications for public health: Disadvantage measures based on small spatial units can more accurately identify socioeconomic cancer disparities to inform priority settings in service planning.
Estimates of over-diagnosis of breast cancer due to population-based mammography screening in South Australia after adjustment for lead time effects
Publisher: SAGE Publications
Date: 20-04-2015
Abstract: To estimate over-diagnosis due to population-based mammography screening using a lead time adjustment approach, with lead time measures based on symptomatic cancers only. Women aged 40–84 in 1989–2009 in South Australia eligible for mammography screening. Numbers of observed and expected breast cancer cases were compared, after adjustment for lead time. Lead time effects were modelled using age-specific estimates of lead time (derived from interval cancer rates and predicted background incidence, using maximum likelihood methods) and screening sensitivity, projected background breast cancer incidence rates (in the absence of screening), and proportions screened, by age and calendar year. Lead time estimates were 12, 26, 43 and 53 months, for women aged 40–49, 50–59, 60–69 and 70–79 respectively. Background incidence rates were estimated to have increased by 0.9% and 1.2% per year for invasive and all breast cancer. Over-diagnosis among women aged 40–84 was estimated at 7.9% (0.1–12.0%) for invasive cases and 12.0% (5.7–15.4%) when including ductal carcinoma in-situ (DCIS). We estimated 8% over-diagnosis for invasive breast cancer and 12% inclusive of DCIS cancers due to mammography screening among women aged 40–84. These estimates may overstate the extent of over-diagnosis if the increasing prevalence of breast cancer risk factors has led to higher background incidence than projected.
Prostate cancer outcomes for men who present with symptoms at diagnosis
Publisher: Wiley
Date: 03-09-2016
DOI: 10.1111/BJU.13622
Abstract: To compare clinical features, treatments and outcomes in men with non-metastatic prostate cancer (PCa) according to whether they were referred for symptoms or elevated prostate-specific antigen (PSA) level. This study used data from the South Australia Prostate Cancer Clinical Outcomes Collaborative database a multi-institutional clinical registry covering both the public and private sectors. We included all non-metastatic cases from 1998 to 2013 referred for urinary rostatic symptoms or elevated PSA level. Multivariate Poisson regression was used to identify characteristics associated with symptomatic presentation and compare treatments according to reason for referral. Outcomes (i.e. overall survival, PCa-specific survival, metastasis-free survival and disease-free survival) were compared using multivariate Cox proportional hazards and competing risk regression. Our analytical cohort consisted of 4 841 men with localized PCa. Symptomatic men had lower-risk disease (incidence ratio [IR] 0.70, 95% confidence interval [CI] 0.61-0.81 for high vs low risk), fewer radical prostatectomies (IR 0.64, CI: 0.56-0.75) and less radiotherapy (IR 0.86, CI: 0.77-0.96) than men presenting with elevated PSA level. All-cause mortality (hazard ratio [HR] 1.31, CI: 1.16-1.47), disease-specific mortality (HR 1.42, CI: 1.13-1.77) and risk of metastases (HR 1.36, CI: 1.13-1.64) were higher for men presenting with symptoms, after adjustment for other clinical characteristics however, risk of disease progression did not differ (HR 0.90, CI: 0.74-1.07) amongst those treated curatively. Subgroup analyses indicated poorer PCa survival for symptomatic referral among men undergoing radical prostatectomy (HR 3.4, CI: 1.3-8.8), those aged >70 years (HR 1.4, CI: 1.0-1.8), men receiving private treatment (HR 2.1, CI: 1.3-3.3), those diagnosed via biopsy (HR 1.3, CI: 1.0-1.7) and those diagnosed before 2006 (HR 1.6, CI: 1.2-2.7). Our results suggest that symptomatic presentation may be an independent negative prognostic indicator for PCa survival. More complete assessment of disease grade and extent, more definitive treatment and increased post-treatment monitoring among symptomatic cases may improve outcomes. Further research to determine any pathophysiological basis for poor outcomes in symptomatic men is warranted.
What factors affect the odds of NSW cancer patients presenting with localised as opposed to more advanced cancer?
Publisher: Springer Science and Business Media LLC
Date: 27-11-2011
DOI: 10.1007/S10552-011-9873-X
Abstract: The purpose was to examine the odds of presenting with localised as opposed to more advanced cancer by place of residence to gain evidence for planning early detection initiatives. Design, settings and participant's cases of invasive cancer reported to the NSW population-based Cancer Registry for the 1980-2008 diagnostic periods. Main outcome measure(s) between 1980 and 2008, 293,848 of reported cases (40.2%), had localised cancer at diagnosis. Logistic regression analysis was undertaken to determine the odds of localised cancer by place of residence for all cancers sites combined while adjusting for age, sex, period of diagnosis, socioeconomic status, migrant status and prognosis (as inferred from cancer type). Multivariate logistic regression analysis indicated that patients from rural areas were less likely than urban patients to present with localised cancer after adjusting for other socio-demographic factors and prognosis by cancer type (regardless of how rurality was classified). The difference ranged from 4% for remote (OR = 0.96, 95% CI 0.95-0.98) to 14% (OR = 0.86, 95% CI 0.79-0.84) for very remote compared with highly accessible areas. It is estimated that a maximum of 4,205 fewer cases of localised cancer occurred in patients from rural areas over the study period than expected from the stage distribution for urban patients. Residents aged between 30 and 74 years of age at diagnosis and those living in high socioeconomic status areas were more likely to present with localised cancer. By contrast, people aged 75 years or older at diagnosis, migrants from non-English-speaking countries and people diagnosed in more recent diagnostic periods were less likely to present with localised cancer. Targeted strategies that specifically encourage earlier diagnosis and treatment that may subsequently influence better survival are required to increase the proportion of NSW residents presenting with localised cancer at diagnosis.
Monitoring TNM stage of female breast cancer and survival across the South Australian population, with national and international TNM benchmarking: A population-based cohort study
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2020-037069
Abstract: Using linked cancer registry and administrative data to monitor, tumour, node and metastases (TNM) stage and survival from female breast cancer in Australia. Analysis of 2000–2014 diagnoses with linked population-based data to investigate: (1) sociodemographic predictors of advanced stage (stages III and IV), using unadjusted and adjusted logistic regression and (2) sociodemographic factors and stage as predictors of breast cancer survival using competing risk regression. Population-based registry cohort. 14 759 South Australian women diagnosed in 2000–2014. Stage and survival. At diagnosis, 46% of women were classified as stage I, 39% as stage II, 12% as stage III and 4% as stage IV. After adjusting for sociodemographic factors, advanced stage was more common: (1) for ages years and although not statistically significant, for ages 80+ years and (2) in women from socioeconomically disadvantaged areas. Compared with 2000–2004 diagnoses, stage and sociodemographic adjusted risks (sub-HRs (SHRs)) of breast cancer death were lower in 2005–2009 (SHR 0.75, 95% CI 0.67 to 0.83) and 2010–2015 (SHR 0.57, 95% CI 0.48 to 0.67). Compared with stage I, the SHR was 3.87 (95% CI 3.32 to 4.53) for stage II, 10.87 (95% CI 9.22 to 12.81) for stage III, and 41.97 (95% CI 34.78 to 50.65) for stage IV. Women aged 70+ years at diagnosis and those living in the most socioeconomically disadvantaged areas were at elevated risk of breast cancer death, independent of stage and sociodemographic factors. Stage varied by age, diagnostic period and socioeconomic status, and was a stronger predictor of survival than other statistically significant sociodemographic predictors. Achieving earlier diagnosis outside the original BreastScreen target of 50–69 years (as applying ) and in residents of socioeconomically disadvantaged areas likely would increase cancer survival at a population level.
A novel case-control design to estimate the extent of over-diagnosis of breast cancer due to organised population-based mammography screening
Publisher: Wiley
Date: 18-08-2015
DOI: 10.1002/IJC.29124
Abstract: Debate about the extent of breast cancer over-diagnosis due to mammography screening has continued for over a decade, without consensus. Estimates range from 0 to 54%, but many studies have been criticized for having flawed methodology. In this study we used a novel study design to estimate over-diagnosis due to organised mammography screening in South Australia (SA). To estimate breast cancer incidence at and following screening we used a population-based, age-matched case-control design involving 4,931 breast cancer cases and 22,914 controls to obtain OR for yearly time intervals since women's last screening mammogram. The level of over-diagnosis was estimated by comparing the cumulative breast cancer incidence with and without screening. The former was derived by applying ORs for each time window to incidence rates in the absence of screening, and the latter, by projecting pre-screening incidence rates. Sensitivity analyses were undertaken to assess potential biases. Over-diagnosis was estimated to be 8% (95%CI 2-14%) and 14% (95%CI 8-19%) among SA women aged 45 to 85 years from 2006-2010, for invasive breast cancer and all breast cancer respectively. These estimates were robust when applying various sensitivity analyses, except for adjustment for potential confounding assuming higher risk among screened than non-screened women, which reduced levels of over-diagnosis to 1% (95%CI 5-7%) and 8% (95%CI 2-14%) respectively when incidence rates for screening participants were adjusted by 10%. Our results indicate that the level of over-diagnosis due to mammography screening is modest and considerably lower than many previous estimates, including others for Australia.
Obstetric Profiles of Immigrant Women from Non‐English Speaking Countries in South Australia, 1981–1983
Publisher: Wiley
Date: 05-1988
DOI: 10.1111/J.1479-828X.1988.TB01630.X
Abstract: Obstetric profiles of non-English speaking immigrant women in South Australia are presented to assist in planning for health services. They were derived from perinatal data routinely collected by midwives and neonatal nurses. The characteristics of 5,675 immigrant women were compared with those of a random s le of approximately 5% of Australian-born women who delivered babies in 1981-1983 in South Australia. This study demonstrates that immigrant women tended to be urban dwellers and to deliver their babies in large metropolitan hospitals. They were less often from unemployed families but more often from those of low occupational status. They were older, with fewer teenagers and single women among them. They were of higher parity, and tended to commence antenatal care later. They had lower incidences of pregnancy hypertension and induced labour, but were more likely to have anaemia, antepartum haemorrhage and a Caesarean section. There were also important differences between the 7 largest immigrant groups. For ex le, the very high Caesarean section rate (36%) in Filipino women is of concern. Also, the mean birth-weight of babies of Vietnamese women was 263g lower than that of babies of Australian-born women. Support services need to be logistically located and address the findings of this study in a culturally acceptable way.
Environmental sustainability assessment using dynamic Autoregressive-Distributed Lag simulations—Nexus between greenhouse gas emissions, biomass energy, food and economic growth
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.SCITOTENV.2019.02.432
Abstract: Increasing population demand has triggered the enhancement of food production, energy consumption and economic development, however, its impact on climate change has become a global concern. This study applied a novel environmental sustainability assessment tool using dynamic Autoregressive-Distributed Lag (ARDL) simulations for model estimation of the relationships between greenhouse gas (GHG) emissions, energy, biomass, food and economic growth for Australia using data spanning from 1970 to 2017. The study found an inversed-U shaped relationship between energy consumption and income level, showing a decarbonized and services economy, hence, improved energy efficiency. While energy consumption increases emissions by 0.4 to 2.8%, biomass consumption supports Australia's transition to a decarbonized economy by reducing GHG emissions by 0.13% and shifts the demand for fossil fuel. Food and energy consumption underpin socio-economic development and vice versa. However, food waste from production and consumption increases ecological footprint, implying a lost opportunity to improve food security and reduce environmental pressure from agricultural production. There is no single path to achieving environmental sustainability, nonetheless, the integrated approach applied in this study reveals conceptual tools which are applicable for decision making.
TREATMENT AND OUTCOMES OF METASTATIC COLORECTAL CANCER PATIENTS IN PUBLIC AND PRIVATE HOSPITALS: RESULTS FROM THE SOUTH AUSTRALIAN METASTATIC COLORECTAL CANCER REGISTRY
Publisher: Wiley
Date: 2021
DOI: 10.1111/IMJ.14765
Abstract: Studies have reported significant differences in baseline characteristics and outcomes of metastatic colorectal cancer (mCRC) patients when managed in private versus public hospitals. To compare disease, treatment and survival outcomes of patients with mCRC in public versus private hospitals in South Australia (SA). Analysis of prospectively collected data from the SA mCRC Registry. Patterns of care and outcome data according to location of care and socioeconomic status based on Index of Relative Socio-Economic Advantage and Disadvantage were analysed. A total of 3470 patients' data was analysed during February 2006-January 2015. The majority (70%) of patients received treatment in public hospitals. Patients in the upper 50% for Index of Relative Socio-Economic Advantage and Disadvantage score were more likely to receive treatment at a private hospital (41.2% vs 21.56%) compared to <50%. Public patients had higher burden of disease (10.49% vs 7.41%, P = 0.005). Public patients received less treatment compared to the private patients (odds ratio = 0.48 (0.38-0.61), P = 0.01) and rates of surgical resections were lower in public patients. After adjusting for the covariates, public patients survive 1.33 months (P = 0.025) shorter than private patients with follow-up time of 5 years. Patients receiving metastasectomy and more than three lines of treatment were shown to have the greatest survival benefit. Public patients have a higher burden of disease and in comparison are less likely to receive systemic therapy and have lower survival than patients treated in private hospitals.
The use of State and hospital‐based cancer‐registry data to describe the epidemiological and clinical characteristics of laryngeal cancer in South Australia
Publisher: AMPCo
Date: 03-1989
DOI: 10.5694/J.1326-5377.1989.TB136457.X
Abstract: State and hospital-based cancer registries can be complementary sources for data that describe the general epidemiological and clinical features of cancers in specific populations. This has been illustrated with data on laryngeal cancer from registries in South Australia. The data were sufficiently detailed to indicate: trends in incidence by calendar year, age, sex, place of residence and country of birth the distribution of cases by the subsite of the tumour, the histological type and grade, and the pretreatment clinical stage of the cancer at diagnosis the complaints of patients at presentation the modes of treatment by the stage of the cancer and case-survival rates, both over all and as related to the subsite of the tumour, the sex and the stage of disease. Data also were available to indicate the increased risks of disease that were associated with tobacco smoking and alcohol consumption. The findings broadly are consistent with the results of previous epidemiological studies and show the utility of the combined use of state and hospital registry data to describe the general features of cancers in local populations.
Treatment and survival from breast cancer: the experience of patients at South Australian teaching hospitals between 1977 and 2003
Publisher: Wiley
Date: 12-12-2006
DOI: 10.1111/J.1365-2753.2006.00678.X
Abstract: Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines. To use registry data to: (1) investigate trends in survival and treatment and (2) compare treatment with guidelines. Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast cancers during 1977-2003 (n=4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan-Meier product limit estimates and multivariable Cox proportional hazards regression. The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997-2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997-2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977-1990 to 76.8% in 1997-2003 for stage I (P<0.001) and from 31.1% to 52.2% across these periods for stage II (P<0.001). Adjuvant radiotherapy also became more common (P<0.001), with 20.6% of patients receiving this treatment in 1977-1990 compared with 60.7% in 1997-2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P<0.001), from 19.6% in 1977-1990 to 36.9% in 1997-2003, and the proportion having hormone therapy also increased (P<0.001), from 34.3% to 59.4% between these periods. Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based.
Total Synthesis of Allene-Containing Cyclic Tetrapeptide Pseudoxylallemycin C
Publisher: Georg Thieme Verlag KG
Date: 05-10-2020
DOI: 10.1055/A-1282-6870
Abstract: The first total synthesis of the allene-containing cyclic tetrapeptide pseudoxylallemycin C is reported. The Tyr(t-Bu)-protected linear peptide was prepared on-resin and cyclized in solution phase to yield the protected cyclic precursor. Upon deprotection of Tyr(t-Bu), the desired phenolic cyclic tetrapeptide was separated by RP-HPLC from its epimer that also formed during the macrocyclisation step. Subsequent alkylation with 4-bromobuta-1,2-diene yielded pseudoxylallemycin C.
Total Synthesis of Novel Antimicrobial β-Hairpin Capitellacin Via Rapid Flow-Based SPPS Assembly and Regioselective On-Resin Disulfide Cyclisation
Publisher: Springer Science and Business Media LLC
Date: 16-12-2021
Trends in prostate cancer incidence and mortality rates in South Australia, 1977‐1993
Publisher: AMPCo
Date: 05-1995
DOI: 10.5694/J.1326-5377.1995.TB138509.X
Abstract: To investigate trends in recorded incidence and mortality rates for prostate cancer in South Australia. A multiple Poisson regression analysis of recorded incidence (by diagnostic period) and mortality (by year of death), after adjusting for age at diagnosis and residential location. 8073 patients with prostate cancer and 2659 who died of prostate cancer as notified to the South Australian Cancer Registry for 1977-1993. The relative risk of a recorded diagnosis of prostate cancer (by period of diagnosis), and of a death from prostate cancer (by year of death). During 1977-1989, the recorded age-standardised incidence of prostate cancer was stable, but it increased markedly thereafter. The relative risk (95% confidence limits) of diagnosed prostate cancer was 1.36 (1.29, 1.43) in 1990-1992, and 2.26 (2.12, 2.42) in 1993, when compared with 1977-1989. There was a smaller and less certain increase in prostate cancer mortality. The large increase in recorded incidence of prostate cancer in South Australia is thought to be due mostly to increased disclosure of latent cases from increased clinical investigations. Until there is experimental evidence of health benefits from screening and related investigations for prostate cancer in asymptomatic men, it will be difficult to reconcile benefits with costs.
PD47-11 OPTIMUM TOOLS FOR PREDICTING CLINICAL OUTCOMES IN PROSTATE CANCER PATIENTS UNDERGOING RADICAL PROSTATECTOMY: A SYSTEMATIC REVIEW OF PROGNOSTIC ACCURACY AND VALIDITY
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Mammography screening and breast cancer mortality in Australia: an aggregate cohort study
Publisher: SAGE Publications
Date: 18-02-2012
Abstract: Evidence that mammography screening reduces breast cancer mortality derives from trials, with observational studies broadly supporting trial findings. The purpose of this study was to evaluate the national mammographic screening programme, BreastScreen Australia, using aggregate screening and breast cancer mortality data. Breast cancer mortality from 1990 to 2004 in the whole Australian population was assessed in relation to screening exposure in the target of women aged 50–69 years. Population cohorts were defined by year of screening (and diagnosis), five-year age group at screening (and diagnosis), and local area of residence at screening (and diagnosis). Biennial screening data for BreastScreen Australia were related to cumulated mortality from breast cancer in an event analysis using Poisson regression, and in a time-to-event analysis using Cox proportional hazards regression. Results were adjusted for repeated measures and the potential effects of mammography outside BreastScreen Australia, regionality, and area socio-economic status. From the adjusted Poisson regression model, a 22% (95% CI:12–31%) reduction in six-year cumulated mortality from breast cancer was predicted for screening participation of approximately 60%, compared with no screening 21% (95% CI:11–30%) for the most recently reported screening participation of 56% and 25% (95% CI:15–35%) for the programme target of 70% biennial screening participation. Corresponding estimates from the Cox proportional hazard regression model were 30% (95% CI:17–41%), 28% (95% CI:16–38%) and 34% (95% CI:20–46%). Despite data limitations, the results of this nationwide study are consistent with the trial evidence, and with results of other service studies of mammography screening. With sufficient participation, mammography screening substantially reduces mortality from breast cancer.
LOCAL GOVERNMENT AND COMMUNITY LEADERS' PERSPECTIVES ON CHILD HEALTH AND MORTALITY AND INEQUITY ISSUES IN RURAL EASTERN INDONESIA.
Publisher: Cambridge University Press (CUP)
Date: 29-04-2017
DOI: 10.1017/S0021932016000134
Abstract: Since 2001 a decentralization policy has increased the responsibility placed on local government for improving child health in Indonesia. This paper explores local government and community leaders’ perspectives on child health in a rural district in Indonesia, using a qualitative approach. Focus group discussions were held in May 2013. The issues probed relate to health personnel skills and motivation, service availability, the influence of traditional beliefs, and health care and gender inequity. The participants identify weak leadership, inefficient health management and inadequate child health budgets as important issues. The lack of health staff in rural areas is seen as the reason for promoting the use of traditional birth attendants. Midwifery graduates and village midwives are perceived as lacking motivation to work in rural areas. Some local traditions are seen as detrimental to child health. Husbands provide little support to their wives. These results highlight the need for a harmonization and alignment of the efforts of local government agencies and local community leaders to address child health care and gender inequity issues.
Colorectal cancer screening and subsequent incidence of colorectal cancer: results from the 45 and Up Study
Publisher: AMPCo
Date: 11-2014
DOI: 10.5694/MJA14.00197
Abstract: To investigate the association of colorectal cancer (CRC) screening history and subsequent incidence of CRC in New South Wales, Australia. A total of 196,464 people from NSW recruited to the 45 and Up Study, a large Australian population-based prospective study, by completing a baseline questionnaire distributed from January 2006 to December 2008. In iduals without pre-existing cancer were followed for a mean of 3.78 years (SD, 0.92 years) through linkage to population health datasets. Incidence of CRC hazard ratio (HR) according to screening history, adjusted for age, sex, body mass index, income, education, remoteness, family history, aspirin use, smoking, diabetes, alcohol use, physical activity and dietary factors. Overall, 1096 cases of incident CRC accrued (454 proximal colon, 240 distal colon, 349 rectal and 53 unspecified cancers). Ever having undergone CRC screening before baseline was associated with a 44% reduced risk of developing CRC during follow-up (HR, 0.56 95% CI, 0.49-0.63) compared with never having undergone screening. This effect was more pronounced for those reporting endoscopy (HR, 0.50 95% CI, 0.43-0.58) than those reporting faecal occult blood testing (FOBT) (HR, 0.61 95% CI, 0.52-0.72). Associations for all screening exposures were strongest for rectal cancer (HR, 0.35 95% CI, 0.27-0.45) followed by distal colon cancer (HR, 0.60 95% CI, 0.46-0.78), while relationships were weaker for cancers of the proximal colon (HR, 0.76 95% CI, 0.62-0.92). CRC incidence is lower among in iduals with a history of CRC screening, through either FOBT or endoscopy, compared with in iduals who have never had CRC screening, lasting for at least 4 years after screening.
Does the primary site of colorectal cancer impact outcomes for patients with metastatic disease?
Publisher: Wiley
Date: 06-11-2015
DOI: 10.1002/CNCR.29129
Abstract: Previous reports have described differences in biology and outcome for colorectal cancer based on whether the primary is right or left sided. Further ision by right, left, and rectum or even exact primary site has also been explored. Possible differences in response to biological agents have also been reported based on side of primary lesion. We explored the South Australian registry for metastatic colorectal cancer to assess if there were any differences in patient characteristics, prognostic markers, and treatment received and outcomes based on whether the primary was right or left sided. We also explored if differences exist based on left colon and rectum and by exact primary site. Two thousand nine hundred seventy-two patients were analyzed. Thirty-five percent had a right-sided primary. The median overall survival for the entire group right versus left was 9.6 versus 20.3 months (P < .001). Multivariate analysis confirmed side of primary as an independent prognostic factor. For the group that had active therapy, defined as chemotherapy (± metastasis resection), median overall survival was right, 18.2 months and left, 29.4 months (P < .001). Importantly, we found no suggestion of major differences if left side was ided by left colon and rectum, and trends by in idual site still supported a left and right ision. Patients with a right-sided primary have more negative prognostic factors and indeed have inferior outcomes compared with those with a left-sided primary. Our data with further breakdown by exact site still favor a simple left-versus-right ision moving forward for metastatic colorectal cancer.
Epidemiological surveillance of occupational health in Australia
Publisher: AMPCo
Date: 09-1984
DOI: 10.5694/J.1326-5377.1984.TB132795.X
Abstract: As curricula move from a time-based system to a competency-based medical education system, faculty development will be required. Faculty will be asked to engage in the observation, assessment and feedback of tasks in the form of educational coaching. Faculty development in coaching is necessary, as the processes and tools for coaching learners toward competence are evolving with a novel assessment system. Here, we provide a scoping review of coaching in medical education. Techniques and content that could be included in the curricular design of faculty development programming for coaching (faculty as coach) are discussed based on current educational theory. A novel model of coaching for faculty (faculty as coachee) has been developed and is described by the authors. Its use is proposed for continuing professional development.
Realising opportunities for evidence-based cancer service delivery and research: Linking cancer registry and administrative data in Australia
Publisher: Hindawi Limited
Date: 22-09-2014
DOI: 10.1111/ECC.12242
Abstract: The traditional roles of Australian cancer registries have been incidence, mortality and survival surveillance although increasingly, roles are being broadened to include data support for health-service management and evaluation. In some Australian jurisdictions, cancer stage and other prognostic data are being included in registry databases and this is being facilitated by an increase in structured pathology reporting by pathology and haematology laboratories. Data linkage facilities are being extended across the country at national and jurisdictional level, facilitating data linkage between registry data and data extracts from administrative databases that include treatment, screening and vaccination data, and self-reported data from large population cohorts. Well-established linkage protocols exist to protect privacy. The aim is to gain better data on patterns of care, service outcomes and related performance indicators for health-service management and population health and health-services research, at a time of increasing cost pressures. Barriers include wariness among some data custodians towards releasing data and the need for clearance for data release from large numbers of research ethics committees. Progress is being made though, and proof of concept is being established.
Intentions to reduce sugar-sweetened beverage consumption: the importance of perceived susceptibility to health risks
Publisher: Cambridge University Press (CUP)
Date: 21-01-2021
DOI: 10.1017/S1368980021000239
Abstract: There are numerous health effects associated with excess sugar-sweetened beverage (SSB) consumption. Interventions aimed at reducing population-level consumption require understanding of the relevant barriers and facilitators. This study aimed to identify the variables with the strongest relationship with intentions to reduce SSB consumption from a suite of variables derived from the literature. Random-digit dialling of landline and mobile phones was used to survey adults using computer-assisted telephone interviews. The outcome variable was ‘likelihood of reducing SSB consumption in next 6 months’, and the predictor variables were demographics, SSB attitudes and behaviour, health risk perceptions and social/environmental exposure. Australia. A subs le of 1630 regular SSB consumers from a nationally representative s le of 3430 Australian adults (38 % female, 51 % aged 18–45 years, 56 % overweight or obese). Respondents indicated that they were ‘not at all’ (30·1 %), ‘somewhat’ (43·9 %) and ‘very likely’ (25·3 %) to reduce SSB consumption. Multivariate nominal logistic regressions showed that perceiving future health to be ‘very much’ at risk was the strongest predictor of intention to reduce SSB consumption (OR = 8·1, 95 % CI 1·8, 37·0, P 0·01). Other significant predictors ( P 0·01) included self-perceptions about too much consumption, habitual consumption, difficulty reducing consumption and likelihood of benefitting from reduced consumption. Health risk perceptions had the strongest relationship with intentions to reduce consumption. Age and consumption perceptions were also predictors in the multivariate models, whereas social/environmental exposure variables were not. Interventions may seek to incorporate strategies to denormalise consumption practices and increase knowledge about perceived susceptibility to health risks.
Factors involved in treatment decision making for women diagnosed with ductal carcinoma in situ: A qualitative study
Publisher: Elsevier BV
Date: 12-2021
A nine year retrospective mortality study of workers a british pharmaceutical company
Publisher: Oxford University Press (OUP)
Date: 1986
Abstract: Pulmonary hypertension is a common but often overlooked complication associated with thalassemia syndromes. There are limited data on the safety and efficacy of selective pulmonary vasodilators in this at-risk population. We, therefore, designed a 12-week, open-label, phase 1/2, pilot-scale, proof-of-principle trial of sildenafil therapy in 10 patients with β-thalassemia and at increased risk of pulmonary hypertension based on an elevated tricuspid regurgitant jet velocity >2.5 m/s on Doppler-echocardiography. Variables compared at baseline and after 12 weeks of sildenafil treatment included Doppler-echocardiographic parameters, 6-minute walked distance, Borg Dyspnea Score, New York Heart Association functional class, pulmonary function, and laboratory parameters. Treatment with sildenafil resulted in a significant decrease in tricuspid regurgitant jet velocity by 13.3% (3.0±0.7 versus 2.6±0.5 m/s, P=0.04), improved left ventricular end systolic/diastolic volume, and a trend towards a improved New York Heart Association functional class. No significant change in 6-minute walked distance was noted. Sildenafil was well tolerated, although minor expected adverse events were commonly reported. The total dose of sildenafil (mg) was strongly correlated with percent change in nitric oxide metabolite concentration in the plasma (ρ=0.80, P=0.01). There were also significant increases in plasma and erythrocyte arginine concentrations. Our study suggests that sildenafil is safe and may improve pulmonary hemodynamics in patients at risk of pulmonary hypertension however, it was not demonstrated to improve the distance walked in 6 minutes. Clinical trials are needed to identify the best treatment strategy for pulmonary hypertension in patients with β-thalassemia. (clinicaltrials.gov identifier: NCT00872170).
Risk factors for poorer breast cancer outcomes in residents of remote areas of Australia
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2013
DOI: 10.7314/APJCP.2013.14.1.547
Abstract: To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio- economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.
IMMUNIZATION STATUS OF SOUTH AUSTRALIAN CHILDREN BY SOCIOECONOMIC STATUS AND ETHNICITY
Publisher: Wiley
Date: 12-02-2010
Developing a comorbidity index for comparing cancer outcomes in Aboriginal and non-Aboriginal Australians
Publisher: Springer Science and Business Media LLC
Date: 16-10-2018
Novel soft information forwarding protocols in two-way relay channels
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2013
Female breast cancer in New South Wales, Australia, by country of birth: implications for health-service delivery
Publisher: Research Square Platform LLC
Date: 24-08-2020
DOI: 10.21203/RS.3.RS-59676/V1
Abstract: The authors have requested that this preprint be removed from Research Square.
Rehospitalisation for asthma within 12 months: unequal rates on the basis of gender at two hospitals
Publisher: Wiley
Date: 12-1997
DOI: 10.1111/J.1445-5994.1997.TB00996.X
Abstract: High asthma morbidity has been reported in certain demographic groups in geographical areas of low socioeconomic status (SES). We tested for an ecological association between the gender of people being frequently hospitalised for asthma and the SES of the area in which they lived, using a cross-sectional study. Women represented 75% of the readmission population at The Queen Elizabeth Hospital (TQEH--low SES hospital) and 55% at Modbury Hospital (moderate-high SES hospital). Women at TQEH were significantly more likely to have one readmission within 12 months and over 30 times more likely to have two or more readmissions than women at Modbury Hospital. The ecological association observed in this study needs to be confirmed elsewhere in Australia.
Do the benefits of screening mammography outweigh the harms of overdiagnosis and unnecessary treatment?
Publisher: AMPCo
Date: 2012
DOI: 10.5694/MJA11.11466
Abstract: Yes. Public health adviser David Roder and Cancer Council Australia CEO Ian Olver believe the reduction in breast cancer mortality in Australia reflects both treatment and screening effects.
Fluoridation II: An interim economic analysis
Publisher: Wiley
Date: 12-1980
DOI: 10.1111/J.1834-7819.1980.TB03893.X
Abstract: Species in the genus
The La antigen is over-expressed in lung cancer and is a selective dead cancer cell target for radioimmunotherapy using the La-specific antibody APOMAB®
Publisher: Springer Science and Business Media LLC
Date: 2014
High quality data are the key to understanding inequalities in cancer outcomes for Aboriginal and Torres Strait Islander Australians
Publisher: AMPCo
Date: 11-2016
DOI: 10.5694/MJA16.00980
Transition-Entropy: A Novel Metric for Privacy Preservation in Location-Based Services
Publisher: IEEE
Date: 29-04-2019
Machine Learning Aided Anonymization of Spatiotemporal Trajectory Datasets
Publisher: IEEE
Date: 29-04-2019
Development of comorbidities in men with prostate cancer treated with androgen deprivation therapy: an Australian population-based cohort study
Publisher: Springer Science and Business Media LLC
Date: 02-05-2018
DOI: 10.1038/S41391-018-0036-Y
Abstract: The increasing use of androgen deprivation therapy has prompted further evaluation of its potential adverse effects as the treatment may exacerbate or increase the risk of developing new comorbid diseases. This study aims to assess the patterns of comorbidities among Australian men with prostate cancer treated with androgen deprivation therapy. Pharmaceutical Benefits Scheme (PBS) 10% data between 1 January 2003 and 31 December 2014 was utilised in this retrospective cohort study. Men who had received their first androgen deprivation therapy between 2004 and 2010 were selected as the prostate cancer cohort. Comorbidities were identified using the dispensing claims data and classified with the Rx-Risk-V model. Comparisons were made between the prostate cancer cohort and specific control groups (age-matched and sex-matched without any dispensing of anti-neoplastic agents during the study period and without the in idual comorbidity of interest evaluated at baseline at 1:10 ratio) for the development of nine in idual comorbidities over time using Cox regression models. The prostate cancer cohort had a significant higher risk of developing cardiovascular conditions (hazard ratio 1.37, 95% CI: 1.26-1.48), depression (1.86, 95% CI: 1.73-2.01), diabetes (1.30, 95% CI: 1.15-1.47), gastric acid disorders (1.48, 95% CI: 1.39-1.57), hyperlipidaemia (1.18, 95% CI: 1.09-1.29), osteoporosis (1.65, 95% CI: 1.48-1.85) and pain ain-inflammation (1.47, 95% CI: 1.39-1.55) compared to the control groups. The hazard ratios for cardiovascular conditions and depression were highest in the first year and declined over time. There were no significant differences between the two groups for reactive airway diseases and Alzheimer's disease. Men with prostate cancer treated with androgen deprivation therapy had a higher likelihood of developing new comorbidities than men who did not receive androgen deprivation therapy. Our results support the need for developing coordinated care models that effectively address multiple chronic diseases experienced by prostate cancer survivors.
Cohort profile: indigenous human papillomavirus and oropharyngeal squamous cell carcinoma study - a prospective longitudinal cohort
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-046928
Abstract: Our aims are to: (1) estimate prevalence, incidence, clearance and persistence of oral human papillomavirus (HPV) infection among Indigenous Australians (2) identify risk factors associated with oropharyngeal squamous cell carcinoma (OPSCC)-related HPV types (HPV 16 or 18) (3) develop HPV-related health state valuations and (4) determine the impact on OPSCC and cervical cancers, and the cost-effectiveness of extending publicly-funded HPV vaccination among Indigenous Australians. Participants were recruited from February 2018 to January 2019. Twelve-month follow-up occurred from March 2019 to March 2020. Participants provided socio-demographic characteristics, health-related behaviours including tobacco and alcohol use and sexual history. Health state preferences in regard to HPV vaccination, knowledge regarding HPV infection, OPSCC and cervical cancer were collected using a two-stage standard gamble approach. Participants provided saliva s les and DNA for microbial genotyping was extracted. Of the 910 participants who were positive for β-globin at baseline, 35% had any oral HPV infection. The most prevalent HPV types were 13 or 32 (Heck’s disease 23%). The second most prevalent types were associated with OPSCC (HPV 16 or 18 3.3%). Of the 645 participants who were positive for β-globin at 12-month follow-up, 43% had any HPV infection. Of these, 33% were HPV types 13 or 32 and 2.5% were HPV 16 or 18. Some 588 participants had β-globin positive oral s les at baseline and 12-month follow-up. The prevalence of any oral HPV infection increased from 34% at baseline to 44% at 12-month follow-up due to increases in HPV types 13 or 32 (20% at baseline and 34% at 12-month follow-up). Further funding will be sought to continue follow-up of this cohort, and to include (after a full medical history) a thorough clinical examination of the external head and neck a complete oral examination and examination of the oropharynx. Blood tests for early stage OPSCC will also be undertaken.
The dental health of South Australian country children
Publisher: Wiley
Date: 12-1971
DOI: 10.1111/J.1834-7819.1971.TB03434.X
Abstract: The purpose of the current study was to describe the use of a brief maltreatment assessment instrument to classify adolescents receiving alcohol or other drug (AOD) treatment services based on the extensiveness and severity of prior maltreatment. This goal is significant because maltreatment reduces the effectiveness of AOD treatment and is associated significantly with co-occurring patterns of psychiatric symptoms and sexual risk behaviors. Structured interviews were administered to 300 adolescent treatment clients (202 males, 98 females M = 16.22 years SD = 1.13 years) to assess childhood maltreatment experiences, past year psychiatric symptoms, and sexual risk behaviors during the past 180 days. Cluster analysis classified adolescents into unique groups via self-reported sexual abuse, physical punishment, and parental neglect/negative home environment. Significant between-cluster differences in psychiatric symptoms and sexual risk behaviors were documented using MANOVA and chi-square analyses. More severe maltreatment profiles were associated with higher scores for psychiatric symptoms and unprotected intercourse. Significant heterogeneity and distinct types within this treatment s le of adolescents supports the adaptation of selected prevention efforts to promote HIV/STI risk reduction.
Direct synthesis of cyclic lipopeptides using intramolecular native chemical ligation and thiol–ene CLipPA chemistry
Publisher: Royal Society of Chemistry (RSC)
Date: 2020
DOI: 10.1039/D0OB00203H
Abstract: Cyclic lipopeptides are often challenging synthetic targets. A synthetic approach is presented that employs cyclisation by intramolecular native chemical ligation (NCL) and a thiol–ene “CLipPA” reaction to afford S -lipidated analogues of iturin A.
Clinical characteristics and outcomes of bilateral breast cancer in an Australian cohort
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.BREAST.2010.10.004
Abstract: Uncertainty remains about the impact of bilateral breast cancer. Characteristics and outcomes of unilateral and bilateral breast cancer were compared within an Australian multi-institutional cohort. Demographic, tumour and treatment characteristics were compared among unilateral (n = 2336) and bilateral cases (52 synchronous, 35 metachronous) using descriptive analyses. Disease-specific outcomes were investigated using Cox regression modelling to adjust for prognostic and treatment factors. Factors associated with increased risk of bilateral breast cancer included lobular histology (p = 0.046), family history (p = 0.025) and metropolitan residence (p = 0.006). Mastectomy was more common for bilateral cases (p = 0.001) while radiotherapy was less common (p = 0.015). Index metachronous cases were less likely to receive hormonal therapy (p = 0.001). Five-year survivals for metachronous, synchronous and unilateral cases were 79%, 88% and 94%, respectively. Poorer outcomes remained after adjusting for prognostic factors [HR = 2.26, 1.21-4.21]. Our results confirm international findings indicating worse outcomes from bilateral compared with unilateral breast cancer.
Factors predictive of immediate breast reconstruction following mastectomy for invasive breast cancer in Australia
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.BREAST.2013.09.011
Abstract: To investigate person, cancer and treatment determinants of immediate breast reconstruction (IBR) in Australia. Bi-variable and multi-variable analyses of the Quality Audit database. Of 12,707 invasive cancers treated by mastectomy circa 1998-2010, 8% had IBR. This proportion increased over time and reduced from 29% in women below 30 years to approximately 1% in those aged 70 years or more. Multiple regression indicated that other IBR predictors included: high socio-economic status private health insurance being asymptomatic a metropolitan rather than inner regional treatment centre higher surgeon case load small tumour size negative nodal status, positive progesterone receptor status more cancer foci multiple affected breast quadrants synchronous bilateral cancer not having neo-adjuvant chemotherapy, adjuvant radiotherapy or adjuvant hormone therapy and receiving ovarian ablation. Variations in access to specialty services and other possible causes of variations in IBR rates need further investigation.
Survival for patients with resectable lung metastatic colorectal cancer (mCRC).
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-01-2015
DOI: 10.1200/JCO.2015.33.3_SUPPL.708
Abstract: 708 Background: Hepatic resection for CRC metastasis is now considered a standard of care and perioperative chemotherapy may improve outcomes. Resection of metastasis isolated to lung is also considered potentially curable, although there is still some variation in recommendations and no evidence for perioperative or adjuvant chemotherapy. Here, we explore patient characteristics and outcomes for patients undergoing lung resection for mCRC, with the liver resection group as the comparator. Methods: SA mCRC registry data were analysed to assess patient characteristics and survival outcomes between patients suitable for lung or liver resection. K-M survival analysis was used to assess OS. Results: 3,241 patient are registered on the database. 102 (3.1%) patients were able to undergo a lung resection compared to 420 (12.9%) a liver resection. Of the lung resection patients, 21% initially presented with liver only disease, 11% both lung and liver, and 7% brain or pelvic disease. 62 (61%) presented with lung only disease. Of these patients, 79% went straight to surgery and 34% had lung resection as the only intervention. When comparing the groups, they were balanced for age and sex, liver v lung 67.7 years v 69.5 years, 63.6% v 57.8% male. There was no difference in pathological grade or KRAS MT rate when tested (36% liver v 32% lung). Compared to patients undergoing liver resection, those having lung resection were more likely to be metachronous (75.5% v 44%, p= .0001) and have a rectal primary (43.1% v 30.7%, p=0.017). Chemotherapy for metastatic disease was given more often in liver resection patients (76.9% v 53.9%, p=0.17). Median overall survival is not reached for both arms and the lower hazard rate for lung than liver resection does not approach statistical significance (HR 0.82, 95% CI 0.54-1.24, p=0.33). The 3 and 5 year survival liver v lung as follows 77% v 81% and 62% v 70%. Conclusions: Lung resection occurs less frequently than liver resection for metastatic disease as expected. There was no statistical difference in overall survival in patients suitable for lung or liver resection. These data support the potential for long term survival with resection of both lung and liver metastasis in mCRC.
Outcomes of lymphoma in South Australia, 1977-2007
Publisher: AMPCo
Date: 2012
DOI: 10.5694/MJA11.10002
Abstract: To determine survival rates of patients with lymphoma in South Australia. De-identified data from the SA Cancer Registry on all patients with lymphoma were analysed, as well as the subgroup treated at the Royal Adelaide Hospital (RAH). For non-Hodgkin lymphoma (NHL), we used the International Working Formulation (IWF) grading. SA and RAH data on survival rates were compared with those for the whole of Australia and the United States. All patients diagnosed with lymphoma and treated in SA in 1977-2007. 5-year survival rates for patients with lymphoma, by type of lymphoma and age. Of the total of 8651 patients with lymphoma, 939 were classified as having Hodgkin lymphoma (HL) and 7712 as having NHL. Of those with NHL, 1805 had low-grade, 3576 intermediate-grade, and 510 high-grade NHL. In another 1821 patients, the data were insufficient to make an IWF grading. There was a substantial increase in 5-year survival rates for patients with lymphoma between 1977 and 2007 in SA. While the increase in 5-year survival rates for HL was 7.6 percentage points, survival rates peaked at 88%. For NHL, there was an 18.7 percentage points increase in 5-year survival rates. The first significant increase of 7 percentage points was associated with the introduction of bone marrow transplantation this was maintained with the increase in 5-year survival rates reaching 14 percentage points by 1995-1999. Since 1999, there has been a further increase of 5 percentage points in 5-year survival rates with the introduction of rituximab. Outcomes in patients with NHL have improved significantly, most likely because of the use of bone marrow transplantation and rituximab. Hospital- and state-based cancer registry data reflect the reality of population outcomes and the impact of new technologies.
Performance analysis of dense small cell networks with dynamic TDD
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2018
Exploring the epidemiological characteristics of cancers of unknown primary site in an Australian population: Implications for research and clinical care
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1111/J.1753-6405.2008.00260.X
Abstract: To investigate incidence, mortality and case survival trends for cancer of unknown primary site (CUP) and consider clinical implications. South Australian Cancer Registry data were used to calculate age-standardised incidence and mortality rates from 1977 to 2004. Disease-specific survivals, socio-demographic, histological and secular predictors of CUP, compared with cancers of known primary site, and of CUP histological types, using multivariable logistic regression were investigated. Incidence and mortality rates increased approximately 60% between 1977--80 and 1981--84. Rates peaked in 1993--96. Male to female incidence and mortality rate ratios approximated 1.3:1. Incidence and mortality rates increased with age. The odds of unspecified histological type, compared with the more common adenocarcinomas, were higher for males than females, non-metropolitan residents, low socio-economic areas, and for 1977--88 than subsequent diagnostic periods. CUP represented a higher proportion of cancers in Indigenous patients. Case survival was 7% at 10 years from diagnosis. Factors predictive of lower case survival included older age, male sex, Indigenous status, lower socio-economic status, and unspecified histology type. Results point to poor CUP outcomes, but with a modest improvement in survival. The study identifies socio-demographic groups at elevated risk of CUP and of worse treatment outcomes where increased research and clinical attention are required.
The fraction of life years lost after diagnosis (FLYLAD): a person-centred measure of cancer burden
Publisher: Springer Science and Business Media LLC
Date: 13-09-2023
Investigations of the key macrolactamisation step in the synthesis of cyclic tetrapeptide pseudoxylallemycin A
Publisher: Royal Society of Chemistry (RSC)
Date: 2019
DOI: 10.1039/C9OB00227H
Abstract: During total synthesis of pseudoxylallemycin A, an unstable intermediate was observed and appeared to be reactivated by coupling reagent by-products.
A synthetic approach to ‘click’ neoglycoprotein analogues of EPO employing one-pot native chemical ligation and CuAAC chemistry
Publisher: Royal Society of Chemistry (RSC)
Date: 2019
DOI: 10.1039/C8SC03409E
Abstract: The batch-wise variability of commercial erythropoietin (EPO) preparations warrants development of more advanced synthetic methodologies. We have developed a erse chemical toolkit to prepare ‘click’ neoglycoprotein variants of EPO.
The effect of treatment provided by dentists and therapists in the South Australian School Dental Service
Publisher: Wiley
Date: 12-10-1973
DOI: 10.1111/J.1834-7819.1973.TB03492.X
Abstract: Efferocytosis, the process by which dying or dead cells are removed by phagocytosis, has an important role in development, tissue homeostasis and innate immunity. Efferocytosis is mediated, in part, by receptors that bind to exofacial phosphatidylserine (PS) on cells or cellular debris after loss of plasma membrane asymmetry. Here we show that a bacterial pathogen, Listeria monocytogenes, can exploit efferocytosis to promote cell-to-cell spread during infection. These bacteria can escape the phagosome in host cells by using the pore-forming toxin listeriolysin O (LLO) and two phospholipase C enzymes. Expression of the cell surface protein ActA allows L. monocytogenes to activate host actin regulatory factors and undergo actin-based motility in the cytosol, eventually leading to formation of actin-rich protrusions at the cell surface. Here we show that protrusion formation is associated with plasma membrane damage due to LLO's pore-forming activity. LLO also promotes the release of bacteria-containing protrusions from the host cell, generating membrane-derived vesicles with exofacial PS. The PS-binding receptor TIM-4 (encoded by the Timd4 gene) contributes to efficient cell-to-cell spread by L. monocytogenes in macrophages in vitro and growth of these bacteria is impaired in Timd4(-/-) mice. Thus, L. monocytogenes promotes its dissemination in a host by exploiting efferocytosis. Our results indicate that PS-targeted therapeutics may be useful in the fight against infections by L. monocytogenes and other bacteria that use similar strategies of cell-to-cell spread during infection.
The South Australian school canteen programme: An interim report
Publisher: Wiley
Date: 08-1970
DOI: 10.1111/J.1834-7819.1970.TB03398.X
Abstract: Effects of abiotic and biotic stresses on plant photosynthetic performance lead to fitness and yield decrease. The maximum quantum efficiency of photosystem II (F v/F m) is a parameter of chlorophyll fluorescence (ChlF) classically used to track changes in photosynthetic performance. Despite recent technical and methodological advances in ChlF imaging, the spatio-temporal heterogeneity of F v/F m still awaits for standardized and accurate quantification. We developed a method to quantify the dynamics of spatial heterogeneity of photosynthetic efficiency through the distribution-based analysis of F v/F m values. The method was applied to Arabidopsis thaliana grown under well-watered and severe water deficit (survival rate of 40%). First, whole-plant F v/F m shifted from unimodal to bimodal distributions during plant development despite a constant mean F v/F m under well-watered conditions. The establishment of a bimodal distribution of F v/F m reflects the occurrence of two types of leaf regions with contrasted photosynthetic efficiency. The distance between the two modes (called S) quantified the whole-plant photosynthetic heterogeneity. The weighted contribution of the most efficient/healthiest leaf regions to whole-plant performance (called W max) quantified the spatial efficiency of a photosynthetically heterogeneous plant. Plant survival to water deficit was associated to high S values, as well as with strong and fast recovery of W max following soil rewatering. Hence, during stress surviving plants had higher, but more efficient photosynthetic heterogeneity compared to perishing plants. Importantly, S allowed the discrimination between surviving and perishing plants four days earlier than the mean F v/F m. A sensitivity analysis from simulated dynamics of F v/F m showed that parameters indicative of plant tolerance and/or stress intensity caused identifiable changes in S and W max. Finally, an independent comparison of six Arabidopsis accessions grown under well-watered conditions indicated that S and W max are related to the genetic variability of growth. The distribution-based analysis of ChlF provides an efficient tool for quantifying photosynthetic heterogeneity and performance. S and W max are good indicators to estimate plant survival under water stress. Our results suggest that the dynamics of photosynthetic heterogeneity are key components of plant growth and tolerance to stress.
Cancer Data and Aboriginal Disparities Project (CanDAD) - an overdue cancer control initiative
Publisher: Hindawi Limited
Date: 26-02-2016
DOI: 10.1111/ECC.12466
REPCAN: Guideline for REporting Population-based CANcer Registry Data
Publisher: EpiSmart Science Vector Ltd
Date: 09-2023
A population-based study of soft tissue sarcoma incidence and survival in Australia: An analysis of 26,970 cases
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.CANEP.2019.101590
Abstract: Soft tissue sarcomas (STS) are rare, often fatal tumors, but little is known of the epidemiology and survival in the Australian population. This study aims to provide the first epidemiological analysis of incidence and survival rates of STS in the Australian population. A retrospective population-based observational study was conducted between 1982 and 2009 of all patients with a diagnosis of STS using the Australian Institute of Health and Welfare (AIHW) Australian Cancer Database. Incidence rates per 100,000 incidence rate ratios, age-standardized incidence rates, prevalence and incidence rates of subtypes of STS, median, one-year and 5-year survival rates were examined. A total of 26,970 patients were identified. Between 1982 and 2009 STS incidence rates significantly increased from 3.99 [95% CI 3.68-4.32] to 6.12 [95% CI 5.80-6.46] per 100,000 Australian population, with a peak incident rate ratio (IRR) of 1.59 [95% CI 1.51-1.69] (p < 0.0001) in 2001. Median age at diagnosis increased from 58 to 63 years. Incidence rates were stable across all 10-year age cohorts, except for people aged over 70 where it increased. Overall, age-standardized incidence rates increased from 4.70 [95% CI 4.42-5.00] in 1982 to 5.87 [95% CI 5.63-6.11] per 100 000 Australians in 2009. Leiomyosarcoma (20.43%), malignant fibrous histiocytoma (16.14%), and soft tissue tumors/sarcomas, not otherwise specified (10.18%) were the most common STS subtypes. Median survival from diagnosis increased from 5.80 years [95% CI 5.06-6.54] in 1985-1989 cohort to 8.18 years [95% CI 7.54-8.81] in the 2000-2004 cohort (log-rank test p < 0.0001). The incidence of STS is increasing in Australia, most noticeably in those aged over 70 years, with a small but statistically significant increase in overall survival rates.
Flow-Based Fmoc-SPPS Preparation and SAR Study of Cathelicidin-PY Reveals Selective Antimicrobial Activity
Publisher: MDPI AG
Date: 20-02-2023
DOI: 10.3390/MOLECULES28041993
Abstract: Antimicrobial peptides (AMPs) hold promise as novel therapeutics in the fight against multi-drug-resistant pathogens. Cathelicidin-PY (NH2-RKCNFLCKLKEKLRTVITSHIDKVLRPQG-COOH) is a 29-residue disulfide-cyclised antimicrobial peptide secreted as an innate host defence mechanism by the frog Paa yunnanensis (PY) and reported to possess broad-spectrum antibacterial and antifungal properties, exhibiting low cytotoxic and low hemolytic activity. Herein, we detail the total synthesis of cathelicidin-PY using an entirely on-resin synthesis, including assembly of the linear sequence by rapid flow Fmoc-SPPS and iodine-mediated disulfide bridge formation. By optimising a synthetic strategy to prepare cathelicidin-PY, this strategy was subsequently adapted to prepare a bicyclic head-to-tail cyclised derivative of cathelicidin-PY. The structure-activity relationship (SAR) of cathelicidin-PY with respect to the N-terminally positioned disulfide was further probed by preparing an alanine-substituted linear analogue and a series of lactam-bridged peptidomimetics implementing side chain to side chain cyclisation. The analogues were investigated for antimicrobial activity, secondary structure by circular dichroism (CD), and stability in human serum. Surprisingly, the disulfide bridge emerged as non-essential to antimicrobial activity and secondary structure but was amenable to synthetic modification. Furthermore, the synthetic AMP and multiple analogues demonstrated selective activity towards Gram-negative pathogen E. coli in physiologically relevant concentrations of alent cations.
Prognostic differences of RAS mutations: results from the South Australian metastatic colorectal registry
Publisher: Springer Science and Business Media LLC
Date: 25-11-2022
DOI: 10.1007/S11523-021-00856-9
Abstract: Effective targeting of RAS mutations has proven elusive until recently. Novel agents directly targeting KRAS G12C have shown promise in early-phase clinical trials that included patients with metastatic colorectal cancer. Prior reports have suggested that G12C mutation may be predictive of poor outcome. Assessment of the specific characteristics and prognostic implications of in idual RAS mutation subtypes in patients with metastatic colorectal cancer. Retrospective review of in idual RAS mutation types from the South Australian Metastatic Colorectal Registry between 2006 and 2020. Of the 5165 patients entered onto the registry, 2305 (45%) had RAS mutation results available. 772 (33%) had a RAS mutation. The nature of the RAS mutation was available in 668 (87% of those with RAS mutation). Rare mutations (outside codons 12 and 13) made up 12.6% of the total. There were numerical differences in survival between the specific RAS mutation subgroups, with the longest median overall survival (30 months) observed in those with G12S mutations. However, there was no statistical difference in survival when comparing the various RAS mutations, including the comparison of G12C to G12S (p = 0.38). Patients with cancer harbouring rare RAS mutations had a median survival of 30 months. Whilst the G12S mutation was associated with the longest survival numerically, the observed survival for patients with the most common RAS mutations (G12C, G12V, G12A, G12D and G13D) did not significantly differ.
Tooth loss in South Australia
Publisher: Wiley
Date: 12-1975
DOI: 10.1111/J.1600-0528.1975.TB00325.X
Abstract: A survey of approximately 8,300 subjects in the State of South Australia indicated that approximately 228,400 South Australians aged 15 years and over (26%) were edentulous and, of these, 95% wore full maxillary and mandibular dentures. The proportion of edentulous subjects increased with age and was lower in males, upper socioeconomic groups, immigrants and in the State capital.
Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival?
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.CANEP.2017.04.002
Abstract: Death Certificate Only (DCO) cancer cases are commonly excluded from survival analyses due to unknown survival time. This study examines whether socio-demographic factors are associated with DCO diagnosis, and the potential effects of excluding DCO cases on socio-demographic cancer survival disparities in NSW, Australia. NSW Cancer Registry data for cases diagnosed in 2000-2008 were used in this study. Logistic regression was used to estimate the odds of DCO registration by socio-demographic sub-group (socio-economic disadvantage, residential remoteness, country of birth, age at diagnosis). Cox proportional hazard regression was used to estimate the probability of death from cancer by socio-demographic subgroup when DCO cases were included and excluded from analyses. DCO cases consisted of 1.5% (n=4336) of all cases (n=299,651). DCO diagnosis was associated with living in socio-economically disadvantaged areas (most disadvantaged compared with least disadvantaged quintile: odds ratio OR 1.25, 95%CI 1.12-1.40), living in inner regional (OR 1.16, 95%CI 1.08-1.25) or remote areas (OR 1.48, 95%CI 1.01-2.19), having an unknown country of birth (OR 1.63, 95%CI 1.47-1.81) and older age. Including or excluding DCO cases had no significant impact on hazard ratios for cancer death by socio-economic disadvantage quintile or remoteness category, and only a minor impact on hazard ratios by age. Socio-demographic factors were associated with DCO diagnosis in NSW. However, socio-demographic cancer survival disparities remained unchanged or varied only slightly irrespective of including/excluding DCO cases. Further research could examine the upper limits of DCO proportions that significantly alter estimated cancer survival differentials if DCOs are excluded.
Performance optimization of UAV-based IoT communications using a novel constrained gravitational search algorithm
Publisher: Springer Science and Business Media LLC
Date: 05-06-2021
An appraisal of analytical tools used in predicting clinical outcomes following radiation therapy treatment of men with prostate cancer: A systematic review
Publisher: Springer Science and Business Media LLC
Date: 21-03-2017
Comorbidities contribute to the risk of cancer death among Aboriginal and non-Aboriginal South Australians: Analysis of a matched cohort study
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.CANEP.2017.12.005
Abstract: Aboriginal Australians have poorer cancer survival than other Australians. Diagnoses at later stages and correlates of remote area living influence, but do not fully explain, these disparities. Little is known of the prevalence and influence of comorbid conditions experienced by Aboriginal people, including their effect on cancer survival. This study quantifies hospital recorded comorbidities using the Elixhauser Comorbidity Index (ECI), examines their influence on risk of cancer death, then considers effect variation by Aboriginality. Cancers diagnosed among Aboriginal South Australians in 1990-2010 (N = 777) were matched with randomly selected non-Aboriginal cases by birth year, diagnostic year, sex, and primary site, then linked to administrative hospital records to the time of diagnosis. Competing risk regression summarised associations of Aboriginal status, stage, geographic attributes and comorbidities with risk of cancer death. A threshold of four or more ECI conditions was associated with increased risk of cancer death (sub-hazard ratio SHR 1.66, 95%CI 1.11-2.46). Alternatively, the presence of any one of a subset of ECI conditions was associated with similarly increased risk (SHR = 1.62, 95%CI 1.23-2.14). The observed effects did not differ between Aboriginal and matched non-Aboriginal cases. However, Aboriginal cases experienced three times higher exposure than non-Aboriginal to four or more ECI conditions (14.2% versus 4.5%) and greater exposure to the subset of ECI conditions (20.7% versus 8.0%). Comorbidities at diagnosis increased the risk of cancer death in addition to risks associated with Aboriginality, remoteness of residence and disease stage at diagnosis. The Aboriginal cohort experienced comparatively greater exposure to comorbidities which adds to disparities in cancer outcomes.
Keratinocyte cancers in South Australia: incidence, geographical variability and service trends
Publisher: Elsevier BV
Date: 08-2018
Abstract: To determine the incidence, multiplicity, geographical variability and service trends of keratinocyte cancers (KC) in South Australia (SA). Medicare Australia data with a unique identifier were used to assess the number of people treated over years 2010-2014. A maximum of one KC service claim per year was used to determine incidence. Age-standardised rates were estimated as were KC service activity trends. There were 497,581 services to 204,183 SA residents for KC, solar keratoses, locally aggressive skin tumours or suspicious skin lesions. Of these, n=159,137 services were for KC (77,502 people). The five-year (2010-2014) age-standardised rate of KC in SA was 1,466.6 (95%CI 1,458.3-1,474.8) per 100,000. Forty per cent of people had more than one KC removed. Men accounted for more incident cases (59.2%). Age-specific rates showed least variability over time in the youngest age group (15-44 years). For 26 geographical areas, higher age-standardised ratios of KC were seen in coastal and agricultural areas. There was a 59% increase in services for KC from 2000 to 2015. Age-standardised rates for KC are relatively stable in SA, but regional variations are evident. Services for KC continue to rise. Implications for public health: This is the first systematic report of KC in SA. We demonstrate the utility of using validated Medicare data for assessing KC incidence and trends.
Time from diagnosis to treatment of colorectal cancer in a South Australian clinical registry cohort: How it varies and relates to survival
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2019-031421
Abstract: Some early studies indicated lower survival with longer time from diagnosis to cancer treatment, but others showed the reverse. We investigated time to treatment of colorectal cancer and associations with survival. Clinical registry data for colorectal cancer cases diagnosed in 2000–2010 at four major public hospitals in South Australia and treated by surgery (n=1675), radiotherapy (n=616) and/or systemic therapy (n=1556). A historic cohort design, with rank-order tests for ordinal clinical and sociodemographic predictors and multiple logistic regression for comparing time from diagnosis to treatment. Unadjusted Kaplan-Meier estimates and adjusted Cox proportional hazards regression were used to investigate disease-specific survival by time to treatment. Time to treatment and survival from diagnosis to death from colorectal cancer. Treatment (any type) commenced for 87% of surgical cases 60 days of diagnosis, with 80% having surgery within this period. Of those receiving radiotherapy, 59% began this treatment 60 days, and of those receiving systemic therapy, the corresponding proportion was 56%. Adjusted analyses showed treatment delay days was more likely for rectal cancers, 2006–2010 diagnoses, residents of northern than other metropolitan regions and for surgery, younger ages years and unexpectedly, those residing closer to metropolitan services. Adjusting for clinical and sociodemographic factors, and diagnostic year, better survival occurred in 2 years from diagnosis for time to treatment days. Survival in the 3–10 years postdiagnosis generally did not differ by time to treatment, except for lower survival for any treatment days for surgical cases. The lower survival 2 years from diagnosis for treatment 30 days of diagnosis is consistent with other studies attributed to preferencing more complicated cases for earlier care. Lower 3–10 years survival for surgical cases first treated days from diagnosis is consistent with previously reported U-shaped relationships.
Breast screening and breast cancer survival in Aboriginal and Torres Strait Islander women of Australia
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2012
DOI: 10.7314/APJCP.2012.13.1.147
Abstract: Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment had an elevated ductal carcinoma in situ but not invasive cancer detection rate had larger breast cancers and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.
Abstracts of poster presentations
Publisher: Hindawi Limited
Date: 06-2015
DOI: 10.1111/ECC.12330
Bevacizumab first line and impact on subsequent anti-EGFR activity
Publisher: Elsevier BV
Date: 09-2017
Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival
Publisher: Springer Science and Business Media LLC
Date: 30-08-2018
Australian Adolescents and Young Adults-Trends in Cancer Incidence, Mortality, and Survival Over Three Decades
Publisher: Mary Ann Liebert Inc
Date: 06-2018
Abstract: Cancer is a significant health concern for adolescents and young adults (AYAs aged 15-24 years). Monitoring population-level changes in incidence, mortality, and survival is complicated by the lack of published data presenting statistics separately for AYAs. This study synthesizes and reviews data on AYA cancers in Australia, including trends in incidence and mortality. National data were extracted for 1980-2012, primarily from the Australian Cancer Database and Australian National Mortality Database. Incidence, mortality, and survival trends are described, and incidence and mortality projections are reported. In 2000-2009, the annual all-cancer incidence was 31.7 cases per 100,000 population, and the mortality rate was 4.1 per 100,000. Incidence, mortality, and survival varied widely, indicating areas of concern. Melanoma was the most common cancer, and bone cancer had the highest mortality and poorest survival rates. All-cancer incidence rates peaked in the late 1990s, but then declined, largely due to melanoma. All-cancer mortality decreased throughout the study period, but showed no improvements for some common sites (i.e., brain, bone, soft tissue). Further reductions in all-cancer incidence and mortality are projected for the next decade, although specific cancers (colorectal cancers and lymphomas) were projected to increase in incidence. Observed Australian cancer trends are largely consistent with trends for other high-income populations. While overall decreases in incidence and mortality are encouraging, consistently high mortality and poor survival for some cancers remain concerning. Planned data initiatives for AYAs with cancer will aid in resolving whether trends continue and projections are realized in the future.
Increased early cancer diagnosis: unveiling immune-cancer biology to explain clinical Overdiagnosis
Publisher: MDPI AG
Date: 10-02-2023
Abstract: Even though clinically small ‘early’ cancers represent many millions of cells biologically, when removed surgically, these often never recur or regrow, nor reduce the in idual’s lifespan. However, some early cancers remain quiescent and indolent while others grow and metastasize, threatening life. Distinguishing between these different clinical behaviours using clinical athological criteria is currently problematic. It is reported that many suspicious lesions and early cancers are being removed surgically that would not threaten the patient’s life. This has been termed ‘overdiagnosis’, especially in the sphere of cancer screening. Although a controversial and emotive topic, it poses clinical and public health policy challenges. The diagnostic differentiation between ‘non-lethal’ and ‘lethal’ tumor forms is generally impossible. One perspective gathering evidential support is that a dynamic balance exists between the immune response and malignant processes governing ‘lethality’, where many more cancers are produced than become clinically significant due to the immune system preventing their progression. Higher medical screening “diagnosis” rates may reflect lead-time effects, with more ‘non-progressing’ cancers detected when an early immune-cancer interaction is occurring. We present a model for this immune-cancer interaction and review ‘excess’ or ‘overdiagnosis’ claims that accompany increasingly sensitive diagnostic and screening technologies. We consider that immune tools should be incorporated into future research, with potential for immune system modulation for some early cancers.
Development of South Australian-Victorian Prostate Cancer Health Outcomes Research Dataset
Publisher: Springer Science and Business Media LLC
Date: 22-01-2016
Factors predictive of treatment by Australian breast surgeons of invasive female breast cancer by mastectomy rather than breast conserving surgery
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2013
DOI: 10.7314/APJCP.2013.14.1.539
Abstract: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery and (2) to consider service delivery implications. Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (<10) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.
Cancer survivorship monitoring systems for the collection of patient-reported outcomes: a systematic narrative review of international approaches
Publisher: Springer Science and Business Media LLC
Date: 03-04-2017
DOI: 10.1007/S11764-017-0607-2
Abstract: This systematic narrative review describes and compares the development and operational approaches of monitoring systems without a clinical care component that collect patient-reported outcome (PRO) data from cancer survivors. Searches were conducted using Medline, PubMed, PsycINFO, the Cochrane Library, CINAHL, Scopus, Joanna Briggs Institute EBP Database and Google Scholar (Advanced). Sources of grey literature and websites of relevant organisations were also searched for relevant published and unpublished material. Articles were included if they described the development (including piloting) of monitoring systems with ongoing recruitment that collect PRO at more than one time point, from 6 months post-diagnosis onward. The initial searches returned 7290 unique citations. After screening titles and abstracts, 39 full-text articles were retrieved for more detailed examination. Eleven articles were included in the review, representing seven international monitoring systems. Systems varied in their scope, implementation process, governance and administration, recruitment and data collection, consent rates, PRO collection, use of PRO and translation strategies. The most suitable approach for setting-up and implementing a monitoring system for ongoing surveillance will differ depending on the unique requirements, aims and level of resourcing available within a particular context. Better specification and consideration of how PRO data will be used, for what purpose, and by whom, is required to inform effective translational strategies to improve outcomes for cancer survivors. The findings from this review may inform the future development of survivorship monitoring systems in varied environments, which in turn may improve practices that lead to better outcomes for survivors.
Late mortality in people with cancer: a population‐based Australian study
Publisher: AMPCo
Date: 09-12-2021
DOI: 10.5694/MJA2.50879
Performance Impact of LoS and NLoS Transmissions in Dense Cellular Networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2016
Optimizing the measurement of comorbidity for a South Australian colorectal cancer population using administrative data
Publisher: Wiley
Date: 13-11-2019
DOI: 10.1111/JEP.13305
Abstract: In epidemiological research, it is essential to account for the confounding effects of factors such as age, stage, and comorbidity for accurate prediction of cancer outcomes. There are several internationally developed and commonly used comorbidity indices. However, none are regarded as the gold-standard method. This study will assess and compare the predictive validity of established indices for use in a South Australian (SA) colorectal cancer (CRC) population against a local index. Furthermore, the prognostic influence of comorbidity on survival is investigated. A population-based study of patients diagnosed with CRC from 2003 to 2012 and linked to in-hospital data to retrieve comorbidity information was conducted. The predictive performance of established indices, Charlson comorbidity index (CCI), National Cancer Institute comorbidity index (NCI), Elixhauser comorbidity index (ECI), and C3 index was evaluated using the Fine and Gray competing risk regression and reported using measures of calibration and discrimination, area under the curve (AUC), and Brier score. Furthermore, to identify the optimal index, a local CRC comorbidity index (CRCCI) was also developed and its performance compared with the established indices. Comorbidity models adjusted for age, sex, and stage showed that all indices were good predictors of mortality as measured by the AUC (CCI: 0.738, NCI: 0.742, ECI: 0.733, C3: 0.739). CRCCI had similar mortality prediction as established indices (CRCCI: 0.747). There was a significant increase in cumulative risk of noncancer and CRC-specific mortality with increase in comorbidity scores. The two most prevalent comorbidities were hypertension and diabetes. The existing indices are still valid for adjusting for comorbidity and accurately predicting mortality in an SA CRC population. Internationally developed indices are preferred when policymakers and researchers wish to compare local study results with those of studies (national and international) that have used these indices. Comorbidity is a predictor of mortality and should be considered when assessing CRC survival.
Promotion of breast self‐examination in South Australia: A short‐term evaluation
Publisher: AMPCo
Date: 1985
Empirical study of the Environmental Kuznets curve and Environmental Sustainability curve hypothesis for Australia, China, Ghana and USA
Publisher: Elsevier BV
Date: 11-2018
Impact of age on choice of chemotherapy and outcome in advanced colorectal cancer
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.EJCA.2011.09.029
Abstract: Age is a major risk factor for development of sporadic colorectal cancer but elderly patients are underrepresented in clinical trials and are potentially offered chemotherapy less often. Data were obtained from South Australian Clinical Registry for advanced colorectal cancer between 1st February 2006 and 9th September 2010. Patients who received chemotherapy were analysed to assess the impact of single versus combination chemotherapy and to assess the outcome in two age cohorts, age < 70 years and ≥ 70 years. Out of a total of 1745 patients in the database during this time period, 951 (54.5%) received systemic chemotherapy. 286 (30%) received first line therapy (median age 74 years) with single agent fluoropyrimidine and 643 patients (68%) received first line combination chemotherapy (median age 64 years). The median overall survival of patients receiving first line combination chemotherapy was 23.9 months compared to 17.2 months for those who received single agent fluoropyrimidine (p<0.001). Combination chemotherapy was given to 81% of patients aged < 70 years compared to 53% of those ≥ 70 years. There was no significant difference in median overall survival of patients receiving chemotherapy by age cohort, 21.3 months for age <70 years and 21.1 months for age ≥ 70 years (p = 0.4). Treatment outcomes are comparable in both the elderly and younger patients. Patients who received initial combination chemotherapy were younger and had a longer median overall survival. In our study, age appeared to influence the treatment choices but not necessarily outcome.
Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings
Publisher: Springer Science and Business Media LLC
Date: 10-08-2017
System archetypes underlying the problematic behaviour of construction activity in Kenya
Publisher: Informa UK Limited
Date: 2011
South Australian clinical registry for metastatic colorectal cancer
Publisher: Wiley
Date: 27-12-2010
DOI: 10.1111/J.1445-2197.2010.05589.X
Abstract: The aims of the South Australian Clinical Registry for Metastatic Colorectal Cancer are to record case outcomes according to site of recurrence and mode of clinical practice and to utilize the accumulated information for quality assurance activities. All patients who had a diagnosis of synchronous or metachronous metastatic colorectal cancer (CRC) after 1 February 2006 were eligible to be included in the registry. Data on patient details, disease characteristics, investigations, histopathology and treatment were collected. Disease-specific survival data were assessed using Kaplan-Meier product moment estimates and the log-rank test of equality was used for comparisons. 1544 patients have been entered as of 22 March 2010. In addition, 54.7% of primary CRCs were in the rectosigmoid area, 92.9% of them adenocarcinomas. Also, 52.6% of patients received chemotherapy and 15% had radiotherapy. Two hundred five patients underwent liver resection, nine had radiofrequency ablation and seven had selective internal radiotherapy. The overall 3-year survival from time of diagnosis of metastatic CRC was 29.5%. There was no significant survival difference between patients with synchronous and metachronous metastatic CRC. Patients with lung- or liver-only metastases have significantly improved survival if they underwent surgical resection. The treatment of patients with metastatic CRC continues to progress with modern medical and surgical developments. Important insights into the current patterns of care and clinical outcomes for metastatic CRC are provided by these data. In addition, this registry provides a feasible and useful database for the evaluation of current treatments established as best evidence in this population.
A review of community engagement in cancer control studies among Indigenous people of Australia, New Zealand, Canada and the USA
Publisher: Hindawi Limited
Date: 28-02-2012
DOI: 10.1111/J.1365-2354.2012.01325.X
Abstract: This review aimed to address studies of cancer control in Indigenous populations, with a focus on: (1) the nature and extent of community engagement and (2) the extent to which community engagement has facilitated successful outcomes. Articles addressing Indigenous cancer control using some degree of community engagement were identified by a search of the following electronic databases: MEDLINE (via Ovid and Pubmed), psycINFO, CINAHL and Google Scholar. Relevant studies were scored and analysed according to Green et al.'s guidelines for participatory research. Studies often engaged the community only minimally. Where studies resulted in successful outcomes, they tended to have included Indigenous community members in genuine research roles, from planning, to implementation, to presentation of results at conferences. Studies with positive health outcomes were often initiated by a combination of academic researchers and community members or organisations. This narrative review highlighted significant scope for improvement in community-based studies addressing Indigenous cancer control. Increased attention to the philosophical underpinnings of community engagement is required to ensure that the benefits of this approach are translated to achieve improved cancer control outcomes. An increased awareness of the benefits of community engagement may prove effective in conducting cancer control research that leads to improved outcomes in Indigenous communities.
INFILTRATING DUCTAL CARCINOMA OF THE BREAST IN SOUTH-AUSTRALIA - IMPLICATIONS OF TRENDS IN TUMOR DIAMETER, NODAL STATUS AND CASE-SURVIVAL RATES FOR CANCER CONTROL
Publisher: AMPCo
Date: 1990
DOI: 10.5694/J.1326-5377.1990.TB124422.X
Abstract: The SA Central Cancer Registry gained sufficient information from routine pathology reports to record both the diameter and the nodal status for approximately half the infiltrating ductal carcinomas of the breast that were diagnosed in that State between 1980 and 1986. Of these, 27% of cancers had diameters of less than 2.0 cm at diagnosis and a similar proportion measured 4.0 cm or more. Almost half (48% of cancers) showed evidence of axillary nodal metastasis. Although the over-all variation in diameters by socioeconomic status did not approach statistical significance, lesions tended to be smaller in cases from the upper than the middle or lower socioeconomic areas of Adelaide. There also was evidence of earlier diagnosis during a breast self-examination c aign, but only a marginal increase in case-survival rates that readily was attributable to chance. A relatively poor case-survival rate applied in non-metropolitan areas, especially among older women, after adjusting for the available information on the stage of disease at diagnosis. A more limited access to treatment services may have been responsible. It will be important in a State-wide mammographic screening programme to provide for ready access by women in non-metropolitan areas to both screening and follow-up treatment services.
A population-based study of metastatic colorectal cancer in individuals aged ≥80 years
Publisher: Wiley
Date: 18-09-2012
DOI: 10.1002/CNCR.27802
Abstract: Life expectancy is increasing, and more patients are presenting with cancer at an advanced age (≥80 years). Optimal management for this group of patients has not been well defined. The South Australian Clinical Registry for Metastatic Colorectal Cancer (mCRC) collects data on all patients diagnosed since February 2006 in South Australia. The authors examined cancer characteristics, treatments administered, and outcomes for patients aged ≥80 years compared with patients aged <80 years. Data from 2314 patients were evaluable, and 29.2% of these patients were aged ≥80 years. The majority had moderately differentiated tumors. Poorly differentiated tumors were reported in fewer patients aged ≥80 years (20.1% vs 26.1% P < .005). Overall, 28.1% of patients aged ≥80 years received chemotherapy, and 74.2% received single-agent fluoropyrimidines as first-line treatment. By comparison, 68.2% of patients aged <80 years received chemotherapy, 74.3% received combination chemotherapy, and 25.7% received single-agent fluoropyrimidine as first-line treatment. No treatment was received by 38.2% of patients aged ≥80 years compared with 11.4% of those aged <80 years. Participation in clinical trials was lower in patients aged ≥80 years (2% vs 13%). The median survival was worse for patients aged ≥80 years (8.2 months vs 19.2 months P < .001), and the median survival of patients who received chemotherapy was 19.0 months for those aged ≥80 years and 22.3 months for those aged <80 years (P = .139). Patients who did not receive treatment had a poor median survival regardless of age (2.6 months for patients aged ≥80 years vs 2.7 months for patients aged <80 years). Patients aged ≥80 years were less likely to receive intervention for their metastatic colorectal cancer and had poorer survival. The survival of selected patients aged ≥80 years who received chemotherapy was similar to the survival of those aged <80 years despite the receipt of single-agent therapy. Patients aged ≥80 years with metastatic colorectal cancer are less likely to receive intervention for their disease and have poorer survival. Survival for selected patients aged ≥80 years who receive chemotherapy is similar to the survival of patients aged <80 years despite the receipt of single-agent therapy.
Changing roles of population-based cancer registries in Australia
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14250
Abstract: Registries have key roles in cancer incidence, mortality and survival monitoring and in showing disparities across the population. Incidence monitoring began in New South Wales in 1972 and other jurisdictions soon followed. Registry data are used to evaluate outcomes of preventive, screening, treatment and support services. They have shown decreases in cancer incidence following interventions and have been used for workforce and other infrastructure planning. Crude markers of optimal radiotherapy and chemotherapy exist and registry data are used to show shortfalls against these markers. The data are also used to investigate cancer clusters and environmental concerns. Survival data are used to assess service performance and interval cancer data are used in screening accreditation. Registries enable determination of risk of multiple primary cancers. Clinical quality registries are used for clinical quality improvement. Population-based cancer registries and linked administrative data complement clinical registries by providing high-level system-wide data. The USA Commission on Cancer has long used registries for quality assurance and service accreditation. Increasingly population-based registry data in Australia are linked with administrative data on service delivery to assess system performance. Addition of tumour stage and other prognostic indicators is important for these analyses and is facilitated by the roll-out of structured pathology reporting. Data linkage with administrative data, following checks on the quality of these data, enables assessment of patterns of care and other performance indicators for health-system monitoring. Australian cancer registries have evolved and increasingly are contributing to broader information networks for health system management.
Pre-diagnostic colonoscopies reduce cancer mortality - Results from linked population-based data in South Australia
Publisher: Springer Science and Business Media LLC
Date: 29-08-2019
Associations between breast cancer screening participation and residential area sociodemographic features, geographic accessibility, and features of screening venue location in Greater Sydney, Australia
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.YPMED.2021.106774
Abstract: Breast cancer screening (BCS) participation rates are often suboptimal and vary geographically. Environmental features may influence BCS participation, but few studies have assessed this relationship. This study assessed the associations between BCS participation, residential area sociodemographic characteristics, distance to BCS venue, and venue location attributes. Data for 384,433 women residing in Greater Sydney, Australia, invited to BCS during 2011-2014 were spatially joined to their state suburb (SSC) (n = 800). SSC sociodemographic measures included women's median age, proportion women speaking English at home, full-time employed, and university educated and proportion dwellings with motor-vehicles. Road network distance was calculated to each BCS venue. BCS venues were coded as co-located with bus-stop, train-station, hospital, general practitioner (GP), and shop. Hot spots were calculated to quantify spatial clustering of BCS participation. Multilevel logistic models were used to estimate the associations between environmental predictors and BCS participation, accounting for SSC-level clustering. BCS participation was 53.9% and spatially clustered. BCS was positively associated with SSC-level median age for women, proportions women speaking English and university educated, and dwellings with motor-vehicles. Distance to venue was inversely associated with BCS. Venue co-location with GP was positively associated and co-location with bus-stop, train-station, and shop, hospital were negatively associated with BCS. Residential sociodemographic features, geographic access, and venue location attributes are associated with BCS participation. These findings implicate the relevance of social and built environmental factors to programmatic aims to raise BCS participation. Additional research on venue location features is required to understand where best to site BCS venues.
Comorbidities in Australian women with hormone-dependent breast cancer: A population-based analysis
Publisher: AMPCo
Date: 2018
DOI: 10.5694/MJA17.00006
Abstract: To compare how frequently selected chronic diseases developed in women with breast cancer receiving endocrine therapy, and in women without cancer. Retrospective, rolling cohort study, analysing a random 10% s le of Pharmaceutical Benefits Scheme (PBS) data for the period 1 January 2003 - 31 December 2014. Women with breast cancer who first commenced endocrine therapy between January 2004 and December 2011 were identified, and age- and sex-matched (1:10) by comorbidity with control groups of women who did not have a dispensing record for antineoplastic agents during the study period or the comorbidity of interest at baseline. Development of any of eight pre-selected comorbidities, identified in PBS claims data with the RxRisk-V model. Women with hormone-dependent breast cancer were significantly more likely than women in the control group to develop depression (overall hazard ratio [HR], 1.36 95% CI, 1.26-1.46), pain or pain-inflammation (HR, 1.30 95% CI, 1.23-1.38), osteoporosis (overall HR, 1.27 95% CI, 1.17-1.39), diabetes (HR, 1.24 95% CI, 1.10-1.41), cardiovascular disorders (overall HR, 1.22 95% CI, 1.13-1.32), and gastric acid disorders (HR, 1.20 95% CI, 1.13-1.28). The hazard ratios for developing cardiovascular disorders, depression and osteoporosis were highest during the first year of endocrine therapy. The risk of hyperlipidaemia was lower among women with breast cancer than in the control group (HR, 0.88 95% CI, 0.81-0.96). There was no significant difference between the two groups in the risk of reactive airway diseases (HR, 1.05 95% CI, 0.98-1.13). Comorbid conditions are more likely to develop in women who have been diagnosed with hormone-dependent breast cancer than in women without cancer. Our results further support the need to develop appropriate models of care to manage the multiple chronic disorders of breast cancer survivors.
Thiol–ene enabled preparation of S-lipidated anti-HBV peptides
Publisher: Royal Society of Chemistry (RSC)
Date: 2021
DOI: 10.1039/D0OB01997F
Abstract: Highly potent anti-HBV lipopeptides were prepared by S -lipidation using the “Cysteine Lipidation on a Peptide or Amino Acid” (CLipPA) thiol–ene reaction. Interestingly, target binding efficacy correlated poorly with inhibitory potency.
Pumped-Up SU(1,1) Interferometry
Publisher: American Physical Society (APS)
Date: 11-04-2017
Bevacizumab and its impact on survival for patients receiving subsequent anti-EGFR therapy: Updated results from the SA metastatic CRC registry
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2017
DOI: 10.1200/JCO.2017.35.15_SUPPL.3569
Abstract: 3569 Background: Debate exists as to whether first line bevacizumab effects subsequent sensitivity to anti-EGFR therapy. Authors hypothesize that initial anti-VEGF therapy may induce biological changes that then increase the risk of acquired resistance to subsequent EGFR inhibitors. Methods: A retrospective cohort study was performed to compare the characteristics and survival of patients who were treated with an anti-EGFR therapy 2nd line and beyond by two groups defined by the first line therapy 1. chemotherapy (chemo) plus bevacizumab (bev) and 2. chemo alone. Survival for this analysis is from the time of commencing first line chemotherapy and secondly from anti-EGFR therapy. Pearson chi test analysis was performed to determine whether receiving first line bev was associated with worse overall survival (OS). Results: 348 mCRC patients who received chemo with or without bev and then an anti-EGFR therapy were studied. Patient characteristics are summarised in the table below. The significant differences between group 1. Vs. 2. were as follows median age 63.8 years v 67.9 years (p = 0.005), lower use of single agent FU 6.4% v 19.2%, KRAS status not tested (reflecting the practice changes over time) 19.3% v 39.2%, KRAS MT 2% v 4%, and where BRAF MT status was known (11%) BRAF MT rate 23% v 0. Median OS for the 2 groups was 34.2 months, and 28.2 months respectively (p = 0.12) from first line therapy. Median OS for patients who underwent single agent anti-EGFR as subsequent therapy was also not significantly different, 31.1 months group 1 (n = 60) versus 27.7 months group 2 (n = 85), p = 0.52. Results based on commencement of anti-EGFR therapy are under way. Conclusions: Survival was not significantly different between the two groups, and the trend was towards higher OS with chemo plus bev suggesting that in our registry population, bev administration in first line therapy with chemo did not lead to a worse outcome overall for those patients subsequently receiving anti-EGFR therapy, either with chemotherapy or as a single agent. Updated results from commencement of anti-EGFR therapy will give further insights and will be presented at the meeting.
Management and Survival Trends in Advanced Colorectal Cancer
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.CLON.2008.04.014
Abstract: Significant improvements in the outcome for patients with advanced colorectal cancer (CRC) have been achieved. The median survival for advanced CRC reported in clinical trials now approaches 2 years, but there is often a question as to whether this partly represents patient selection. We aimed to explore whether the availability of new chemotherapy drugs (irinotecan and oxaliplatin) and surgical advances have affected survival in a normal clinical setting. A review of the Queen Elizabeth and Lyell McEwin health service prospective CRC database from 1992 to 2004 was carried out to assess outcome differences between two time cohorts (1 January 1992-31 December 1997 and 1 January 1998-31 December 2004). For all patients (n = 744) overall survival was seen to improve over time and is maintained out to 5 years. There have been a number of trends over time (1992-1997 vs 1998-2004) that have probably contributed to this gain increased overall chemotherapy use (33% vs 43%) use of combination chemotherapy (i.e. oxaliplatin and irinotecan regimens) increased hepatic resection rates (1.9% vs 10.8%) and increased clinical trial uptake (0.6% vs 14.5%). This current analysis confirms an improvement in survival over time for advanced CRC and this is seen in unselected patients including those over 70 years of age.
Assessing impact of organised breast screening across small residential areas—development and internal validation of a prediction model
Publisher: Hindawi Limited
Date: 07-03-2017
DOI: 10.1111/ECC.12673
Abstract: Monitoring screening mammography effects in small areas is often limited by small numbers of deaths and delayed effects. We developed a risk score for breast cancer death to circumvent these limitations. Screening, if effective, would increase post-diagnostic survivals through lead-time and related effects, as well as mortality reductions. Linked cancer and BreastScreen data at four hospitals (n = 2,039) were used to investigate whether screened cases had higher recorded survivals in 13 small areas, using breast cancer deaths as the outcome (M1), and a risk of death score derived from TNM stage, grade, histology type, hormone receptor status, and related variables (M2). M1 indicated lower risk of death in screened cases in 12 of the 13 areas, achieving statistical significance (p < .05) in 5. M2 indicated lower risk scores in screened cases in all 13 areas, achieving statistical significance in 12. For cases recently screened at diagnosis (<6 months), statistically significant reductions applied in 8 areas (M1) and all 13 areas (M2). Screening effects are more detectable in small areas using these risk scores than death itself as the outcome variable. An added advantage is the application of risk scores for providing a marker of screening effect soon after diagnosis.
Cervical abnormalities are more common among Indigenous than other Australian women: A retrospective record-linkage study, 2000-2011
Publisher: Public Library of Science (PLoS)
Date: 11-04-2016
Differences in impact of Aboriginal and Torres Strait Islander status on cancer stage and survival by level of socio-economic disadvantage and remoteness of residence-A population-based cohort study in Australia
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.CANEP.2016.02.006
Abstract: Aboriginal and Torres Strait Islander people (referred to in this paper as "Aboriginal people") generally have lower cancer survivals and more advanced stages at diagnosis than non-Aboriginal people. There is conflicting evidence on whether these disparities vary by socio-economic disadvantage and geographic remoteness. This study examines variations in these disparities in New South Wales (NSW), Australia. Data for cancers diagnosed in 2000-2008 were extracted from the NSW Cancer Registry (n=264,219). Missing Aboriginal status (13.3%) was multiply imputed. Logistic regression and competing risk regression models were used to examine likelihood of advanced summary stage and risk of cancer death among Aboriginal compared with non-Aboriginal people by socio-economic disadvantage (categorised into quintiles 1: least disadvantaged-5: most disadvantaged) and remoteness. Aboriginal people showed a general pattern of more advanced stage at diagnosis compared with non-Aboriginal people across socio-economic disadvantage and remoteness categories. After adjusting for demographic factors, year of diagnosis, summary stage and cancer site, Aboriginal people living outside the least disadvantaged areas had an increased risk of cancer death compared with non-Aboriginal people living in similar areas (sub-hazard ratio SHR 1.41, 95% confidence interval CI 1.09-1.81 SHR 1.59, 95%CI 1.31-1.93 SHR 1.42, 95%CI 1.22-1.64 and SHR 1.34, 95%CI 1.22-1.48 for quintiles 2-5, respectively). Compared with non-Aboriginal people, Aboriginal people had an elevation in the risk of cancer death irrespective of the remoteness, with the most pronounced elevations detected in remote/very remote areas (SHR 1.56, 95%CI 1.10-2.21). Compared with non-Aboriginal people, Aboriginal people had a higher risk of cancer death and higher likelihood of more advanced stage across socio-economic disadvantage and remoteness categories. All areas appear to require attention in endeavours to improve cancer survival outcomes for Aboriginal people.
Incidence of metastatic breast cancer in an Australian population-based cohort of women with non-metastatic breast cancer at diagnosis
Publisher: AMPCo
Date: 06-2012
DOI: 10.5694/MJA12.10026
Abstract: To estimate the incidence of metastatic breast cancer (MBC) in Australian women with an initial diagnosis of non-metastatic breast cancer. A population-based cohort study of all women with non-metastatic breast cancer registered on the New South Wales Central Cancer Register (CCR) in 2001 and 2002 who received care in a NSW hospital. 5-year cumulative incidence of MBC prognostic factors for MBC. MBC was recorded within 5 years in 218 of 4137 women with localised node-negative disease (5-year cumulative incidence, 5.3% 95% CI, 4.6%-6.0%) and 455 of 2507 women with regional disease (5-year cumulative incidence, 18.1% 95% CI, 16.7%-19.7%). The hazard rate for developing MBC was highest in the second year after the initial diagnosis of breast cancer. Determinants of increased risk of MBC were regional disease at diagnosis, age less than 50 years and living in an area of lower socio-economic status. Our Australian population-based estimates are valuable when communicating average MBC risks to patients and planning clinical services and trials. Women with node-negative disease have a low risk of developing MBC, consistent with outcomes of adjuvant clinical trials. Regional disease at diagnosis remains an important prognostic factor.
Human Papillomavirus and Oropharyngeal Cancer Among Indigenous Australians: Protocol for a Prevalence Study of Oral-Related Human Papillomavirus and Cost-Effectiveness of Prevention (Preprint)
Publisher: JMIR Publications Inc.
Date: 25-03-2018
Abstract: ropharyngeal cancer is an important, understudied cancer affecting Aboriginal and Torres Strait Islander Australians. The human papillomavirus (HPV) is a significant risk factor for oropharyngeal cancer. Current generation HPV vaccines are effective against the 2 most common types of high-risk HPVs in cancer (hrHPVs 16/18). his study aims (1) to yield population estimates of oncogenic genotypes of HPV in the mouth and oropharynx of defined Aboriginal and Torres Strait Islander populations (2) to estimate the proportion of oropharyngeal cancer attributable to HPV among these Australian citizens (3) to estimate the impact of HPV vaccination as currently implemented on rates of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians and (4) taking into account impact on oropharyngeal as well as cervical cancer, to evaluate efficacy and cost-effectiveness of targeted extended HPV vaccination to older ages, among our study population. ur study design and operation is straightforward, with minimal impost on participants. It involves testing for carriage of hrHPV in the mouth and oropharynx among 1000 Aboriginal South Australians by simple saliva collection and with follow-up at 12 and 24 months, collection of sexual history at baseline, collection of information for estimating health state (quality-of-life) utilities at baseline, genotyping of viruses, predictive outcome and cost-effectiveness modeling, data interpretation and development of vaccination, and follow-up management strategies driven by the Aboriginal community. articipant recruitment for this study commenced in February 2018 and enrollment is ongoing. The first results are expected to be submitted for publication in 2019. he project will have a number of important outcomes. Synthesis of evidence will enable generation of estimates of the burden of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians and indicate the likely effectiveness and cost-effectiveness of prevention. This will be important for health services planning, and for Aboriginal health worker and patient education. The results will also point to important areas where research efforts should be focused to improve outcomes in Aboriginal and Torres Strait Islander Australians with oropharyngeal cancer. There will be a strong focus on community engagement and accounting for the preferences of in iduals and the community in control of HPV-related cancers. The project has international relevance in that it will be the first to systematically evaluate prevention of both cervical and oropharyngeal cancer in a high-risk Indigenous population taking into account all population, testing, and surveillance options. R1-10.2196/10503
“Prostate cancer is far more hidden…”: Perceptions of stigma, social isolation and help-seeking among men with prostate cancer
Publisher: Hindawi Limited
Date: 07-11-2018
DOI: 10.1111/ECC.12790
Abstract: The purpose of this study was to provide in-depth insight into men's experiences of prostate cancer, specifically: perceived stigma and self-blame, social isolation, unmet need and help-seeking. A qualitative descriptive approach was used. Semi-structured interviews were undertaken with 20 men diagnosed with prostate cancer, and thematic analysis was undertaken. Some participants perceived a stigma associated with prostate cancer and cancer in general, which sometimes acted as a barrier to disclosure. Self-blame and internalisation of cause was not a prominent issue. Participants' descriptions of emotional distress, social isolation and anxiety demonstrated the impact of prostate cancer. Social isolation was most commonly reported as a physical consequence of treatment and/or side effects. Participants felt both support and ongoing care were limited at post-treatment. Most did not seek or receive help for emotional or psychosocial problems from a formal source due to anticipated awkwardness, autonomous coping, not burdening others, unwanted sympathy and retaining privacy. Prostate cancer can cause considerable emotional and social burden for some men, and many are unlikely to seek or receive help. Men, and their support networks, require active encouragement throughout diagnosis, treatment and follow-up to overcome barriers and access additional support, particularly for sexual, emotional and psychosocial issues.
The outcome of patients (pts) with metastatic colorectal cancer (mCRC) based on site of metastases (mets) and the impact of molecular markers and site of primary cancer on metastatic pattern.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2017
DOI: 10.1200/JCO.2017.35.15_SUPPL.3560
Abstract: 3560 Background: Although liver is the commonest site of mets in pts with CRC, pattern of spread is variable and may reflect different biology in different subsets of pts. Methods: This is a retrospective analysis to explore the outcome of pts with mCRC based on their site of mets at diagnosis and to identify tumor characteristics which could predict the site of mets. Pts from 2 Australian databases, BioGrid (BG) and South Australian Cancer Registry (SA), from 01/2006 to 12/2015 were grouped into 5 cohorts lung only, liver only or any pts with brain, bone or peritoneal mets. Overall survival (OS) for each group was compared with the rest of the s le using Kaplan Meier analysis and the log rank test separately in each dataset. Mantel-Haenszel Chi-squared test was performed in pooled data to assess the association between KRAS, BRAF, Micro satellite instability (MSI), site of primary and site of mets. Results: 5967 pts were included. In both datasets median OS was significantly higher when mets were limited to lung or liver and shorter for those with brain, bone or peritoneal mets. BRAF, KRAS and MSI data were available for 20%, 37% and 21% of the s le. In the pooled analysis BRAF mutation was associated with brain (Relative Risk=5.2) and peritoneal mets (RR=1.8) with lower incidence of lung (RR=0.3) and liver (RR=0.7) limited mets. KRAS mutation was associated with lung only mets(RR=1.4). Left colon tumors were associated with bone (RR=1.6) and lung only mets (RR=2.3) while peritoneal spread was less frequent compared with right colon tumors(RR=0.6). Rectal cancer was strongly associated with brain, bone and lung mets (RR=1.7, 1.7, 2.0). MSI status was not associated with site of mets though liver only mets was less frequent in MSI high tumors. Conclusions: Survival duration with mCRC is related to the site of mets. OS was significantly better when mets were confined to either lung or liver. BRAF mutation and primary rectal cancer were associated with poor prognostic metastatic sites like brain and bone. [Table: see text]
Malignant astrocytoma in South Australia: treatment and case survival
Publisher: AMPCo
Date: 09-1990
DOI: 10.5694/J.1326-5377.1990.TB136894.X
Abstract: Kernohan grade III and IV astrocytomas are usually fetal and in the past have had a case survival rate of only about 10% two years from diagnosis. Data on 285 cases registered at the Royal Adelaide Hospital in 1977-1986 showed a median survival of approximately six months. The survival rate was 25% at one year and 15% at two years. Survival reduced markedly with increase in age at diagnosis from a two-year rate of 53% for patients under 40 years of age to 5% for patients aged 70 years or more. This may have been due in part to the more frequent treatment of younger patients by decompression and radiotherapy. Apart from age and treatment mode, factors related to extended survival included a longer duration of symptoms before diagnosis and location of the tumour in the frontal lobes. Notwithstanding prospects for an increase in short-term survival from the use of radiotherapy as an adjunct to surgery, long-term outcomes for these neoplasms are still very poor.
Findings in young adults at colonoscopy from a hospital service database audit
Publisher: Springer Science and Business Media LLC
Date: 19-04-2017
Sugar-sweetened beverage (SSB) consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/BMJOPEN-2018-023630
Abstract: Sugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities. PubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population’s SSB consumption or an intervention that focused on reducing SSB consumption in this population. Systematic scoping review. 59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options reducing availability of less-healthy options nutrition education multifaceted or policy implementation (store nutrition or government policy). There was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed.
Disparities in cancer stage at diagnosis and survival of Aboriginal and non-Aboriginal South Australians
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.CANEP.2017.04.013
Abstract: This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977-2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990-2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p<0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas.
Comorbidity, physical and mental health among cancer patients and survivors: An Australian population‐based study
Publisher: Wiley
Date: 29-03-2017
DOI: 10.1111/AJCO.12677
Abstract: To assess the prevalence of comorbidities and measures of physical and mental health among the cancer patients and survivors compared with the general population. Data collected by the Australian Bureau of Statistics from 2011-2012 National Health Survey were utilized for this cross-sectional study. Comparisons were made between adults aged 25 years and over with history of cancer (n = 2170) and those respondents who did not report having had a cancer (n = 11 592) using logistic regression models. Analyses were repeated according to cancer status (current cancer vs. cancer survivor). People with history of cancer had significantly higher odds of reporting mental and behavioral problems (overall cancer group adjusted odds ratio 1.36, 95 percent confidence interval 1.20-1.54 current cancer 2.53, 1.97-3.27 cancer survivor 1.20, 1.05-1.38), circulatory conditions (overall cancer group 1.25, 1.12-1.39 current cancer 1.38, 1.08-1.76 cancer survivor 1.22, 1.09-1.38), musculoskeletal conditions (overall cancer group 1.37, 1.24-1.52 current cancer 1.66, 1.30-2.12 cancer survivor 1.33, 1.19-1.48) and endocrine system disorders (overall cancer group 1.19, 1.06-1.34 current cancer 1.29, 1.00-1.66 cancer survivor 1.17, 1.04-1.33) compared with the noncancer group. Cancer patients and survivors were more likely to report poor health status, a higher level of distress, and a greater number of chronic conditions compared with the noncancer group. Poor health and comorbidity is more prevalent among cancer patients and survivors than the noncancer population. Our results further support the need to develop models of care that effectively address multiple chronic conditions experienced by the cancer population.
A PERSPECTIVE OF THE CANCER PROBLEM IN SOUTH AUSTRALIA
Publisher: Wiley
Date: 12-02-2010
Synthesis of endolides A and B: naturally occurring N-methylated cyclic tetrapeptides
Publisher: Royal Society of Chemistry (RSC)
Date: 2019
DOI: 10.1039/C9MD00050J
Abstract: The first syntheses of the bioactive cyclic tetrapeptide natural products, endolides A and B, were accomplished using a solution-phase macrocyclisation reaction the stereoselectivity of which was found to be reagent-controlled.
Variations in outcomes for Indigenous women with breast cancer in Australia: A systematic review
Publisher: Hindawi Limited
Date: 10-02-2017
DOI: 10.1111/ECC.12662
Abstract: This systematic review examines variations in outcomes along the breast cancer continuum for Australian women by Indigenous status. Multiple databases were systematically searched for peer-reviewed articles published from 1 January 1990 to 1 March 2015 focussing on adult female breast cancer patients in Australia and assessing survival, patient and tumour characteristics, diagnosis and treatment by Indigenous status. Sixteen quantitative studies were included with 12 rated high, 3 moderate and 1 as low quality. No eligible studies on referral, treatment choices, completion or follow-up were retrieved. Indigenous women had poorer survival most likely reflecting geographical isolation, advanced disease, patterns of care, comorbidities and disadvantage. They were also more likely to be diagnosed when younger, have advanced disease or comorbidities, reside in disadvantaged or remote areas, and less likely to undergo mammographic screening or surgery. Despite wide heterogeneity across studies, an overall pattern of poorer survival for Indigenous women and variations along the breast cancer continuum of care was evident. The predominance of state-specific studies and small numbers of included Indigenous women made forming a national perspective difficult. The review highlighted the need to improve Indigenous identification in cancer registries and administrative databases and identified key gaps notably the lack of qualitative studies in current literature.
Byssinosis: A Cross-Sectional Study in an Australian Textile Factory
Publisher: Oxford University Press (OUP)
Date: 1983
Somatic mutations, acetylator status, and prognosis in colorectal cancer
Publisher: BMJ
Date: 05-1998
DOI: 10.1136/GUT.42.5.669
Abstract: Background— Somatic mutations in K- ras and TP53 may be associated with both acetylator status and prognosis in colorectal cancer. Aims— To determine whether cancers with somatic mutations are more frequent in fast acetylators and whether mutations or acetylator status influence prognosis after colorectal surgery. Patients— One hundred consecutive subjects undergoing elective surgery for colorectal cancer. Methods— Acetylator status was determined by polymerase chain reaction (PCR) genotyping for polymorphism in the N-acetyltransferase 2 ( NAT 2) gene. Mutations in K- ras (codon 12) and TP53 were determined by PCR analysis using restriction enzyme digestion and single strand conformation polymorphism respectively. Survival from colorectal cancer for up to five years after diagnosis was analysed using the Kaplan-Meier product limit estimator. Cox proportional hazards regression was used to compare survival rates after adjusting for tumour stage. Results— Mutations in K- ras and TP53 were independent of acetylator status. By log rank test, survival was significantly reduced in subjects with TP53 mutations (p=0.003) but was not significantly related to acetylator status or the presence of K- ras mutations. After adjustment for tumour stage, subjects with both TP53 and K- ras mutations had a 4.2-fold case fatality (95% confidence interval 1.5 to 11.6) when compared with that of a TP53 negative reference group. Conclusion— The presence of both TP53 and K- ras mutations in colorectal tumours is an adverse prognostic marker which is independent of tumour stage.
The association between dental caries and the availability of sweets in South Australian school canteens
Publisher: Wiley
Date: 06-1973
DOI: 10.1111/J.1834-7819.1973.TB03456.X
Abstract: Neurogenesis, the process of generating new neurons in the brain, fascinates researchers for its promise to affect multiple cognitive and functional processes in both health and disease. Many cellular pathways are involved in the regulation of neurogenesis, a complexity exemplified by the extensive regulation of this process during brain development. Toll-like receptors (TLRs), hallmarks of innate immunity, are increasingly implemented in various central nervous system plasticity-related processes including neurogenesis. As TLRs are involved in neurodegenerative disorders, understanding the involvement of TLRs in neurogenesis may hold keys for future therapeutic interventions. Herein, we describe the current knowledge on the involvement of TLRs in neurogenesis and neuronal plasticity and point to current knowledge gaps in the field.
Pancreatectomy is underused in NSW regions with low institutional surgical volumes: A population data linkage study
Publisher: AMPCo
Date: 2017
DOI: 10.5694/MJA16.00150
Abstract: To examine differences in the proportions of people diagnosed with pancreatic cancer who underwent pancreatectomy, post-operative outcomes and 5-year survival in different New South Wales administrative health regions of residence. Retrospective analysis of NSW data on pancreatic cancer incidence and surgery, 2005-2013. The proportion of newly diagnosed patients with pancreatic cancer who were resected in each region 90-day post-operative mortality one-year post-operative survival 5-year post-diagnosis survival. 14% of people diagnosed with pancreatic cancer during 2010-2013 (431 of 3064) underwent pancreatectomy, an average of 108 resections per year. After adjusting for age, sex and comorbidities, the proportion that underwent resection varied significantly between regions, ranging between 8% and 21% (P<0.001). Higher resection rates were not associated with higher post-operative 90-day mortality or lower one-year survival (unadjusted and risk-adjusted analyses). Higher resection rates were associated with higher 5-year post-diagnosis survival: the mean survival in regions with resection rates below 10% was 3.4%, compared with 7.2% in regions with rates greater than 15% (unadjusted and adjusted survival analyses P<0.001). There was a positive association between regional resection rate and the pancreatectomy volume of hospitals during 2005-2009. An additional 32 people would be resected annually if resection rates in low rate regions were increased to the 80th percentile regional resection rate (18%). There is significant geographic variation in the proportion of people with pancreatic cancer undergoing pancreatectomy, and the 5-year survival rate is higher in regions where this proportion is higher.
Saliva-based colorimetric test as an index of gingival inflammation in epidemiologic studies
Publisher: Wiley
Date: 12-1978
DOI: 10.1111/J.1600-0528.1978.TB01169.X
Abstract: There is a pressing need for a reliable, low-cost method of assessing the gingival and periodontal status of large population groups. Existing indexes, despite their value in dental public health, are still too subject to examiner variability for use by uncalibrated examiners. This study describes an evaluation of a quick, inexpensive, extraoral colorimetric test for gingival inflammation, based on a reaction between saliva and the test material. It could probably be applied by non-professional personnel. In this study, the test was applied to a population of elementary schoolchildren, dental hygiene students and faculty, and adult inmates of two correctional institutions. These populations were chosen on the assumption that they would exhibit varying intensities of gingival inflammation. Values obtained from the colorimetric test carried out by one researcher were compared with Gingival Index (GI) scores observed by a different examiner. Results suggest that the colorimetric test may be a valid, reliable means of detecting major differences in the prevalence of gingival inflammation in most adult populations, although having little, if any, useful application among children at the mixed dentition stage.
Optimal care pathways: A national policy to improve quality of cancer care and address inequalities in cancer outcomes
Publisher: Elsevier BV
Date: 09-2020
Development of the consensus-based recommendations for podiatry care of neuropathy in cancer survivors (PodNICS): a delphi consensus study of Australian podiatrists
Publisher: Springer Science and Business Media LLC
Date: 09-06-2023
DOI: 10.1186/S13047-023-00632-0
Abstract: Chemotherapy Induced Peripheral Neuropathy (CIPN) is the most common presenting side effect of chemotherapy. As a sensory based neuropathy, this condition can persist for a long time after cessation of chemotherapy and impact the quality of life of cancer survivors. Podiatrists in Australia have been managing people with CIPN related lower limb complications, however guidelines on management of CIPN do not exist. The aim of this study was to achieve consensus and agreement of Australian podiatrists on strategies to best manage people presenting with symptoms of CIPN. An online three-round modified Delphi survey of Australian podiatrists with expertise in CIPN was conducted in line with recommendations for conducting and reporting of Delphi studies (CREDES). Panellists responded to open-ended questions in Round 1, whereupon their responses were themed into statements and analysed for existing consensus. Statements not reaching consensus were returned during Round 2 to seek agreement from responders using a five-point Likert scale and to allow responders to make further comments. For a statement to reach consensus or agreement, 70% or more of panellists needed to make the same comment or agree or strongly agree with the same themed statement. Statements reaching 50 to 69% consensus or agreement were returned to panellists in Round 3 for them to consider their responses in the light of group outcomes. Round one resulted in 229 comments from 21 of 26 podiatrists who agreed to participate. These comments were themed into 53 statements with 11 consensus statements accepted. Round 2 resulted in 22 statements reaching agreement, and 15 new statements being generated from 18 comments made by 17 respondents. Round 3 resulted in 11 statements reaching agreement. Outcomes were developed into a set of clinical recommendations for diagnosis and management of people presenting with CIPN. These recommendations provide guidance on 1) identifying common signs and symptoms of CIPN including sensory, motor and autonomic symptoms 2) diagnosis and assessment of CIPN including neurological, motor and dermatological assessment modalities and 3) best clinical practice and management strategies for CIPN identified by podiatrists including both podiatry and non-podiatry specific care. This is the first study in podiatry literature to develop expert-informed consensus-based recommendations for clinical presentation, diagnosis and assessment and management of people with CIPN. These recommendations aim to help guide podiatrists in the consistent care of people with CIPN.
Use of radiotherapy in the primary treatment of cancer in South Australia
Publisher: Wiley
Date: 06-2003
Regorafenib outcomes from the population based South Australian Metastatic Colorectal Cancer Registry
Publisher: Wiley
Date: 23-11-2022
DOI: 10.1111/AJCO.13672
Abstract: Reviewing outcomes of regorafenib use in metastatic colorectal cancer using real‐world data from the South Australian Metastatic Colorectal Cancer Registry. A retrospective review of the characteristics and outcomes of patients who received regorafenib in the Registry up to December 2018. The registry started in February 2006. Fifty‐three patients received regorafenib therapy since approved by the therapeutic goods administration in November 2013. The median age was 66 (range 34–82). 66% were male, 66% had stage IV disease at diagnosis, 53% had liver only involvement, whereas 13% had liver and lung disease and 6% had lung only involvement. 75% had left‐sided primary. KRAS was available in 35/53 patients with 49% of them being WT. BRAF status was known in 8/53 with 25% of them having a mutated variant. MSI testing was known in 14 patients in whom 21% of them had MSI‐High tumors. Prior lines of treatment received: one line 4%, two 9%, three 23%, four 26%, four 37%. Prior biological use: bevacizumab 72%, anti‐EGFR 100% (for RAS WT). Median survival from diagnosis was 3.3 years (95% CI, 2.8–3.8 years). Median survival from the start of regorafenib was 7.1 months (95% CI, 4.8–9.4 months) and the 12‐month survival rate was 28%. The survival outcome for those patients from our population‐based registry who access regorafenib is in keeping with reports from large, randomized trials. Thus, clinicians can quote local real world data when discussing efficacy and access to regorafenib therapy for mCRC patients.
Cancer survival disparities worsening by socio-economic disadvantage over the last 3 decades in new South Wales, Australia
Publisher: Springer Science and Business Media LLC
Date: 14-09-2017
Tools for Predicting Clinical and Patient-reported Outcomes in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Systematic Review of Prognostic Accuracy and Validity
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.CLGC.2017.03.011
Abstract: Androgen deprivation therapy (ADT) can result in a range of adverse symptoms that reduce patients' quality of life. Careful patient counseling on the likely clinical outcomes and adverse effects is therefore vital. The present systematic review was undertaken to identify and characterize all the tools used for the prediction of clinical and patient-reported outcome measures (PROMs) in patients with prostate cancer undergoing ADT. PubMed and EMBASE were systematically searched from 2007 to 2016. Search terms related to the inclusion criteria were: prostate cancer, clinical outcomes, PROMs, ADT, and prognosis. Titles and abstracts were reviewed to find relevant studies, which were advanced to full-text review. The reference lists were screened for additional studies. The Centre for Evidence Based Medicine critical appraisal of prognostic studies tool was applied. The search strategy identified 8755 studies. Of the 8755 studies, 22 on clinical outcomes were identified. However, no studies of PROMs were found. Nine tools could be used to predict clinical outcomes in treatment-naive patients and 10 in patients with recurrence. The Japan Cancer of the Prostate Risk Assessment (J-CAPRA) nomogram was the best performing and validated tool for the prediction of clinical outcomes in treatment-naive patients, and the Chi and Shamash prognostic indexes have been validated for use in patients with castration-resistant disease in different clinical contexts. Using the J-CAPRA nomogram should help clinicians deliver accurate, evidence-based counseling to patients undergoing primary ADT. A strong need exists for primary studies that derive and validate tools for the prediction of PROMs in patients undergoing ADT under any circumstance because these are currently absent from the literature.
A study of dental knowledge and behaviour in 1,000 Australian schoolchildren
Publisher: Wiley
Date: 10-1969
DOI: 10.1111/J.1834-7819.1969.TB02718.X
Abstract: There are few papers on the combination therapy of deferiprone (DFP) and deferasirox (DFX) in iron-overloaded patients with transfusion-dependent β-thalassemia major (β-TM). A total of 6 patients with β-TM (5 males and 1 female) with a mean age of 23.8±5.8 years (ranging from 17 to 31) used this treatment regimen. The mean doses of DFP and DFX were 53.9±22.2 and 29.3±6.8 mg/kg/day, respectively. The duration of treatment was 11.5±4.6 months. Their serum ferritin levels were measured to be 2800±1900 and 3400±1600 ng/mL before and after treatment, respectively (p<0.6). Their cardiac magnetic resonance imaging (MRI) T2* values were 16.69±15.35
Survival trends for advanced colorectal cancer (CRC): Are improvements only for patients in clinical trials?
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-06-2006
DOI: 10.1200/JCO.2006.24.18_SUPPL.6124
Abstract: 6124 Background: Significant improvements in the outcome for patients with advanced CRC have been achieved. We have reviewed the prospective CRC database at our institution from 1992 to 2004 to explore whether the availability of new chemotherapy drugs (irinotecan & oxaliplatin) and surgical advances has impacted on survival in the normal population. Earlier results had suggested a trend to improved survival (1). Methods: In Australia the first of these drugs became available at the end of 1997 thus we have taken this as the time point to compare outcomes pre and post. Disease-specific survivals were analysed from the date of diagnosis for stage D, and from the date of distant recurrence for stages A, B and C, with a date of censoring of live cases at December 31st, 2004. The Kaplan-Meier product-limit estimate was used for univariate analyses and Cox proportional hazards regression for multivariable analyses. Results: The current analysis is of 744 patients 92–97 n=313, 98–04 n=431. Survival for the respective time periods were 47.6% and 54.9% 12 mths 28.0% and 34.8% 24 mths 18.9% and 23.0% 36 mths 12.6% and 17.2% 48 mths and 10.4% and 14.9% 60 mths. Cox proportional hazards regression indicated a lower risk of case fatality for 1998–2004 than 1992–1997 cases (p=0.048) after adjusting for age measured in years. The key predictors of case fatality in a multivariate analysis were found to be period (i.e., 1992–97/1998–04), age, and stage of disease at time of initial diagnosis. While an upward trend in survival was recorded for all ages, it was most pronounced for 70–79 year olds (n=272), where the increase in 24 mth survival was from 21.1% for 1992–97 to 36.1% for 1998–2004 (p=0.015). For patients aged 80 years and over (1992–97 n=40 & 1998–2004 n=67) the 24mth survivals were 18.6% (6.7%) and 26.4% (6.9%) respectively (p .200). Conclusions: Clinical trials have shown improvements in survival for highly selected patients. This current analysis confirms an improvement in survival over time for advanced CRC and this is seen in unselected patients including the elderly. Preliminary data has suggested that a number of factors have contributed to the trend of improved survival. Final analysis, including updated chemotherapy trends, will be presented at the meeting. (1) Proc ASCO 2004, #3707 No significant financial relationships to disclose.
Breech Presentation in South Australia, 1987–1989
Publisher: Wiley
Date: 02-1993
A Comparison of Australian Suicide Rates in 1969–73 and 1976–80
Publisher: SAGE Publications
Date: 09-1983
DOI: 10.3109/00048678309161281
Abstract: Australian suicide rates were compared for the 1969–73 and 1976–80 periods by age, sex and State. Rates for males were generally at least twice those for females. The sex difference was marked, irrespective of age, State and time period. Middle-aged and older Australians generally had higher rates than 20–29-year-olds, although this finding was not consistent by State for males. The national age-standardised suicide rate for all age groups combined decreased between the 1969–73 period and 1976–80 both for males and (more so) for females. However, there was a 24% Increase for 20–29-year-old males. While the suicide rate for 20–29-year-old females decreased between the 1969–73 period and 1976–80, an analysis of yearly trends within the 1976–80 period revealed an upward trend for in iduals aged 20–29 years, for both females and males.
Brain cancer incidence, mortality and case survival: Observations from two australian cancer registries
Publisher: Wiley
Date: 15-12-1994
Abstract: Data from 2 Australian cancer registries covering a population of 1.7 million people were combined for the purposes of analysing brain cancer incidence, mortality and survival patterns for the time period 1978 through 1992. A total of 1,752 cases of primary brain cancer were registered, representing age-standardised incidence rates of 6.7 per 100,000 in men and 4.6 in women. Histological confirmation was available for 94% of cases. The incidence rate among persons aged 75 or over was higher during 1986-1992 than during 1978-1985, the rate for men increasing from 16.3 to 26.2 and that for women increasing from 9.7 to 18.0. The largest increases in this age group occurred for cases of glioblastoma multiforme. During the study period, 1,411 brain cancer deaths were notified to the 2 registries at age-standardised rates of 5.3 in men and 3.4 in women. Mortality rates among persons aged 75 years or older were higher during 1986-1992 than 1978-1985, increasing from 15.7 to 28.4 in men and from 10.1 to 15.3 in women. Only among men aged 15-49 years was a decline in mortality rates observed, from 3.3 to 2.4. Survival analyses indicated that age and histological type were the most powerful prognostic indicators. There was no improvement in 5-year survival for any of the age groups or histological types. An improvement in 36-month survival was noted for the 15-49 year age group diagnosed with gliomas other than glioblastoma multiforme.
Accounting for immigrant status when calculating cancer incidence rates for Bangkok
Publisher: EpiSmart Science Vector Ltd
Date: 03-2019
Time trends in lung cancer incidence by histology in South Australia: likely causes and public health implications
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1111/J.1467-842X.2003.TB00605.X
Abstract: In response to reported increases in ratios of adenocarcinomas to squamous cell carcinomas of the lung in other populations, to investigate and consider public health and clinical implications of time trends in lung cancer incidence by histological type in South Australia. 11,898 lung cancers, diagnosed during 1982-2000, were analysed to determine age-adjusted incidence rates by sex, diagnostic epoch, and histological type, and changes in histological distribution at diagnosis. The age-adjusted incidence of squamous cell carcinoma reduced by 47.1% in males between 1982-86 and 1997-2000, with larger reductions applying to younger age groups. A 34.1% reduction also occurred for small cell lesions in males, whereas a 55.6% incidence increase applied for large cell lesions, and in the age range of 70 years and over, a 29.9% incidence increase for adenocarcinomas. Larger increases were observed for adenocarcinomas and large cell lesions in females. There was also a 48.0% incidence increase in squamous cell carcinomas in females aged 70 years or more. In general, adverse incidence trends were less pronounced and favourable trends more pronounced in the younger age groups of both sexes. The more favourable incidence trends by histology in younger age groups are a positive sign that hopefully will prove to be cohort effects that extend to older ages. Incidence trends have led to an increased proportion among diagnosed cancers of adenocarcinomas and large cell lesions, but this is unlikely to have more than a marginal effect on overall survivals and treatment requirements.
Breast cancer screening—opportunistic use of registry and linked screening data for local evaluation
Publisher: Wiley
Date: 22-09-2017
DOI: 10.1111/JEP.12640
Abstract: Screening has been found to reduce breast cancer mortality at a population level in Australia, but these studies did not address local settings where numbers of deaths would generally have been too low for evaluation. Clinicians, administrators, and consumer groups are also interested in local service outcomes. We therefore use more common prognostic and treatment measures and survivals to gain evidence of screening effects among patients attending 4 local hospitals for treatment. To compare prognostic, treatment, and survival measures by screening history to determine whether expected screening effects are occurring. Employing routine clinical registry and linked screening data to investigate associations of screening history with these measures, using unadjusted and adjusted analyses. Screened women had a 10-year survival from breast cancer of 92%, compared with 78% for unscreened women and 79% of screened surgical cases had breast conserving surgery compared with 64% in unscreened women. Unadjusted analyses indicated that recently screened cases had earlier tumor node metastasis stages, smaller diameters, less nodal involvement, better tumor differentiation, more oestrogen and progesterone receptor positive lesions, more hormone therapy, and less chemotherapy. Radiotherapy tended to be more common in screening participants. More frequent use of adjunctive radiotherapy applied when breast conserving surgery was used. Results confirm the screening effects expected from the scientific literature and demonstrate the value of opportunistic use of available registry and linked screening data for indicating to local health administrations, practitioners, and consumers whether local screening services are having the effects expected.
Demographic, health, and prognostic characteristics of Australians with liver cancer: a cohort study of linked data in New South Wales for informing cancer control
Publisher: Springer Science and Business Media LLC
Date: 09-10-2023
Cancer registration challenges in low- and middle-income countries—the case of the Pacific Islands
Publisher: Hindawi Limited
Date: 2017
DOI: 10.1111/ECC.12650
'No child or adult would ever probably choose to have 16 teaspoons of sugar': a preliminary study of parents' responses to sugary drink warning label options
Publisher: MDPI AG
Date: 07-10-2022
DOI: 10.3390/NU14194173
Abstract: Front-of-pack (FoP) warning labels are a viable policy option with the potential to inform consumer choice and assist in reducing sugar-sweetened beverage (SSB) consumption as part of a multi-faceted approach. This study explored parents’ perceptions and understanding of a range of SSB warning labels. Focus groups (n = 12) with 82 parents of school-aged children were conducted, stratified according to education level, sex and location. Health effects, exercise equivalents, sugar content (teaspoons in text and pictograms, “high in”) and energy content labels were shown. Through thematic analysis we identified three themes. Theme 1 related to perceptions of effectiveness of labels, underpinned by four subthemes: perceptions of labels as credible, informative and useful, personally relevant and having the potential to change be haviour. Theme 2 related to participants finding opportunities for self-exemption (e.g., physically active) and message rejection (e.g., misinterpretation). Theme 3 encompassed the potential negative consequences of some labels (e.g., body image concerns). The text teaspoons label was perceived most favourably across all themes, with minimal negative issues raised. These results provide in-depth insight into potential responses to labelling as a policy intervention, providing important guidance for the development of labels to ensure optimal message content and framing for future testing and subsequent implementation.
Update of mortality and cancer incidence in the Australian petroleum industry cohort
Publisher: BMJ
Date: 30-05-2006
Pregnancy and birth risk factors for intellectual disability in South Australia
Publisher: Springer Science and Business Media LLC
Date: 09-1989
DOI: 10.1007/BF00144832
Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016
Publisher: SAGE Publications
Date: 12-11-2018
Abstract: Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.
Determinants of the microbiological characteristics of spa pools in South Australia
Publisher: Elsevier BV
Date: 10-1987
The Association of Maternal and Socioeconomic Characteristics in Metropolitan Adelaide with Medical, Obstetric and Labour Complications and Pregnancy Outcomes
Publisher: Wiley
Date: 02-1992
DOI: 10.1111/J.1479-828X.1992.TB01885.X
Abstract: Multiple regression analysis was used to measure associations of maternal age, race, gravidity, marital status and socioeconomic status with medical problems and pregnancy outcomes. The study population comprised all singleton births to residents of metropolitan Adelaide (in South Australia) during 1988 that were included in the State's perinatal statistics collection. The results indicate that in metropolitan Adelaide, low socioeconomic status is related to a higher risk profile of mothers and babies. It also highlights that there is a strong association of orce and separation with medical problems and an adverse pregnancy outcome. Poorer outcomes are also seen in never married women, teenage women, older women, non-Caucasian women and primigravid women. These poorer outcomes in older women and primigravidas include higher risks of low birth-weight and prematurity of their babies. The study also demonstrates that groups that are less likely to have choice of obstetric care, eg. teenage women, non-Caucasian women, and women of low socioeconomic status, have a lower odds of obstetric intervention as characterized by nonspontaneous labour and elective Caesarean section.
The South Australian Cancer Registry: a means of assessing cancer incidence, mortality and case survival
Publisher: Elsevier BV
Date: 1992
DOI: 10.1016/0959-8049(92)90037-3
Abstract: In 1977, a Cancer Control and Surveillance Unit was established by the South Australian government. The infrastructure of the Unit was the State's Cancer Registry which was established simultaneously. By 1990, approximately 70,000 invasive cancer cases had been notified to the Registry for a population which had increased from 1,287,550 in 1977 to 1,400,000. In 1990, 2940 cancers were notified in males and 2640 in females. The leading sites in males were the prostate, lung, colon and melanoma of the skin, while in females they were the breast, colon, melanoma of the skin and lung. An increase in age-standardised incidence rates for all cancer sites combined has been documented for the 1977-1990 period. The magnitude of the increase was 7% in males and 12% in females. Meanwhile, there were 1544 male cancer deaths and 1203 female cancer deaths in 1990. Amongst males, age-standardised mortality rates tended to decline in the 1980's, due largely to a reducing age-standardised incidence of lung cancer. By comparison, an increased lung cancer incidence in females contributed to an overall increase of 6% in the age-standardised mortality rate for cancers of all sites combined in this sex during the life of the Registry. During the period 1977-1990 there was a 55% increase in the number of new invasive cancers in males and females combined. Most of this increase can be attributed to the ageing of the South Australian population and to a much lesser degree to population growth. During the same period there was a concomitant increase in 43% in the number of deaths where the underlying cause of death was cancer. Case survival rates are found to be very similar in South Australia to those reported for the United States, with about 51% of cases surviving their cancers 5 years after diagnosis. 5-year survival rates for the diagnostic period, 1983-1990, were generally better than for 1977-1982. The evidence for improved survival was strongest for cancers of the oesophagus, colon, cervix, prostate and testes, and for low-grade and medium-grade lymphomas and chronic myeloid leukaemias. When case survival rates were calculated for childhood tumours, significant improvements were found for acute lymphatic leukaemias and non-Hodgkin lymphomas for the diagnostic period, 1983-1990, when compared with 1977-1982.
Translation from clinical trials to routine practice: How to demonstrate community benefit
Publisher: Wiley
Date: 28-01-2015
DOI: 10.1111/AJCO.12338
Young-onset colorectal cancer is associated with a personal history of type 2 diabetes
Publisher: Wiley
Date: 03-09-2021
DOI: 10.1111/AJCO.13428
Performance indices of needle biopsy procedures for the assessment of screen detected abnormalities in services accredited by breastscreen Australia
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 22-01-2014
DOI: 10.7314/APJCP.2014.15.24.10665
Abstract: We wished to analyse patterns of use of needle biopsy procedures by BreastScreen Australia (BSA) accredited programs to identify areas for improvement. BSA services provided anonymous data regarding percutaneous needle biopsy of screen detected lesions assessed between 2005-2009. 12 services, from 5 of 7 Australian states and territories provided data for 18212 lesions biopsied. Preoperative diagnosis rates were 96.84% for lesion other than microcalcification (LOTM) and 93.21% for microcalcifications. At surgery 97.9% impalpable lesions were removed at the first procedure. Of 11548 Microcalcification (LOTM) biopsied, 46.9% were malignant. The final diagnosis was reached by conventional core biopsy (CCB) in 72.46%, FNAB in 21.33%, VACB in 1.69% and open biopsy in 4.52% of lesions. FNA is being limited to LOTM with benign imaging After FNAB, core biopsy was required for 38% of LOTM. In LOTM the mean false positive rate (FPR) was 0.36% for FNAB, 0.06% for NCB and 0% for VACB. Diagnostic accuracy was 72.75% for FNAB and 92.1% for core biopsies combined. Of 6441 microcalcifications biopsied 2305 (35.8%) were malignant. Microcalcifications are being assessed primarily by NCB but 6.57% underwent FNAB, 45.6% of which required NCB. False positive diagnoses were rare. FNR was 5% for NCB and 1.53% for VACB. Diagnostic accuracy was 73.52% for FNAB, 86.29% for NCB and 88.63% for VACB. Only 8 of 12 services had access to VACB facilities. BSA services are selecting lesions effectively for biopsy and are achieving high preoperative diagnosis rates. Gaps in the present accreditation standards require further consideration.
Time to clinical investigation for indigenous and non-indigenous queensland women after a high grade abnormal pap smear, 2000-2009
Publisher: AMPCo
Date: 02-2017
DOI: 10.5694/MJA16.00255
Abstract: To investigate time to follow-up (clinical investigation) for Indigenous and non-Indigenous women in Queensland after a high grade abnormality (HGA) being detected by Pap smear. Population-based retrospective cohort analysis of linked data from the Queensland Pap Smear Register (PSR), the Queensland Hospital Admitted Patient Data Collection, and the Queensland Cancer Registry. 34 980 women aged 20-68 years (including 1592 Indigenous women) with their first HGA Pap smear result recorded on the PSR (index smear) during 2000-2009 were included and followed to the end of 2010. Time from the index smear to clinical investigation (histology test or cancer diagnosis date), censored at 12 months. The proportion of women who had a clinical investigation within 2 months of a HGA finding was lower for Indigenous (34.1% 95% CI, 31.8-36.4%) than for non-Indigenous women (46.5% 95% CI, 46.0-47.0% unadjusted incidence rate ratio [IRR], 0.65 95% CI, 0.60-0.71). This difference remained after adjusting for place of residence, area-level disadvantage, and age group (adjusted IRR, 0.74 95% CI, 0.68-0.81). However, Indigenous women who had not been followed up within 2 months were subsequently more likely to have a clinical investigation than non-Indigenous women (adjusted IRR for 2-4 month interval, 1.21 95% CI, 1.08-1.36) by 6 months, a similar proportion of Indigenous (62.2% 95% CI, 59.8-64.6%) and non-Indigenous women (62.8% 95% CI, 62.2-63.3%) had been followed up. Prompt follow-up after a HGA Pap smear finding needs to improve for Indigenous women. Nevertheless, slow follow-up is a smaller contributor to their higher cervical cancer incidence and mortality than their lower participation in cervical screening.
The utility of linked cancer registry and health administration data for describing system‐wide outcomes and research: a BreastScreen example
Publisher: Wiley
Date: 21-03-2016
DOI: 10.1111/JEP.12536
Abstract: Stratification of women with screen-detected ductal carcinoma in situ (DCIS) by risk of subsequent invasive breast cancer (IBC) could assist treatment planning and selection of surveillance protocols that accord with risk. We assessed the utility of routinely collected administrative data for stratifying by IBC risk following DCIS detection in a population-based screening programme to inform ongoing surveillance protocols. A retrospective cohort design was used, employing linked data from the South Australian breast screening programme and cancer registry. Women entered the study at screening commencement and were followed until IBC diagnosis, death or end of the study period (1 December 2010), whichever came first. Routinely collected administrative data were analyzed to identify predictors of invasive breast cancer. Proportional hazards regression confirmed that the DCIS cohort had an elevated risk of IBC after adjustment for relevant confounders (HR = 4.0 (95% CL 3.4, 4.8)), which accorded with previous study results. Within the DCIS cohort, conservative breast surgery and earlier year of screening commencement were both predictive of an elevated invasive breast cancer risk. These linked cancer registry and administrative data gave plausible estimates of IBC risk following DCIS diagnosis, but were limited in coverage of key items for further risk stratification. It is important that the research utility of administrative datasets is maximized in their design phase in collaboration with researchers.
BRAF Mutation Testing and Metastatic Colorectal Cancer in the Community Setting: Is There an Urgent Need for More Education?
Publisher: Springer Science and Business Media LLC
Date: 29-12-2015
DOI: 10.1007/S40291-015-0179-7
Abstract: Patients with metastatic colorectal cancer (mCRC) with BRAF mutation (BRAF MT) generally have a poorer prognosis. BRAF MT may also have implications for treatment strategy. Despite this, inclusion of BRAF in routine molecular testing varies. Here we report the frequency of BRAF reporting in the South Australian (SA) mCRC registry reflecting community practice, together with the survival outcomes based on mutation status. The SA population-based mCRC registry was analysed to assess the number of patients where a BRAF MT result was available. The patient characteristics are reported and overall survival was analysed using the Kaplan-Meier method. Of the 3639 patients who have been entered in the registry, only 6.2% (227) have BRAF MT results available. Of the patients tested, the BRAF MT rate is 12.7%. The mutation rate was highest in rightsided primary right colon 23 versus left colon 8.9% and rectum 7%. There was no significant difference in median age or male/female proportion. The median overall survival (mOS) for BRAF MT versus wild-type (WT) patients is 14.0 versus 32.9 months (p = 0.003). For patients who have chemotherapy (plus or minus surgery) the mOS is 14.6 months BRAF MT versus 36.1 months (p ≤ 0.001) WT. Liver or lung resection was performed on only 8% of the BRAF MT group versus 26.5% of the WT group. Results in a population setting confirm our understanding that BRAF MT is more frequently right sided and of lower frequency in rectal cancer. Survival is lower for patients with mCRC that have BRAF MT, regardless of the therapy. BRAF testing is currently performed infrequently in an Australian setting despite its importance as a significant prognostic factor, and the implications for alternate therapeutic approaches.
Increased age and mortality associated with cervical carcinomas negative for human papillomavirus RNA
Publisher: Elsevier BV
Date: 10-1991
DOI: 10.1016/0140-6736(91)91773-N
Abstract: Attempts to relate presence and type of human papillomavirus in cervical carcinoma with prognosis have yielded conflicting results. To further investigate this relation, the association between survival of cervical cancer patients after diagnosis and the presence of human papillomavirus (HPV) RNA within the tumour was assessed retrospectively. Formalin-fixed biopsy specimens from 212 patients with cervical carcinoma who had been followed for up to 6 years were tested by in-situ hybridisation with 125I-labelled riboprobes. HPV-RNA-positive women were 11.9 years younger than HPV-negative women at diagnosis (p less than 0.001). Case-fatality rates from cervical cancer rose with absence of HPV RNA, age at diagnosis, or FIGO stage. Multivariate analysis confirmed that absence of detectable HPV RNA and advanced FIGO stage were independent risk factors. No differences in survival between HPV types 16, 18, 31, or 33 were seen. These observations suggest that cervical carcinoma patients fall into two groups--a younger, HPV-RNA-positive group, with a better prognosis, and an older, HPV-RNA-negative group with poorer prognosis. Treatment regimens for the two groups may need to differ.
Fast Channel Estimation and Beam Tracking for Millimeter Wave Vehicular Communications
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
The value of local registry data for describing cervical cancer management and outcomes over three decades in Australia
Publisher: Hindawi Limited
Date: 20-09-2018
DOI: 10.1111/ECC.12760
Abstract: Registry data on invasive cervical cancers (n = 1,274) from four major hospitals (1984-2012) were analysed to determine their value for informing local service delivery in Australia. The methodology comprised disease-specific survival analyses using Kaplan-Meier product-limit estimates and Cox proportional hazards models and treatment analyses using logistic regression. Five- and 10-year survivals were 72% and 68%, respectively, equating with relative survival estimates for Australia and the USA. Most common treatments were surgery and radiotherapy. Systemic therapies increased in recent years, generally with radiotherapy, but were less common for residents from less accessible areas. Surgery was more common for younger women and early-stage disease, and radiotherapy for older women and regional and more advanced disease. The proportion of glandular cancers increased in-step with national trends. Little evidence of variation in risk-adjusted survival presented over time or by Local Health District. The study illustrates the value of local registry data for describing local treatment and outcomes. They show the lower use of systemic therapies among residents of less accessible areas which warrants further investigation. Risk-adjusted treatment and outcomes did not vary by socio-economic status, suggesting equity in service delivery. These data are important for local evaluation and were not available from other sources.
What Roles should Population-based Cancer Registries be Playing in the 21st Century? Reflections on the Asian Cancer Registry Forum, Bangkok, February 2014
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 03-2014
DOI: 10.7314/APJCP.2014.15.5.1895
Abstract: Cancer registries have fundamental roles in cancer surveillance, research, and health services planning, monitoring and evaluation. Many are now assuming a broader role by contributing data for health-service management, alongside data inputs from other registries and administrative data sets. These data are being integrated into de-identified databases using privacy-protecting data linkage practices. Structured pathology reporting is increasing registry access to staging and other prognostic descriptors. Registry directions need to vary, depending on local need, barriers and opportunities. Flexibility and adaptability will be essential to optimize registry contributions to cancer control.
Validation of administrative hospital data for identifying incident pancreatic and periampullary cancer cases: A population-based study using linked cancer registry and administrative hospital data in New South Wales, Australia
Publisher: BMJ
Date: 07-2016
Asbestos-Related Cancers in Refinery Workers in the Australian Petroleum Industry
Publisher: Informa UK Limited
Date: 2006
Patient-Reported Outcomes After Radiation Therapy in Men With Prostate Cancer: A Systematic Review of Prognostic Tool Accuracy and Validity
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.IJROBP.2017.02.024
Abstract: To identify, through a systematic review, all validated tools used for the prediction of patient-reported outcome measures (PROMs) in patients being treated with radiation therapy for prostate cancer, and provide a comparative summary of accuracy and generalizability. PubMed and EMBASE were searched from July 2007. Title/abstract screening, full text review, and critical appraisal were undertaken by 2 reviewers, whereas data extraction was performed by a single reviewer. Eligible articles had to provide a summary measure of accuracy and undertake internal or external validation. Tools were recommended for clinical implementation if they had been externally validated and found to have accuracy ≥70%. The search strategy identified 3839 potential studies, of which 236 progressed to full text review and 22 were included. From these studies, 50 tools predicted gastrointestinal/rectal symptoms, 29 tools predicted genitourinary symptoms, 4 tools predicted erectile dysfunction, and no tools predicted quality of life. For patients treated with external beam radiation therapy, 3 tools could be recommended for the prediction of rectal toxicity, gastrointestinal toxicity, and erectile dysfunction. For patients treated with brachytherapy, 2 tools could be recommended for the prediction of urinary retention and erectile dysfunction. A large number of tools for the prediction of PROMs in prostate cancer patients treated with radiation therapy have been developed. Only a small minority are accurate and have been shown to be generalizable through external validation. This review provides an accessible catalogue of tools that are ready for clinical implementation as well as which should be prioritized for validation.
The dental health and habits of South Australian children from different socio-economic environments
Publisher: Wiley
Date: 02-1971
DOI: 10.1111/J.1834-7819.1971.TB00978.X
Abstract: Oxidative stress contributes to the loss of neurons in many disease conditions as well as during normal aging however, small-molecule agents that reduce oxidation have not been successful in preventing neurodegeneration. Moreover, even if an efficacious systemic reduction of reactive oxygen and/or nitrogen species (ROS/NOS) could be achieved, detrimental side effects are likely, as these molecules regulate normal physiological processes. A more effective and targeted approach might be to augment the endogenous antioxidant defense mechanism only in the cells that suffer from oxidation. Here, we created several adeno-associated virus (AAV) vectors to deliver genes that combat oxidation. These vectors encode the transcription factors NRF2 and/or PGC1a, which regulate hundreds of genes that combat oxidation and other forms of stress, or enzymes such as superoxide dismutase 2 (SOD2) and catalase, which directly detoxify ROS. We tested the effectiveness of this approach in 3 models of photoreceptor degeneration and in a nerve crush model. AAV-mediated delivery of NRF2 was more effective than SOD2 and catalase, while expression of PGC1a accelerated photoreceptor death. Since the NRF2-mediated neuroprotective effects extended to photoreceptors and retinal ganglion cells, which are 2 very different types of neurons, these results suggest that this targeted approach may be broadly applicable to many diseases in which cells suffer from oxidative damage.
Breast Cancer Incidence and Survival Among Young Females in Queensland, Australia
Publisher: Mary Ann Liebert Inc
Date: 06-2020
Variations in utilisation of colorectal cancer services in South Australia indicated by MBS/PBS benefits: a benefit incidence analysis
Publisher: Elsevier BV
Date: 04-2022
Tobacco and alcohol‐related mortality in men: estimates from the Australian cohort of petroleum industry workers
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1111/J.1467-842X.2006.TB00842.X
Abstract: To measure the association between major causes of mortality and tobacco use and the association between major causes of mortality and alcohol use, after adjusting for tobacco use. Employees of Australian Institute of Petroleum member companies were enrolled in the cohort in four industry-wide surveys between 1981 and 1999. Mortality of 16,547 men was determined up to 31 December 2001 and cancer incidence to 31 December 2000. Relative mortality and cancer incidence rates were computed for smoking categories compared with never smokers, and for alcohol consumption compared with total abstainers. The highest category of smoking, more than 30 cigarettes per day, was associated with more than a threefold increase in all-cause mortality, a 60% increase in cancer incidence, a 43-fold increase in lung cancer incidence, and a more than fourfold increase in mortality from ischaemic heart disease. There were only four cancers in lifelong non-smokers. Moderate alcohol consumption provided a protective effect from death from all causes combined, relative to nil or low consumption, and relative to heavy alcohol consumption. The main contributor to the protective effect was protection against death from ischaemic heart disease. Lifelong avoidance of tobacco and moderate alcohol consumption confer significant improvements on life expectancy.
Risk of cancer inpatients with scleroderma: A population based cohort study
Publisher: BMJ
Date: 08-2003
DOI: 10.1136/ARD.62.8.728
Abstract: Previous studies have suggested an increased risk of cancer among patients with scleroderma. To study a population based cohort of patients with scleroderma in South Australia. Subjects with scleroderma were identified from the South Australian Scleroderma Registry established in 1993. All subjects on the scleroderma registry were linked to the South Australian Cancer Registry to identify all cases of cancer until 31 December 2000. Standardised incidence ratios (SIRs) for cancer for subjects with scleroderma were determined using the age- and sex-specific rates for South Australia. In 441 patients with scleroderma, 90 cases of cancer were identified, 47 of which developed after inclusion on the scleroderma registry. The SIRs for all cancers among these patients were significantly increased (SIR=1.99 95% confidence interval (95% CI) 1.46 to 2.65) compared with the cancer incidence rates for South Australia. The SIRs for lung cancer (SIR=5.9 95% CI 3.05 to 10.31) were also significantly increased. The SIRs for all cancers among the subgroups with diffuse scleroderma (SIR=2.73 95% CI 1.31 to 5.02) and limited scleroderma (SIR=1.85 95% CI 1.23 to 2.68) were significantly increased. This population based cohort study provides evidence that scleroderma is associated with cancer, and in particular, lung cancer. In addition, both diffuse and limited forms of scleroderma are associated with a similarly increased risk of cancer.
Melanoma case survival rates in South Australia by histological type, thickness and level of tumour at diagnosis
Publisher: AMPCo
Date: 06-1986
DOI: 10.5694/J.1326-5377.1986.TB113693.X
Abstract: Data from the South Australian Cancer Registry on malignant melanoma of the skin showed that case survival rates were higher for lentigo maligna melanomas and superficial spreading lesions than for nodular and other histological classifications. Lower case survival rates applied to the thicker melanomas and those at a more invasive level at diagnosis. After adjusting for differences in thickness and level in this study, no statistically significant differences were apparent between case survival rates for the nodular lesions and the lentigo maligna and superficial spreading melanomas.
Estimating prevalence of distant metastatic breast cancer: A means of filling a data gap
Publisher: Springer Science and Business Media LLC
Date: 08-2012
DOI: 10.1007/S10552-012-0040-9
Abstract: To develop and validate a method for estimating numbers of people with distant cancer metastases, for evidence-based service planning. Estimates were made employing an illness-death model with distant metastatic cancer as the illness state- and site-specific mortality as an outcome, using MIAMOD software. To demonstrate the method, we estimated numbers of females alive in Australia following detection of distant metastatic breast cancer during 1980-2004, using data on patient survival from an Australian population-based cancer registry. We validated these estimates by comparing them with direct prevalence counts. Relative survival at 10 years following detection of distant metastases was low (5-20 %), with better survival experienced by: (1) females where distant metastatic disease was detected at initial diagnosis rather than subsequently (e.g., at recurrence) (2) those diagnosed in more recent calendar years and (3) younger age groups. For Australian females aged less than 85 years, the modeled cumulative risk of detection of distant metastatic breast cancer (either at initial diagnosis or subsequently) declined over time, but numbers of cases with this history rose from 71 per 100,000 in 1980 to 84 per 100,000 in 2004. The model indicated that there were approximately 3-4 prevalent distant metastatic breast cancer cases for every breast cancer death. Comparison of estimates with direct prevalence counts showed a reasonable level of agreement. The method is straightforward to apply and we recommend its use for breast and other cancers when registry data are insufficient for direct prevalence counts. This will provide estimates of numbers of people who would need ongoing medical surveillance and care following detection of distant metastases.
LIP CANCER IN SOUTH AUSTRALIA, 1977–1996
Publisher: Elsevier BV
Date: 05-2001
Breast cancer characteristics and survival differences between Maori, Pacific and other New zealand women included in the quality audit program of breast surgeons of Australia and New Zealand
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 03-04-2015
DOI: 10.7314/APJCP.2015.16.6.2465
Abstract: The Quality Audit (BQA) program of the Breast Surgeons of Australia and New Zealand (NZ) collects data on early female breast cancer and its treatment. BQA data covered approximately half all early breast cancers diagnosed in NZ during roll-out of the BQA program in 1998-2010. Coverage increased progressively to about 80% by 2008. This is the biggest NZ breast cancer database outside the NZ Cancer Registry and it includes cancer and clinical management data not collected by the Registry. We used these BQA data to compare socio-demographic and cancer characteristics and survivals by ethnicity. BQA data for 1998-2010 diagnoses were linked to NZ death records using the National Health Index (NHI) for linking. Live cases were followed up to December 31st 2010. Socio-demographic and invasive cancer characteristics and disease-specific survivals were compared by ethnicity. Five-year survivals were 87% for Maori, 84% for Pacific, 91% for other NZ cases and 90% overall. This compared with the 86% survival reported for all female breast cases covered by the NZ Cancer Registry which also included more advanced stages. Patterns of survival by clinical risk factors accorded with patterns expected from the scientific literature. Compared with Other cases, Maori and Pacific women were younger, came from more deprived areas, and had larger cancers with more ductal and fewer lobular histology types. Their cancers were also less likely to have a triple negative phenotype. More of the Pacific women had vascular invasion. Maori women were more likely to reside in areas more remote from regional cancer centres, whereas Pacific women generally lived closer to these centres than Other NZ cases. NZ BQA data indicate previously unreported differences in breast cancer biology by ethnicity. Maori and Pacific women had reduced breast cancer survival compared with Other NZ women, after adjusting for socio-demographic and cancer characteristics. The potential contributions to survival differences of variations in service access, timeliness and quality of care, need to be examined, along with effects of co- morbidity and biological factors.
Patterns of care and outcomes for young patients (age < 40) with metastatic colorectal cancer (mCRC): Findings from a population-based registry.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2014
The association of naegleria fowleri with the chemical, microbiological and physical characteristics of South Australian water supplies
Publisher: Elsevier BV
Date: 1984
Analysing risk factors for poorer breast cancer outcomes in residents of lower socioeconomic areas of Australia
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13080
Abstract: Objective To investigate patient, cancer and treatment factors associated with the residence of female breast cancer patients in lower socioeconomic areas of Australia to better understand factors that may contribute to their poorer cancer outcomes. Methods Bivariable and multivariable analyses were performed using the Breast Quality Audit database of Breast Surgeons of Australia and New Zealand. Results Multivariable regression indicated that patients from lower socioeconomic areas are more likely to live in more remote areas and to be treated at regional than major city centres. Although they appeared equally likely to be referred to surgeons from BreastScreen services as patients from higher socioeconomic areas, they were less likely to be referred as asymptomatic cases from other sources. In general, their cancer and treatment characteristics did not differ from those of women from higher socioeconomic areas, but ovarian ablation therapy was less common for these patients and bilateral synchronous lesions tended to be less frequent than for women from higher socioeconomic areas. Conclusions The results indicate that patients from lower socioeconomic areas are more likely to live in more remote districts and have their treatment in regional rather than major treatment centres. Their cancer and treatment characteristics appear to be similar to those of women from higher socioeconomic areas, although they are less likely to have ovarian ablation or to be referred as asymptomatic patients from sources other than BreastScreen. What is known about this topic? It is already known from Australian data that breast cancer outcomes are not as favourable for women from areas of socioeconomic disadvantage. The reasons for the poorer outcomes have not been understood. Studies in other countries have also found poorer outcomes in women from lower socioeconomic areas, and in some instances, have attributed this finding to more advanced stages of cancers at diagnosis and more limited treatment. The reasons are likely to vary with the country and health system characteristics. What does this paper add? The present study found that in Australia, women from lower socioeconomic areas do not have more advanced cancers at diagnosis, nor, in general, other cancer features that would predispose them to poorer outcomes. The standout differences were that they tended more to live in areas that were more remote from specialist metropolitan centres and were more likely to be treated in regional settings where prior research has indicated poorer outcomes. The reasons for these poorer outcomes are not known but may include lower levels of surgical specialisation, less access to specialised adjunctive services, and less involvement with multidisciplinary teams. Women from lower socioeconomic areas also appeared more likely to attend lower case load surgeons. Little difference was evident in the type of clinical care received, although women from lower socioeconomic areas were less likely to be asymptomatic referrals from other clinical settings (excluding BreastScreen). What are the implications for practitioners? Results suggest that poorer outcomes in women from lower socioeconomic areas in Australia may have less to do with the characteristics of their breast cancers or treatment modalities and more to do with health system features, such as access to specialist centres. This study highlights the importance of demographic and health system features as potentially key factors in service outcomes. Health system research should be strengthened in Australia to augment biomedical and clinical research, with a view to best meeting service needs of all sectors of the population.
Colorectal cancer treatment and survival over three decades at four major public hospitals in South Australia: trends by age and in the elderly
Publisher: Hindawi Limited
Date: 03-06-2016
DOI: 10.1111/ECC.12515
Abstract: Data from registries at four major public hospitals in South Australia indicate increased 5-year disease-specific survivals for colorectal cancer from 48% to 63% between 1980-1986 and 2005-2010. For 80+ year olds, the increase was smaller, from 47% to 52%. Risk of case fatality halved overall, adjusting for age, gender, stage, differentiation and sub-site. Patients aged 80+ years had a lower risk reduction of about a third (hazards ratio: 0.69 95% confidence limits, 0.52-0.92). Percentages having surgery and other specified treatments were lower for 80+ year olds than younger cases, although increases in treatment intensity occurred in this age range during 1980-2010, as seen in younger ages, in accordance with guidelines. The study illustrates the important feedback clinical registries can provide to clinicians on care patterns and outcomes in their hospital settings. Feedback can be the subject of local deliberations on how to achieve the best outcomes, including in the elderly by considering the best trade-offs between optimal cancer care and accommodations for co-morbidity and frailty. Clinical registry data can be used in comparative effectiveness research in local settings where there are sufficient case numbers.
THE SCHOOL DENTAL THERAPIST OF SOUTH AUSTRALIA
Publisher: Wiley
Date: 06-1972
DOI: 10.1111/J.1752-7325.1972.TB03948.X
Abstract: The anti-inflammatory protein annexin A1 (ANXA1) has been associated with cancer progression and metastasis, suggesting its role in regulating tumor cell proliferation. We investigated the mechanism of ANXA1 interaction with formylated peptide receptor 2 (FPR2/ALX) in control, peritumoral and tumor larynx tissue s les from 20 patients, to quantitate the neutrophils and mast cells, and to evaluate the protein expression and co-localization of ANXA1/FPR2 in these inflammatory cells and laryngeal squamous cells by immunocytochemistry. In addition, we performed in vitro experiments to further investigate the functional role of ANXA1/FPR2 in the proliferation and metastasis of Hep-2 cells, a cell line from larynx epidermoid carcinoma, after treatment with ANXA1(2-26) (annexin A1 N-terminal-derived peptide), Boc2 (antagonist of FPR) and/or dexamethasone. Under these treatments, the level of Hep-2 cell proliferation, pro-inflammatory cytokines, ANXA1/FPR2 co-localization, and the prostaglandin signalling were analyzed using ELISA, immunocytochemistry and real-time PCR. An influx of neutrophils and degranulated mast cells was detected in tumor s les. In these inflammatory cells of peritumoral and tumor s les, ANXA1/FPR2 expression was markedly exacerbated, however, in laryngeal carcinoma cells, this expression was down-regulated. ANXA1(2-26) treatment reduced the proliferation of the Hep-2 cells, an effect that was blocked by Boc2, and up-regulated ANXA1/FPR2 expression. ANXA1(2-26) treatment also reduced the levels of pro-inflammatory cytokines and affected the expression of metalloproteinases and EP receptors, which are involved in the prostaglandin signalling. Overall, this study identified potential roles for the molecular mechanism of the ANXA1/FPR2 interaction in laryngeal cancer, including its relationship with the prostaglandin pathway, providing promising starting points for future research. ANXA1 may contribute to the regulation of tumor growth and metastasis through paracrine mechanisms that are mediated by FPR2/ALX. These data may lead to new biological targets for therapeutic intervention in human laryngeal cancer.
A critical analysis of reasons for improved survival from invasive cutaneous melanoma
Publisher: Springer Science and Business Media LLC
Date: 11-2003
DOI: 10.1023/B:CACO.0000003838.48507.8B
Abstract: To determine the extent to which increases in survival from melanoma are explained by changes in thickness, level, histological type, site of lesion, and sociodemographic characteristics. Analyses of changes in survival among 9519 South Australians with melanoma reported to the State's population-based cancer registry during the 1980-2000 diagnostic period, using proportional hazards regression to adjust for thickness, level and other characteristics. Lower survivals applied for thicker lesions, deeper Clark levels, lesions on the trunk and scalp/neck, and for older cases and males. After adjusting for these characteristics, the relative risk (95% confidence limits) of case fatality for the 1994-2000 diagnostic period was 0.79 (0.63, 0.99), when compared with the 1980-1986 baseline. Prior to adjusting, the relative risk for these cases was 0.58 (0.47, 0.72). An unexpected finding was a secular change for deeper Clark levels within Breslow thickness categories. Approximately half the survival increase was not explained by changes in thickness, level, lesion site, and age and sex. Other possible contributors warranting further study include changes in ulceration, nodal or more distant site involvement, treatment gains and changes in tumour biology. The trend for deeper Clark levels within Breslow thickness categories requires independent confirmation.
Effects of variations in hysterectomy status on population coverage by cervical screening
Publisher: Elsevier BV
Date: 10-2003
DOI: 10.1111/J.1467-842X.2003.TB00823.X
Abstract: To investigate geographic differences in hysterectomy rates and effects on estimated screening coverage in South Australia. Hysterectomy data from South Australian hospitals for 1992-2000 were used to calculate age-specific hysterectomy rates for 20-69 year old women by residential subregion and postcode. Regional variations in rates were used to estimate variations in proportions of women with an intact uterus. Effects on estimates of screening coverage were investigated. About 66% of South Australian women were estimated to have an intact uterus at 70 years of age, based on hysterectomy rates for 1992-2000. The proportion was smaller in lower than upper socio-economic areas, and in country areas than the State capital (Adelaide). Estimates varied from 49% to 73% across 20 subregions. About 67% of 20-69 year olds with an intact uterus were estimated to have been screened in the 24-month period from 2000 to 2001. Similar estimates applied to Adelaide and country areas, irrespective of whether adjustments were made for differences in hysterectomy rates. A lower screening coverage applied to lower than upper socio-economic areas of Adelaide, irrespective of whether these adjustments were made. While adjusting for variations in hysterectomy rates generally had little effect on estimated screening coverage, there were notable exceptions. For ex le, in one subregion, coverage increased among 50-69 year olds from 53% to 66%. Adjustments for variations in hysterectomy rates can affect estimated screening coverage in some localities. Such adjustments should be undertaken to better define areas of under-screening for targeting in screening promotion.
Trends in cancer mortality rates among migrants in Australia: 1981–2007
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.CANEP.2011.10.011
Abstract: Previous studies have shown that migrants have lower cancer mortality rates compared to the Australian-born population, particularly for colorectal and breast cancers, which are associated with an affluent lifestyle. This study seeks to update knowledge in this field by examining mortality from colorectal, stomach, lung, melanoma, breast and bladder cancers, as well as all cancers combined between 1981 and 2007. Data were obtained from the Australian Bureau of Statistics. Average annual age and sex-standardised mortality rates were calculated for each region of birth, period of death registration and cancer site. Generally, mortality rates declined over the study period for most conditions for the majority of migrant groups. Notable exceptions included migrants from South Eastern Europe and Eastern Europe who experienced a significant increase in mortality due to all cancers combined and Australian-born in iduals who recorded a significant increase in mortality due to melanoma of the skin. Migrants generally had more favourable cancer mortality outcomes, particularly for colorectal cancer and melanoma. Migrants from Southern Europe, South Eastern Europe, Chinese Asia and Southern Asia had the greatest advantage. However, migrants displayed higher rates of stomach, lung and bladder cancers than the Australian-born population. The migrant advantage can in part be explained by the protective effects of diet, lifestyle and reproductive behaviours. Possible explanations for why some migrants display greater mortality from stomach and bladder cancer include the consumption of abrasive, salted and preserved foods and higher rates of smoking. Greater emphasis should be placed on targeting at-risk migrant groups through screening and education programs at migrant resource centres and community groups. The study calls for further research to explain the observed trends, which has the potential to uncover important risk and protective factors.
Who drinks sugar sweetened beverages and juice? An Australian population study of behaviour, awareness and attitudes
Publisher: Springer Science and Business Media LLC
Date: 03-01-2019
What factors are predictive of surgical resection and survival from localised nonsmall cell lung cancer?
Publisher: AMPCo
Date: 10-2014
DOI: 10.5694/MJA14.00365
Abstract: To investigate opportunities to reduce lung cancer mortality after diagnosis of localised non-small cell lung cancer (NSCLC) in New South Wales through surgical resection. In this cohort study, resection rates and lung cancer mortality risk were explored using multivariate logistic regression and competing risk regression, respectively. Data for 3040 patients were extracted from the NSW Central Cancer Registry for the diagnostic period 1 January 2003 to 31 December 2007. Subset analyses for patients at low surgical risk indicated resection rates and outcomes under ideal circumstances. Resection rates and lung cancer mortality. The resection rate in NSW was estimated to be between 38% and 43%, peaking at 59% by local health district (LHD) of residence. Not having a resection was associated with older age, lower socioeconomic status, lack of private health insurance, and residence by LHD. Adjusted 5-year cumulated probabilities of death were 76% in absence of resection, 30% for wedge resection, 18% for segmental resection, 22% for lobectomy and 45% for pneumonectomy. Of 255 "low surgical risk" patients, 71% had a resection. Those not receiving a resection had a higher probability of death (adjusted subhazard ratio, 14.1 95% CI, 7.2-27.5). If the low overall resection rate of 38%-43% in NSW were increased to 59% (the highest LHD resection rate), the proportion of all patients with localised NSCLC dying of NSCLC in the 5 years from diagnosis would decrease by about 10%, based on differences in probabilities of death by resection estimated in this study. Potential exists to reduce deaths from NSCLC in NSW through increased resection.
A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/SH07043
Abstract: Background: The cost-effectiveness of adding a human papillomavirus (HPV) vaccine to the Australian National Cervical Screening Program compared to screening alone was examined. Methods: A Markov model of the natural history of HPV infection that incorporates screening and vaccination was developed. A vaccine that prevents 100% of HPV 16/18-associated disease, with a lifetime duration of efficacy and 80% coverage offered through a school program to girls aged 12 years, in conjunction with current screening was compared with screening alone using cost (in Australian dollars) per life-year (LY) saved and quality-adjusted life-year (QALY) saved. Sensitivity analyses included determining the cost-effectiveness of offering a catch-up vaccination program to 14–26-year-olds and accounting for the benefits of herd immunity. Results: Vaccination with screening compared with screening alone was associated with an incremental cost-effectiveness ratio (ICER) of $51 103 per LY and $18 735 per QALY, assuming a cost per vaccine dose of $115. Results were sensitive to assumptions about the duration of vaccine efficacy, including the need for a booster ($68 158 per LY and $24 988 per QALY) to produce lifetime immunity. Accounting for herd immunity resulted in a more attractive ICER ($36 343 per LY and $13 316 per QALY) for girls only. The cost per LY of vaccinating boys and girls was $92 052 and the cost per QALY was $33 644. The cost per LY of implementing a catch-up vaccination program ranged from $45 652 ($16 727 per QALY) for extending vaccination to 14-year-olds to $78 702 ($34 536 per QALY) for 26-year-olds. Conclusions: These results suggest that adding an HPV vaccine to Australia’s current screening regimen is a potentially cost-effective way to reduce cervical cancer and the clinical interventions that are currently associated with its prevention via screening alone.
DNA-GA: A Tractable Approach for Performance Analysis of Uplink Cellular Networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2018
Determinants of case survival for cancers of the lung, colon, breast and cervix in South Australia
Publisher: AMPCo
Date: 11-1984
DOI: 10.5694/J.1326-5377.1984.TB113226.X
Abstract: Survival rates for cancers of the lung, colon and female breast, and for invasive lesions of the cervix have been analysed according to age, place of residence, country of birth, socioeconomic status, and where applicable, by sex and histological type and were found to be negatively related to age. For patients with cancers of the colon and cervix, survival rates were lower in country residents than in those of metropolitan Adelaide. Low socioeconomic status was associated with a lower survival rate for patients with colonic cancers and female breast cancers a similar trend was suggested for those with cancers of the cervix. Higher survival rates were found for patients with squamous cell carcinomas and adenocarcinomas of the lung, and mucinous tumours of the breast. Higher survival rates for patients with breast tumours were associated with small tumour size at diagnosis. In some overseas-born populations, survival rates for patients with lung cancers and cervical cancers were higher than those in the Australian-born population. This warrants further investigation.
Hollow InVO4 Nanocuboid Assemblies toward Promoting Photocatalytic N2 Conversion Performance
Publisher: Wiley
Date: 15-08-2021
Abstract: The unique InVO 4 mesocrystal superstructure, particularly with cubical skeleton and hollow interior, which consists of numerous nanocube building blocks, closely stacking by stacking, aligning by aligning, and sharing the same crystallographic orientations, is successfully fabricated. The synergy of a reaction‐limited aggregation and an Ostwald ripening process is reasonably proposed for the growth of this unique superstructure. Both single‐particle surface photovoltage and confocal fluorescence spectroscopy measurements demonstrate that the long‐range ordered mesocrystal superstructures can significantly retard the recombination of electron–hole pairs through the creation of a new pathway for anisotropic electron flow along the inter‐nanocubes. This promising charge mobility feature of the superstructure greatly contributes to the pronounced photocatalytic performance of the InVO 4 mesocrystal toward fixation of N 2 into NH 3 with the quantum yield of 0.50% at wavelength of 385 nm.
2163 BRAF testing in the community setting; are we testing enough given the importance of BRAF mutation and the clinical implications?
Publisher: Elsevier BV
Date: 09-2015
Breast screen service characteristics as a measure of accessibility
Publisher: Scholink Co, Ltd.
Date: 29-11-2018
Abstract: em Breast Screen Australia is a national breast cancer screening program which aims to reduce illness and death from breast cancer through early detection using mammography. Through this program women aged 40 and over in Australia are eligible for a free mammogram every two years. Around 55% of the target population participate in the program. Understanding the accessibility of breast screen services has the potential to improve the uptake of screening services. Spatial analysis of in idual breast screen services: opening hours, disability and accessibility infrastructure, parking and transport data can be used to describe the accessibility of breast screen services. Through highlighting regional accessibility to breast screen services it is possible to identify regions where accessibility to services could be increased to improved equity in health service provision. /em
Population‐based comparative study of campylobacter and salmonella enteritis in South Australia
Publisher: AMPCo
Date: 08-1982
DOI: 10.5694/J.1326-5377.1982.TB124303.X
Abstract: A total of 658 cases of c ylobacter enteritis was reported in South Australia in the 18 months from March, 1980. Although C ylobacter sp. may cause more gastrointestinal disease than Salmonella sp. during some time periods, our data suggest that the reverse applies over all. However, since c ylobacter enteritis tends to affect older persons who possibly are investigated less frequently, the relative prevalence of c ylobacter infection may have been understated. Both diseases are notified among preschoolers to a disproportionate extent however, C ylobacter sp. show a greater predisposition that Salmonella sp. for affecting teenagers and young adults. Persons with c ylobacter infection are more likely to be residents of metropolitan areas than their counterparts with salmonella enteritis. Virtually all persons with c ylobacter infection experience some diarrhoea three-quarters have abdominal pain approximately one-third report blood, and a similar proportion mucus in their stools. Children are more likely than adults to have mucus, and possibly blood, in their stools.
Primary health care service utilisation before and after entry into long-term care in Australia
Publisher: Elsevier BV
Date: 02-2024
Survival outcomes for patients with metastatic colorectal cancer (mCRC) based on primary site, right (R) colon versus left (L) colon versus rectal (Rec) primary: Results from the South Australian Regi
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2014
Influence of service characteristics on high priority performance indicators and standards in the BreastScreen Australia program
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-07-2014
DOI: 10.7314/APJCP.2014.15.14.5901
Abstract: Data from BreastScreen Australia Screening and Assessment Services (SAS) for 2002-2010 were analysed to determine whether some SAS characteristics were more conducive that others to high screening performance, as indicated by high priority performance indicators and standards. Indicators investigated related to: numbers of benign open biopsies, screen-detected invasive cancers, and interval cancers, and wait times between screening and assessment. Multivariate Poisson regression was undertaken using as candidate predictors of performance, SAS size (screening volume), urban or rural location, year of screening, accreditation status, and percentages of clients from culturally and linguistically erse backgrounds, rural and remote areas, and socio-economically disadvantaged areas. Performance standards for benign biopsies and invasive cancer detection were uniformly met irrespective of SAS location and size. The interval cancer standard was also met, except in 2003 when the 95% confidence interval of the rate still incorporated the national standard. Performance indicators improved over time for: benign open biopsy for second or subsequent screening rounds rates of invasive breast cancer detection for second or subsequent screening rounds and rates of small cancer detection. No differences were found over time in interval cancer rates. Interval cancer rates did not differ between non-metropolitan and metropolitan SAS, although state-wide SAS had lower rates. The standard for wait time between screening and assessment (being assessed <28 days) was mostly unmet and this applied in particular to SAS with high percentages of culturally and linguistically erse women in their screening populations. Gains in performance were observed, and all performance standards were met irrespective of SAS characteristics, except wait times to assessment. Additional descriptive data should be collected on SAS characteristics, and their associations with favourable screening performance, as these may be important when deciding on SAS design.
Antimicrobial Peptides Incorporating Halogenated Marine-Derived Amino Acid Substituents
Publisher: American Chemical Society (ACS)
Date: 04-05-2023
Consumption of sugar-sweetened beverages, juice, artificially-sweetened soda and bottled water: an Australian population study
Publisher: MDPI AG
Date: 19-03-2020
DOI: 10.3390/NU12030817
Abstract: Reducing consumption of free sugars, such as those found in high concentrations in manufactured products such as sugar-sweetened beverages (SSBs) and 100% fruit juices, is a global public health priority. This study aimed to measure prevalence of widely available pre-packaged non-alcoholic water-based beverages (carbonated sodas, sports drinks, energy drinks, artificially-sweetened sodas, fruit juices (any type), and bottled water) and to comprehensively examine behavioral, environmental, current health, and demographic correlates of consumption. A cross-sectional, nationally-representative population survey of 3430 Australian adults (18+ years) was conducted using computer-assisted telephone (mobile and landline) interviewing. Past week prevalence of pre-packaged drinks containing free sugar was 47.3% daily prevalence was 13.6%. Of all the pre-packaged drinks assessed, consumption of fruit juices (any type) was the most prevalent (38.8%), followed by bottled water (37.4%), soda (28.9%), artificially-sweetened soda (18.1%), sports drinks (8.1%), and energy drinks (4.2%). Higher soda consumption was associated with males, younger age, socio-economic disadvantage, frequent takeaway food consumption, availability of soda in the home, obesity, and a diagnosis of heart disease or depression. A diagnosis of Type 2 Diabetes was associated with increased likelihood of consuming artificially-sweetened sodas and decreased likelihood of consuming sugar-sweetened soda. SSB consumption is prevalent in Australia, especially among young adults and males, foreshadowing continued population weight gain and high burdens of chronic disease. To reduce consumption, Australia must take a comprehensive approach, incorporating policy reform, effective community education, and active promotion of water.
Use of guideline-recommended adjuvant therapies and survival outcomes for people with colorectal cancer at tertiary referral hospitals in South Australia
Publisher: Wiley
Date: 04-05-2018
DOI: 10.1111/JEP.12757
Abstract: Adjuvant care for colorectal cancer (CRC) has increased over the past 3 decades in South Australia (SA) in accordance with national treatment guidelines. This study explores the (1) receipt of adjuvant therapy for CRC in SA as related to national guideline recommendations, with a focus on stage C colon and stage B and C rectal cancer (2) timing of these adjuvant therapies in relation to surgery and (3) comparative survival outcomes. Data from the SA Clinical Cancer Registry from 4 tertiary referral hospitals for 2000 to 2010 were examined. Patterns of care were compared with treatment guidelines using multivariable logistic regression. Disease-specific survivals were calculated by treatment pathway. Four hundred forty-three (60%) patients with stage C colon cancer and 363 (46%) with stage B and C rectal cancer received guideline-recommended care. While an overall increase in proportion receiving adjuvant care was not evident across the study period, the proportion having neoadjuvant care increased substantially. Older age was an independent predictor of not receiving adjuvant care. Patients with stage C colon cancer who received recommended adjuvant care had a higher 5-year survival than those not receiving this care, ie, 71.2% vs 53.2%. Similarly adjuvant therapy was associated with better outcomes for stage C rectal cancers. The median time for receiving adjuvant care was 8 weeks. Survival was better for stage C CRC treated according to guidelines. Adjuvant care should be provided except where clear contraindications present. Other possible contributors to guideline adherence warranting additional investigation include co-morbidity status, multidisciplinary team involvement, and choice.
PROPOSALS FOR EPIDEMIOLOGICAL SURVEILLANCE OF OCCUPATIONAL HEALTH IN AUSTRALIA
Publisher: Wiley
Date: 26-03-2010
DOI: 10.1111/J.1753-6405.1984.TB00521.X
Abstract: Acute myocardial infarction (AMI) and the heart failure (HF) that often complicates this condition, are among the leading causes of death and disability worldwide. To reduce myocardial infarct (MI) size and prevent heart failure, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). In this regard, targeting cardiac innervation may provide a novel therapeutic strategy for cardioprotection. A number of cardiac neural pathways mediate the beneficial effects of cardioprotective strategies such as ischaemic preconditioning and remote ischaemic conditioning, and nerve stimulation may therefore provide a novel therapeutic strategy for cardioprotection. In this article, we provide an overview of cardiac innervation and its impact on acute myocardial IRI, the role of extrinsic and intrinsic cardiac neural pathways in cardioprotection, and highlight peripheral and central nerve stimulation as a cardioprotective strategy with therapeutic potential for reducing MI size and preventing HF following AMI. This article is part of a Cardiovascular Research Spotlight Issue entitled 'Cardioprotection Beyond the Cardiomyocyte', and emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225.
Development of an International Prostate Cancer Outcomes Registry
Publisher: Wiley
Date: 15-02-2016
DOI: 10.1111/BJU.13258
Abstract: To establish a Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ) for monitoring outcomes of prostate cancer treatment and care, in a cost-effective manner. Stakeholders were recruited based on their interest, importance in achieving the monitoring and reporting of clinical practice and patient outcomes, and in amalgamation of existing registries. Each participating jurisdiction is responsible for local governance, site recruitment, data collection, and data transfer into the PCOR-ANZ. To establish each local registry, hospitals and clinicians within a jurisdiction were approached to voluntarily contribute to the registry following relevant ethical approval. Patient contact occurs following notification of prostate cancer through a hospital or pathology report, or from a cancer registry. Patient registration is based on an opt-out model. The PCOR-ANZ is a secure web-based registry adhering to ISO 27001 standards. Based on a standardised minimum data set, information on demographics, diagnosis, treatment, outcomes, and patient reported quality of life, are collected. Eight of nine jurisdictions have agreed to contribute to the PCOR-ANZ. Each jurisdiction has commenced implementation of necessary infrastructure to support rapid rollout. PCOR-ANZ has defined a minimum data set for collection, to enable analysis of key quality indicators that will aid in assessing clinical practice and patient focused outcomes. PCOR-ANZ will provide a useful resource of risk-adjusted evidence-based data to clinicians, hospitals, and decision makers on prostate cancer clinical practice.
A retrospective analysis of Victorian and South Australian clinical registries for prostate cancer: trends in clinical presentation and management of the disease
Publisher: Springer Science and Business Media LLC
Date: 05-08-2016
Near‐fatal asthma in South Australia:descriptive features and medication use
Publisher: Wiley
Date: 06-1996
DOI: 10.1111/J.1445-5994.1996.TB01922.X
Abstract: Self-reported prior morbidity levels and medication use among survivors of a near-fatal asthma attack (NFA) were studied. To identify deficiencies in asthma management and opportunities for intervention. A hundred and twenty-seven consecutive patients aged 15 years or more presenting with a NFA to accident and emergency departments of teaching hospitals were interviewed. High levels of morbidity due to asthma were reported. Most cases (79%) reported symptoms occurring at least weekly in the three months before their NFA. A mean of 20.8 days was reportedly lost from work, school or other usual daily activity in the 12 months before these events. Regular use of beta agonist as nebuliser solution was reported by 27% of cases, increasing to 34.5% in response to increased symptoms, while 41% reported use of nebulised beta agonist in response to the NFA event. Less than half of all cases (46%) reported using an inhaled corticosteroid on a regular basis. Oral corticosteroids were used by 33% of cases at times of increased symptoms in the preceding 12 months. However, only 7% of cases reported initiating or increasing oral corticosteroids at the time of the NFA. Despite high levels of prior asthma morbidity, regular preventive inhaled corticosteroid use was not widespread in this series of NFA asthmatics. By comparison, over-reliance on regular beta agonist medication was common. Oral corticosteroids were rarely commenced in response to the NFA.
Pregnancy-associated gynecological cancer in New South Wales, Australia 1994-2013: a population-based historical cohort study
Publisher: Wiley
Date: 13-03-2023
DOI: 10.1111/AOGS.14530
Abstract: Pregnancy‐associated gynecological cancer (PAGC) refers to cancers of the ovary, uterus, fallopian tube, cervix, vagina, and vulva diagnosed during pregnancy or within 12 months postpartum. We aimed to describe the incidence of, and perinatal outcomes associated with, invasive pregnancy‐associated gynecological cancer. We conducted a population‐based historical cohort study using linked data from New South Wales, Australia. We included all women who gave birth between 1994 and 2013, with a follow‐up period extending to September 30, 2018. Three groups were analyzed: a gestational PAGC group (women diagnosed during pregnancy), a postpartum PAGC group (women diagnosed within 1 year of giving birth), and a control group (women with control diagnosis during pregnancy or within 1 year of giving birth). We used generalized estimation equations to compare perinatal outcomes between study groups. There were 1 786 137 deliveries during the study period 70 women were diagnosed with gestational PAGC and 191 with postpartum PAGC. The incidence of PAGC was 14.6/100 000 deliveries and did not change during the study period. Women with gestational PAGC (adjusted odds ratio [aAOR] 6.81, 95% confidence interval [CI] 2.97–15.62) and with postpartum PAGC (aOR 2.65, 95% CI 1.25–5.61) had significantly increased odds of a severe maternal morbidity outcome compared with the control group. Babies born to women with gestational PAGC were more likely to be born preterm (aOR 3.11, 95% CI 1.47–6.59) and were at increased odds of severe neonatal complications (aOR 3.47, 95% CI 1.45–8.31) compared with babies born to women without PAC. The incidence of PAGC has not increased over time perhaps reflecting, in part, the effectiveness of cervical screening and early impacts of human papillomavirus vaccination programs in Australia. The higher rate of preterm birth among the gestational PAGC group is associated with adverse outcomes in babies born to these women.
Overdiagnosis of cancer in Australia: the role of screening
Publisher: AMPCo
Date: 06-02-2020
DOI: 10.5694/MJA2.50494
Extended kalman filter beam tracking for millimeter wave vehicular communications
Publisher: IEEE
Date: 06-2020
Short Block-Length Codes for Ultra-Reliable Low Latency Communications
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2019
Tools for predicting patient-reported outcomes in prostate cancer patients undergoing radical prostatectomy: A systematic review of prognostic accuracy and validity
Publisher: Springer Science and Business Media LLC
Date: 06-06-2017
DOI: 10.1038/PCAN.2017.28
Abstract: Radical prostatectomy is a common surgical procedure performed to treat prostate cancer. Patient-reported outcomes after surgery include urinary incontinence, erectile dysfunction, decreased quality of life and psychological effects. Predictive tools to assess the likelihood of an in idual experiencing various patient-reported outcomes have been developed to aid decision-making when selecting treatment. A systematic review was undertaken to identify all papers describing tools for the prediction of patient-reported outcome measures in men with prostate cancer treated with radical prostatectomy. To be eligible for inclusion, papers had to provide a summary measure of accuracy. PubMed and EMBASE were searched from July 2007. Title/abstract screening, and full-text review were undertaken by two reviewers, while data extraction and critical appraisal was performed by a single reviewer. The search strategy identified 3217 potential studies, of which 191 progressed to full-text review and 14 were included. From these studies, 27 tools in total were identified, of which 18 predicted urinary symptoms, six predicted erectile function and one predicted freedom from a group of three outcomes ('trifecta') (biochemical recurrence, incontinence and erectile dysfunction). On the basis of tool accuracy (>70%) and external validation, two tools predicting incontinence and two tools predicting erectile dysfunction are ready for implementation. A small number of tools for the prediction of patient-reported outcomes following radical prostatectomy have been developed. Four tools were found to have adequate accuracy and validation and are ready for implementation for the prediction of urinary incontinence and erectile dysfunction.
Metastasectomy and BRAF mutation; an analysis of survival outcome in metastatic colorectal cancer
Publisher: Elsevier BV
Date: 02-2021
The survival outcome of patients with metastatic colorectal cancer based on the site of metastases and the impact of molecular markers and site of primary cancer on metastatic pattern
Publisher: Informa UK Limited
Date: 23-07-2018
Incidence of Comorbidities in Women with Breast Cancer Treated with Tamoxifen or an Aromatase Inhibitor: An Australian Population-Based Cohort Study
Publisher: SAGE Publications
Date: 2018
Abstract: The development of comorbidities has become increasingly relevant with longer-term cancer survival. To assess the pattern of comorbidities among Australian women with breast cancer treated with tamoxifen or an aromatase inhibitor. Retrospective cohort study using Pharmaceutical Benefits Scheme (PBS) data (10% s le) from January 2003 to December 2014. Dispensing claims data were used to identify comorbidities and classified with the Rx-Risk-V model. The breast cancer cohort had tamoxifen or an aromatase inhibitor dispensed between 2004 and 2011 with no switching between types of endocrine therapy. Comparisons were made between the breast cancer cohort and specific control groups (age- and sex-matched at 1:10 ratio without any dispensing of anti-neoplastic agents during the study period) for the development of five in idual comorbidities over time using Cox regression models. Women treated with tamoxifen had a higher incidence of cardiovascular conditions, diabetes, and pain or pain-inflammation, but a lower incidence of hyperlipidaemia compared with non-cancer control groups, as indicated by PBS data. Women treated with aromatase inhibitors were more likely to develop cardiovascular conditions, osteoporosis, and pain or pain-inflammation compared with non-cancer control groups. The risks of hyperlipidaemia and osteoporosis were significantly lower among tamoxifen users compared with aromatase inhibitor users. Women with hormone-dependent breast cancer treated with an endocrine therapy had a higher risk of developing specified comorbid conditions than women without cancer, with different comorbidity profiles for those on tamoxifen versus aromatase inhibitors. Further research into the causes and mechanism of development and management of comorbidities after cancer is needed.
Variations in care for operable breast cancer and outcomes between rural and metropolitan centers in Australia
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2009
DOI: 10.1200/JCO.2009.27.15_SUPPL.E11517
Abstract: e11517 Background: The causes of variation in breast cancer survival remain uncertain. Care provided to women with breast cancer may vary in relation to both the care setting and characteristics of the clinicians. Methods: To compare the outcomes of management of breast cancer treated in rural and metropolitan centers, a prospective audit of breast cancer in a region of Australia was undertaken. Over a nine-year observation period 2102 women with invasive breast cancer underwent potentially curative surgery. Treatments received, including systemic adjuvant therapy, were compared to contemporary guideline-based indicators. Breast cancer specific mortality was analyzed using Cox proportional hazards models. Results: Overall agreement of received treatment with the indicators was high. Women treated within rural centers were, however, much less likely to receive post operative radiotherapy after breast conserving surgery (86.4% vs. 97.0% p .001). The overall recurrence rate, including distant metastases, for all women was 11.6%. Local or regional recurrence was more frequent in rural centers compared with metropolitan centers (4.1% versus 2.1% p=0.05). Breast cancer mortality was increased in women with large tumors, high grade disease, and positive axillary lymph nodes. Non-compliance with treatment guidelines was associated with a trend towards increased breast cancer mortality (HR=1.55 p=0.056). After adjustment for these factors and patient age, undergoing surgery in rural centers was associated with increased breast cancer mortality (HR=1.84 p .001). Although women treated in rural centers were older, their cancer stage and tumour characteristics were similar to those of women treated in metropolitan centers. Non-cancer related mortality was elevated in women treated in rural centers compared with women travelling to a city for surgery (HR=2.08 p=0.005). Conclusions: Increased non-cancer related mortality in rural treated women suggests increased medical co-morbidity in this group, which may have influenced treatment choices and outcomes. Low rates of adjuvant radiotherapy were noted for women treated in rural centers. In addition, clinically significant differences in outcome, including breast cancer mortality, were observed. No significant financial relationships to disclose.
Assessment of contribution of Australia's energy production to CO2 emissions and environmental degradation using statistical dynamic approach
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.SCITOTENV.2018.05.204
Abstract: Energy production remains the major emitter of atmospheric emissions, thus, in accordance with Australia's Emissions Projections by 2030, this study analyzed the impact of Australia's energy portfolio on environmental degradation and CO
Oral cancer in South Australia—incidence and case survival
Publisher: Wiley
Date: 10-1983
Survival improvements associated with access to biologic agents: Results from the South Australian (SA) Metastatic Colorectal (mCRC) Registry.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2014
Client Scheduling in Wireless Federated Learning Based on Channel and Learning Qualities
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2022
Cardiotoxicity following Cancer Treatment: Linked Health Data Analysis
Publisher: Elsevier BV
Date: 08-2014
Associations of advanced age with comorbidity, stage and primary subsite as contributors to mortality from colorectal cancer
Publisher: Frontiers Media SA
Date: 06-04-2023
DOI: 10.3389/FPUBH.2023.1101771
Abstract: Although survival from colorectal cancer (CRC) has improved substantially in recent decades, people with advanced age still have a high likelihood of mortality from this disease. Nonetheless, few studies have investigated how cancer stage, subsite and comorbidities contribute collectively to poor prognosis of older people with CRC. Here, we decided to explore the association of age with mortality measures and how other variables influenced this association. Using linkage of several administrative datasets, we investigated the risk of death among CRC cases during 2003–2014. Different models were used to explore the association of age with mortality measures and how other variables influenced this association. Our results indicated that people diagnosed at a young age and with lower comorbidity had a lower likelihood of all-cause and CRC-specific mortality. Aging had a greater association with mortality in early-stage CRC, and in rectal cancer, compared that seen with advanced-stage CRC and right colon cancer, respectively. Meanwhile, people with different levels of comorbidity were not significantly different in terms of their increased likelihood of mortality with advanced age. We also found that while most comorbidities were associated with all-cause mortality, only dementia [SHR = 1.43 (1.24–1.64)], Peptic ulcer disease [SHR = 1.12 (1.02–1.24)], kidney disease [SHR = 1.11 (1.04–1.20)] and liver disease [SHR = 1.65 (1.38–1.98)] were risk factors for CRC-specific mortality. This study showed that the positive association of advanced age with mortality in CRC depended on stage and subsite of the disease. We also found only a limited number of comorbidities to be associated with CRC-specific mortality. These novel findings implicate the need for more attention on factors that cause poor prognosis in older people.
Cancer treatment and the risk of cancer death among Aboriginal and non-Aboriginal South Australians
Publisher: Springer Science and Business Media LLC
Date: 29-10-2019
DOI: 10.1186/S12913-019-4534-Y
Abstract: Aboriginal and Torres Strait Islander Australians have poorer cancer outcomes than other Australians. Comparatively little is known of the type and amount of cancer treatment provided to Aboriginal and Torres Strait Islander people and the consequences for cancer survival. This study quantifies the influence of surgical, systemic and radiotherapy treatment on risk of cancer death among matched cohorts of cancer cases and, the comparative exposure of cohorts to these treatments. Cancers registered among Aboriginal South Australians in 1990–2010 ( N = 777) were matched with randomly selected non-Indigenous cases by sex, birth and diagnostic year, and primary site, then linked to administrative cancer treatment for the period from 2 months before to 13 months after diagnosis. Competing risk regression summarised associations of Indigenous status, geographic remoteness, comorbidities, cancer stage and treatment exposure with risk of cancer death. Fewer Aboriginal cases had localised disease at diagnosis (37.2% versus 50.2%) and they were less likely to: experience hospitalisation with cancer diagnosis, unadjusted odds ratio (UOR) = 0.76 95%CI = 0.59–0.98 have surgery UOR = 0.65 95%CI = 0.53–0.80 systemic therapies UOR = 0.64 95%CI = 0.52–0.78 or radiotherapy, UOR = 0.76 95%CI = 0.63–0.94. Localised disease carried lower risk of cancer death compared to advanced cases receiving surgery or systemic therapies, SHR = 0.34 95%CI = 0.25–0.47 and SHR = 0.35 95%CI = 0.25–0.48. Advanced disease and no treatment carried higher risk of cancer death, SHR = 1.82 95%CI = 1.26–2.63. The effects of treatment did not differ between Aboriginal and non-Indigenous cohorts. However, comparatively less exposure to surgical and systemic treatments among Aboriginal cancer cases further complicated the disadvantages associated with geographic remoteness, advanced stage of disease and co-morbid conditions at diagnosis and add to disparities in cancer death. System level responses to improving access, utilisation and quality of effective treatments are needed to improve survival after cancer diagnosis.
BLOOD LEAD LEVELS IN CHILDREN IN THE NORTHWEST OF ADELAIDE
Publisher: AMPCo
Date: 05-1986
DOI: 10.5694/J.1326-5377.1986.TB112272.X
Abstract: Capillary blood lead levels were investigated in a s le of 513 children of preschool age who were drawn from an industrial working-class region of Adelaide. The geometric mean lead level was 16.3 micrograms/dL. Fourteen children (2.7%) had a blood lead level of at least 30 micrograms/dL, which is designated by the National Health and Medical Research Council as "the level of concern". Boys tended to have higher lead levels than did girls, and children who lived closer to the inner city generally had higher levels than did those who lived further away. Compared with most other Australian findings, the blood lead levels in this study tended to be high. We suspect that the age groups that were studied, and the industrial urban quality of the region that was included, would have had an important bearing on this finding. However, the proportion of children with elevated lead levels in this study did not seem high when compared with US data for children in a comparable age range.
Tooth loss, the wearing of dentures and the demand for dental care in the south-east of South Australia
Publisher: Wiley
Date: 12-1974
DOI: 10.1111/J.1834-7819.1974.TB02371.X
Abstract: The genetic basis of hearing loss in humans is relatively poorly understood. In recent years, experimental approaches including laboratory studies of early onset hearing loss in inbred mouse strains, or proteomic analyses of hair cells or hair bundles, have suggested new candidate molecules involved in hearing function. However, the relevance of these genes/gene products to hearing function in humans remains unknown. We investigated whether single nucleotide polymorphisms (SNPs) in the human orthologues of genes of interest arising from the above-mentioned studies correlate with hearing function in children. 577 SNPs from 13 genes were each analysed by linear regression against averaged high (3, 4 and 8 kHz) or low frequency (0.5, 1 and 2 kHz) audiometry data from 4970 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth-cohort at age eleven years. Genes found to contain SNPs with low p-values were then investigated in 3417 adults in the G-EAR study of hearing. Genotypic data were available in ALSPAC for a total of 577 SNPs from 13 genes of interest. Two SNPs approached s le-wide significance (pre-specified at p = 0.00014): rs12959910 in CBP80/20-dependent translation initiation factor (CTIF) for averaged high frequency hearing (p = 0.00079, β = 0.61 dB per minor allele) and rs10492452 in L-plastin (LCP1) for averaged low frequency hearing (p = 0.00056, β = 0.45 dB). For low frequencies, rs9567638 in LCP1 also enhanced hearing in females (p = 0.0011, β = -1.76 dB males p = 0.23, β = 0.61 dB, likelihood-ratio test p = 0.006). SNPs in LCP1 and CTIF were then examined against low and high frequency hearing data for adults in G-EAR. Although the ALSPAC results were not replicated, a SNP in LCP1, rs17601960, is in strong LD with rs9967638, and was associated with enhanced low frequency hearing in adult females in G-EAR (p = 0.00084). There was evidence to suggest that multiple SNPs in CTIF may contribute a small detrimental effect to hearing, and that a sex-specific locus in LCP1 is protective of hearing. No in idual SNPs reached s le-wide significance in both ALSPAC and G-EAR. This is the first report of a possible association between LCP1 and hearing function.
Medroxyprogesterone acetate therapy in advanced breast cancer: the predictive value of androgen receptor expression.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 07-1995
DOI: 10.1200/JCO.1995.13.7.1572
Abstract: To determine the predictive value of androgen receptor (AR) levels in primary tumors of women who undergo medroxyprogesterone acetate (MPA) therapy for advanced breast cancer after relapse on tamoxifen adjuvant therapy. Between 1984 and 1987 at Flinders Medical Centre, South Australia, 136 postmenopausal women received adjuvant tamoxifen therapy for lymph node-positive breast cancer. Estrogen receptor (ER), progesterone receptor (PgR), and AR levels, tumor size, and degree of axillary node involvement were determined at the time of diagnosis. The median follow-up period was 81 months 89 women developed metastatic disease, 83 of whom subsequently received MPA (500 mg/d). The objective response rate ([RR] ie, complete response [CR] and partial response [PR]) and progression-free interval (PFI) were assessed in response to MPA therapy. Associations between RR, PFI, and primary tumor characteristics including ER, PgR, and AR levels were examined using the Mann-Whitney U test, Kaplan-Meier product-limit estimator, and Cox proportional hazards regression, as appropriate. Thirty-two of 83 patients (38.6%) responded to MPA. RR was significantly associated with the presence of AR (P .001), but not with other primary tumor characteristics or duration of tamoxifen therapy. After initiation of MPA treatment, PFI increased with increasing concentration of AR in the primary tumor. Response to MPA after adjuvant tamoxifen treatment for lymph node-positive breast cancer was positively associated with AR level in the primary tumor. This finding suggests that MPA action in breast cancer may be mediated in part by the AR.
The use of travel time to measure geographic accessibility to breast screening services in New South Wales, Australia short paper
Publisher: Exeley, Inc.
Date: 2020
Cancer case‐survival rates for South Australia: a comparison with US rates and a preliminary investigation of time trends
Publisher: AMPCo
Date: 06-1988
DOI: 10.5694/J.1326-5377.1988.TB93810.X
Abstract: Five-year relative case-survival rates for all cancers collectively are similar in South Australia (49%) and the United States (50%). This suggests that outcomes of cancer treatment do not vary appreciably between the two populations. There is an indication of higher survival rates in South Australia for melanoma, Hodgkin's disease, multiple myeloma and gastric cancer, but lower survival rates for cancers of the thyroid, corpus uteri, prostate, colon, kidney and lung. The differences in point estimates of the rates were most conspicuous for Hodgkin's disease, multiple myeloma and prostatic cancer. The reasons for a cautious interpretation of these findings are discussed and some possible explanations are suggested. South Australian data point to an upward trend in survival rates between the diagnostic periods 1977-1980 and 1981-1985 for patients with Hodgkin's disease, diffuse large-cell lymphomas, melanomas and cancers of the prostate and rectum.
Trends in perinatal characteristics in South Australia, 1981 to 1994, by place of residence of mother
Publisher: Elsevier BV
Date: 08-1997
DOI: 10.1111/J.1467-842X.1997.TB01739.X
Abstract: We investigated differentials and time trends in perinatal mortality and perinatal risk factors by geographic area of residence in South Australia during 1981-1994, to assess whether sociodemographic inequalities had lessened. The areas analysed were Adelaide and the country region of South Australia, with Adelaide being ided by socioeconomic status into two ares. Subjects were 267,116 singleton births of at least 400 g birthweight (or at least 20 weeks' gestation) notified to the state's perinatal data collection. Year of birth, residential area, and interactions between year of birth and residential area were analysed as predictors of perinatal risk factors and deaths. There was a statistically significant decline in the perinatal death rate in all residential areas (mainly because of a decrease in neonatal deaths), which did not vary significantly by area. The frequency of low birthweight (< 2500 g) increased in the country areas and in the lower socioeconomic areas of Adelaide, but not in the higher socioeconomic areas. Although premature births increased in all areas, the increase was less pronounced for the higher socioeconomic areas of Adelaide. By comparison, although all areas showed an increase in the proportions of mothers aged 35 years or over, the increase was larger for the higher socioeconomic areas. Australia has a national policy of reducing social inequalities in health status. Perinatal mortality rates declined in Adelaide and country residential areas from 1981 to 1994. This trend is favourable, but from the relativities of these rates by residential area, there is not compelling evidence of a reduction in inequalities.
Comparable survival outcome of metastatic colorectal cancer in Indigenous and non-Indigenous patients: Retrospective analysis of the South Australian metastatic colorectal cancer registry
Publisher: Wiley
Date: 10-08-2016
DOI: 10.1111/AJR.12219
Abstract: This study aims to investigate disparities in demographics, disease characteristics, treatment and overall survival between South Australian (SA) Indigenous and non-Indigenous patients with metastatic colorectal cancer (mCRC). This employs a retrospective population study using the SA mCRC registry. The SA mCRC registry identifies mCRC patients from hospital encounters, histopathology reports, medical oncology letters, clinician notification, attendances at multidisciplinary meetings and death audits by the SA Cancer Registry. A total of 2865 adult mCRC patients including 14 Indigenous patients were identified through the SA mCRC registry between February 2006 and August 2013. Patients were linked to the SA Cancer Registry to obtain Indigenous status. Demographic, disease and treatment characteristics were compared using Chi-squared test and t-test while overall survival defined as time to any cause of death was analysed using Cox regression. No difference was observed for clinical characteristics, except for a higher proportion of Indigenous patients receiving chemotherapy (85.7% versus 58.5% P = 0.04). The rate of liver surgery was similar across the two groups (21.0% versus 15.1% P = 0.40). The median overall survivals were equivalent (11.9 months versus 15.1 months hazard ratio = 1.00 95% confidence interval for hazard ratio, 0.54-1.86). Clinical characteristics and survival outcomes were similar between Indigenous and non-Indigenous patients captured on the SA mCRC registry, and outcome of those who have an access to comprehensive cancer care appeared independent of Indigenous status and in line with large clinical trials. Underestimation of Indigenous cases due to their lower utilisation of cancer service could not be excluded and ultimately the accurate reporting of these patients is crucial.
Breast cancer treatment and survival differences in women in remote and socioeconomically disadvantaged areas, as demonstrated by linked data from New South Wales (NSW), Australia
Publisher: Springer Science and Business Media LLC
Date: 21-03-2021
DOI: 10.1007/S10549-021-06170-2
Abstract: Reducing variations in cancer treatment and survival is a key aim of the NSW Cancer Plan. Variations in breast cancer treatment and survival in NSW by remoteness and socioeconomic status of residence were investigated to determine benchmarks. Reducing variations in cancer treatment and survival is a key aim of the NSW Cancer Plan. Variations in breast cancer treatment and survival in NSW by remoteness and socioeconomic status of residence were investigated to determine benchmarks. A retrospective cohort study used linked data for invasive breast cancers, diagnosed in May 2002 to December 2015 from the NSW Cancer Registry, with corresponding inpatient, and medical and pharmaceutical insurance data. Associations between treatment modalities, area socioeconomic status and residential remoteness were explored using logistic regression. Predictors of breast cancer survival were investigated using Kaplan–Meier product-limit estimates and multivariate competing risk regression. Results indicated a high 5-year disease-specific survival in NSW of 90%. Crude survival was equivalent by residential remoteness and marginally lower in lower socioeconomic areas. Competing risk regression showed equivalent outcomes by area socioeconomic status, except for the least disadvantaged quintile, which showed a higher survival. Higher sub-hazard ratios for death occurred for women with breast cancer aged 70 + years, and more advanced stage. Adjusted analyses indicated more advanced stage in lower socioeconomic areas, with less breast reconstruction and radiotherapy, and marginally less hormone therapy for women from these areas. Conversely, among these women who had breast conserving surgery, there was higher use of chemotherapy. Remoteness of residence was associated in adjusted analyses with less radiotherapy and less immediate breast reconstruction. In these short term data, remoteness of residence was not associated with lower survival. This study provides benchmarks for monitoring future variations in treatment and survival.
Endometrial cells as a predictor of uterine cancer
Publisher: Wiley
Date: 29-01-2007
Female breast cancer in New South Wales, Australia, by country of birth: implications for health-service delivery
Publisher: Springer Science and Business Media LLC
Date: 17-02-2021
DOI: 10.1186/S12889-021-10375-X
Abstract: NSW has a multicultural population with increasing migration from South East Asia, the Western Pacific and Eastern Mediterranean. To compare cancer stage, treatment (first 12 months) and survival for 12 country of birth (COB) categories recorded on the population-based NSW Cancer Registry. Historic cohort study of invasive breast cancers diagnosed in 2003–2016. Data for 48,909 women (18+ ages) analysed using linked cancer registry, hospital inpatient and Medicare and pharmaceutical benefits claims data. Comparisons by COB using multivariate logistic regression and proportional hazards regression with follow-up of vital status to April 30th, 2020. Compared with the Australia-born, women born in China, the Philippines, Vietnam and Lebanon were younger at diagnosis, whereas those from the United Kingdom, Germany, Italy and Greece were older. Women born in China, the Philippines, Vietnam, Greece and Italy lived in less advantaged areas. Adjusted analyses indicated that: (1) stage at diagnosis was less localised for women born in Germany, Greece, Italy and Lebanon (2) a lower proportion reported comorbidity for those born in China, the Philippines and Vietnam (3) surgery type varied, with mastectomy more likely for women born in China, the Philippines and Vietnam, and less likely for women born in Italy, Greece and Lebanon (4) radiotherapy was more likely where breast conserving surgery was more common (Greece, Italy, and Lebanon) and the United Kingdom and (5) systemic drug therapy was less common for women born in China and Germany. Five-year survival in NSW was high by international standards and increasing. Adjusted analyses indicate that, compared with the Australian born, survival from death from cancer at 5 years from diagnosis was higher for women born in China, the Philippines, Vietnam, Italy, the United Kingdom and Greece. There is ersity by COB of stage, treatment and survival. Reasons for survival differences may include cultural factors and healthier migrant populations with lower comorbidity, and potentially, less complete death recording in Australia if some women return to their birth countries for treatment and end-of-life care. More research is needed to explore the cultural and clinical factors that health services need to accommodate.
Probabilistic small-cell caching: Performance analysis and optimization
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2017
Detection by screening mammography is a powerful independent predictor of survival in women diagnosed with breast cancer
Publisher: Elsevier BV
Date: 02-2004
The first comprehensive report on Indigenous Australian women's inequalities in cervical screening
Publisher: Wiley
Date: 11-04-2016
DOI: 10.1002/CNCR.29954
Multi-jurisdictional Prostate cancer registry linkage
Publisher: Swansea University
Date: 25-08-2022
Abstract: ObjectiveThe Prostate Cancer Outcomes Registry for Australian and New Zealand (PCOR-ANZ) aims to monitor population-wide prostate cancer characteristics, treatments, and outcomes. However, long-term follow-up of secondary treatments, disease progression, and side effects is limited. This novel project provides increased utility, enhancing this clinical registry by integrating national and jurisdictional data. ApproachThe Tasmanian and South Australian jurisdictional registries (PCOR-Tas and PCOR-SA) are being treated as pilots for this nationally relevant data linkage project. Each contains descriptive data on clinical characteristics, primary treatments, survival, and patient-reported outcomes for prostate cancer in their jurisdictions. Data linkages include state-based hospital patient records and central cancer registries, with additional linkages to national data on prescribed medicines, procedures, and deaths refer Figure 1. Authorisation by contributing custodians and ethics committees, and funding from the Movember charity, has enabled the more detailed evaluation of patient follow-up after the initial treatment to examine historical trends, health service utilisation, disparities and gaps, and long-term patient outcomes. ResultsSouth Australian study cohort consists of all men in the SACR (South Australia's central cancer registry) who were diagnosed with prostate cancer [ICD10=C61] as well as any additional men recorded in the PCOR-SA diagnosed from January 2002 to June 2021 (n=25,000). Men who do not have SA addresses recorded in either source are excluded from the South Australian pilot. The Tasmanian cohort is younger (established 2015) and smaller (n=2080), but for comparison is linked with the equivalent local and national datasets The South Australian data linkage is being undertaken by SA NT DataLink, with the Tasmanian linkage undertaken by the Tasmania Data linkage Unit. For both jurisdictions, the national datasets are being linked by the Australian Institute for Health and Welfare (AIHW). ConclusionSince the Australian health system involves components managed at both the State and Federal levels, multijurisdictional data linkage adds additional complexity to linkage projects. Undertaking this project was not without its challenges, but it demonstrates what can be achieved and the value of enhancing high-quality clinical registry data to address important outcomes in prostate cancer.
Privacy Preservation in Location-Based Services: A Novel Metric and Attack Model
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2021
Prognosis of sub-types of cancer of unknown primary (CUP) compared to metastatic cancer
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-06-2007
DOI: 10.1200/JCO.2007.25.18_SUPPL.21010
Abstract: 21010 Background: The aim is to study the clinical characteristics and outcomes of a complete cohort of presentations of Cancer of Unknown Primary (CUP) compared with patients presenting with metastatic cancer of known primary site. Methods: All persons diagnosed with cancer in New South Wales, Australia, from 1980 to 2004 were studied using a population based cancer registry. Patients classified as CUP were documented, compared to those with initial metastatic presentations of a known primary, for the same period. Results: There were 65,239 histologically or cytologically confirmed metastatic cancers presented. Of these 46,435 (77%) were metastatic with a known primary site and 13,280 (22%) were CUP. The median survival (ms) of all patients presenting with CUP was 3 months compared with 7 months for metastatic cancers of known primary site (p .0001). Patients with CUP with adenocarcinoma had significantly worse prognosis compared to metastatic adenocarcinoma of known primary site. However patients with squamous cell CUP had a significantly better outcome (ms 12 months) than metastatic squamous histology with a known primary site (ms 5 months, p .0001) with 31% of squamous cell CUP alive at 6 years. For those with CUP and adenocarcinoma the risk of dying was 80% greater compared to those with a known primary and adenocarcinoma (HR 1.8 95%CI 1.7–1.8). For those with CUP and squamous cell carcinoma the risk of dying was 50 % less (HR 0.49 95%CI 0.46–0.53). CUP with small cell, (HR 0.77 95%CI 0.71–0.85) and undifferentiated histology (HR 0.84, 95%CI 0.76–0.93) after controlling for sex and age, had a significantly better prognosis than other metastatic cancers. Germ cell CUP represented only 0.2% of all CUP presentations. Conclusions: CUP is a heterogeneous classification of cancer with a poorer prognosis overall when compared to metastatic cancer of known primary site especially if adenocarcinoma. However, squamous cell and small cell CUP had a better prognosis suggesting a need for specific and more focused treatment. Lack of trends for less CUP presentations compared to reducing metastatic cancer over this 24 year period suggests that CUP is in part a distinct clinico-pathological entity rather than a missed primary diagnosis. No significant financial relationships to disclose.
The effect of treatment provided by dentists and therapists in the South Australian school dental service. The second report
Publisher: Wiley
Date: 04-1976
DOI: 10.1111/J.1834-7819.1976.TB02840.X
Abstract: A survey of over 2,000 second year high school students at 13 South Australian schools indicated that those who had received school dental care at primary school had fewer carious teeth and, in some respects, better oral hygiene habits. Whilst they were better informed on dental subjects than were control students, fewer had attended a private dentist since leaving primary school.
Brain metastasis in advanced colorectal cancer: Results from the South Australian metastatic colorectal cancer (SAmCRC) registry
Publisher: Elsevier BV
Date: 10-2016
“You can’t just eat 16 teaspoons of sugar so why would you drink 16 teaspoons’ worth of sugar?”: a qualitative study of young adults’ reactions to sugary drink warning labels
Publisher: Springer Science and Business Media LLC
Date: 22-06-2022
DOI: 10.1186/S12889-022-13648-1
Abstract: Several jurisdictions have introduced nutrient warning front of pack (FoP) labels in an effort to curb consumption of ultra-processed foods and beverages high in free sugars (sugars added to foods and beverages, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates). This study aimed to explore consumer understanding and perceptions of FoP warning labels that convey different nutritional and health information messages regarding the consumption of sugary drinks. Sixteen focus groups were held with 4–8 young adults per group (aged 18–24 n = 105 participants in total) stratified by education level, location (rural centres, large cities) and gender (males, females) to ensure ersity. Labels shown to participants during group discussions included text warning labels of health effects, exercise equivalents, calorie/kilojoule information and sugar content as a “high in” label and as teaspoons (text and pictograms). Thematic analysis was undertaken. Four themes were identified related to participants’ perceived effectiveness of labels: the extent to which labels were perceived to be useful, relevant and credible the extent to which a label elicited shock or disgust (perceived aversiveness) the extent to which the label message was resistant to self-exemption and participants’ perceived potential of the label to reduce purchasing and consumption behaviour. Across all four themes, labels communicating the number of teaspoons of sugar in a sugary drink (whether by text or pictogram) were perceived as the most impactful, resistant to self-exemption and to have the greatest potential to reduce consumption, with enhanced reactions to the pictogram label. Labels depicting health effects, exercise equivalents, calorie/kilojoule information or a general ‘high in sugar’ warning were perceived by consumers to be less effective in one or more themes. Labels conveying the amount of sugar in a beverage in teaspoons were perceived as highly factual, relatable and interpretable, and as having the greatest potential to impact consumption attitudes and intentions. Further quantitative studies are required to compare the potential effectiveness of the teaspoons of sugar labels in reducing purchasing and consumption behaviour than other alternative warning labels, such as health effects or “high in” sugar labels.
Differences in cancer incidence by age at diagnosis between Aboriginal and non-Aboriginal people for cancer types included in Australian national screening programs
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.CANEP.2019.03.012
Abstract: This study examined age distributions and age-specific incidence of screened cancers by Aboriginal status in New South Wales (NSW) to consider the appropriateness of screening target age ranges. The NSW Cancer Registry identified invasive (female) breast, cervical and bowel cancers in people diagnosed in 2001-2014. Aboriginal people were younger at diagnosis with higher proportions of breast and bowel cancers diagnosed before the screening target age range (<50 years) compared with non-Aboriginal people (30.6% vs. 22.8%, and 17.3% vs. 7.3%, respectively). Age-specific incidence rate ratios (IRRs) were lower/similar for breast and bowel cancers in younger and higher in older Aboriginal than non-Aboriginal people. All age-specific cervical cancer IRRs were higher for Aboriginal compared with non-Aboriginal people. Although higher proportions of breast and colorectal cancers were diagnosed before screening commencement age in Aboriginal people, this does not necessarily indicate a need for earlier screening commencement. Other aspects needing consideration include benefits, harms and cost-effectiveness.
Infiltrating ductal carcinoma of the breast in South Australia Sizes of primary lesions and histological evidence of axillary nodal metastases
Publisher: AMPCo
Date: 07-1983
DOI: 10.5694/J.1326-5377.1983.TB142081.X
Abstract: There are few data available at the community level in Australia to indicate the stages of breast cancers at diagnosis, and whether there is a trend towards earlier detection. Therefore, the tumour diameters and extent of axillary nodal metastases in 434 cases of infiltrating ductal carcinoma, which were reported to the South Australian Central Cancer Registry during a three-year period, were analysed. Approximately 27% of tumours were 1.9 cm or less in diameter, about 48% were in the 2.0 cm to 3.9 cm range, and 25% had a diameter of 4.0 cm or greater. Almost half of the patients (48%) had axillary nodal metastases. The extent of nodal involvement was positively related to size of the primary lesion both in women under 50 years of age and in older women. It is intended that this information will be used in future analyses to discover trends over time in tumour size and nodal involvement at diagnosis.
DENTAL HEALTH EDUCATION
Publisher: Wiley
Date: 06-1980
Variations in colorectal cancer pattern of care by age and comorbidity in South Australia
Publisher: Wiley
Date: 21-04-2023
DOI: 10.1002/CAM4.5901
Abstract: Advanced age is associated with decreased likelihood of colorectal cancer treatment. Here, we investigated the extent to which comorbidities are accountable for this lesser treatment. Using population‐based datasets, the pattern of care among CRC cases in South Australia during 2004–2013 was investigated. Models were used to investigate associations of age with each treatment type, and differences in these associations were explored by comorbidity and cancer site. The presence of comorbidity was associated with a significantly weaker relationship of age with surgery and chemotherapy. The association of age with surgery also varied for colon and rectal primary cancer sites. In idual comorbidity types varied in their associations with each treatment category. For ex le, dementia was associated with less chemotherapy provision, however, it was not significantly related to the likelihood of surgery. This study indicates that the association of age with surgical treatment differed significantly by the CRC subsite. Comorbidity moderated the negative association of age with chemotherapy, and less so, with extent of surgery. Results were novel in indicating associations of multiple in idual comorbidity types with CRC treatment modalities. The data suggest that different in idual comorbidity types may have different effects on treatment and should be studied separately.
Does emotional support influence survival? Findings from a longitudinal study of patients with advanced cancer
Publisher: Springer Science and Business Media LLC
Date: 07-12-2004
DOI: 10.1007/S00520-004-0722-2
Abstract: A total of 163 patients with advanced cancer at an Australian teaching hospital were interviewed to investigate whether emotional support was predictive of survival duration. Survival was analysed using the Kaplan-Meier product-limit estimate, and multivariable Cox proportional hazards regression, from entry to the study in 1996 to date of death, or 31 March 2003, whichever came first. The number of confidants with whom feelings were being shared at the time of study entry was predictive of survival duration. The regression analysis indicated that compared with patients reporting two or three confidants, the relative risk of a shorter survival (95% confidence limits) was 0.44 (0.25, 0.79) for those with no or one confidant and 0.60 (0.40, 0.89) for those with four or more confidants. Shorter survivors shared their feelings more with family members than longer survivors. Conversely, longer survivors shared their feelings more with friends than shorter survivors. These relationships did not hold at 12 weeks from study entry. At that time, longer survivors were more likely to be sharing their feelings with a doctor than shorter survivors. The relationship between emotional support and survival duration was not linear and appeared to be more complex than reported previously for people with heart disease and newly diagnosed breast cancer.
The potential for tailored screening to reduce bowel cancer mortality for Aboriginal and Torres Strait Islander peoples in Australia
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.JCPO.2022.100325
Abstract: Australian Aboriginal and Torres Strait Islander peoples experience health and socioeconomic disparities, including lower life-expectancy, have a younger mean age of colorectal cancer (CRC) diagnosis, and lower CRC survival than non-Indigenous Australians. The National Bowel Cancer Screening Program (NBCSP) provides biennial CRC screening for Australians aged 50-74 years to reduce the burden of CRC. The 2019 participation rate was 42% nationwide and 23% in Aboriginal and Torres Strait Islander peoples. For Aboriginal and Torres Strait Islander peoples, this study aims to estimate the health outcomes and cost-effectiveness of the current NBCSP and extensions to include people < 50 years. An existing microsimulation model, Policy1-Bowel, was adapted to the Aboriginal and Torres Strait Islander population and was used to evaluate three strategies assuming biennial iFOBT screening from 50-74, 45-74, or 40-74 years under two participation scenarios: 23% and 42% per screening round (psr.). At 23-42% participation psr., the current NBCSP was predicted to reduce lifetime CRC incidence and mortality by 14-24% and 23-39%, respectively, be cost-effective (incremental cost-effectiveness ratio 95 (> 60). For Aboriginal and Torres Strait Islander peoples, the current NBCSP is cost-effective but participation is limited. Lowering the screening start age will further reduce CRC incidence and mortality. These findings highlight a need to increase NBCSP participation whilst exploring the feasibility and acceptability of lowering the NBCSP start age for Aboriginal and Torres Strait Islander peoples. These findings could inform new co-designed, community-led strategies to improve CRC outcomes for Aboriginal and Torres Strait Islander peoples.
Diagnosis, treatment planning and referral by school dental therapists
Publisher: Wiley
Date: 08-1974
DOI: 10.1111/J.1834-7819.1974.TB02788.X
Abstract: Parkinson's disease was long considered a non-hereditary disorder. Despite extensive research trying to find environmental risk factors for the disease, genetic variants now stand out as the major causative factor. Since a number of genes have been implicated in the pathogenesis it seems likely that several molecular pathways and downstream effectors can affect the trophic support and/or the survival of dopamine neurons, subsequently leading to Parkinson's disease. The present review describes how toxin-based animal models have been valuable tools in trying to find the underlying mechanisms of disease, and how identification of disease-linked genes in humans has led to the development of new transgenic rodent models. The review also describes the current status of the most common genetic susceptibility factors for Parkinson's disease identified up to today.
Factors predictive of preferred place of death in the general population of South Australia
Publisher: SAGE Publications
Date: 06-2006
DOI: 10.1191/0269216306PM1149OA
Abstract: In a population survey, 2652 respondents aged 15+years reported their preferred place of death, if dying of ‘a terminal illness such as cancer or emphysema’, to be home (70%), a hospital (19%), hospice (10%), or nursing home ( 1%). The majority of respondents in all socio-demographic categories reported a preference for dying at home, with the greatest majorities occurring in younger age groups. After weighting to the age-sex distribution of all South Australian cancer deaths, 58% in our survey declared a preference to die at home, which is much higher than the 14% of cancer deaths that actually occurred at home in South Australia in 2000-2002. Multivariable analyses indicate that predictors of preferred home death include younger age, male, born in the UK/Ireland or Italy/Greece, better physical health, poorer mental health, and fewer concerns about dying at home. Predictors of preference for death in a hospice rather than hospital include older age, female, single, metropolitan residence, having higher educational and income levels, paid employment, awareness of advanced directives, and interpreting ‘dying with dignity’ as death without pain or suffering. Investigating the differences between preferred and actual places of death may assist service providers to meet end-of-life wishes.
The organised chaos of English adolescent rugby union: Influence of weekly match frequency on the variability of match and training loads
Publisher: Informa UK Limited
Date: 05-01-2018
DOI: 10.1080/17461391.2017.1418026
Abstract: The aims of this study were to determine the variability of weekly match and training loads in adolescent rugby union players across a competitive season, and to investigate the effect of match frequency on load distribution across different activities. Internal match and training load data (i.e. session-rating of perceived exertion (sRPE)) were collected daily from 20 players from a regional academy across a 14-week season. Data were analysed using a mixed-effects linear model, and variability was reported as a coefficient of variation (CV). Differences between 0-, 1-, 2-, and 3-match weeks were assessed using Cohen's d effect sizes and magnitude-based inferences. Mean weekly total match and training sRPE load was 1425 ± 545 arbitrary units (AU), with a between-player CV of 10 ± 6% and within-player CV of 37 ± 3%. Mean week-to-week change in total sRPE load was 497 ± 423 AU (35%), and 40% of weekly observations were outside the suggested acute:chronic workload ratio 'safe zone'. Total weekly sRPE loads increased substantially with match frequency (1210 ± 571, 1511 ± 489, and 1692 ± 517 AU, for 0-, 1-, and 2-match weeks, respectively), except for 3-match weeks (1520 ± 442 AU). Weekly match and training loads were highly variable for adolescent rugby players during the competitive season, and match frequency has a substantial effect on the distribution of loads. Therefore, match and training loads should be coordinated, monitored, and managed on an in idual basis to protect players from negative training consequences, and to promote long-term athlete development.
Socio-demographic disadvantage and distant summary stage of cancer at diagnosis-A population-based study in New South Wales
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.CANEP.2015.10.032
Abstract: Past studies generally indicate that socio-demographic disadvantage is associated with lower cancer survival but evidence of an association with stage of cancer at diagnosis has been less consistent. This study examines the associations between distant summary stage and remoteness, socio-economic status and country of birth in New South Wales for invasive cancers overall and by cancer site. The population-based New South Wales Central Cancer Registry was used to obtain data on all cases diagnosed in 1980-2009 (n=699,382). Logistic regression models were used to compute odds ratios (ORs) with 95% confidence intervals (CIs) for odds of distant summary stage at diagnosis. A higher likelihood of being diagnosed with distant cancer was detected for those living in the most socio-economically disadvantaged areas compared with the least disadvantaged areas (OR 1.27, 95% CI 1.24-1.30) and for those born in other English and non-English speaking countries compared with Australian-born (OR 1.10, 95% CI 1.07-1.12 and OR 1.12, 95% CI 1.10-1.14, respectively) after adjusting for age, sex, diagnostic period, remoteness, socio-economic status and country of birth. Cases living in inner (OR 0.90, 95% CI 0.88-0.91) and outer regional (OR 0.92, 95% CI 0.89-0.94) areas were less likely to be diagnosed with distant stage than cases living in major cities. Odds of distant stage increased over time for those living in socio-economically disadvantaged areas. In cancer site-specific analyses, living in socio-economically disadvantaged areas was generally a stronger predictor of distant stage than remoteness or country of birth. Our results highlight the importance of lower socio-economic status as a predictor of distant stage at diagnosis. Socio-demographic disadvantage patterns varied for specific cancers, but in general, policy actions are recommended that emphasize earlier detection of cancers in people from lower socio-economic areas.
Changes in five‐year survival for people with acute leukaemia in South Australia, 1980–2016
Publisher: Wiley
Date: 16-02-2022
DOI: 10.5694/MJA2.51423
Carcinosarcomas of the uterus: prognostic factors and impact of adjuvant treatment
Publisher: Informa UK Limited
Date: 06-2021
DOI: 10.2147/CMAR.S309551
The effect of general practice contact on cancer stage at diagnosis in Aboriginal and non-Aboriginal residents of New South Wales
Publisher: Springer Science and Business Media LLC
Date: 17-06-2023
DOI: 10.1007/S10552-023-01727-6
Abstract: Older age, risks from pre-existing health conditions and socio-economic disadvantage are negatively related to the prospects of an early-stage cancer diagnosis. With older Aboriginal Australians having an elevated prevalence of these underlying factors, this study examines the potential for the mitigating effects of more frequent contact with general practitioners (GPs) in ensuring local-stage at diagnosis. We compared the odds of local vs. more advanced stage at diagnosis of solid tumours according to GP contact, using linked registry and administrative data. Results were compared between Aboriginal ( n = 4,084) and non-Aboriginal ( n = 249,037) people aged 50 + years in New South Wales with a first diagnosis of cancer in 2003–2016. Younger age, male sex, having less area-based socio-economic disadvantage, and fewer comorbid conditions in the 12 months before diagnosis (0–2 vs. 3 +), were associated with local-stage in fully-adjusted structural models. The odds of local-stage with more frequent GP contact (14 + contacts per annum) also differed by Aboriginal status, with a higher adjusted odds ratio (aOR) of local-stage for frequent GP contact among Aboriginal people (aOR = 1.29 95% CI 1.11–1.49) but not among non-Aboriginal people (aOR = 0.97 95% CI 0.95–0.99). Older Aboriginal Australians diagnosed with cancer experience more comorbid conditions and more socioeconomic disadvantage than other Australians, which are negatively related to diagnosis at a local-cancer stage. More frequent GP contact may act to partly offset this among the Aboriginal population of NSW.
Near fatal asthma attacks: the reliability of descriptive information collected from close acquaintances.
Publisher: BMJ
Date: 11-1993
Abstract: The reliability of information collected from close acquaintances of the deceased in studies on mortality from asthma has not been assessed. As part of a South Australian asthma mortality study, levels of agreement for information obtained directly from cases--that is, cases who had experienced near fatal asthma attacks--were compared with corresponding information concerning these cases obtained independently from close acquaintances. The first 51 subjects presenting from the outset of the main study to hospital accident and emergency departments with near fatal asthma attacks were included to gain an early assessment of the reliability of responses. The level of agreement between self reported information and that obtained from close acquaintances was compared by means of a kappa statistic or intraclass correlation coefficient, depending on the measurement scale. Both score one for complete agreement and zero when there is no agreement. High levels of agreement were found for questions relating to use of hospital services, with agreement levels ranging from 0.92 for visits in the past month to accident and emergency departments, to 0.86 for prior hospital admissions and 0.78 for prior need for assisted ventilation. Levels of agreement for drug treatment ranged from 1.00 for use of beta agonists to 0.64 for corticosteroid use, and to a low 0.24 for use of sodium cromoglycate. There was moderate agreement for histories of regular use of over the counter medications without a medical consultation (0.57). Psychiatric characteristics showed moderate levels of agreement, with values of 0.44 for personal history of psychiatric consultations and 0.50 for denial score. Agreement scores were 0.66 for doctor visits in the past month, 0.66 for limitations in daily activities, 0.76 for loss of work days in the past month, 0.59 for severity of asthma, and 0.55 for frequency of asthma attacks in the past month. Poorer agreement scores were found for trends in asthma symptoms (0.21) and frequency of symptoms during the past three years (0.12). Sleep disturbance was also associated with a low agreement score (0.25). The more visible the asthma manifestation, and the more recent the period to which it applies, the more reliable is the information provided by close acquaintances. These factors need to be taken into account when using information from close acquaintances in asthma mortality studies.
Optimal Base Station Antenna Downtilt in Downlink Cellular Networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2019
Professionally defined dental treatment needs of middle‐aged and older patients attending 21 general practitioners, as related to tooth retention
Publisher: Wiley
Date: 04-1988
DOI: 10.1111/J.1834-7819.1988.TB00653.X
Abstract: High-throughput short read sequencing is revolutionizing genomics and systems biology research by enabling cost-effective deep coverage sequencing of genomes and transcriptomes. Error detection and correction are crucial to many short read sequencing applications including de novo genome sequencing, genome resequencing, and digital gene expression analysis. Short read error detection is typically carried out by counting the observed frequencies of kmers in reads and validating those with frequencies exceeding a threshold. In case of genomes with high repeat content, an erroneous kmer may be frequently observed if it has few nucleotide differences with valid kmers with multiple occurrences in the genome. Error detection and correction were mostly applied to genomes with low repeat content and this remains a challenging problem for genomes with high repeat content. We develop a statistical model and a computational method for error detection and correction in the presence of genomic repeats. We propose a method to infer genomic frequencies of kmers from their observed frequencies by analyzing the misread relationships among observed kmers. We also propose a method to estimate the threshold useful for validating kmers whose estimated genomic frequency exceeds the threshold. We demonstrate that superior error detection is achieved using these methods. Furthermore, we break away from the common assumption of uniformly distributed errors within a read, and provide a framework to model position-dependent error occurrence frequencies common to many short read platforms. Lastly, we achieve better error correction in genomes with high repeat content. The software is implemented in C++ and is freely available under GNU GPL3 license and Boost Software V1.0 license at "oku.php?id = redeem". We introduce a statistical framework to model sequencing errors in next-generation reads, which led to promising results in detecting and correcting errors for genomes with high repeat content.
Children's Blood Lead Levels in the Lead Smelting Town of Port Pirie, South Australia
Publisher: Informa UK Limited
Date: 08-1986
DOI: 10.1080/00039896.1986.9938340
Abstract: This survey included 1,239 children, representing 50% of the elementary school population of the lead smelting town of Port Pirie. Of these children, 7% had a capillary blood lead level equal to or greater than 30 micrograms/dl, which is the Australian National Health and Medical Research Council's "level of concern." There was a statistically significant difference in capillary lead levels by area of residence that was independent of age, sex, soil lead, rainwater tank lead, and school attended. A case-control study indicated that the following subset of factors was most predictive of an elevated blood lead level: household members who worked with lead in their occupations living in a house with flaking paint on the outside walls biting finger nails eating lunch at home on school days when at school, appearing to have relatively dirty clothing when at school, appearing to have relatively dirty hands and living on a household block with a large area of exposed dirt. A program to reduce the risk of elevated blood lead levels in Port Pirie children has been introduced.
Birthweight‐Specific Trends in Perinatal Mortality by Hospital Category in South Australia, 1985–1990
Publisher: AMPCo
Date: 05-1993
DOI: 10.5694/J.1326-5377.1993.TB121911.X
Abstract: To investigate differences by birthweight in risk of perinatal death between level 3 hospitals (which provide care for high risk pregnancies and neonatal intensive care) and other hospitals in South Australia, using perinatal data for the 1985-1990 period. Analysis of birthweight-specific trends in risk of perinatal death by hospital category for singleton births, adjusting for risk factors. 114 725 singleton births of at least 400 g birthweight (or at least 20 weeks' gestation) born in hospitals in the 1985-1990 period and notified to the perinatal data collection. The relative odds of a perinatal death, as opposed to a live birth which survived the neonatal period. Births at level 3 hospitals had a higher crude risk of perinatal death than those at other hospitals, but this was due to the higher frequency of low birthweights at level 3 hospitals. For birthweights under 2000 g, and especially for the very low birth-weights, there was a higher risk at non-level-3 than level 3 hospitals. There was also the unexpected finding that births at level 3 hospitals in the 2500-2999 g range had a comparatively high risk of perinatal death. There was little difference in risk for births of higher birthweight. The greatly reduced risk of perinatal death in level 3 hospitals for babies with birthweights under 2000 g seems likely to be due to the specialist services in these hospitals. Further investigation is required to determine why babies in the 2500-2999 g range of birthweights had a comparatively high risk of perinatal death at these hospitals. This appears to be due, at least in part, to an excess contribution of deaths from congenital abnormalities. Also, it seems that the higher prevalence of complications in pregnancy in level 3 hospitals, and the transfers for induction of labour after intrauterine fetal death, would have made a contribution. These same factors may also have affected the risk in level 3 hospitals for higher birthweight births.
Review Paper: The Health Status of Migrants in Australia: A Review
Publisher: SAGE Publications
Date: 04-2010
Abstract: This review summarizes the findings of studies conducted in Australia between 1980 and 2008 that focused on the health status of migrants in one or more of Australia’s National Health Priority Areas (NHPAs), identifies gaps in knowledge, and suggests further research directions. Systematic literature searches were performed on CINAHL, MediText, PsycINFO, and MEDLINE. It was found that the majority of migrants enjoy better health than the Australian-born population in the conditions that are part of the NHPAs, with the exception of diabetes. Mediterranean migrants have particularly favorable health outcomes. The migrant health advantage appears to deteriorate with increasing duration of residence. Many of the analyzed studies were conducted more than 10 years ago or had a narrow focus. Little is known about the health status of migrants with respect to a number of NHPAs, including musculoskeletal conditions and asthma.The health status of recently arrived migrant groups from the Middle East and Africa has not been explored in detail.
Pregnancy associated cancer, timing of birth and clinical decision making-a NSW data linkage study
Publisher: Springer Science and Business Media LLC
Date: 09-02-2023
DOI: 10.1186/S12884-023-05359-1
Abstract: The incidence of pregnancy-associated cancer (PAC), comprising cancer diagnosed during pregnancy or within one year postpartum, is increasing. We investigated the obstetric management and outcomes of women with PAC and their babies. A population-based observational study of all women who gave birth between 1994 and 2013 in New South Wales, Australia. Women were stratified into three groups: those diagnosed during pregnancy (gestational cancer group), those diagnosed within one year of giving birth (postpartum cancer group), and a no-PAC group. Generalized estimating equations were used to examine the association between PAC and adverse maternal and neonatal outcomes. One million seven hundred eighty-eight thousand four hundred fifty-onepregnancies were included—601 women (614 babies) were in the gestational cancer group, 1772 women (1816 babies) in the postpartum cancer group, and 1,786,078 women (1,813,292 babies) in the no-PAC group. The overall crude incidence of PAC was 132.7/100,000 women giving birth. The incidence of PAC increased significantly over the twenty-year study period from 93.5/100,000 in 1994 to 162.5/100,000 in 2013 (2.7% increase per year, 95% CI 1.9 – 3.4%, p -value 0.001). This increase was independent of maternal age. The odds of serious maternal complications (such as acute abdomen, acute renal failure, and hysterectomy) were significantly higher in the gestational cancer group (adjusted odds ratio (AOR) 5.07, 95% CI 3.72 – 6.90) and the postpartum cancer group (AOR 1.55, 95% CI 1.16 – 2.09). There was no increased risk of perinatal mortality in babies born to women with PAC. However, babies of women with gestational cancer (AOR 8.96, 95% CI 6.96 – 11.53) or postpartum cancer (AOR 1.36, 95% CI 1.05 – 1.81) were more likely to be planned preterm birth. Furthermore, babies of women with gestational cancer had increased odds of a severe neonatal adverse outcome (AOR 3.13, 95% CI 2.52 – 4.35). Women with PAC are more likely to have serious maternal complications. While their babies are not at increased risk of perinatal mortality, they are more likely to experience poorer perinatal outcomes associated with preterm birth. The higher rate of birth intervention among women with gestational cancers reflects the complexity of clinical decision-making in this context.
Engagement of general practice in an Australian organised bowel cancer screening program: A cross-sectional survey of knowledge and practice
Publisher: EpiSmart Science Vector Ltd
Date: 07-2020
Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
Publisher: American Thoracic Society
Date: 15-11-2014
Estimating the lifetime risks of cancer: the best measure depends on your purpose
Publisher: AMPCo
Date: 10-12-2020
DOI: 10.5694/MJA2.50444
An analysis of factors associated with interval as opposed to screen-detected breast cancers, including hormone therapy and mammographic density
Publisher: Elsevier BV
Date: 04-2002
Mortality from influenza and allied infections in South Australia during 1968‐1981
Publisher: AMPCo
Date: 1985
DOI: 10.5694/J.1326-5377.1985.TB113275.X
Abstract: Numbers of deaths from pneumonia and influenza and other causes were analysed for successive four-week periods in South Australia during 1968-1981. An overall excess in deaths from pneumonia or influenza of 74% was evident during the winter months and early spring, compared with summer and early autumn. An accompanying excess of 18% occurred for deaths assigned to other causes. There was a strong association between numbers of deaths from pneumonia and influenza and other deaths, suggesting that influenza may have a broad impact on mortality. This mostly applied to in iduals aged 60 years and over. There is the need for medical practitioners to provide prophylactic care to protect aged patients against the effects of influenza. This should be done in autumn, and special attention should be given to in iduals with underlying conditions.
An analysis of the effect of stage at diagnosis of bowel cancer on survival: Findings from the South Australian Clinical Registry (SACR) for metastatic colorectal cancer (mCRC).
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2011
The burden of cancer on primary and secondary health care services before and after cancer diagnosis in New South Wales, Australia
Publisher: Springer Science and Business Media LLC
Date: 27-06-2019
Cervical cancer: effect of glandular cell type on prognosis, treatment, and survival
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2003
DOI: 10.1016/S0029-7844(02)02275-5
Abstract: To investigate survivals from cervical cancer, with special reference to effects of glandular histology and its influence on prognostic characteristics and management decisions. Data on cervical cancers, diagnosed in 1984-2000, were obtained from the gynecologic oncology registry of hospitals of the University of Adelaide. Comparisons were made of disease-specific survival, age at diagnosis, diagnostic period, stage, grade, and primary course of treatment. The study included 544 squamous cell carcinomas, 43 adenosquamous carcinomas, five clear cell cancers, 136 other adenocarcinomas, and 19 cancers of "other" histological type. Overall survival was 72.2% at 5 years from diagnosis, decreasing to 67.5% at 15 years. Survival was lower for older ages, higher grades, and higher International Federation of Gynecology and Obstetrics stages, although equivalent for stages IIA and IIB. Unadjusted survivals varied by histological type (P =.001), with lower survivals suggested for adenosquamous and clear cell lesions and "other" histological types than for squamous cell carcinomas and other adenocarcinomas. After adjusting for age, stage, grade, and diagnostic period, adenocarcinomas had a higher case fatality than squamous cell lesions (relative risk 2.08, 95% confidence limit 1.35, 3.21), whereas the elevation in relative risk was lower and not statistically significant for a combined adenosquamous and clear cell category at 1.25 (0.69, 2.24). For stage II, both adenocarcinomas and the adenosquamous and clear cell group had lower survivals than squamous cell cancers. Relative to squamous cell carcinomas, adenocarcinomas and potentially adenosquamous cancers are becoming more common. This has implications for screening, treatment, and prognosis.
Reporting Real-World Data on Prostate Cancer Treatment Outcomes to Consumers: The Prostate Cancer Report Card
Publisher: Hindawi Limited
Date: 13-10-2023
DOI: 10.1155/2023/6660371
Estimating cancer incidence in Indigenous Australians
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1111/J.1753-6405.2011.00762.X
Abstract: To assess data quality of cancer registrations for Indigenous Australians and produce reliable national Indigenous cancer incidence statistics. Completeness of Indigenous identification was assessed for the eight Australian cancer registries using an innovative indirect assessment method based on registry-specific registration rates for smoking-related cancers. National age-standardised incidence rates and rate ratios (Indigenous:non-Indigenous) were calculated for all cancers combined and 26 in idual cancer sites. Multivariate regression analysis was used to investigate trends in Indigenous cancer incidence by time or remoteness of residence, and whether the incidence rate ratio (Indigenous:non-Indigenous) was different in younger than older age-groups. Four registries covering 84% of the Indigenous population had sufficiently complete Indigenous identification to be included in analysis. Compared to other Australians, Indigenous Australians had much higher incidence of lung and other smoking-related cancers, cervix, uterus and liver cancer, but much lower incidence of breast, prostate, testis, colorectal and brain cancer, melanoma of skin, lymphoma and leukaemia. Incidence was higher in remote areas for some cancers (including several smoking-related cancers) but lower for others. The incidence rate ratios (IRRs) for smoking-related cancers were higher in younger than older people. Indigenous Australians have a different pattern of incidence of specific cancers than other Australians and large geographical variations for several cancers. All cancer registries need to further improve Indigenous identification, but national Indigenous cancer incidence statistics can, and should, be regularly reported. Tobacco control is a critical cancer-control issue for Indigenous Australians.
Survival from breast cancer: An analysis of Australian data by surgeon case load, treatment centre location, and health insurance status
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/AH11060
Abstract: Objective. Early invasive breast cancer data from the Australian National Breast Cancer Audit were used to compare case fatality by surgeon case load, treatment centre location and health insurance status. Method. Deaths were traced to 31 December 2007, for cancers diagnosed in 1998–2005. Risk of breast cancer death was compared using Cox proportional hazards regression. Results. When adjustment was made for age and clinical risk factors: (i) the relative risk of breast cancer death (95% confidence limit) was lower when surgeons’ annual case loads exceeded 20 cases, at 0.87 (0.76, 0.995) for 21–100 cases and 0.83 (0.72, 0.97) for higher case loads. These relative risks were not statistically significant when also adjusting for treatment centre location (P ≥ 0.15) and (ii) compared with major city centres, inner regional centres had a relative risk of 1.32 (1.18, 1.48), but the risk was not elevated for more remote sites at 0.95 (0.74, 1.22). Risk of death was not related to private insurance status. Conclusion. Higher breast cancer mortality in patients treated in inner regional than major city centres and in those treated by surgeons with lower case loads requires further study. What is known about the topic? Studies in some countries show an association of poorer outcomes with lower case load and lack of private health insurance. What does this paper add? Lower survivals apply in contemporary Australian environments where annual case loads are 20 or fewer and for patients treated in inner regional compared with major city centres. Poorer survivals for patients without private health insurance status are not statistically significant after adjusting for tumour size and other risk factors. What are the implications for practitioners? Additional research is needed to determine why survivals are lower in Australian settings where case loads are low and when treatment is provided in inner regional centres. Meanwhile, it would be appropriate to target these settings in quality improvement programs.
Administrative data provide vital research evidence for maximizing health-system performance and outcomes
Publisher: Wiley
Date: 24-01-2017
DOI: 10.1111/AJCO.12644
Abstract: Although the quality of administrative data is frequently questioned, these data are vital for health-services evaluation and complement data from trials, other research studies and registries for research. Trials generally provide the strongest evidence of outcomes in research settings but results may not apply in many service environments. High-quality observational research has a complementary role where trials are not applicable and for assessing whether trial results apply to groups excluded from trials. Administrative data have a broader system-wide reach, enabling system-wide health-services research and monitoring of performance markers. Where administrative data raise questions about service outcomes, follow-up enquiry may be required to investigate validity and service implications. Greater use should be made of administrative data for system-wide monitoring and for research on service effectiveness and equity.
Investigating the breast cancer screening-treatment-mortality pathway of women diagnosed with invasive breast cancer: results from linked health data
Publisher: Hindawi Limited
Date: 30-11-2022
DOI: 10.1111/ECC.13539
Abstract: To examine the screening-treatment-mortality pathway among women with invasive breast cancer in 2006-2014 using linked data. BreastScreen histories of South Australian women diagnosed with breast cancer (n = 8453) were investigated. Treatments recorded within 12 months from diagnosis were obtained from linked registry and administrative data. Associations of screening history with treatment were investigated using logistic regression and with cancer mortality outcomes using competing risk analyses, adjusting for socio-demographic, cancer and comorbidity characteristics. For screening ages of 50-69 years, 70% had participated in BreastScreen SA ≤ 5 years and 53% ≤ 2 years of diagnosis. Five-year disease-specific survival post-diagnosis was 90%. Compared with those not screened ≤5 years, women screened ≤2 years had higher odds, adjusted for socio-demographic, cancer and comorbidity characteristics, and diagnostic period, of breast-conserving surgery (aOR 2.5, 95% CI 1.9-3.2) and radiotherapy (aOR 1.2, 95% CI 1.1-1.3). These women had a lower unadjusted risk of post-diagnostic cancer mortality (SHR 0.33, 95% CI 0.27-0.41), partly mediated by stage (aSHR 0.65, 95% CI 0.51-0.81), and less breast surgery (aSHR 0.78, 95% CI 0.62-0.99). Screening ≤2 years and conserving surgery appeared to have a greater than additive association with lower post-diagnostic mortality (interaction term SHR 0.42, 95% CI 0.23-0.78). The screening-treatment-mortality pathway was investigated using linked data.
The effect of a pilot dental health education programme on high school students
Publisher: Wiley
Date: 02-1977
DOI: 10.1111/J.1834-7819.1977.TB04434.X
Abstract: A dental health education programme for fourth and fifth year high school students reduced the levels of debris and periodontal disease significantly. Although the use of recommended toothbrushes and fluoride paste was increased the demand for professional care was greater in the control group.
Impact of watching prior to commencement of chemotherapy for metastatic colorectal cancer (mCRC): Findings from the South Australian Clinical Registry (SACR) for mCRC.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2011
History, development and future of cancer screening in Australia
Publisher: The Sax Institute
Date: 2017
DOI: 10.17061/PHRP2731725
Abstract: The aim of screening an asymptomatic population for cancer is to achieve better health outcomes, particularly a population survival benefit. Australia has three population screening programs: the National Cervical Screening Program (NCSP), BreastScreen Australia and the National Bowel Cancer Screening Program (NBCSP). We reviewed the history and development of the three programs. NCSP: Women have a Pap smear every 2 years from age 18-20, or 2 years after first becoming sexually active, until age 69. Since introduction of the NCSP, the cervical cancer incidence has halved, with an approximate 60% decrease in mortality. The screening participation rate approximates 57%, but is lower for Aboriginal and Torres Strait Islander women, women in remote areas, and women with lower socio-economic status. The National HPV (human papillomavirus) Vaccination Program, introduced in 2007, is expected to reduce the incidence of cervical cancer by a further 70% and has already reduced the incidence of high-grade lesions in girls. In 2017, testing for HPV every 5 years starting at age 25 will replace the Pap smear as the principal screening test. BreastScreen Australia: This program targets women aged 50-74. Over 20 years, mortality from breast cancer has decreased by 32% in response to screening and treatment advances. The participation rate is 56%. The major adverse impact of breast screening is overdiagnosis, estimated in Australia to be as low as 8% of detected cancers, but with estimates of up to 30% from some research. Women should be made aware of both the potential benefits and harms from screening. Genetic testing for BRCA1 and BRCA2 mutations in high-risk women leads to earlier screening. The NBCSP uses immunochemical faecal occult blood test (iFOBT) kits on stool s les to detect bleeding from the bowel. When rollout is complete in 2020, test kits will be sent every 2 years to people aged 50-74. People who test positive are followed up with a colonoscopy. The participation rate is currently 37%. The positivity rate is 7%, and stage 1 bowel cancer presentations have tripled since the program began. Research needs to focus on reducing mortality through increased screening participation and, in the future, obtaining guidance for customised screening from genomic testing.
Wireless Sensing and Networking for the Internet of Things
Publisher: MDPI AG
Date: 28-01-2023
DOI: 10.3390/S23031461
Abstract: In recent years, we have witnessed the exponential proliferation of the Internet of Things (IoT)-based networks of physical devices, vehicles, and appliances, as well as other items embedded with electronics, software, sensors, actuators, and connectivity, which enable these objects to connect and exchange data [...]
Socially Aware Caching Strategy in Device-to-Device Communication Networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2018
A randomised online experimental study to compare responses to brief and extended surveys of health-related quality of life and psychosocial outcomes among women with breast cancer
Publisher: Springer Science and Business Media LLC
Date: 29-09-2021
DOI: 10.1007/S11136-020-02651-X
Abstract: Collecting patient-reported outcomes is important in informing the well-being of women with breast cancer. Consumer perceptions are important for successful implementation of monitoring systems, but are rarely formally assessed. We compared reactions to two different surveys (assessing psychosocial outcomes and/or Health-related Quality of Life (HrQoL) outcomes) among Australian women with breast cancer. Women (18 + years) within 5 years diagnosis of breast cancer were randomly allocated to complete one of two online surveys: (i) minimum HrQoL measures or (ii) minimum HrQoL measures plus psychosocial outcomes (body image, depression, anxiety stress, fear of cancer recurrence, decisional difficulties and unmet need). Participants completed questions regarding their perceptions of the survey, including qualitative feedback. Data were available for 171 participants (n Assessment of HrQoL and psychosocial outcomes was well received by consumers. Results alleviate concern regarding possible patient burden imposed by longer more in-depth surveys. The importance placed on assessment brevity should not outweigh the need to assess outcomes that consumers consider important.
Manipulating Intermediates at the Au-TiO2Interface over InP Nanopillar Array for Photoelectrochemical CO2Reduction
Publisher: American Chemical Society (ACS)
Date: 31-08-2021
Survival impact of primary tumor resection in patients (pts) with unresectable metastatic colorectal cancer (mCRC): Findings from the South Australian Metastatic Colorectal Cancer Registry (SAMCRC).
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2015
Nothing beats taste or convenience: a national survey of where and why people buy sugary drinks in Australia
Publisher: Elsevier BV
Date: 08-2020
Human Papillomavirus and Oropharyngeal Cancer Among Indigenous Australians: Protocol for a Prevalence Study of Oral-Related Human Papillomavirus and Cost-Effectiveness of Prevention
Publisher: JMIR Publications Inc.
Date: 08-06-2018
DOI: 10.2196/10503
Survival improvements associated with access to biological agents: Results from the South Australian (SA) metastatic colorectal cancer (mCRC) registry
Publisher: Informa UK Limited
Date: 15-02-2016
Second primary cancers following cancer among adolescents and young adults in Queensland, Australia, 1982-2018
Publisher: Mary Ann Liebert Inc
Date: 08-2023
Diabetes and smoking as predictors of cancer in Indigenous adults from rural and remote communities of North Queensland – A 15‐year follow up study
Publisher: Wiley
Date: 16-04-2018
DOI: 10.1002/IJC.31403
Abstract: Indigenous Australians generally have a poor health status and an elevated cancer mortality that has increased in recent decades. A cohort of 2,273 Aboriginal and Torres Strait Islander (TSI) adults (18+ years) from 26 remote communities in far North Queensland, who were initially free of cancer, were followed-up for an average of 15 years. The associations of baseline anthropometric, biochemical and behavioural factors with cancer incidence were investigated using competing risk survival analysis. The age-standardised incidence (all cancers) was 5.2 cases/1,000 person-years (pys) (95% CI 4.1-6.6). Liver/bile duct and lung were the most common cancer sites. Overall cancer incidence was significantly higher in TSIs than Aboriginal people. The baseline prevalence of diabetes was 15.6% in Aboriginal and 25.6% in TSI people. The smoking rate of 59.8% for Aboriginal people was higher than the rate of 45.2% for TSIs. At follow-up, the adjusted sub hazard ratios (SHRs) of diabetes for all cancers combined were 1.8 (95% CI, 1.3-2.6), and for digestive system cancers, 2.3 (95% CI, 1.2-4.4). Smokers had a 60% higher risk (SHR 1.6, 95% CI: 1.1-2.0) for all cancers combined and a fourfold risk (SHR 3.7, 95% CI 1.7-8.0) for lung cancers when compared to non-smokers, regardless of age, sex and ethnicity. The most common cancers encountered by this Indigenous cohort and their consequences are potentially preventable in Indigenous Australians by effective management of highly prevalent modifiable risks in primary service settings, screening participation and arranging for good access to treatment services.
Monitoring approval of new legislation banning smoking in children's playgrounds and public transport stops in South Australia: Table 1
Publisher: BMJ
Date: 31-10-2014
Impact of hormone replacement therapy use on mammographic screening outcomes
Publisher: Springer Science and Business Media LLC
Date: 07-05-2013
DOI: 10.1007/S10552-013-0221-1
Abstract: This study aims to measure the impact of HRT use at the time of screening on rates of screen-detected invasive breast cancer (IBC) and ductal carcinoma in situ (DCIS), interval cancers and investigative procedures, within a well-established population-based mammography screening program. Using South Australian BreastScreen data from 1998 to 2009 pertaining to 819,722 screening episodes, Poisson regression models were undertaken to estimate the incidence risk ratios (IRR) for various screening outcomes at both the first and subsequent screening rounds, among women who had been using HRT in the 6 months prior to screening compared with those who had not. Current HRT use was associated with increased risk of recall for assessment, biopsy procedures, and breast cancer diagnosis among BreastScreen participants. Risk of screen-detected breast cancer was increased at subsequent screening rounds (IRR = 1.30, 95% confidence interval 1.18-1.34), but not at women's first screening round (1.05, 0.88-1.25). This increased risk applied to IBC (1.35, 1.27-1.45), but not to DCIS (1.04, 0.89-1.23). Interval cancer risk was elevated among HRT users following both the first screen (1.77, 1.33-2.37) and subsequent screening episodes (1.92, 1.72-2.15). Increased risks of recall, biopsy rates, screen-detected, and interval cancers among HRT users have important implications for population-based breast cancer screening programs. Our findings support the concept that HRT use may increase the growth of preexisting cancers. Lack of effect on DCIS could imply different etiology or time frames for DCIS and IBC development or increased transition from preinvasive to invasive disease due to HRT use.
Recent advances of sonodynamic therapy in cancer treatment
Publisher: China Anti-cancer Association
Date: 2016
Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012)
Publisher: Public Library of Science (PLoS)
Date: 08-05-2018
Long-term benefits for lower socioeconomic groups by improving bowel screening participation in South Australia: A modelling study
Publisher: Public Library of Science (PLoS)
Date: 21-12-2022
DOI: 10.1371/JOURNAL.PONE.0279177
Abstract: The gap in bowel cancer screening participation rates between the lowest socioeconomic position (SEP) groups and the highest in Australia is widening. This study estimates the long-term health impacts and healthcare costs at current colorectal cancer (CRC) screening participation rates by SEP in South Australia (SA). A Markov microsimulation model for each socioeconomic quintile in SA estimated health outcomes over the lifetime of a population aged 50–74 years (total n = 513,000). The model simulated the development of CRC, considering participation rates in the National Bowel Cancer Screening Program and estimated numbers of cases of CRC, CRC deaths, adenomas detected, mean costs of screening and treatment, and quality adjusted life years. Screened status, stage of diagnosis and survival were obtained for patients diagnosed with CRC in 2006–2013 using data linked to the SA Cancer Registry. We predict 10915 cases of CRC (95%CI: 8017─13812) in the lowest quintile (Q1), 17% more than the highest quintile (Q5) and 3265 CRC deaths (95%CI: 2120─4410) in Q1, 24% more than Q5. Average costs per person, were 29% higher in Q1 at $11997 ($8754─$15240) compared to Q5 $9281 ($6555─$12007). When substituting Q1 screening and diagnostic testing rates with Q5’s, 17% more colonoscopies occur and adenomas and cancers detected increase by 102% in Q1. Inequalities were evident in CRC cases and deaths, as well as adenomas and cancers that could be detected earlier. Implementing programs to increase screening uptake and follow-up tests for lower socioeconomic groups is critical to improve the health of these priority population groups.
Epidemiological features of melanoma in South Australia: implications for cancer control (for editorial comment, see page 490)
Publisher: AMPCo
Date: 11-1989
The sealing of fissures in a school dental programme
Publisher: Wiley
Date: 12-1976
DOI: 10.1111/J.1834-7819.1976.TB05778.X
Abstract: An examination was made of 817 children, mean age 6.9 years. Of their first permanent molars 42.4 per cent were assessed as suitable for fissure sealant. Of these teeth 522 were sealed and compared with contra-lateral controls after one year. The retention rate of and the mean application time for the sealant are presented and discussed.
A systematic review of surgical biopsy for LCIS found at core needle biopsy – Do we have the answer yet?
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.EJSO.2013.10.024
Abstract: The natural history of lobular carcinoma in-situ (LCIS) suggests that women are at increased risk of subsequent invasive breast cancer. Questions of effective management for women with this lesion have led to the need for evidence-based guidance and, in particular, guidance regarding management after LCIS is found at core needle biopsy (CNB). A systematic review was conducted to determine the most appropriate management for women with LCIS found at CNB. A comprehensive search of the scientific literature was conducted to identify the literature pertaining to this population. Critical appraisal of the literature, data extraction and a narrative synthesis of the results were conducted. The outcome of interest was upgrade of diagnosis to invasive breast cancer or ductal carcinoma in-situ (DCIS). Sparse data, with limited generalisability and considerable uncertainty, are available for women with LCIS at CNB. Nine studies were identified that met pre-specified inclusion criteria. The reported estimates of upgrade of diagnosis from LCIS to invasive breast cancer or DCIS ranged from 2% to 25%. The body of evidence was limited by its retrospective nature, risk of selection bias and poor generalisability to all women with LCIS at CNB. Further, higher quality research is required to determine the best approach for women with LCIS at CNB with any certainty.
Cancer data and aboriginal disparities (CanDAD)-developing an Advanced Cancer Data System for Aboriginal people in South Australia: A mixed methods research protocol
Publisher: BMJ
Date: 12-2016
The treatment of first permanent molars in a school dental programme: Implications for fissure sealants
Publisher: Wiley
Date: 04-1975
DOI: 10.1111/J.1834-7819.1975.TB04336.X
Abstract: Analysis of data derived from the pattern of treatment for first permanent molars in New Zealand school children from fluoridated and non-fluoridated areas shows that occlusal surfaces became carious at a later age in the former and in such areas sealants could further reduce the need for occlusal restorations. Since occlusoproximal restorations are rare, retention of sealants for long periods is needed.
Trends in the terminal care of cancer patients: South Australia, 1981–1990
Publisher: Wiley
Date: 06-1993
DOI: 10.1111/J.1445-5994.1993.TB01725.X
Abstract: The increasing numbers of cancer patients, the high costs of terminal care, and the development of palliative care services have led to a growing interest in patterns of terminal cancer care. These patterns are relevant to the formulation and evaluation of health services policy. To investigate trends in the place of death of South Australian cancer patients between 1981 and 1990, and to examine associations of socio-demographic and clinical variables with the place of death. Data relating to 2715 deaths attributed to cancer in 1990 were extracted from the Central Cancer Registry. To assess trends, these data were directly standardised to the age-sex distribution of cancer deaths in 1981 and 1985 which were investigated in a previous study. Unconditional logistic regression was used to investigate predictors of place of death. The proportion of deaths which occurred in major metropolitan public hospitals decreased from 40% in 1981 to 28% in 1990. Conversely, the proportion which occurred in hospice units increased from 5% to 20% over the same period. There was a decline in the proportion of deaths which occurred in private hospitals, but there was no significant change in the proportion which occurred in country hospitals or nursing homes. The proportion of deaths at home remained around 14%. Associated with place of death were age, sex, type of malignancy, survival time from diagnosis to death, Aboriginality, and area of residence. Further research to assess the clinical appropriateness of terminal care patterns is suggested.
Do breast cancer risk factors differ among those who do and do not undertake mammography screening?
Publisher: SAGE Publications
Date: 23-10-2013
Abstract: There is considerable interest in whether mammography screening leads to over-diagnosis of breast cancer. However self-selection into screening programmes may lead to risk differences that affect estimates of over-diagnosis. This study compares the breast cancer risk profiles of participants and non-participants of population-based mammography screening. Risk profiles are also compared between those who have and have not used private screening services. This study involved 1162 women aged 40–84 who participated in the 2012 Health Omnibus, an annual face-to-face interview-based survey of a representative s le of the population in the state of South Australia. Data were collected on participation in mammography screening, demographic characteristics and breast cancer risk factors (including reproductive, familial and lifestyle factors). Missing data were multiply imputed. Factors independently associated with ever having been screened were identified using multivariable logistic regression, for population-based and ad hoc, private mammography screening separately. Compared with non-participants, participants of population-based screening were more likely to have used hormone replacement therapy (odds ratio [OR] = 3.72), experienced breast biopsy or surgery (OR = 2.22), and be overweight or obese (OR = 1.57). They were less likely to be sufficiently active (OR = 0.57) or be born in a non-English speaking country (OR = 0.50) or aged under 50 (OR = 0.09). Women who were screened privately were more likely to have a family history of breast cancer (OR = 1.66) and have experienced breast biopsy or surgery (OR = 3.17) than those who had not. South Australian women who participated in the population-based mammography screening have a slightly higher prevalence of breast cancer risk factors. This also applies to those who undertook private screening.
Perinatal mortality trends among South Australian Aboriginal births 1981–92
Publisher: Wiley
Date: 10-1995
DOI: 10.1111/J.1440-1754.1995.TB00855.X
Abstract: To assess changes in perinatal mortality and risk factors for births to Aboriginal mothers in South Australia in 1981-92. All 4013 singleton Aboriginal births in the South Australian perinatal data collection were included. Trends in proportions with specific maternal and infant characteristics, and perinatal mortality by year of birth, were investigated by logistic regression analysis. Changes found included an increase in the proportion of mothers aged 35 years and over, preterm births and births of very low birthweight (< 1500 g), but a decrease in the proportions of births to women under 20 years of age, and of births with a birth defect. There was no statistically significant change in the crude perinatal mortality rate nor in the risk of perinatal death after adjusting for risk factors. The perinatal mortality rate among Aboriginal births, which is three times higher than the rate for all South Australian births, is not declining, in contrast to the State rate overall. This highlights the need for a concerted approach to Aboriginal perinatal health.
A case–control study of the protective benefit of cervical screening against invasive cervical cancer in NSW women
Publisher: Springer Science and Business Media LLC
Date: 20-02-2008
DOI: 10.1007/S10552-008-9118-9
Abstract: To examine the effects of different Pap screening patterns in preventing invasive cervical cancer among women in New South Wales, Australia. A total of 877 women aged 20-69 years diagnosed with invasive cervical cancer during 2000-2003 were matched with 2,614 controls by month and year of birth. Screening behavior patterns in 4 years preceding the time of cancer diagnosis in the cases were classified into none (no Pap test in the 4 years), 'irregular' (1 of the 4 years with Pap test(s)), and 'regular' (2 or more of the 4 years with a Pap test), and compared with those in the matched non-cases over the same period. Conditional logistic regression modeling was used to estimate the relative risk, approximated by the odds ratio, of invasive cervical cancer for regular and irregular cervical screening compared with no screening in the previous 4 years, before and after controlling for potential confounders including the first recorded Pap test result in the preceding 6-year reference period. Compared with no screening, irregular Pap screening in the 4 years preceding the cancer diagnosis is estimated to reduce the risk of invasive cervical cancer by about 85% (RR = 0.15, 95% CI: 0.120-0.19) regular Pap screening reduces the risk by about 96% (RR = 0.04, 95% CI: 0.03-0.05). After adjusting for the index Pap test result, the relative risks for invasive cervical cancer were 0.19 (95% CI: 0.13-0.27) for irregular screening and 0.07 (95% CI: 0.04-0.10) for regular Pap screening. Regular and irregular Pap tests among women aged 20-69 years were highly effective in preventing invasive cancer. At-risk women with no Pap test history should be encouraged to undergo a Pap test every 2 years, but any Pap screening over a 4-year period remains highly protective against future invasive cervical cancer.
Survival from synchronous bilateral breast cancer: The experience of surgeons participating in the breast audit of the society of breast surgeons of Australia and New Zealand
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-04-2012
DOI: 10.7314/APJCP.2012.13.4.1413
Abstract: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand were investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/ vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.
The coverage of cancer patients by designated palliative services: a population-based study, South Australia, 1999
Publisher: SAGE Publications
Date: 07-2002
DOI: 10.1191/0269216302PM571OA
Abstract: Our aims were to determine the extent of coverage by designated palliative care services of the population of terminally ill cancer patients in South Australia, and to identify the types of patients who receive these services and the types who do not. All designated hospice and palliative care services in South Australia notified to the State Cancer Registry the identifying details of all their patients who died in 1999. This information was cross-referenced with the data for all cancer deaths (n=3086) recorded on the registry for 1999. We found that the level of coverage by designated palliative services of patients who died with cancer in 1999 was 68.2%. This methodology was previously used to show that the level of coverage had increased from 55.8% for cancer deaths in 1990 to 63.1% for those in 1993. Patients who died at home had the largest coverage by palliative services (74.7%), whereas patients who died in nursing homes had the lowest coverage (48.4%). Patients who did not receive care from these palliative services tended to be 80 years of age or older at death, country residents, those with a survival time from diagnosis of three months or less, and those diagnosed with a prostate, breast, or haematological malignancy. Gender, socioeconomic status of residential area, and race were not related to coverage by a designated palliative service, whereas migrants to Australia from the UK, Ireland, and Southern Europe were relatively high users of these services. We conclude that the high level of palliative care coverage observed in this study reflects widespread support for the establishment of designated services. When planning future care, special consideration should be given to the types of patients who most miss out on these services.
Sharing Government Health Data With the Private Sector: Community Attitudes Survey (Preprint)
Publisher: JMIR Publications Inc.
Date: 14-09-2020
Abstract: he use of government health data for secondary purposes, such as monitoring the quality of hospital services, researching the health needs of populations, and testing how well new treatments work, is increasing. This increase in the secondary uses of health data has led to increased interest in what the public thinks about data sharing, in particular, the possibilities of sharing with the private sector for research and development. Although international evidence demonstrates broad public support for the secondary use of health data, this support does not extend to sharing health data with the private sector. If governments intend to share health data with the private sector, knowing what the public thinks will be important. This paper reports a national survey to explore public attitudes in Australia toward sharing health data with private companies for research on and development of therapeutic drugs and medical devices. his study aims to explore public attitudes in Australia toward sharing government health data with the private sector. web-based survey tool was developed to assess attitudes about sharing government health data with the private sector. A market research company was employed to administer the web-based survey in June 2019. he survey was completed by 2537 in iduals residing in Australia. Between 51.8% and 57.98% of all participants were willing to share their data, with slightly fewer in favor of sharing to improve health services (51.99%) and a slightly higher proportion in favor of sharing for research and development (57.98%). There was a preference for opt-in consent (53.44%) and broad support for placing conditions on sharing health information with private companies (62% to 91.99%). Wide variability was also observed in participants’ views about the extent to which the private sector could be trusted and how well they would behave if entrusted with people’s health information. In their qualitative responses, the participants noted concerns about private sector corporate interests, corruption, and profit making and expressed doubt about the Australian government’s capacity to manage data sharing safely. The percentages presented are adjusted against the Australian population. his nationally representative survey provides preliminary evidence that Australians are uncertain about sharing their health data with the private sector. Although just over half of all the respondents supported sharing health data with the private sector, there was also strong support for strict conditions on sharing data and for opt-in consent and significant concerns about how well the private sector would manage government health data. Addressing public concern about sharing government health data with the private sector will require more and better engagement to build community understanding about how agencies can collect, share, protect, and use their personal data.
The dental health status of children not included by parents in the South Australian School Dental Programme. A pilot study
Publisher: Wiley
Date: 10-1980
DOI: 10.1111/J.1834-7819.1980.TB05199.X
Abstract: About 90 per cent of children have received school dental care at South Australian schools where this care has been available. However, following recent extension of the dental programme to metropolitan schools without clinics located in their grounds, lower participation rates of about 74 per cent have emerged. A pilot study of 161 children not included in the school dental programme at 13 of these metropolitan schools without clinics was conducted to evaluate their dental health status and determine why they were not enrolled for school dental care.
Type 2 diabetes as a potential risk marker for early onset colorectal cancer.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2019
DOI: 10.1200/JCO.2019.37.15_SUPPL.E15005
Abstract: e15005 Background: Colorectal cancer (CRC) is rising in incidence in young adults. Because they are not included in population screening, and are more likely to present at an advanced stage, there is a need to identify young adults at increased risk for CRC. An association has been reported between type 2 diabetes (T2D) and CRC in the general population. Though lifestyle risk factors may be involved, the early occurrence of CRC in young adults suggests that there may also be a role for inherited predispositions. We therefore investigated whether having a personal and/or first-degree family history of T2D was a potential risk marker for early onset CRC. Methods: The South Australian Young Onset (SAYO) CRC study is an unselected series of young adults with CRC up to age 55. Fifty unrelated young adults (31/50 or 62% female) diagnosed with CRC were recruited to the study. Personal history of T2D was confirmed. Detailed family history of T2D was recorded. 253 patients with clear colonoscopies and no known CRC predisposition served as controls for personal history studies of T2D. Diabetes status was recorded on admission for colonoscopy controls. Associations were explored using a chi-squared statistic. Results: CRC patients ranged in age from 23-54 years (median age 42) and controls from 18-54 (median age 45). Six patients (12%) met the WHO clinical criteria for serrated polyposis, and two (4%) carried a Lynch syndrome mutation. CRC was present in the distal colon in 15/19 males (79%) and 17/31 females (55%) (p = 0.12). A personal history of T2D was confirmed in 12/50 (24%) CRC patients compared with clear colonoscopy controls under 55 years (13/258 or 5% P 0.001 OR = 5.9 95%CI 2.5-13.8). T2D was seen in 7/31 or 23% females and 5/19 or 26% males. Young adults with CRC frequently reported at least one first-degree relative with T2D (24/47 or 51%). All patients with personal history of T2D also had first-degree relatives with T2D. A first-degree family history of T2D was observed in 12/27 (44%) CRC patients aged under 45 yrs and 12/20 (60%) of CRC patients aged between 45 and 54 yrs having this characteristic (p = 0.29), and was present in both males and females (10/17 or 58% and 13/30 or 43% respectively p = 0.37). Conclusions: Though the mechanism remains unclear, given the prevalence of T2D in those aged 55yrs is 5% in Australia, our observations suggest that there is a striking enrichment for personal and first-degree family history of T2D in young adults with CRC. These features could potentially identify a subset of young adults at increased risk for CRC and in whom early screening might be appropriate.
Reasons for Improved Survival From Ovarian Cancer in New South Wales, Australia, Between 1980 and 2003
Publisher: BMJ
Date: 05-2009
MONITORING CASE SURVIVAL BY HISTOLOGICAL TYPE FOR LUNG CANCER, BREAST CANCER AND NON-HODGKIN'S LYMPHOMAS - ONE FUNCTION OF A POPULATION-BASED REGISTRY
Publisher: Wiley
Date: 12-02-2010
Death Analysis of a Cohort of Blood, Lymphatic Cancer and Breast Cancer Patients Who Have Developed Heart Failure Following Cancer Treatment
Publisher: Elsevier BV
Date: 08-2015
Exploring the added value of hospital-registry data for showing local service outcomes: cancers of the ovary, fallopian tube and peritoneum
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/BMJOPEN-2018-024036
Abstract: To explore the added value of hospital-registry data on invasive epithelial ovarian, tubal and peritoneal cancers. Historic cohort analyses. Unadjusted and adjusted regression. Major South Australian hospitals. 1596 women (1984–2015 diagnoses). 5-Year and 10-year survival was 48% and 41%, respectively, equivalent to relative survival for Australia and the USA. After adjusting for age, clinical and geographic factors, risk of ovarian cancer death was 25% lower in 2010–2015 than 1984–1989. Women generally had surgical treatment (87%) in their first round of care. This was more common for younger patients (adjusted OR (95% CIs) 0.17 (0.04 to 0.65) for 80+ vs years) and earlier International Federation of Gynecology and Obstetrics stages (adjusted OR 0.48 (0.13 to 1.78) for stage IIIB/C and 0.13 (0.04 to 0.45) for stage IV vs stage IA). Most (74%) had systemic therapy, which was more common for advanced stages (adjusted ORs .0 for stages III and IV vs stage IA). Few (9%) had radiotherapy. Women generally had systemic therapy (74%), without difference by service accessibility and socioeconomic disadvantage, suggesting equity. However, surgery was less common for residents of the most compared with least remote areas (adjusted OR 0.49 (0.24 to 0.99)) and more common prior to adjustment in the highest versus lowest socioeconomic category (unadjusted OR 1.55 (1.01 to 2.39)), but this elevation did not apply after adjustment (adjusted OR 0.19 (0.63 to 2.25)), with the difference largely explained by stage. Hospital-registry data add value for assessing local service delivery. Equivalent survival to Australia-wide and USA survival, and temporal gains after adjusting for stage and other patient characteristics are reassuring. Survival gains may reflect therapeutic benefits of more extensive surgery and improved chemotherapy regimens.
Interference Management in In-Band D2D Underlaid Cellular Networks
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 12-2019
Female breast cancer treatment and survival in South Australia: Results from linked health data
Publisher: Hindawi Limited
Date: 28-03-2021
DOI: 10.1111/ECC.13451
Sociodemographic disparities in survival from colorectal cancer in South Australia: A population-wide data linkage study
Publisher: Springer Science and Business Media LLC
Date: 12-2016
LIP CANCER IN SOUTH AUSTRALIA, 1977-1996
Publisher: Elsevier BV
Date: 2001
Increased tolerance to complete dentures after surgical modification of mylohyoid ridges
Publisher: Elsevier BV
Date: 08-1985
DOI: 10.1016/0022-3913(85)90294-X
Abstract: Of 521 patients referred to a specialist prosthodontic practice for complete dentures, 274 were considered as candidates for simple surgery to smooth prominent mylohyoid ridges before denture construction. Of these, 183 were thus treated. The remaining 91 did not receive surgery because of personal preference, underlying medical conditions, or other reasons. The percent who required three or more postinsertion visits to achieve comfort with their dentures was 7% for those who received surgery, 27% for those who required but did not receive surgery, and 17% for those not deemed to require surgery. This suggests that the surgical smoothing of prominent mylohyoid ridges may markedly improve patients' tolerance of dentures in the short term. However, the potential for confounding from extraneous factors in these nonexperimental circumstances must be considered.
Overdiagnosis of screen‐detected breast cancer
Publisher: AMPCo
Date: 16-05-2021
DOI: 10.5694/MJA2.51045
The epidemiology of gastric cancer
Publisher: Springer Science and Business Media LLC
Date: 12-2002
DOI: 10.1007/S10120-002-0203-6
Abstract: Gastric cancer mortality has declined markedly around the world. In South Australia, the reduction approximated 40% over the last 20 years. Possible reasons include: better refrigeration reduced consumption of salted, smoked, and chemically preserved foods increased intake of fruit and vegetables and improved living standards and a greater use of antibiotics, which may have reduced Helicobacter pylori infection. Reductions generally have been greater for intestinal than diffuse histopathologies. Gastric cancer remains the second leading cause of cancer death worldwide, probably accounting for about 10% of newly diagnosed cancers. High rates apply to Japan, China. Central and South America, Eastern Europe, and parts of the Middle East, and low rates to North America, Australia and New Zealand, Northern Europe, and India. Rates usually are higher in lower socioeconomic groups. Five-year relative survivals of around 20% or less are frequently reported. A figure of 50% or more has been cited for Japan, where there has been radiological screening, although this exceptional figure could have been affected artificially by lead-time and related effects. Male-to-female incidence ratios generally are in the 1.5-2.5 range, with higher ratios for intestinal than diffuse cancers and higher-risk populations. In South Australia, the ratio has been 1.8 to one, although higher at 4.6 to one for cardia lesions. Recent increases in cardia cancers, especially in males in populations of European extraction, often are accompanied by increases for esophageal adenocarcinoma. It is estimated that the global burden of gastric cancer could be reduced by up to 50% by dietary changes that included an increased intake of fruit and vegetables.
Performance Analysis of Raptor Codes under Maximum Likelihood Decoding
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2016
Development and Validation of a Risk Score Predicting Risk of Colorectal Cancer
Publisher: American Association for Cancer Research (AACR)
Date: 11-2014
DOI: 10.1158/1055-9965.EPI-14-0206
Abstract: Background: Quantifying the risk of colorectal cancer for in iduals is likely to be useful for health service provision. Our aim was to develop and externally validate a prediction model to predict 5-year colorectal cancer risk. Methods: We used proportional hazards regression to develop the model based on established personal and lifestyle colorectal cancer risk factors using data from 197,874 in iduals from the 45 and Up Study, Australia. We subsequently validated the model using 24,233 participants from the Melbourne Collaborative Cohort Study (MCCS). Results: A total of 1,103 and 224 cases of colorectal cancer were diagnosed in the development and validation s le, respectively. Our model, which includes age, sex, BMI, prevalent diabetes, ever having undergone colorectal cancer screening, smoking, and alcohol intake, exhibited a discriminatory accuracy of 0.73 [95% confidence interval (CI), 0.72–0.75] and 0.70 (95% CI, 0.66–0.73) using the development and validation s le, respectively. Calibration was good for both study s les. Stratified models according to colorectal cancer screening history, that additionally included family history, showed discriminatory accuracies of 0.75 (0.73–0.76) and 0.70 (0.67–0.72) for unscreened and screened in iduals of the development s le, respectively. In the validation s le, discrimination was 0.68 (0.64–0.73) and 0.72 (0.67–0.76), respectively. Conclusion: Our model exhibited adequate predictive performance that was maintained in the external population. Impact: The model may be useful to design more powerful cancer prevention trials. In the group of unscreened in iduals, the model may be useful as a preselection tool for population-based screening programs. Cancer Epidemiol Biomarkers Prev 23(11) 2543–52. ©2014 AACR.
Federated Learning for Smart Healthcare: A Survey
Publisher: Association for Computing Machinery (ACM)
Date: 03-02-2023
DOI: 10.1145/3501296
Abstract: Recent advances in communication technologies and the Internet-of-Medical-Things (IOMT) have transformed smart healthcare enabled by artificial intelligence (AI). Traditionally, AI techniques require centralized data collection and processing that may be infeasible in realistic healthcare scenarios due to the high scalability of modern healthcare networks and growing data privacy concerns. Federated Learning (FL), as an emerging distributed collaborative AI paradigm, is particularly attractive for smart healthcare, by coordinating multiple clients (e.g., hospitals) to perform AI training without sharing raw data. Accordingly, we provide a comprehensive survey on the use of FL in smart healthcare. First, we present the recent advances in FL, the motivations, and the requirements of using FL in smart healthcare. The recent FL designs for smart healthcare are then discussed, ranging from resource-aware FL, secure and privacy-aware FL to incentive FL and personalized FL. Subsequently, we provide a state-of-the-art review on the emerging applications of FL in key healthcare domains, including health data management, remote health monitoring, medical imaging, and COVID-19 detection. Several recent FL-based smart healthcare projects are analyzed, and the key lessons learned from the survey are also highlighted. Finally, we discuss interesting research challenges and possible directions for future FL research in smart healthcare.
Assessing the effectiveness of dental health education in the South Australian School Dental Programme
Publisher: Wiley
Date: 10-1979
DOI: 10.1111/J.1834-7819.1979.TB05809.X
Abstract: Approximately 25--30 per cent of operational time in the School Dental Programme is assigned to dental health education, representing a sizeable investment of public resources. If the full potential of dental health education is to be realized, the respective effectiveness of various dental health education activities need to be identified so that the more effective activities can be emphasized and developed further. As an essential prerequisite there is a need to refine the evaluation process by introducing: (1) improved dental indices (2) improved methods of classifying and maintaining records of the dental health education activities undertaken (3) better methods of quantifying dental care items and other social and environmental covariables and (4) more sophisticated forms of multivariate analysis.
Evaluation of the lead Decontamination programme in the leading smelting town of port Pirie (South Australia)
Publisher: Informa UK Limited
Date: 09-1993
Adherence to recommended treatments for early invasive breast cancer: Decisions of women attending surgeons in the breast cancer audit of Australia and New Zealand
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-04-2012
DOI: 10.7314/APJCP.2012.13.4.1675
Abstract: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29 p<0.001) and (2) although not approaching statistical significance p≥ 0.200), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.
Performance Analysis of Ambient Backscatter Systems With LDPC-Coded Source Signals
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2021
After accounting for competing causes of death and more advanced stage, do Aboriginal and Torres Strait Islander peoples with cancer still have worse survival? A population-based cohort study in New South Wales
Publisher: Springer Science and Business Media LLC
Date: 02-06-2017
Patterns of health service utilisation among the Australian population with cancer compared with the general population
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH18184
Abstract: Objective The aim of this study was to describe patterns of health service utilisation among the Australian population with cancer compared with the general population. Methods Data for all respondents aged ≥25 years from two successive National Health Surveys conducted between 2011 and 2014 were analysed. Respondents with a history of cancer were identified as the cancer group, whereas all other respondents who did not report having had a cancer were included in the non-cancer control group. Comparisons were made between the two groups using logistic regression models. Results The population with cancer was more likely to report having consulted their general practitioner, specialist, chemist, dietician, naturopath, nurse, optometrist, dentist, audiologist and other health professionals than the non-cancer population. The cancer population was also more likely to be admitted to hospital and to have visited an out-patient clinic, emergency department and day clinic. The presence of comorbidity and a current cancer were associated with a greater likelihood of receiving health services among the population with cancer. Conclusion The population with cancer used health services significantly more than the non-cancer population. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation. What is known about the topic? Multimorbidity is highly prevalent among the cancer population due to risk factors shared between cancer and other chronic diseases, and the development of new conditions resulting from cancer treatment and cancer complications. However, the Australian healthcare system is not set up optimally to address issues related to multimorbidity. What does this paper add? This study is the first step in quantifying health services use by the population with cancer compared with the general population without cancer. Cancer survivors have an increased need for specific health services, particularly among those with multimorbidity. What are the implications for practitioners? The development of integrated care models to manage multiple chronic diseases aligned with the Australian National Strategic Framework for Chronic Conditions is warranted. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation.
Female breast cancers are getting smaller, but socio‐demographic differences remain
Publisher: Elsevier BV
Date: 08-2004
DOI: 10.1111/J.1467-842X.2004.TB00435.X
Abstract: To investigate trends towards early detection of infiltrating ductal carcinomas, possible effects on patients' prognosis, and characteristics of women still at high risk of late detection. South Australian Cancer Registry data were analysed to compare breast tumour diameters for the 1980-86 and 1997-2002 diagnostic periods by age. Relative survivals for 1980-86 were compared with corresponding survival estimates for 1997-2000, obtained by weighting diameter-specific survivals for 1980-86 to equate with the diameter distribution for 1997-2002. Multivariable logistic regression was used to determine socio-demographic predictors of large diameters (> or =30 mm) in 1997-2002. The proportion of tumours with diameters smaller than 15 mm increased from 13.0% in 1980-86 to 36.7% in 1997-2002, whereas the proportion with large diameters reduced from 43.0% to 18.6%. Estimated changes in 20-year survivals equated with a 33% reduction in breast-cancer mortality among patients aged 50-69 years at diagnosis. Data for 1997-2002 indicate that early diagnosis is not evenly distributed, with large diameters more common in age ranges outside the 50-69 year target for mammography screening low socio-economic areas non-Caucasians patients born in northern/eastern Europe and potentially Asia/Middle East and in some country locations. Increased emphasis on early detection should be directed at sectors of the population where delays in diagnosis and poorer prognosis are evident. Projected reductions in breast-cancer mortality among patients are indicative of effects of earlier detection on patients' prognosis, but require confirmation with follow-up data. More particularly, parallel studies of effects on population-based mortality are warranted.
Occurrence of comorbidity with colorectal cancer and variations by age and stage at diagnosis
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.CANEP.2022.102246
Abstract: While age and stage at diagnosis are known to affect treatment choices and survival from colorectal cancer (CRC), few studies have investigated the extent to which these effects are influenced by comorbidity. In this study, we describe the occurrence of comorbidity in CRC cases in South Australia and associations of comorbidity with age, stage and the age-stage relationship. Furthermore, we report on the association of in idual comorbidities with age and stage at diagnosis. The South Australian Cancer Registry (SACR) provided CRC data (C18-C20, ICD-10) for 2004-2013 diagnoses. CRC data were linked with comorbidity data drawn from hospital records and health insurance claims. Logistic regression was used to model associations of comorbidity with age and stage. For the 8462 CRC cases in this study, diabetes, peptic ulcer disease, and previous cancers were the most commonly recorded co-existing conditions. Most comorbidities were associated with older age, although some presented more frequently in younger people. Patients at both ends of the age spectrum (<50 and 80 + years) had an increased likelihood of CRC diagnosis at an advanced stage compared with other ages (50-79 years old). Adjusting for comorbidities moderated the association of older age with advanced stage. Conditions associated with advanced stage included dementia (OR = 1.25 (1.01-1.55)), severe liver disease (OR = 1.68 (1.04-2.70)), and a previous cancer (OR = 1.18 (1.08-1.28)). Comorbidities are prevalent with CRC, especially in older people. These comorbidities differ in their associations with age at diagnosis and stage. Dementia and chronic heart failure were associated with older age whereas inflammatory bowel disease and alcohol access were associated with younger onset of the disease. Severe liver disease and dementia were associated with more advanced stage and rheumatic disease with less advanced stage. Comorbidities also interact with age at diagnosis and appear to vary the likelihood of advanced-stage disease. CRC patient have different association of age with stage depending on their comorbidity status.
On‐Resin Preparation of Allenamidyl Peptides: A Versatile Chemoselective Conjugation and Intramolecular Cyclisation Tool
Publisher: Wiley
Date: 03-09-2020
Patterns of care for synchronous rectal cancer with liver-only metastasis: Results from the South Australian registry of metastatic colorectal cancer
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2017
DOI: 10.1200/JCO.2017.35.4_SUPPL.701
Abstract: 701 Background: Management of rectal cancer with synchronous liver metastasis is not clear. Optimal timing of radiotherapy, chemotherapy, resection of primary and liver metastasis is debated. Methods: The South Australian Registry for metastatic colorectal cancer has entered all patients with mCRC since 1st February 2006. Registry data were analyzed to assess patient characteristics, therapy received and outcomes for patients with liver only metastasis and synchronous rectal or colon primary. KM analysis was used for survival outcomes. Results: 2677 patents had synchronous mCRC. 42% (n = 1125) had liver only metastasis (primary: 275 rectal/850 colon). The main differences between rectal/liver vs. colon/liver were: more males (68.7% v 57.8%, p = 0.001), younger age (65.8 v 73.3 years, p 0.001) and less poorly differentiated histology (14.2% v 24.1%, p = 0.003). The rate of no surgery on the primary was 21.4% for rectal cancers v. 36% for colon (p ≤ 0.001). Liver surgery rates in both groups was similar (28.4% v 23.0% (p = 0.075). Out of the 275 rectal cancer patients, 100 (36.3%) had rectal surgery, 83 (30%) had chemo-RT and 47 (17%) had chemotherapy +/- targeted therapy as initial treatment, 45 (16%) patients had no treatment. Median OS of rectal cancer patients based on their initial treatment was 33.2m (Chemo-RT) vs. 22.2m (surgery) vs. 19.2m (chemotherapy +/- targeted therapy, p 0.001). The mOS for rectal group was 22.8m v. 14.8m (p = 0.001) for colon group. For patients who had liver surgery mOS was 60.7m vs. 67.1m respectively. Survival was better if primary was rectum or left colon vs. right colon (mOS 18.3m vs 18.8m vs 10.2m respectively p 0.001). Resection of the primary occurred first in all patients who had liver resection. Conclusions: Patients with synchronous rectal cancer with liver only metastases have better survival compared to those with colon cancer and liver only metastases. Where surgery is possible, OS is equivalent between the two groups and in our registry population surgery on the rectal primary or chemo-RT were found to be the preferred initial treatment for rectal cancer patients with synchronous liver metastases.
Synthesis and SAR Analysis of Lipovelutibols B and D and Their Lipid Analogues
Publisher: American Chemical Society (ACS)
Date: 22-11-2019
Abstract: The first syntheses of the cytotoxic peptides lipovelutibols B and D are described. While lipovelutibol D was prepared using solid-phase peptide synthesis followed by an
ACTUARIAL PREDICTIONS FROM POPULATION-BASED DISEASE REGISTRIES WITH UNIDENTIFIED RANDOM LOSSES - REPLY
Publisher: AMPCo
Date: 02-1990
Mobility handover optimization in millimeter wave heterogeneous networks
Publisher: IEEE
Date: 09-2017
Can cancer registries show whether treatment is contributing to survival increases for melanoma of the skin at a population level?
Publisher: Wiley
Date: 23-09-2013
DOI: 10.1111/JEP.12081
Abstract: It is uncertain whether survival increases from melanoma recorded by some population registries include a treatment effect. The US Surveillance, Epidemiology and End Results (SEER) programme has good data quality control, large numbers of cases enabling high statistical precision and summary stage plus thickness, which we consider to be a best-case population registry scenario to investigate potential for a treatment effect. We have investigated SEER data to indicate whether survivals increases are fully attributable to earlier diagnosis and other non-treatment factors. Through relative survival regression, the effects of diagnostic period on 5-year excess mortality were investigated, adjusting for socio-demographic factors, lesion sub-site, histology, thickness and stage at diagnosis in 1990-2009 (n = 99 690 cases). The reduction in excess mortality (95% confidence interval) between 1990-1999 and 2000-2009 was 31 (20-41)% for localised melanoma, 18 (12-22)% for regional melanoma and 3 (-5-10)% for melanomas with distant spread. Younger age was predictive of a greater percentage reduction. Treatment benefits are inferred from the higher survivals in 2000-2009 but uncertainty remains due to incomplete data to adjust for non-treatment factors and a lack of treatment data. Registries should use new information systems to collect more complete data on stage, other prognostic indicators, co-morbidities and treatment, to provide more definitive and detailed information on population effects of cancer control.
The impact of primary tumour resection and sidedness in patients with synchronous metastatic colorectal cancer (mCRC): Findings from the South Australian Metastatic Colorectal Cancer Registry (SAMCRC)
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2018
DOI: 10.1200/JCO.2018.36.4_SUPPL.739
Abstract: 739 Background: The benefit of primary tumour resection (PTR) in patients with synchronous mCRC is not clear. The influence of tumour location on PTR benefit is also uncertain. Methods: SAMCRC is a population based registry collating data from all patients in South Australia diagnosed with mCRC from February 2006. We examined outcomes according to whether the primary colorectal tumour was excised within 3 months of diagnosis or remained in situ we also examined whether outcomes were affected by tumour side (right v left). Registry data was included for patients with synchronous metastic adenocarcinoma from colon or rectum. Exclusion criteria included metastasectomy, tumour resection within 7 days or death within 3 months of mCRC diagnosis. Kaplan Meier analysis was used for Survival. Tumour sidedness and PTR were analysed with a multivariate Cox proportional hazards model. Survival was measured from the landmark date (3 months from date of diagnosis). Results: 2575 patients with synchronous mCRC have entered the database, of which 1869 patients were eligible for the PTR analysis. 50.2% (n = 938) underwent PTR. 481 patients (51.3%) of the PTR analysis group had left-sided primary tumours whilst 436 had right sided tumours (46.5%) which was significant (p 0.001). 63% of the PTR cohort were male (n = 1006). Site and age metastases were included in the multivariate analysis. PTR was associated with improved survival from landmark compared to no resection (15.0 mo vs 11.2 mo, 95% CI 15.0 – 16.3 vs 11.2 – 12.3, p = 0.031). In the entire synchronous mCRC group, left-sided tumours (62.1%) had a longer median survival (17.8 mo vs 10.4 mo, 95% CI 15.7 – 19.5 vs 10.4 – 11.7 p = 0.001). An interaction test was performed for sidedness and was not significant. Conclusions: PTR was associated was associated with improvement in survival in this large population based registry. This finding did not differ signifcantly between right and left sided tumours. Survival was superior for patients with left sided tumours, in keeping with established data. Criteria for selection of patients with mCRC who benefit from PTR need to be defined.
Bladder cancer survivals in New South Wales, Australia: why do women have poorer survival than men?
Publisher: Wiley
Date: 21-07-2009
Antibiotic exposure within six months before systemic therapy was associated with lower cancer survival
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JCLINEPI.2022.04.003
Abstract: The objective of the study was to quantify associations between cancer survival and antibiotic exposure before systemic anticancer therapy. This population-based cohort study compares cause-specific survival according to antibiotic exposure before non-immune checkpoint inhibitor (ICI) systemic therapy in patients diagnosed with single primary cancers in New South Wales between 2013 and 2016. Proportional hazards regression was used to control for confounding, with no antibiotic exposure in the six months before non-ICI systemic therapy serving as the comparator. After adjusting for tumour spread, cancer site, age, sex and comorbidity, people having antibiotic exposure within 180 days before non-ICI systemic therapy had poorer cancer survival (hazard ratios ranging from 1.21 [95% confidence interval: 1.06-1.39] to 1.58 [1.34-1.87]) for shorter periods since antibiotic exposure (P < .0001). Similarly, poorer survival trends applied for localized and metastatic cancer. Of six prevalent cancers studied, lung and breast primaries showed the strongest associations of lower survival with prior antibiotic exposure. Antibiotic exposure within 180 days before non-ICI systemic cancer treatment is associated with poorer survival. If confirmed in other studies, it provides another reason for vigilant antibiotic stewardship.
Age effects on survival from early breast cancer in clinical settings in Australia
Publisher: Wiley
Date: 07-2012
DOI: 10.1111/J.1445-2197.2012.06114.X
Abstract: Background: The study aim was to determine whether age is an independent risk factor for survival from early invasive breast cancer in contemporary Australian clinical settings. Methods: The study included 31 493 breast cancers diagnosed in 1998–2005. Risk of death from breast cancer was compared by age, without and with adjustment for clinical risk factors, using Cox proportional hazard regression. Results: Risk of breast cancer death was elevated for cancers of larger size, higher grade, positive nodal status, oestrogen receptor negative status, vascular invasion and multiple foci. Ductal lesions presented a higher risk than other lesions. Adjusting for these factors, the relative risk of breast cancer death (95% confidence limits) was lower for 40–49‐year‐olds at 0.80 (0.66, 0.96) than for the reference category under 40 years, but higher for 70–79‐year‐olds at 1.64 (1.36, 1.98) and women aged 80 years or more at 2.19 (1.79, 2.69). The risk for 50–69‐year‐olds and women under 40 years was similar. Risk‐factor adjustment reduced the difference in risk between the reference category under 40 years and 40–49‐year‐olds, largely eliminated the lower relative risk for 50–69‐year‐olds, and increased the relative risks for women aged 70–79 years and older. Discussion: Survivals in women under 40 and over 70 years of age are poorer than for 40–69‐year‐olds. Research is needed into the best treatment modalities for younger women and older women with co‐morbidity.
Bevacizumab and its impact on survival for patients receiving subsequent anti-EGFR therapy: Results from the South Australian metastatic colorectal cancer registry
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2017
DOI: 10.1200/JCO.2017.35.4_SUPPL.754
Abstract: 754 Background: Questions over the impact of 1st line bevacizumab on subsequent sensitivity to anti-EGFR therapy have been raised with authors hypothesizing that up-front anti-VEGF agent’s use influences biological changes that increase the risk of acquired resistance to subsequent EGFR inhibitors. Methods: Aretrospective cohort study was performed to compare the characteristics and survival of patients who were treated with an anti-EGFR therapy 2nd line and beyond by two groups defined by the 1st line therapy 1. chemotherapy (chemo) plus bevacizumab (bev) and 2. chemo alone. Pearson chi test analysis was performed to determine whether receiving 1 st line bev was associated with worse OS. Results: 348 mCRC patients who received chemo with or without bev and then an anti-EGFR therapy were studied. Patient characteristics are summarised in table. The significant differences between group 1. Vs. 2. were as follows median age, lower use of single agent FU, KRAS status not tested, and where BRAF MT status was known (11%) BRAF MT rate. Median OS for the 2 groups was 34.2 mths, and 28.2 mths respectively (p = 0.12). Conclusions: Survival was not significantly different between the two groups, and the trend was towards higher OS with chemo plus bev suggesting that in our registry population, bev administration in first line therapy with chemo did not lead to a worse outcome for those patients subsequently receiving anti-EGFR therapy. [Table: see text]
Nonagenarian patients with metastatic colorectal cancer: Results from the South Australian metastatic colorectal cancer registry.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2017
DOI: 10.1200/JCO.2017.35.4_SUPPL.752
Abstract: 752 Background: With improved healthcare we now face an ageing population worldwide. More patients with metastatic colorectal cancer (mCRC) will present at advanced age. Patients with mCRC now have the potential of living longer due to surgery, chemotherapeutic agents and monoclonal antibodies. Australian data (2011) indicated 1.3% of the population are aged over 90 years*. Medical oncologists are now being referred patients in their 90’s and the optimal management for this group is unknown. Methods: The population based South Australian Clinical Registry for mCRC includes all patients with metastatic CRC diagnosed since the 1st February 2006. We examined cancer characteristics, treatments administered and outcomes for patients aged 90 years. Results: 130 patients of 4199 (3%) were aged 90 years or older. The median age was 92.1 years (range 90-104.8 years). 61% were female, 70% presented with synchronous disease. Organ involvement was as follows 58% liver, 32% lung, 8% peritoneal and 7% bone. Primary site was: right 46%, left 28%, rectum 20%, unknown 6%. Only 4 patients had KRAS testing (all WT). 44.6% overall have had no surgery for their CRC primary. 24% of those with synchronous disease at diagnosis had resection of primary lesion and 3% had stoma formed for palliation. One patient had lung resection for metastasis. Only 4 patients received systemic therapy (age range 90-93). Lines of therapy delivered one in 2 patients, two lines in one and 4 lines in one. Aside single agent 5FU, combination therapy (oxaliplatin/FU+/- bevacizumab) was given to two patients and cetuximab single agent in 2 (WT one, unknown one). The median survival overall was 3 months (95% CI 1.4-4.6 months). Two year survival was 10%. Conclusions: This analysis gives us some insight into the management of the very old. Female sex and right sided cancers are more frequent. Systemic therapy is rarely offered and the outlook is poor. Further research to understand whether active therapy is possible or warranted in this age group should be considered. *www.abs.gov.au/ausstats/abs@.nsf
Factors Predictive of Corneal Graft Survival
Publisher: Elsevier BV
Date: 03-1992
DOI: 10.1016/S0161-6420(92)31960-8
Abstract: Risk factors for graft failure after penetrating keratoplasty were investigated in 961 patients from records collected prospectively by the Australian Corneal Graft Registry. The most common cause of graft failure was irreversible rejection. A multivariate proportional hazards regression analysis indicated that the key predictors of graft failure were: an indication for graft other than keratoconus or corneal dystrophy a failed previous graft (ipsilateral eye) aphakia inflammation at the time of graft presence of an anterior chamber or iris-clip intraocular lens graft size outside the range of 7.0 to 7.9 mm diameter and corneal vascularization occurring in the postoperative period.
On the Theoretical Analysis of Network-Wide Massive MIMO Performance and Pilot Contamination
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2022
PREVALENCE OF COMORBIDITIES AND HEALTH STATUS AMONG CURRENT CANCER AND CANCER SURVIVORS: AN AUSTRALIAN POPULATION-BASED STUDY
Publisher: Elsevier BV
Date: 11-2016
THE EMPLOYMENT OF DENTAL NURSES
Publisher: Wiley
Date: 06-1978
Cervical Cancer in South Australia: Trends in Incidence, Mortality and Case Survival
Publisher: Wiley
Date: 08-1989
DOI: 10.1111/J.1479-828X.1989.TB01717.X
Abstract: Approximately 90% of cervical cancers are considered preventable through regular screening and the treatment of precursor lesions, but fewer than 20% of South Australian women were found to have been screened in 1984. Data from the State Cancer Registry have shown an increase in cervical cancer incidence of approximately 80% in women under 50 years of age in the 9-year period to 1986, but a decrease of about 25% in older women. Mortality data have shown similar patterns by age, although the increase in younger women tended to extend to an older age. Case survival was unchanged between the diagnostic periods 1977-1981 and 1982-1987 and there was little change in the proportion of cases that were adenocarcinomas.
The association of low socio-economic status in metropolitan adelaide with maternal demographic and obstetric characteristics and pregnancy outcome
Publisher: Springer Science and Business Media LLC
Date: 09-1992
DOI: 10.1007/BF00145388
Extent and predictors of grade upgrading and downgrading in an Australian cohort according to the new prostate cancer grade groupings
Publisher: Elsevier BV
Date: 10-2019
Outcomes for Metastatic Colorectal Cancer Based on Microsatellite Instability: Results from the South Australian Metastatic Colorectal Cancer Registry
Publisher: Springer Science and Business Media LLC
Date: 18-01-2019
DOI: 10.1007/S11523-018-0615-9
Abstract: Microsatellite instability (MSI) is the molecular marker for DNA mismatch repair deficiency (dMMR) in colorectal cancer (CRC) and has been associated with better survival outcomes in early stage disease. In metastatic CRC (mCRC), outcomes for patients with MSI are less clear. There is evolving evidence that treatment pathways for MSI CRC should include programmed-death 1 (PD-1) antibodies. An analysis was performed to explore the impact of MSI status on overall survival (OS) in mCRC. South Australian Metastatic CRC Registry data were analysed to assess patient characteristics and survival outcomes, comparing patients with MSI CRC with those whose tumours were microsatellite stable (MSS). Kaplan-Meier survival analysis was used to assess OS. Cox regression analysis was undertaken to assess the independence of MSI as a prognostic factor. Of 4359 patients registered on the database, 598 (14%) had been tested for, and 62 (10.1%) of these patients had, demonstrable MSI. There were significantly higher rates of right-sided primary (p < 0.001), poorly differentiated pathology (p = 0.002), and BRAF V600E mutation (p < 0.001) in the MSI group. The MSI group were also less likely to receive chemotherapy (p < 0.001) or to have liver surgery, but more likely to be diagnosed at an early stage. The median overall survival was 9.5 months for those with MSI CRC versus 21.3 months for MSS CRC patients (p = 0.052). Cox regression analysis indicated that MSI was not an independent predictor of OS. Independent predictors of better OS included having liver surgery for metastasis, having chemotherapy, and being initially diagnosed at an early stage. Only 14% of patients with mCRC were tested for MSI, and 1 in 10 were found to be MSI high. The clinical characteristics of MSI mCRC are in keeping with those previously reported. MSI in this population-based registry was associated with a numerically lower survival which did not attain statistical significance.
Prognostic value of comorbidity measures among Australian men with non-metastatic prostate cancer
Publisher: Elsevier BV
Date: 12-2023
Population screening and intensity of screening are associated with reduced breast cancer mortality: Evidence of efficacy of mammography screening in Australia
Publisher: Springer Science and Business Media LLC
Date: 22-05-2008
DOI: 10.1007/S10549-007-9609-5
Abstract: Efficacy of breast screening may differ in practice from the results of randomized trials. We report one of the largest case-control evaluations of a screening service. Subjects included 491 breast-cancer deaths affecting 45-80-year-old South Australian females during 2002-2005 (diagnosed after BreastScreen commencement) and 1,473 live controls (three per death) randomly selected from the State Electoral Roll after birth-date matching. Cancer Registry and BreastScreen records provided cancer and screening details. Risk estimates were calculated by BreastScreen participation, using conditional logistic regression. Interpretation was assisted by a population survey of risk factor prevalence by BreastScreen participation in 1,684 females aged > or =40 years. The relative odds (OR) (95% confidence limits) of breast-cancer death in BreastScreen participants compared with non-participants were 0.59 (0.47, 0.74). Compared with non-participants, the OR was 0.70 (0.47, 1.05) for women last screened through BreastScreen more than 3 years before diagnosis of the index case, and 0.57 (0.44, 0.72) for women screened more recently. The OR of 0.47 (0.34, 0.65) for women screened more frequently in the pre-diagnosis phase was lower than the 0.64 (0.50, 0.82) for other screened women. The overall OR of 0.59 approximated 0.70 when corrected for the screening self-selection bias observed in five randomized trials. However, multivariable analysis of survey data did not indicate a lower prevalence of breast-cancer risk factors among BreastScreen participants, suggesting that this correction may be inappropriate. Participation in screening was associated with a breast-cancer mortality reduction of between 30 and 41%, depending on assumptions about screening self-selection bias. A downward mortality risk by recency of last screen prior to cancer diagnosis, and frequency of recent screening, is consistent with a screening effect.
History of screening by BreastScreen New South Wales of women with invasive breast cancer
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.CANEP.2019.101659
Abstract: The principal target age for Australian BreastScreen services was 50-69 years in 1991-2013 and 50-74 years from 2014. History of BreastScreen NSW screening participation of NSW women diagnosed with breast cancer in 2005-2014 was examined using linked BreastScreen and Cancer Registry data. Differences in BreastScreen participation were investigated by sociodemographic and tumour characteristics, and diagnostic period, using the Pearson Chi-square test, or Fisher's Exact test when numbers were small, and by multivariate logistic regression. At breast cancer diagnosis, a history of BreastScreen participation varied by age from 23 % for 40-49 years to 68 % for 50-59 years, 72 % for 70-74 years and 78 % for 60-69 years. Among women experiencing breast cancer at age 50-69 years, 60 % had participated in BreastScreen <24 months of diagnosis. Higher odds of BreastScreen participation applied to residents of inner regional and remote compared with major city areas and for women with localized compared with more distant cancer spread. BreastScreen participation was lower in Indigenous than non-Indigenous women. Differences in participation existed by country of birth and residential location, but they were not pronounced. The history of BreastScreen NSW participation of 60 % <24 months for women aged 50-69 years at breast-cancer diagnosis is less than the 70 % target for biennial screening coverage at a population level, but this target has never been reached by an Australian jurisdiction. Qualitative research of screening barriers and opportunities may provide a useful guide for reducing barriers across the population.
Is Survival for Patients with Resectable Lung Metastatic Colorectal Cancer Comparable to Those with Resectable Liver Disease? Results from the South Australian Metastatic Colorectal Registry
Publisher: Springer Science and Business Media LLC
Date: 06-2016
DOI: 10.1245/S10434-016-5290-4
Abstract: Hepatic resection for colorectal (CRC) metastasis is considered a standard of care. Resection of metastasis isolated to lung also is considered potentially curable, although there is still some variation in recommendations. We explore outcomes for patients undergoing lung resection for mCRC, with the liver resection group as the comparator. South Australian (SA) metastatic CRC registry data were analysed to assess patient characteristics and survival outcomes for patients suitable for lung or liver resection. A total of 3241 patients are registered on the database to December 2014. One hundred two (3.1 %) patients were able to undergo a lung resection compared with 420 (12.9 %) who had a liver resection. Of the lung resection patients, 62 (61 %) presented with lung disease only, 21 % initially presented with liver disease only, 11 % had both lung and liver, and 7 % had brain or pelvic disease resection. Of these patients, 79 % went straight to surgery without any neoadjuvant treatment and 34 % had lung resection as the only intervention. Chemotherapy for metastatic disease was given more often to liver resection patients: 76.9 versus 53.9 %, p = 0.17. Median overall survival is 5.6 years for liver resection and has not been reached for lung resection (hazard ratio 0.82, 95 % confidence interval 0.54-1.24, p = 0.33). Lung resection was undertaken in 3.1 % of patients with mCRC in our registry. These data provide further support for long-term survival after lung resection in mCRC, survival that is at least comparable to those who undergo resection for liver metastasis in mCRC.
Colorectal Cancer Survival: An Analysis of Patients With Metastatic Disease Synchronous and Metachronous With the Primary Tumor
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.CLCC.2013.11.008
Abstract: Whether metastatic colorectal cancer (mCRC) that presents synchronously with the primary lesion behaves differently from mCRC that appears metachronously to the primary disease is not clear. The South Australian Clinical Registry for mCRC collects data for patients diagnosed after February 2006. Data from 2502 patients, available on October 22, 2012, were analyzed according to stage at initial diagnosis (SAID) to compare outcomes between metachronous tumors (MTs) (stages I, II, III) and synchronous tumors (STs) (stage IV). Overall survival (OS) was calculated from the date of mCRC diagnosis. Patients with ST had more liver-only metastases, and patients with MT had more lung-only, non-lung and non-liver, and non-lung metastases. The median time to recurrence differed significantly according to SAID: stage I, 49.3 mo (n = 29), stage II, 25.2 mo (n = 346) and stage III, 18.4 mo (n = 497). The median OS was longer for patients with MT than for those with ST (19.0 vs.14.9 mo, P = .003). For patients who received any treatment for mCRC, the OS was longer for patients with MT than for those with ST (19.2 vs. 15.3 mo, P = .005). In patients who received only chemotherapy for mCRC, the median OS was longer for patients with MT than for those with ST (15.2 vs. 9.9 mo, P < .0001). No difference in OS between the MT and ST groups for patients who did not receive treatment for mCRC (1.6 vs. 2.6 mo P = .95). Patients with MT have a longer OS than those with ST, independent of treatment. Classification of patients according to whether they have metachronous or synchronous presentation of mCRC is prognostic. These results may add further support for population screening with the aim to reduce de novo metastatic disease.
Changes in the prevalence of comorbidity in the Australian population with cancer, 2007–2014
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.CANEP.2018.03.010
Abstract: Coexistence of multiple chronic diseases is highly prevalent among the cancer population. This study aims to assess changes in the prevalence of chronic conditions among the population with cancer compared to the Australian general population between 2007 and 2014. Data from three successive National Health Surveys conducted by the Australian Bureau of Statistics between 2007 and 2014 were utilized. Comparisons were made between the s les of the Australian population aged 25 years and above with a history of cancer and those respondents who did not report having had a cancer using logistics regression models. People with a history of cancer had significantly higher odds of reporting non-infectious comorbidity compared to the non-cancer groups across the three surveys. There were no significant changes in the prevalence of diseases affecting circulatory, musculoskeletal, digestive, nervous system, blood and blood forming organs, eye, skin and infectious and parasitic diseases over time among the population with cancer. The prevalence of mental and behavioural problems, endocrine, nutritional and metabolic diseases, and diseases of respiratory and genitourinary system has increased over time among the cancer survivors. Comorbidity is more prevalent among the cancer population than the general population without cancer. The prevalence of comorbidity was fairly stable for most but not all comorbidities in the population with cancer over the eight-year study period. Further studies on the impacts of coordinated care models for the management of multi-morbidity experienced by cancer survivors that align with the 'National Strategic Framework for Chronic Conditions' are needed.
Fluoridation 1. Effects on children's caries rates and professionally defined requirements for dental care
Publisher: Wiley
Date: 04-1980
DOI: 10.1111/J.1834-7819.1980.TB03679.X
Abstract: In 1977, after six years of fluoridation in South Australia, 337 six year-olds with continuous fluoride-drinking-water histories had DMFT values 53.2 per cent lower and df values 48.5 per cent lower than base-line values. For five to six year-olds presenting for follow-up care in the School Dental Service in 1977, continuous intake of fluoridated water evidently had reduced: (1) the number of teeth needing restorations by 40.0 per cent (2) the total care items required by 32.6 per cent (3) the total time required for care by 37.5 per cent and (4) the fee-for-service value of care required by 34.3 per cent.
Ultra-Dense Networks: A Holistic Analysis of Multi-Piece Path Loss, Antenna Heights, Finite Users and BS Idle Modes
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2021
Cancer epidemiology in the small nations of Pacific Islands
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.CANEP.2017.09.002
Abstract: Pacific island countries and territories (PICTs) comprise 20,000-30,000 islands in the Pacific Ocean. PICTs face challenges in relation to small population sizes, geographic dispersion, increasing adoption of unhealthy life-styles and the burden of both communicable and non-communicable diseases, including cancer. This study reviews data on cancer incidence and mortality in the PICTs, with special focus on indigenous populations. PICTs with populations of <1.5 million ('small nations') were included in this study. Information on cancer incidence and mortality was extracted from the GLOBOCAN 2012 database. Scientific and grey literature was narratively reviewed for publications published after 2000. Of the 21 PICTs, seven countries were included in the GLOBOCAN 2012 (Fiji, French Polynesia, Guam, New Caledonia, Samoa, Solomon Islands, Vanuatu). The highest cancer incidence and mortality rates were reported in New Caledonia (age-standardized incidence and mortality rates 297.9 and 127.3 per 100.000) and French Polynesia (age-standardized incidence and mortality rates 255.0 and 134.4 per 100.000), with relatively low rates in other countries. Literature indicated that cancer was among the leading causes of deaths in most PICTs thus they now experience a double burden of cancers linked to infections and life-style and reproductive factors. Further, ethnic differences in cancer incidence and mortality have been reported in some PICTs, including Fiji, Guam, New Caledonia and Northern Mariana Islands. Cancer incidence in the PICTs was recorded to be relatively low, with New Caledonia and French Polynesia being exceptions. Low recorded incidence is likely to be explained by incomplete cancer registration as cancer had an important contribution to mortality. Further endeavors are needed to develop and strengthen cancer registration infrastructure and practices and to improve data quality and registration coverage in the PICTs.
EVALUATION OF DENTAL HEALTH EDUCATION IN A SCHOOL DENTAL CARE PROGRAM
Publisher: Wiley
Date: 03-1978
DOI: 10.1111/J.1752-7325.1978.TB03715.X
Abstract: Cross-reaction agglutinin titers to Brucella abortus antigen were found in 42 of 128 tularemia serum specimens, and cross-reaction titers to Francisella tularensis antigen were found in 8 of 34 brucellosis serum specimens. The cross-reaction titers were reduced to 10 or less by dithiothreitol, suggesting that the titers are due to immunoglobulin M antibody.
Privacy Preserving Location Data Publishing: A Machine Learning Approach
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2021
Influence of mammographic screening on breast cancer incidence trends in South Australia
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 04-2014
DOI: 10.7314/APJCP.2014.15.7.3105
Abstract: To examine breast cancer (BC) incidence trends in relation to mammographic screening and risk factor prevalence in South Australia (SA). Trends in annual BC incidence rates were calculated using direct standardisation and compared with projected incidence derived from Poisson regression analysis of pre-screening rates. Annual percentage change and change time points were estimated using Joinpoint software. Biennial mammography screening participation rates were calculated using data from BreastScreen SA. Trends in overweight/obesity, alcohol use and hormone replacement therapy (HRT) use were examined using 1991-2009 Health Omnibus Survey data. Trends in total fertility were examined using data from the Australian Bureau of Statistics. BC incidence increased around the time BreastScreen commenced and then stabilised in the mid-1990s. However rates have remained higher than projected, even though the proportion and age distribution of first time screening attendees stabilised around 1998. A decrease in BC incidence was observed among women aged 50-59yrs from the late-1990's but not among older women. Obesity and alcohol use have increased steadily in all age groups, while HRT use declined sharply from the late-1990s. BC incidence has remained higher than projected since mammography screening began. The sustained elevation is likely to be due to lead time effects, though over-diagnosis cannot be excluded. Declining HRT use has also impacted incidence trends. Studies using in idual level data, which can account for changes in risk factor prevalence and lead time effects, are required to evaluate 'over-diagnosis' due to screening.
When Machine Learning Meets Privacy
Publisher: Association for Computing Machinery (ACM)
Date: 05-03-2022
DOI: 10.1145/3436755
Abstract: The newly emerged machine learning (e.g., deep learning) methods have become a strong driving force to revolutionize a wide range of industries, such as smart healthcare, financial technology, and surveillance systems. Meanwhile, privacy has emerged as a big concern in this machine learning-based artificial intelligence era. It is important to note that the problem of privacy preservation in the context of machine learning is quite different from that in traditional data privacy protection, as machine learning can act as both friend and foe. Currently, the work on the preservation of privacy and machine learning are still in an infancy stage, as most existing solutions only focus on privacy problems during the machine learning process. Therefore, a comprehensive study on the privacy preservation problems and machine learning is required. This article surveys the state of the art in privacy issues and solutions for machine learning. The survey covers three categories of interactions between privacy and machine learning: (i) private machine learning, (ii) machine learning-aided privacy protection, and (iii) machine learning-based privacy attack and corresponding protection schemes. The current research progress in each category is reviewed and the key challenges are identified. Finally, based on our in-depth analysis of the area of privacy and machine learning, we point out future research directions in this field.
Stereochemical Effects on the Antimicrobial Properties of Tetrasubstituted 2,5-Diketopiperazines
Publisher: American Chemical Society (ACS)
Date: 05-04-2022
DNA-GA: A new approach of network performance analysis
Publisher: IEEE
Date: 05-2016
Optimum Tools for Predicting Clinical Outcomes in Prostate Cancer Patients Undergoing Radical Prostatectomy: A Systematic Review of Prognostic Accuracy and Validity
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.CLGC.2017.06.001
Abstract: Prostate cancer is a heterogeneous disease whose therapies frequently have adverse effects. Informed patient counseling regarding likely clinical outcomes is therefore important. In this systematic review we aimed to identify all external validations of tools that are used to predict clinical outcomes in patients undergoing radical prostatectomy and evaluate which are optimum for clinical implementation. PubMed and EMBASE were searched from 2007 to 2016. Search terms related to the inclusion criteria were: prostate cancer, clinical outcomes, radical prostatectomy, and prognosis. Titles and abstracts were screened and relevant studies were advanced to full-text review. Reference lists were reviewed for further studies. The Centre for Evidence Based Medicine prognostic tool was used for critical appraisal. Seventy-three studies externally validated 13 pre- and 41 postoperative tools for the prediction of biochemical recurrence (BCR), aggressive BCR, metastasis, and prostate cancer-specific mortality (PCSM). Recommendations for clinical implementation were made on the basis of accuracy, cohort sizes, and consistency. The accuracy of recommended tools ranged from 68% to 79% and 72% to 92% among the largest validation cohorts for pre- and postoperative tools. For preoperative prognosis we recommended the Cancer of the Prostate Risk Assessment (CAPRA) and Stephenson nomograms for BCR, the CAPRA nomogram for aggressive BCR as well as metastasis, and the D'Amico criteria for PCSM. For postoperative prognosis we recommended the CAPRA-Surgery (CAPRA-S), Stephenson, Kattan, Duke prostate cancer (DPC), and the Suardi nomograms for the prediction of BCR, the DPC nomogram for aggressive BCR, the CAPRA-S and Eggener nomograms for metastasis, and the Eggener nomogram for PCSM. Use of these tools should help clinicians deliver accurate, evidence-based counseling to patients undergoing prostatectomy.
“When we were young, it really was a treat; now sugar is just the norm every day”—A qualitative study of parents’ and young adults’ perceptions and consumption of sugary drinks
Publisher: Wiley
Date: 29-05-2019
DOI: 10.1002/HPJA.257
Abstract: Sugar-sweetened beverages (SSB) are the leading source of free sugars in Australian children's and adults' diets. This study explores drivers of consumption among parents and young adults to inform interventions. Eight focus groups (n = 59) stratified by gender, age/life stage and SES were analysed thematically. Daily SSB consumption was normalised. Participants drank SSBs to avoid perceived energy/sugar deficits, to treat themselves and as a function of familial influence. Frequent consumption was considered acceptable if "in moderation" and/or "balanced" with exercise/diet however, there was a large disconnect between this language of moderation and actual consumption practices. Participants acknowledged that social norms had changed over time. There was little evidence of accurate knowledge of sugar content for any beverage type. Participants relied heavily on packaging and labelling, much of which conveyed a health halo effect. While participants could list health effects of excess consumption, they were considered long-term or of low personal relevance. Awareness of health recommendations was low. Consumers' adoption and use of concepts such as "treat," "moderation" and "balance" reflect both food and beverage industry marketing and public health messaging. However, the disconnect between this language and knowledge and consumption practices is problematic. SO WHAT?: SSB consumption is very high with serious implications for health. Curbing consumption among young adults and parents has potential to change the health trajectories for current and future generations. There is a clear need to increase health literacy around SSB consumption. Simple consumption guidelines, clearer sugar content labelling and health warnings offer potential.
Does Exact Primary Site Impact on Outcome for Metastatic Colorectal Cancer (Mcrc)?
Publisher: Elsevier BV
Date: 09-2014
Body image and quality of life in women with breast cancer: Appreciating the body and its functionality
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.BODYIM.2021.11.001
Abstract: Women with breast cancer often experience major physical changes, which can impact their body image and Quality of Life (QoL). Traditional assessments of body image implemented within breast cancer research focus solely on body dissatisfaction. This study explored the association between both positive and negative body image and QoL. Australian women (N = 123) within 5-years of a breast cancer diagnosis were invited to complete a web-based questionnaire including measures of body appreciation and functionality appreciation, cancer-specific measures of body dissatisfaction and QoL, and demographic, health and treatment/illness questions. All body image measures were significantly associated with QoL (p < .01). However, when body image variables were entered simultaneously as predictors of QoL (adjusting for comorbidity, treatment and employment), only body dissatisfaction was significantly associated with QoL (p < .001). Further analyses indicated this was due to shared variance in QoL between body and functionality appreciation, suggesting they assess highly related constructs within this population. Results indicate positive and negative components of body image are relevant to QoL within breast cancer populations though, body dissatisfaction remained the strongest predictor of QoL indicating its pervasiveness. Future research should explore the development and use of breast cancer-specific measures of positive body image.
Mammography service screening and breast cancer mortality in New Zealand: a National Cohort Study 1999-2011
Publisher: Springer Science and Business Media LLC
Date: 09-02-2017
DOI: 10.1038/BJC.2017.6
Right (R) or left (L) primary site of colorectal cancer and outcomes for metastatic colorectal cancer (mCRC): Results from the south Australian registry of mCRC.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-01-2014
DOI: 10.1200/JCO.2014.32.3_SUPPL.596
Abstract: 596 Background: Previous reports have described differences in biology and outcome based on whether the primary is R or L sided. Possible differences in response to biological agents have also been reported based on side of primary lesion (SY Brule et al., JCO31, 2013 (supp #3528). Methods: We explored the SA mCRC registry to assess if there were any differences in patient characteristics, treatment received and outcomes based on whether the primary was R (caecum to transverse colon) or L (splenic flexure to rectum) sided (JA Bufill, Ann Int Med. 113, 1990, 779-788). KM was used for survival outcomes and Cox proportional hazards regression modeling was used to assess defined prognostic markers. Results: 2,877 patients were analysed. 33% had R sided primary. Major differences between R and L respectively are as follows Female 51.3% vs. 37.9% (p = .0001), Med age 75.8 yrs vs. 70.5yrs (p = .0001), poorly differentiated pathology 34.3% vs. 20.8% (p = .0001), KRAS mutation 48% vs. 37% (p = 0.023), and liver surgery 10.5% vs. 16.3% (p = .0001). Analysis of chemotherapy (defined as either cytotoxic and/or molecular-targeted) revealed similar rates of first-line therapy, but differences in rates of therapy beyond first-line R vs. L respectively second-line 46% vs. 60.4%, third-line 17% vs. 30%, fourth-line 7% vs. 13%. There was however no difference in single agent vs. combination first-line therapy. The median overall survival (mOS) for the entire group R vs. L was 9.6 vs. 20.3 months (p .0001). For the group who had active therapy defined as chemotherapy (+/- metastasis resection), mOS was R 18.2 months vs. L 29.4 months (p .0001). For those (n = 123) who underwent liver resection (+/- chemotherapy) mOS was 6.2 years for both R and L (p = 0.32). Patients who were treated with only chemotherapy, the mOS was 10.7 mths vs. 15.3 mths for R v L (p = 0.0005). Conclusions: Patients with R sided primary have more negative prognostic factors and indeed have inferior outcomes when compared with those with a L sided primary. This did not appear to be the case for patients who were suitable for hepatic surgery.
Tumour location and prognostic characteristics as determinants of survival of women with invasive breast cancer: South Australian hospital-based cancer registries, 1987–1998
Publisher: Elsevier BV
Date: 06-2002
A population-based study of metastatic colorectal cancer (mCRC) in people age 80 and older: Findings from the South Australian Clinical Registry (SACR) for mCRC.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2011
DOI: 10.1200/JCO.2011.29.4_SUPPL.514
Abstract: 514 Background: Life expectancy is increasing and more patients (pts) with mCRC are presenting at an advanced age ( ). Optimal management approach for this group of pts is not well defined as they are under-represented in clinical trials. Methods: The SACR for mCRC collects data on mCRC pts diagnosed after 1/2/2006. We examined cancer characteristics, treatments administered and outcomes for pts aged yrs. Comparison was made with pts yrs. Results: Data from 1737 mCRC pts has been entered to date of which 522 (30%) pts were aged ≥ 80. Key patient characteristics and treatments are reported in the table. The majority had grade 2 tumours. Grade 3 differentiation was reported in lower proportion of pts ≥80 yrs than the younger group (18% v 26%, p 0.001). Only 23.6% of pts received chemotherapy (CT). Of these, 63% received single agent CT (mostly capecitabine) while 37% received combination CT as first line treatment. In contrast, 67% of pts received CT, 73% of which received combination CT and 27% single agent (majority capecitabine) as their first line CT. Pts aged ≥ 80 had fewer liver resections and were also less likely to receive radiotherapy or monoclonal antibodies. Median survival was 7.1 mths for yrs v 17.4 mths for yrs, p 0.001. Median survival for pts treated with chemotherapy was 19 mths for and 21.7 mths for , p = 0.141. Pts without any treatment had a poor survival regardless of their age (median survival 2.9 mths yrs v 2.4 mths yrs). Conclusions: Older pts (≥ 80 yrs) were less likely to receive intervention for their mCRC and had poorer survival. However, survival for selected elderly pts, who received CT, was similar to those , despite most receiving single agent therapy. [Table: see text] [Table: see text]
Treatment patterns among colorectal cancer patients in South Australia: a demonstration of the utility of population-based data linkage
Publisher: Wiley
Date: 22-05-2014
DOI: 10.1111/JEP.12183
Abstract: Population level data on colorectal cancer (CRC) management in Australia are lacking. This study assessed broad level patterns of care and concordance with guidelines for CRC management at the population level using linked administrative data from both the private and public health sectors across South Australia. Disparities in CRC treatment were also explored. Linking information from the South Australian Cancer Registry, hospital separations, radiotherapy services and hospital-based cancer registry systems provided data on the socio-demographic, clinical and treatment characteristics for 4641 CRC patients, aged 50-79 years, diagnosed from 2003 to 2008. Factors associated with receiving site/stage-specific treatments (surgery, chemotherapy and radiotherapy) and overall concordance with treatment guidelines were identified using Poisson regression analysis. About 83% of colon and 56% of rectal cancer patients received recommended treatment. Provision of neo-adjuvant/adjuvant therapies may be less than optimal. Radiotherapy was less likely among older patients (prevalence ratio 0.7, 95% confidence interval 0.5-0.8). Chemotherapy was less likely among older patients (0.7, 0.6-0.8), those with severe or multiple co-morbidities (0.8, 0.7-0.9), and those from rural areas (0.9, 0.8-1.0). Overall discordance with treatment guidelines was more likely among rectal cancer patients (3.0, 2.7-3.3), older patients (1.6, 1.4-1.8), those with multiple co-morbid conditions (1.3, 1.1-1.4), and those living in rural areas (1.2, 1.0-1.3). Greater emphasis should be given to ensure CRC patients who may benefit from neo-adjuvant/adjuvant therapies have access to these treatments.
Small Cell Lung Cancer: Patterns of care and their influence on survival - 25years experience of a single Australian oncology unit
Publisher: Wiley
Date: 28-08-2011
DOI: 10.1111/J.1743-7563.2011.01426.X
Abstract: Evidence supporting improved outcomes for small cell lung cancer (SCLC) in recent decades is limited. This study aimed to identify patterns of care and survival over two time periods 1 January 1987 to 31 December 1996 (cohort A) and 1 January 1997 to 31 December 2006 9 (cohort B). Patients' characteristics, management and outcome data were extracted from the Hospital Cancer Registry and clinical records. Survival analysis was determined using the Kaplan-Meier method and the log-rank test. Factors influencing survival outcome were assessed using Cox proportional hazards regression. The total number of patients was 392 (224 in cohort A, 168 in cohort B). Overall 38% patients in cohort A and 24% in cohort B had limited stage (LS) disease at diagnosis. Combined chemoradiotherapy for LS increased from 5% in cohort A to 65% in cohort B. Overall 19% of patients in cohort A and 24% in cohort B received symptomatic treatment alone (STA). Median survival for LS in cohort B was significantly higher (19.5 months), than in cohort A (11.8 months) (P = 0.03). In extensive stage (ES) disease, median survival was 6.2 months in cohort A and 4.3 months in cohort B (P = 0.7). Variables for poorer outcome were STA, male gender, poor performance status, ES and whether the diagnosis was made in the earlier time period in cohort A. Outcomes for LS SCLC have improved with combined chemoradiotherapy, in keeping with worldwide data. The trends may also reflect recent improvements in staging and standardization of treatment. The outcome for ES-SCLC remains poor.
Metastasectomy and BRAF mutation: An analysis of survival outcome in metastatic colorectal cancer.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2019
DOI: 10.1200/JCO.2019.37.15_SUPPL.3531
Abstract: 3531 Background: Surgical resection of oligometastases improves survival in metastatic colorectal cancer (mCRC). It is unclear whether such benefit is consistently observed for BRAF V600E mutant (MT) and wild type (WT) mCRC. We conducted a retrospective analysis to explore the influence of BRAF mutation status on survival outcomes after metastasectomy. Methods: Data collected from two large prospective population databases in Australia (Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) and South Australian cancer registry). Overall survival (OS) and recurrence free survival (RFS) for BRAF MT and WT mCRC were evaluated by Kaplan-Meier method and compared by log-rank test. Results: 513 patients who had undergone metastasectomy were identified, 6% were BRAF MT. Median age 63. Metastasectomy rate was lower in BRAF MT (13 v 27%). In BRAF WT, 4% underwent resection of metastases (mets) in organ at diagnosis and 5% had 3 or 4 metastasectomies versus none in BRAF MT. Median OS in BRAF MT v WT: 25.7 v 48.5 months (HR 1.95 1.18-3.22). In a multivariate model adjusting for variables which were significant on univariate analysis, OS differences were not statistically significant. Right primary tumor, intact primary, metastatic sites at diagnosis, non R0 resection, peritoneal mets and synchronous mets were independent predictors of worse OS. Among 364 patients with RFS data there was no difference between BRAF MT and WT (16 v 19 months, p=0.09). Rate of downsizing was higher with triplet chemo than doublet +/- bevacizumab or doublet/EGFR in BRAF WT (50 v 30%) as well as MT (33 v 11%). Conclusions: Median OS was 2 years in BRAF MT V600E after metastasectomy in this study consistent with an OS benefit. OS did not differ after metastasectomy between BRAF MT and WT in a multivariate model. Presence of BRAF MT should not impact patient selection for metastasectomy.[Table: see text]
Patterns of comorbidities in women with breast cancer: a Canadian population-based study
Publisher: Springer Science and Business Media LLC
Date: 06-07-2019
DOI: 10.1007/S10552-019-01203-0
Abstract: Improving the understanding of co-existing chronic diseases prior to and after the diagnosis of cancer may help to facilitate therapeutic decision making in clinical practice. This study aims to examine patterns of comorbidities in Canadian women with breast cancer. We conducted a retrospective cohort study using provincial linked administrative health datasets from British Columbia, Canada, between 2000 and 2013. Women diagnosed with breast cancer between 2005 and 2009 were identified. The index date was defined as the date of diagnosis of breast cancer. Subsets of the breast cancer cohort were identified based on the absence of in idual type of comorbidity of interest within 5 years prior to breast cancer diagnosis. For each subset, cases were then in idually matched by year of birth at 1:2 ratios with controls without a history of cancer and the in idual type of comorbidity of interest within 5 years prior to the assigned index year, matching with the year of breast cancer diagnosis of the corresponding case. Baseline comorbidities were measured over a 1-year period prior to the index date using two comorbidity indices, Rx-Risk-V and Aggregated Diagnosis Groups (ADG). Cox regression model was used to assess the development of seven specific comorbidities after the index date between women with breast cancer and non-cancer women. The most prevalent baseline comorbidity in the breast cancer cohort measured using the Rx-Risk-V model was cardiovascular conditions (39.0%), followed by pain ain-inflammation (34.8%). The most prevalent category measured using the ADG model was major signs or symptoms (71.8%), followed by stable chronic medical conditions (52.2%). The risks of developing ischemic heart disease, heart failure, depression, diabetes, osteoporosis, and hypothyroidism were higher in women with breast cancer compared to women without cancer, with the hazard ratios ranging from 1.09 (95 CI% 1.03-1.16) for ischemic heart disease to 2.10 (95% CI 1.99-2.21) for osteoporosis in the model adjusted for baseline comorbidity measured using Rx-Risk-V score. Women with breast cancer had a higher risk of developing new comorbidities than women without cancer. Development of coordinated care models to manage multiple chronic diseases among breast cancer patients is warranted.
Epidemiology of neuroendocrine cancers in an Australian population
Publisher: Springer Science and Business Media LLC
Date: 24-04-2010
DOI: 10.1007/S10552-010-9519-4
Abstract: The aim was to explore incidence, mortality and case survivals for invasive neuroendocrine cancers in an Australian population and consider cancer control implications. Directly age-standardised incidence and mortality rates were investigated from 1980 to 2006, plus disease-specific survivals. Annual incidence per 100,000 increased from 1.7 in 1980-1989 to 3.3 in 2000-2006. A corresponding mortality increase was not observed, although numbers of deaths were low, reducing statistical power. Increases in incidence affected both sexes and were more evident for female lung, large bowel (excluding appendix), and unknown primary site. Common sites were lung (25.9%), large bowel (23.3%) (40.9% were appendix), small intestine (20.6%), unknown primary (15.0%), pancreas (6.5%), and stomach (3.7%). Site distribution did not vary by sex (p = 0.260). Younger ages at diagnosis applied for lung (p = 0.002) and appendix (p < 0.001) and older ages for small intestine (p < 0.001) and unknown primary site (p < 0.001). Five-year survival was 68.5% for all sites combined, with secular increases (p < 0.001). After adjusting for age and diagnostic period, survivals were higher for appendix and lower for unknown primary site, pancreas, and colon (excluding appendix). Incidence rates are increasing. Research is needed into possible aetiological factors for lung and large-bowel sites, including tobacco smoking, and excess body weight and lack of exercise, respectively and Crohn's disease as a possible precursor condition.
Patient and carer perceptions of cancer care in South Australia
Publisher: CSIRO Publishing
Date: 2009
DOI: 10.1071/AH090645
Abstract: Quality of care from the patient?s perspective is an increasingly important outcome measure for cancer services. Patients? and carers? perceptions of cancer care were assessed through structured telephone interviews, 4?10 months post-discharge, which focused on experiences during the most recent hospital admission. A total of 481 patients with a primary diagnosis of cancer (ICD-10 C codes) were recruited, along with 345 carers nominated by the patients. Perceptions of clinical care were generally positive. Less positive aspects of care included not being asked how they were coping, not being offered counselling, and not receiving written information about procedures. Results also highlighted inadequate discharge processes. Carers were more likely than patients to report negative experiences. Perceptions of care also differed by cancer type.
A qualitative investigation of knowledge, beliefs and attitudes regarding sugar-sweetened beverages, including responses to potential regulatory measures aimed at curbing obesity
Publisher: Elsevier BV
Date: 12-2014
Survival from breast cancers managed by surgeons participating in the National Breast Cancer Audit of the Royal Australasian College of Surgeons
Publisher: Wiley
Date: 25-10-2010
DOI: 10.1111/J.1445-2197.2010.05341.X
Abstract: he National Breast Cancer Audit (NBCA) of the Royal Australasian College of Surgeons has collected data on early breast cancer since 1998. In this project, deaths were traced by linkage of NBCA patient identifiers (first three digits of surname and date of birth) with the National Death Index that covers all deaths in Australia. Death data were traced to 31 December 2007. Invasive cancers diagnosed in 1998-2005 were included in survival analyses to allow enough follow-up for assessment. Survivals were compared with survivals for similar stages recorded by the New South Wales (NSW) Cancer Registry and USA Surveillance Epidemiology and End Results (SEER) programme. Survivals were analysed by conventional clinical risk factors to see if expected differences presented. The 5-year survival from breast cancer of 93% for NBCA cases was the same as the SEER figure for local and regional cases combined in 1996-2004. The NBCA figure for localized cases was 97%, which was the same as for NSW. Node-positive NBCA cancers had a 5-year survival of 89%, which was slightly higher than the corresponding 86% for NSW, which may reflect exclusion from the NBCA of some cases with a poorer prognosis, including those with positive fixed nodes. As expected, lower survivals presented for older cases and those with conventional clinical risk factors. These survivals are credible both overall and by clinical risk factor. Opportunities present to use these data for survival monitoring and to investigate survival by socio-demographic characteristic, treatment protocol, case volume and provider characteristics.
Privacy-Preserved Optimal Energy Trading, Statistics, and Forecasting for a Neighborhood Area Network
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2020
Risk profile of breast cancer following atypical hyperplasia detected through organized screening
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.BREAST.2015.01.006
Abstract: Few population-based data are available indicating the breast cancer risk following detection of atypia within a breast screening program. Prospectively collected data from the South Australian screening program were linked with the state cancer registry. Absolute and relative breast cancer risk estimates were calculated for ADH and ALH separately, and by age at diagnosis and time since diagnosis. Post-hoc analysis was undertaken of the effect of family history on breast cancer risk. Women with ADH and ALH had an increase in relative risk for malignancy (ADH HR 2.81 [95% CI 1.72, 4.59] and (ALH HR 4.14 [95% CI 1.97, 8.69], respectively. Differences in risk profile according to time since diagnosis and age at diagnosis were not statistically significant. Estimates of the relative risk of breast cancer are necessary to inform decisions regarding clinical management and/or treatment of women with ADH and ALH.
Synthesis, Antibacterial Activity, and Nephrotoxicity of Polymyxin B Analogues Modified at Leu-7, d -Phe-6, and the N-Terminus Enabled by S-Lipidation
Publisher: American Chemical Society (ACS)
Date: 22-11-2022
DOI: 10.1021/ACSINFECDIS.1C00347
Abstract: With the post-antibiotic era rapidly approaching, many have turned their attention to developing new treatments, often by structural modification of existing antibiotics. Polymyxins, a family of lipopeptide antibiotics that are used as a last line of defense in the clinic, have recently developed resistance and exhibit significant nephrotoxicity issues. Using thiol-ene chemistry, the facile preparation of six unique S-lipidated building blocks was demonstrated and used to generate lipopeptide mimetics upon incorporation into solid-phase peptide synthesis (SPPS). We then designed and synthesized 38 polymyxin analogues, incorporating these unique building blocks at the N-terminus, or to replace hydrophobic residues at positions 6 and 7 of the native lipopeptides. Several polymyxin analogues bearing one or more S
Related Organisations
South Australian Health And Medical Research Institute
Location: Australia
Related Funding Activities
No related grants have been discovered for David Roder.