Microsimulation Modelling Of Post-Polypectomy Colonoscopy Surveillance Strategies For The Prevention Of Colorectal Cancer
Funder
National Health and Medical Research Council
Funding Amount
$101,535.00
Summary
This research will provide a comprehensive evidence-based framework for post-polypectomy endoscopic surveillance in bowel cancer screening. A population-based micro-simulation model of colorectal cancer development will be used to perform epidemiological and health economic evaluations of Australian and international endoscopic surveillance guidelines. These will help inform policy that will potentially lead to improvements in bowel cancer screening and surveillance programs in Australia.
Quantifying Breast Cancer Over-diagnosis In An Organized Mammography Screening Program
Funder
National Health and Medical Research Council
Funding Amount
$92,314.00
Summary
While breast screening reduces breast cancer deaths by finding cancers earlier, it may also find cancers that would never have required treatment. Currently there is no clear consensus about the level over-diagnosis. This study will examine the extent of over-diagnosis by comparing the breast screening histories of women diagnosed with breast cancer and women who have not had breast cancer. Findings will inform policy on breast screening in Australia.
Generating The Evidence To Control Cancer And Optimise Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$6,564,341.00
Summary
Our Program addresses the public health aspects of common cancers, particularly cancers of the skin and gynaecological tracts. Each year in Australia, nearly 400,000 people are treated for skin cancer, and more than 3,500 women develop ovarian or uterine cancer. Our aims are first, to understand how we might prevent these cancers in the future; second, to enhance diagnosis of these cancers; and third, to improve the survival and quality of life for people who are diagnosed with these cancers
The Benefits And Harms Associated With Breast Cancer Screening In The Australian Context.
Funder
National Health and Medical Research Council
Funding Amount
$80,222.00
Summary
Australia is caught in a dilemma. Breast screening is well-established however there has been fierce debate about the value of screening programmes. I will determine the frequency of benefit and harm due to breast screening programs in Australia to better understand the true extent of overdiagnosis and overtreatment. Based on this information, I will make recommendations about how breast screening should be provided in Australia in future and clearly communicate this information to the community
Investigating The Utility Of Primary Care Skin Cancer Clinics In Queensland
Funder
National Health and Medical Research Council
Funding Amount
$187,000.00
Summary
Skin cancer is the most common cancer in Australia, with an estimated 375,000 people being treated for some skin cancer in Australia in 2002, and 1462 dying from the disease (mainly from melanoma) in 2001. Australia has the highest rate of skin cancer, both melanoma and non-melanoma is the world. However, if detected early, skin cancer is curable, and the focus of current treatment programs internationally is to detect the disease before it progresses to an advanced stage. A large proportion of ....Skin cancer is the most common cancer in Australia, with an estimated 375,000 people being treated for some skin cancer in Australia in 2002, and 1462 dying from the disease (mainly from melanoma) in 2001. Australia has the highest rate of skin cancer, both melanoma and non-melanoma is the world. However, if detected early, skin cancer is curable, and the focus of current treatment programs internationally is to detect the disease before it progresses to an advanced stage. A large proportion of skin cancers are first detected by the non-medical community. However, due to the two-tiered medical system in Australia, a person first seeks medical opinion from a general practitioner (GP), who acts as a gatekeeper for further treatment from a specialist. Therefore the ability of GPs to be able to discern which lesions require further treatment is crucial, both for the patient, and the financial burden on the health system. A recent development has been the establishment of dedicated primary skin care clinics, which offer open access consultations to the community for the diagnosis and treatment of skin cancers and pigmented lesions. The emergence of these clinics has created much debate in the medical media. Concern has been expressed about the skills of practitioners in these clinics, whilst others argue that sub-specialisation in primary care will lead to improvements in the management of patients. As there is currently no data on the volume, casemix and diagnostic accuracy of these clinics it is difficult to assess the diagnostic ability of skin cancer clinics. This will be the first project to quantify the role of skin clinics in the diagnosis of skin cancer in the community, and in particular their case volume, casemix and diagnostic accuracy, and assess these measures in relation to a comparable sample of general practitioners. Queensland is an ideal location for a study of this type due to its high incidence of both types of skin cancer.Read moreRead less
A Prospective Study Of The Effects Of Early Life Growth On Adult Mammographic Density
Funder
National Health and Medical Research Council
Funding Amount
$460,517.00
Summary
It is now well-known that a woman's breast density, as measured by a breast scan, is a predictor of her future risk of breast cancer. It is also known that women who are heavier as babies and grow rapidly before age 7 are more likely to develop breast cancer in adult life. The effects were strongest in women who had early puberty. It has been suggested that there are critical points in early life growth that contribute to higher breast density in middle-age. Population-based surveys with early l ....It is now well-known that a woman's breast density, as measured by a breast scan, is a predictor of her future risk of breast cancer. It is also known that women who are heavier as babies and grow rapidly before age 7 are more likely to develop breast cancer in adult life. The effects were strongest in women who had early puberty. It has been suggested that there are critical points in early life growth that contribute to higher breast density in middle-age. Population-based surveys with early life growth data on large numbers of women that span birth to adulthood are necessary to estimate accurately the association between early life growth and breast density in middle age. Few such studies exist; Tasmanian Asthma Study is one of them. In 1968, all 4,194 female Tasmanian school children born in 1961 were surveyed and height and weight measured. Subsequently, weight and height measurements were carried out on samples of this cohort. We are currently conducting the 37-year follow-up of the TAS and to date have traced 87% and achieved a response rate of 77% (2,850) for a postal survey. This included self-reported weight and height measurements and detailed information reproductive history and the use of hormones. Weight, height and waist to hip ratio are currently measured on 600 of these respondents. We have access to school medical records of the full cohort, which have weight and height data measured at school medical inspections throughout school years, and maternal records so far for half of the total cohort, which have information on birth weight and length, and period of gestation. Hence, TAS now provides an ideal opportunity, unique within Australia, to investigate prospectively the association between early life growth and mammographic density in middle-age women. We will measure breast density in these women now they are in their late 40s, using the Australian Mammographic Density Research Facility at The University of Melbourne.Read moreRead less
Enterovirus, Vitamin D Status And Inflammation At The Clinical Onset Of Type 1 Diabetes In Childhood
Funder
National Health and Medical Research Council
Funding Amount
$410,542.00
Summary
Type 1 diabetes is a serious disease that is increasing in incidence among Australian children. This project will build on an exsisting study to provide new information on the role of enteroviral infection, vitamin D status and the associated inflammatory changes in blood at the onset of disease.
Congenital Cytomegalovirus: Understanding The Long-term Outcomes And Identifying Opportunities For Secondary Prevention
Funder
National Health and Medical Research Council
Funding Amount
$318,768.00
Summary
Cytomegalovirus is a herpesvirus that can be transmitted from mother to baby during pregnancy. Congenital cytomegalovirus (cCMV) can cause damage to the developing central nervous system leading to long-term disabilities including cerebral palsy and hearing loss. This epidemiological research program seeks to investigate cCMV risk factors and burden, opportunities for early detection of neuro-developmental disabilities and to study the effects of postnatal antiviral therapies in this population.
The Role Of EBV And HHV-6 Infection In Demyelinating Disease With A Consideration Of Past UVR Exposure.
Funder
National Health and Medical Research Council
Funding Amount
$305,800.00
Summary
The marked increase in immune disorders over the past fifty years is thought to reflect modern environmental and lifestyle factors, rather than changes in diagnosis. The hypothesis that has the most evidence to support it is the 'hygiene hypothesis'. That is, that a reduction in early life infection among modern children leads to immune system dysfunction and thus an increase in immune disorders. Delayed child infection, particularly of Epstein-Barr Virus has been prospectively linked to multipl ....The marked increase in immune disorders over the past fifty years is thought to reflect modern environmental and lifestyle factors, rather than changes in diagnosis. The hypothesis that has the most evidence to support it is the 'hygiene hypothesis'. That is, that a reduction in early life infection among modern children leads to immune system dysfunction and thus an increase in immune disorders. Delayed child infection, particularly of Epstein-Barr Virus has been prospectively linked to multiple sclerosis (MS) risk. This project aims to document the role of herpes virus (EBV, HHV-6) infection in the onset of first demyelinating events, a precursor to MS. The strength of this proposal is that it lies within an existing study framework - the Ausimmune Study, allowing detailed exploration of related associations with latitude, early life infant contact and past sun exposure. The incidence of MS has doubled from 1.2-100,000 to 2.4-100,000 from 1961 to 1996 in Newcastle, Australia. Although incidence is low, the disease has a median age of first onset of 24 years and progresses to serious disability even with immunomodulatory therapy (50% will need assistance in walking within 13 years) thus the current prevalence of 1 per 1,000 adults in Tasmania and 0.8 per 1,000 in Newcastle represent a serious burden of morbidity.Read moreRead less
Integration Of Epidemiological, Biological, And Health Services Data In Cancer Research
Funder
National Health and Medical Research Council
Funding Amount
$290,032.00
Summary
Improved understanding of carcinogenic mechanisms, such as the importance of gene and environment interaction, has placed increased emphasis on the need for studies combining biological and epidemiological data. The proposed research program incorporates a number of cross-disciplinary studies which bridge classical epidemiology and basic science and strive to improve the clinical relevance and translational potential of research outcomes.