Optimising Cervical Screening After The Introduction Of HPV Vaccination In Australia: Modelling Of Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$316,089.00
Summary
This research project will aid decision-making about how best to perform cervical screening in Australia after the introduction of vaccination against the human papillomavirus (or HPV). The project will use computer simulation techniques to explore different scenarios for vaccination and screening and to determine the optimal approach. This project involves a group of international collaborators with expertise in a number of areas including cancer epidemiology, screening for cancer, and computer ....This research project will aid decision-making about how best to perform cervical screening in Australia after the introduction of vaccination against the human papillomavirus (or HPV). The project will use computer simulation techniques to explore different scenarios for vaccination and screening and to determine the optimal approach. This project involves a group of international collaborators with expertise in a number of areas including cancer epidemiology, screening for cancer, and computer simulation methods. HPV is the virus responsible for the development of cervical cancer, and clinical trials have demonstrated that HPV vaccines administered to adoloescent girls are very effective at preventing disease that might have led to cancer in the future. However, Australia currently has a very effective Pap smear screening program, and in the first phase after the introduction of vaccination it will be important for women to continue being screened as usual. In the long term, HPV vaccination is expected to reduce the need for Pap smears. The research will involve a very detailed simulation of how HPV is transmitted in the Australian population, and how this will change after vaccination. The simulation will address questions of importance for any future public HPV vaccination program, such as whether males should be vaccinated as well as females. The simulation will also be used to determine the optimal starting age and frequency of Pap smears in the future. The outcomes of the research will be very important for policy-makers. In the long term, this research will ensure that the best recommendations are formulated for the timing and frequency of Pap smears after HPV vaccination is introduced.Read moreRead less
The Role And Inheritance Of Constitutional Epimutations In Early-onset Colorectal Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$347,551.00
Summary
Traditionally familial cancers are thought to be caused by spelling mistakes within the genetic code of cancer prevention genes. Our group has found that chemical attachments to one gene (MLH1) stops it working, even where there is no spelling mistake, and that those chemical changes can be inherited in families with bowel cancer. We will determine how frequently this type of defect occurs in bowel cancer patients, how and why it arises, and if other cancer genes are similarly affected.
Using Mathematical Models To Assess The Impact Of Interventions To Reduce Sexually Transmitted Infections In Australia
Funder
National Health and Medical Research Council
Funding Amount
$562,276.00
Summary
Sexually transmitted infections (STIs) are an increasing public health problem in Australia. Australia's recent National Transmissible Infections Strategy identified chlamydia control, STI prevention in gay men and STIs in Aboriginal and Torres Strait Islander communities as priority areas. We propose to develop mathematical models of STI transmission and use these to help understand and identify the most cost-effective interventions to reduce the impact of STIs on Australian populations.
Infectious And Lifestyle Determinants Of Non-melanoma Skin Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$983,711.00
Summary
Basal and squamous cell skin cancers are the leading cancers in Australia, with about 2% of the population developing them each year. As well as sun exposure, a number of other factors have been thought to effect these cancers. This study will examine if factors such as smoking, alcohol consumption and infection with certain skin related human papillomaviruses also increase their risk. Even a small effect may make a big difference when it comes to preventing these common cancers.
MICROFABRICATED DEVICES: A SIGNIFICANT ADVANCE FOR THE DETECTION AND MOLECULAR ANALYSES OF CIRCULATING CANCER CELLS?
Funder
National Health and Medical Research Council
Funding Amount
$422,107.00
Summary
Using advanced microfabrication concepts, this project aims to develop a platform technology able to capture tumour cells circulating in the blood of cancer patients. Although present only in extremely small numbers, these cells provide invaluable insights into the pathophysiology of the disease and consequently provide vital diagnostic and prognostic information. Molecular analyses of these cancer cells could ultimately enable the design of improved and personalized cancer treatment.
Therapeutic Implications Of A Molecular Link Between Survivin And Telomerase Reverse Transcriptase
Funder
National Health and Medical Research Council
Funding Amount
$547,970.00
Summary
A unifying feature of all types of cancer cells is that they are immortal. Our investigations will build upon our recent results that showed the gene survivin is involved in cancer cell immortalisation. We will characterise a molecular link between survivin and the enzyme telomerase, which is central to cancer cell immortality. Furthermore, we will demonstrate the therapeutic potential of turning off both survivin and telomerase as a novel approach to halting the growth of cancer cells.
The Effect Of Exogenous Hormones, Smoking And HPV On The Incidence Of Screen Detected Pre-invasive Cervical Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$1,201,168.00
Summary
Cervical cancer is one of the leading causes of cancer death in women internationally. About 15,000 women are detected in NSW annually as having pre-invasive cervical cancer (cervical intraepithelial neoplasia (CIN) grade I, II or III). Infection with certain high risk human papillomaviruses is known to be necessary for the development of cervical cancer. In addition, recent long term exposure to smoking and to hormonal contraception are two new factors considered as independent risk factors for ....Cervical cancer is one of the leading causes of cancer death in women internationally. About 15,000 women are detected in NSW annually as having pre-invasive cervical cancer (cervical intraepithelial neoplasia (CIN) grade I, II or III). Infection with certain high risk human papillomaviruses is known to be necessary for the development of cervical cancer. In addition, recent long term exposure to smoking and to hormonal contraception are two new factors considered as independent risk factors for the disease. Hormone replacement therapy (HRT) preparations taken around the menopause are a similar composition to hormonal contraceptives, (oestrogen and progestogen), therefore women on HRT may also be at increased risk. No comprehensive study exists internationally to measure the relative importance of these exogenous hormones on the development of pre-invasive cervical cancer in a way that is of public health relevance (e.g. recent long-term use of oral contraceptives and time since stopped, and among smokers and non-smokers). No Australian data are available on the proportion of women who are current users of hormonal contraceptives or HRT. No local prevalence data on the major high risk HPV subtypes (e.g. 16, 18, 33, 45) are available for Australia to describe its distribution and to inform the cervical screening program and future vaccine initiatives. The NSW Pap Test Register holds the screening history of all women on the cervical screening program, hence this is an ideal source for recruiting a representative sample into a study. We wish to conduct a large study of ~2600 NSW women using the NSW Pap Test Register to measure the relative importance of hormones, smoking and HPV infection on the development of CIN II or III.Read moreRead less
A Clinical Trial To Determine The Optimal Timing Of Androgen Deprivation In Relapsed Or Non-curable Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$627,600.00
Summary
The aim of the study is to clarify when is the optimal time to start hormone treatment for men with certain stages of prostate cancer. It has long been known that testosterone removal impedes prostate cancer growth, although not permanently. The removal of testosterone, however, has side effects , including loss of libido, hot flushes, weight gain, and in the longer term osteoporosis, loss of muscle bulk and mental changes such as loss of memory. Any benefit to be gained for a patient must there ....The aim of the study is to clarify when is the optimal time to start hormone treatment for men with certain stages of prostate cancer. It has long been known that testosterone removal impedes prostate cancer growth, although not permanently. The removal of testosterone, however, has side effects , including loss of libido, hot flushes, weight gain, and in the longer term osteoporosis, loss of muscle bulk and mental changes such as loss of memory. Any benefit to be gained for a patient must therefore be weighed against these side effects. This is particularly relevant in situations in which cure is not possible, when the aim of treatment should be to manage symptoms (either by preventing or delaying them or treating them as they arise). There are two situations in which a man may be diagnosed as having active prostate cancer but be without symptoms requiring immediate treatment. The first is after the failure of curative treatment, shown by the presence of prostate specific antigen (PSA) in the blood, but without any other evidence of prostate cancer. The second is a man newly diagnosed with asymptomatic prostate cancer, but with other reasons (such as heart disease) which make an attempt at cure inappropriate. We do not know in either case whether or not men live longer if treatment is started immediately, or whether it is reasonable to wait until symptoms develop, thus potentially postponing the side effects of treatment. The trial will therefore include these two groups of men. Half the men will be randomised to receive immediate treatment, and half to treatment starting when symptoms develop, or when there is evidence of progressive disease. The main endpoint is overall survival, balanced against quality of life and side effects from the disease and treatment. The hypothesis is that early treatment will improve survival with acceptable effects on quality of life.Read moreRead less
Value Of Androgen Deprivation And Bisphosphonate Therapy In Patients Treated By Radiotherapy For Limited Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$1,757,375.00
Summary
Prostate cancer depends for its growth on the male hormone, testosterone, which circulates in the blood. As a result treatment which reduces testosterone level ('androgen deprivation'[AD] therapy) can produce clinically important shrinkage of prostate cancer. Each year approximately 4000 men in Australia and New Zealand develop prostate cancer which has not spread widely and which is amenable to attempted cure by surgery or radiation. Results from recent trials, including a large trial run in Au ....Prostate cancer depends for its growth on the male hormone, testosterone, which circulates in the blood. As a result treatment which reduces testosterone level ('androgen deprivation'[AD] therapy) can produce clinically important shrinkage of prostate cancer. Each year approximately 4000 men in Australia and New Zealand develop prostate cancer which has not spread widely and which is amenable to attempted cure by surgery or radiation. Results from recent trials, including a large trial run in Australia and New Zealand by the Trans-Tasman Radiation Oncology Group (TROG) between 1996 and 2000, suggest that 6 months AD will benefit many of these men if administered in conjunction with radiotherapy.The aim of this project is to run a further trial to find out whether 12 months of AD, after radiotherapy will prevent the need for further treatment and prolong more lives than only 6 months AD. Bisphosphonate treatment also offers important benefits to prostate cancer patients because it can increase bony stregth by increasing its density and can also arrest cancerous growth in bones. A further aim of the trial therefore is to determine whether 18 months of bisphosphonate therapy (BP) will prevent bone loss (osteoporosis) caused by AD, and also further reduce the risk of secondary bone cancer developing. This trial will involve recruitment of 1000 men across Australia and New Zealand over a 5 year period. When complete the trial will determine whether further treatment can be delayed and life prolonged in up to half of all men in whom treatment presently fails. This grant will support collection of patient data and the necessary quality checks to ensure that reliable conclusions can be drawn.Read moreRead less