Endometrial cancer (uterine or womb cancer) is the most common invasive gynaecological cancer in Australia. Each year more than 1400 women are affected by the condition, and death is common amongst a subset with more aggressive disease. We plan to conduct a national study of endometrial cancer to identify options for prevention of the disease. No previous studies have looked at risk factors for endometrial cancer in Australian women. In particular, we hope to identify modifiable risk factors for ....Endometrial cancer (uterine or womb cancer) is the most common invasive gynaecological cancer in Australia. Each year more than 1400 women are affected by the condition, and death is common amongst a subset with more aggressive disease. We plan to conduct a national study of endometrial cancer to identify options for prevention of the disease. No previous studies have looked at risk factors for endometrial cancer in Australian women. In particular, we hope to identify modifiable risk factors for endometrial cancer, and identify genes that make some women particularly susceptible to the disease. There are at least two main types of endometrial cancer and limited evidence suggests that they may have different causes. Few studies have examined the two different types separately, and there is virtually no information regarding risk factors for the more aggressive forms. In addition, little is known about genetic factors that predispose women to endometrial cancer. In the present study, we will investigate which genes cause endometrial cancer in women who have a strong family history of the disease. We will also identify genes that are related to endometrial cancer in women with no obvious family history of cancer, and investigate how these genes interact with environmental factors (such as hormone replacement therapy and obesity) to cause disease. National epidemiological studies of other cancers are currently being conducted by our research groups within QIMR. In the present proposal, we will use our experience to build on the infrastructure and procedures already in place to conduct a new study on endometrial cancer. As one of the largest population-based studies of endometrial cancer ever conducted, it will be able to answer many of the questions that are currently unresolved. Moreover, answers will be relevant to Australian women and clinicians as well as to inform prevention strategies.Read moreRead less
SUcceSS: SUrgery For Spinal Stenosis - A Randomised Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,303,245.00
Summary
This will be the first placebo-controlled randomised trial of surgery for lumbar spinal stenosis and aims to determine the efficacy and safety of this intervention in decreasing pain and improving disability in this population. The cost-effectiveness of surgery for lumbar spinal stenosis will also be determined.
Long Term Supplementation With Retinyl Palmitate (Vitamin A) And The Risk Of Bone Fractures: A Population Based Study.
Funder
National Health and Medical Research Council
Funding Amount
$167,707.00
Summary
Osteoporosis is a major health problem in Australia and other western industrialised countries where populations are increasingly ageing. In Australia, the number of hip fractures is expected to increase by 36% between 1996 and 2006, owing to the rise in elderly aged 85 years and over. This is in contrast to projections in Europe and North America, where the number of hip fractures are expected to double by 2026 and then stabilise. Clarification of the role of vitamin A in bone health is pertine ....Osteoporosis is a major health problem in Australia and other western industrialised countries where populations are increasingly ageing. In Australia, the number of hip fractures is expected to increase by 36% between 1996 and 2006, owing to the rise in elderly aged 85 years and over. This is in contrast to projections in Europe and North America, where the number of hip fractures are expected to double by 2026 and then stabilise. Clarification of the role of vitamin A in bone health is pertinent, given that the popularity of supplement use has increased markedly in western industrialised countries over the past two decades. Around 37% of the adult population in Australia is thought to take a supplement regularly and figures range from 28% to 54% of adults in the US, with women and adults aged over 49 years being more likely to use supplements. Furthermore, the fortification of food with minerals and vitamins is increasing. For all of these reasons, is it imperative that the role of vitamin A in inducing fractures be clarified. Results from this study will contribute to knowledge about the safety of retinol and beta carotene supplements in relation to bone health, which is especially relevant to people at risk of osteoporosis, and people who take vitamin A supplements. We will also be able to clarify the upper levels of dietary retinol, beta carotene and vitamin A intake beyond which fracture risk increases. Because of the age range of subjects in our study, our results should be applicable to the whole population, not only the elderly or post menopausal. The results of our study will be useful to agencies such as Food Standards Australia and New Zealand which regulates our food supply.Read moreRead less
Predicting The Individual Risk Of Prostate Cancer In Australian Men
Funder
National Health and Medical Research Council
Funding Amount
$348,656.00
Summary
Prostate cancer is a major cause of disability and death in Australian men. A number of factors, particularly age and family history, influence the risk of prostate cancer but, in contrast to breast cancer, we don't know what is the risk of developing prostate cancer over a period of time for a man with a specific set of risk factors. In fact, while a number of statistical models have been developed that use a woman's risk factor profile to estimate her risk of breast cancer, none is currently a ....Prostate cancer is a major cause of disability and death in Australian men. A number of factors, particularly age and family history, influence the risk of prostate cancer but, in contrast to breast cancer, we don't know what is the risk of developing prostate cancer over a period of time for a man with a specific set of risk factors. In fact, while a number of statistical models have been developed that use a woman's risk factor profile to estimate her risk of breast cancer, none is currently available for prostate cancer. We will apply standard statistical methods to existing data from the Australian Risk Factors for Prostate Cancer study and from the Australian Institute of Health and Welfare to develop a prostate cancer risk prediction model. We will test how factor like age, detailed family history, diet, baldness status and possibly previous PSA tests and prostate biopsies predict the risk. After developing the model, we will test the accuracy of the predictions in three ways. First, using existing data from the Australian Prostate Cancer Family Study, we will see whether the number of cases in a group of men is close to the number predicted by the model (calibration). Second, to test whether the model discriminate well men who develop prostate cancer from those who do not, we will collect family trees in a sample from the Melbourne Collaborative Cohort Study. We will use these data also to estimate the optimal cut point: men above this level of risk will be considered at high risk. Third, we will apply the model to existing data from the Dutch Prostate Cancer Family Study (DPCFS) to test whether the optimal cut point identify high-risk men and to validate the model in a non-Australian population. Finally, we will prepare a computer package that health professionals will use as decision-making tool in different scenarios including individual cancer risk assessment, design of prevention trials and targeting prevention programs to high-risk men.Read moreRead less
Genetic Epidemiology Of Endometrial Cancer: Towards Understanding Aetiology And Improving Risk Prediction.
Funder
National Health and Medical Research Council
Funding Amount
$353,573.00
Summary
Studies investigating thousands of genetic markers have revolutionised our understanding of genes involved in cancer, and shown that a single gene can be associated with multiple cancers. We will conduct the largest ever study to find new genes for endometrial cancer, the most common gynaecological cancer. Our unique approach will examine >11million markers across the genome, some specifically in regions known to be important for other cancers. Findings will be used for risk prediction models ....Studies investigating thousands of genetic markers have revolutionised our understanding of genes involved in cancer, and shown that a single gene can be associated with multiple cancers. We will conduct the largest ever study to find new genes for endometrial cancer, the most common gynaecological cancer. Our unique approach will examine >11million markers across the genome, some specifically in regions known to be important for other cancers. Findings will be used for risk prediction models.Read moreRead less
Clinical, Environmental And Genetic Factors And The Risk Of Oesophageal Cancer
Funder
National Health and Medical Research Council
Funding Amount
$145,685.00
Summary
Oesophageal cancer is a rapidly fatal disease which is becoming more common in Australia, the United States and other industrialised nations. This study will examine the mechanisms leading to the development of oesophageal cancer and aims to measure the effects of genes and environment on the burden of cancer. Ultimately, this research will help target persons at highest risk so that screening, prevention and surveillance efforts can be directed more effectively.
Obesity, Pre-diabetes And Future Risk Of Diabetes: Maximising The Evidence, Minimising The Cost
Funder
National Health and Medical Research Council
Funding Amount
$470,136.00
Summary
The overarching aim of this proposal is to reliably determine how best to identify people at high risk of developing future diabetes. We will do this by using information on biological and behavioural risk factors that was collected on nearly 200,000 people many years ago and who were subsequently followed up to see who developed diabetes. This information will be used to create a risk prediction tool for spotting individuals most at risk of developing diabetes at some point in the future.
Automated Mammographic Measures That Predict Breast Cancer Risk
Funder
National Health and Medical Research Council
Funding Amount
$406,260.00
Summary
Mammographic density (MD) is one of the strongest predictors of breast cancer risk but its impractical measurement prevents its use in a clinical setting. An automated measure of MD would allow screening programs to identify and target women at higher risk of breast cancer which could lead to earlier diagnoses and better breast cancer outcomes. We aim to develop an automated measurement, maximized by its ability to predict breast cancer risk, and applicable to both film and digital mammograms.