Impact Of Genetic Testing For Breast Cancer Predisposition On Psychological Adjustment And Related Health Behaviours.
Funder
National Health and Medical Research Council
Funding Amount
$96,897.00
Summary
This Australia-wide, longitudinal study will examine the psychological effects of testing for breast cancer predisposing genes in women with a strong family history of breast cancer. Mutation detection carries with it the possibility of improving survival through increased emphasis on screening and prevention, while those found to be non-carriers can return to population screening levels, alleviating both their anxiety and the costs associated with greater vigilance. Preventative surgery is now ....This Australia-wide, longitudinal study will examine the psychological effects of testing for breast cancer predisposing genes in women with a strong family history of breast cancer. Mutation detection carries with it the possibility of improving survival through increased emphasis on screening and prevention, while those found to be non-carriers can return to population screening levels, alleviating both their anxiety and the costs associated with greater vigilance. Preventative surgery is now known to significantly reduce risk in women with a strong family history of breast cancer. Whether these potential benefits are realised in practice needs to be evaluated, as do potential psychological harms, if any. Predictive genetic testing for hereditary breast cancer has become technically possible before its impact on psychological outcomes has been evaluated. As yet there are no Australian data on the impact of predisposition testing in any potentially treatable adult onset conditions and only preliminary overseas data. Results from this study may therefore have application to other potentially treatable adult onset conditions. Changes before and after testing in psychological status will be studied (using established methodology) over a 2-year period to identify when negative outcomes are most likely to occur. In addition, this study aims to identify factors that facilitate or hinder psychological adjustment so as to inform clinical decisions about testing and to allow appropriate interventions to be devised. Assessment of individual's preferences for the amount of information they receive will allow tailoring of information to maximise the benefit of educational materials and potentially minimise distress. Factors which influence women's decisions to undertake prophylactic surgery and their satisfaction with those procedures will be assessed.Read moreRead less
Germline Mutations In Mismatch Repair Genes: Prevalence, Risk Of Cancer, And Environmental Modifiers Of Risk.
Funder
National Health and Medical Research Council
Funding Amount
$216,750.00
Summary
Aims: 1. Develop a model that will predict who has a mutation in a group of genes that cause cancer 2. Estimate risk of cancer in people who have a mutation in these genes (carriers) 3. Determine if cancer risk in carriers can be reduced People who inherit a mutation in a group of genes called 'mismatch repair genes' are at increased risk of cancer, particularly cancer of the colon and rectum. If these carriers can be identified they can take preventive measures such as screening to reduce their ....Aims: 1. Develop a model that will predict who has a mutation in a group of genes that cause cancer 2. Estimate risk of cancer in people who have a mutation in these genes (carriers) 3. Determine if cancer risk in carriers can be reduced People who inherit a mutation in a group of genes called 'mismatch repair genes' are at increased risk of cancer, particularly cancer of the colon and rectum. If these carriers can be identified they can take preventive measures such as screening to reduce their risk of cancer and death. We will develop a model using data from the Colon Cancer Family Registry (CFR), the world's largest dataset of carriers and non-carriers which has already recruited and genetically tested over 4,000 families from Australasia, USA and Canada. The model will allow clinicians to predict who is a likely be a carrier based so they can be tested for the mutation. We know the risk of cancer is high in carriers, but we don't have precise estimates. We will use the Colon CFR applying sophisticated statistical methods required to answer this question. This data is critical for genetic counselling so appropriate decisions can be made by the patient and the doctor as to what preventive measures to take. We will also use the Colon CFR data to find out what how the carriers who develop cancer differ from those who stay cancer free using their completed lifestyle questionnaires which includes questions on diet, smoking, alcohol consumption, exercise, aspirin use, and oral contraceptive pill use. We may identify risk factors that carriers can avoid (or take up if they reduce cancer risk) to reduce their risk of cancer.Read moreRead less
Statistical Analyses Of Breast Cancer Risks For Australian BRCA1 And BRCA2 Mutation Carriers
Funder
National Health and Medical Research Council
Funding Amount
$424,628.00
Summary
About 10 years ago two genes, called BRCA1 and BRCA2, were discovered. The normal function of these genes is to prevent breast and other cancers from developing. All people have two copies of each gene, one inherited from their mother and one from their father. Women who have inherited a fault in one copy are at increased risk of breast and ovarian cancer. There has been considerable controversy about what their actual cancer risks are, especially about how those risks might depend on their age. ....About 10 years ago two genes, called BRCA1 and BRCA2, were discovered. The normal function of these genes is to prevent breast and other cancers from developing. All people have two copies of each gene, one inherited from their mother and one from their father. Women who have inherited a fault in one copy are at increased risk of breast and ovarian cancer. There has been considerable controversy about what their actual cancer risks are, especially about how those risks might depend on their age. We have already conducted studies on this and have developed the necessary statistical methods to address these issues by analysing data from the families in which there are faulty genes. In this study we propose to use two large Australian studies, one of families with multiple-cases of breast cancer (Kathleen Cuningham Consortium for Research on Familial Breast Cancer; kConFab) and the other of the families of women with breast cancer chosen, irrespective of their family cancer histories, through the Victorian and NSW Cancer Registries (Australian Breast Cancer Family Study; ABCFS). A large amount of work has already been conducted to identify these families and test them for faults in BRCA1 and BRCA2. There are over 350 families who carry faults, making this one of the largest studies of its type in the world. We will check the cancer histories of these families and determine which members have, or are likely to have, inherited a faulty gene. We will then estimate the breast and ovarian cancer risks accurately, and with much more precision, than has been done previously. We will also use these large datasets to develop a simple method to identify which Australian women are most likely to carry a fault in BRCA1 or BRCA2, based on their personal and family cancer histories. This study will assist genetic counsellors inform Australian women who consider mutation testing for BRCA1 and BRCA2 about their cancer risks, and help make breast cancer genetics more cost effective.Read moreRead less
Identification Of The Gene For A Novel Syndrome Of Gastric Adenocarcinoma And Proximal Polyposis Of The Stomach (GAPPS)
Funder
National Health and Medical Research Council
Funding Amount
$378,152.00
Summary
We have identified a previous undescribed syndrome of multiple polyps in the stomach, and a tendency to develop stomach cancer. We are now want to identify the gene responsible, and to determine if it plays a part in the development of other cancers that occur outside people with this rare syndrome.
Identification Of New Mutations That Contribute To Breast Cancer
Funder
National Health and Medical Research Council
Funding Amount
$323,825.00
Summary
Breast cancer affects approximately one in ten women and is therefore a major health problem. In order to improve the diagnosis, treatment and prognosis of this disease, it is critical to understand the genetic defects that contribute to disease initiation and progression. Although a number of breast cancer susceptibility genes have been identified, the contribution each of these genes makes to breast cancer susceptibility is currently unclear. This is partly due to limitations in current diagno ....Breast cancer affects approximately one in ten women and is therefore a major health problem. In order to improve the diagnosis, treatment and prognosis of this disease, it is critical to understand the genetic defects that contribute to disease initiation and progression. Although a number of breast cancer susceptibility genes have been identified, the contribution each of these genes makes to breast cancer susceptibility is currently unclear. This is partly due to limitations in current diagnostic processes and an incomplete understanding of all of the genetic elements for which disruption can lead to loss of gene function. This proposal aims to identify regulatory pathways that are critical for the expression of an important breast cancer gene called BRCA1. Furthermore, it aims to determine the status of these pathways in breast cancer patients, thus expanding our knowledge of the actual contribution that disruption of this gene makes to this disease. It also aims to determine the potential for trans-acting factors to regulate the expression of BRCA1 and thus activity of the BRCA1 pathway. The predicted outcome of this research is an improved ability to perform presymptomatic diagnostic testing for breast cancer and the ultimately the development of more effective drugs to treat certain breast tumours.Read moreRead less
Accurate Prediction Of Individual Risk To Disease From Genome-wide Association Studies
Funder
National Health and Medical Research Council
Funding Amount
$269,371.00
Summary
Risk for many complex diseases (such as psychiatric disorders or heart disease) has a substantial genetic component, however few specific high risk variants have been identified. Evidence is mounting that there are likely to be hundreds of risk loci each individually conferring a very low increase in relative risk for disease. We aim to develop methods that utilise information from multiple genetic risk variants simultaneously to create a 'genomic profile' of risk.
Investigation Of Sudden Cardiac Death In The Young
Funder
National Health and Medical Research Council
Funding Amount
$682,823.00
Summary
Sudden cardiac death is a major tragedy in young people. In approximately one third of such cases, no cause of death is found at autopsy. This study will investigate the causes of sudden cardiac death in the young, with a specific emphasis on the underlying genetic causes of sudden unexplained death. This information will be used for screening surviving family relatives, thereby improving both diagnostic and treatment-prevention opportunities and reducing sudden cardiac death in our community.
Behavioural, Virological And Immunological Factors Influencing Hepatitis C Virus Infection In Injecting Drug Users
Funder
National Health and Medical Research Council
Funding Amount
$963,437.00
Summary
The hepatitis C virus (HCV) is a major public health problem affecting over 170 million people worldwide. In Australia an estimated 157,000 people have HCV and are at risk of serious disease, and 16,000 new infections occur each year. Treating HCV-related disease is expensive, and this healthcare burden is projected to grow significantly in coming years. Almost all new HCV infections in Australia occur among injecting drug users (IDUs), and despite our world-leading prevention programs, the viru ....The hepatitis C virus (HCV) is a major public health problem affecting over 170 million people worldwide. In Australia an estimated 157,000 people have HCV and are at risk of serious disease, and 16,000 new infections occur each year. Treating HCV-related disease is expensive, and this healthcare burden is projected to grow significantly in coming years. Almost all new HCV infections in Australia occur among injecting drug users (IDUs), and despite our world-leading prevention programs, the virus is spreading. Consensus is emerging that the best hope for control of HCV and related disease lies in a vaccine; our research will lay much of the groundwork for its development. The applicants' research to date shows that IDUs are being infected with HCV more frequently than previously assumed, that many carry multiple strains, and that dominant strains vary rapidly in individuals over time. These results reinforce the view that our prevention methods will not reduce infection rates and that current anti-viral treatments are not the solution. Nevertheless, we also found that some IDUs remain free of HCV infection despite risky behaviour with infected associates; intensive study of the immune functioning of these persistently non-infected individuals holds promise for vaccine development. In our proposed research, a collaboration of leading Australian epidemiologists, virologists and immunologists, we will recruit 210 young IDUs and follow them regularly for two years. Recruits will describe their social networks and nominate IDUs with whom they inject, provide blood samples and be interviewed about their behaviour at 3-month intervals. Individuals with recent and resolved HCV infection, change of dominant strain and lack of infection despite risky behaviour will be identified and their blood analysed for genetic factors that may be linked to immune protection. The outcomes will be crucial to the development and trialling of a vaccine against HCV.Read moreRead less