ORCID Profile
0000-0002-2413-5992
Current Organisation
University of Adelaide
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Publisher: JMIR Publications Inc.
Date: 24-11-2022
Abstract: uman papillomavirus (HPV) infection, a common sexually transmitted disease, is associated with cancers of the cervix, vulva, vagina, penis, anus, and head and neck. Oropharyngeal squamous cell carcinoma (OPSCC throat cancer) is a type of cancer involving the head and neck area that is rapidly increasing across the globe. There are higher rates of OPSCC among Indigenous populations relative to non–Indigenous Australian populations, although the HPV-attributable fraction remains unknown. For the first time at a global level, we plan to extend an Indigenous Australian adult cohort to monitor, screen, and ultimately prevent HPV-associated OPSCC and to undertake extensive cost-effectiveness modelling around HPV vaccination. his study aims to (1) extend follow-up to a minimum of 7 years post recruitment to describe the prevalence, incidence, clearance, and persistence of oral HPV infection and (2) conduct clinical examinations of the head and neck, oral cavity, and oropharynx and collect saliva s les for early-stage OPSCC testing. e will continue to implement a longitudinal design for the next study phase, where we will ascertain the prevalence, incidence, clearance, and persistence of oral HPV infection at 48, 60, and 72 months undertake clinical examinations/saliva assessments to detect early-stage OPSCC and refer for treatment. The primary outcome measures are changes in oral HPV infection status, biomarker measures of early HPV-related cancer, and clinical evidence of early-stage OPSCC. articipant 48-month follow-up will commence in January 2023. The first results are expected to be submitted for publication 1 year after 48-month follow-up begins. ur findings have potential to change the way in which OPSCC among Australian Indigenous adults is managed, with desired impacts including cost-savings on expensive cancer treatments improved nutritional, social, and emotional outcomes and improved quality of life for both Indigenous adults and the Indigenous community more broadly. Continuing a large, representative Indigenous adult cohort to track oral HPV infection and monitor early OPSCC is essential to yield critical information to include in the management armamentarium of health and well-being recommendations for Australia’s First Nations. RR1-10.2196/44593
Publisher: American Association for Cancer Research (AACR)
Date: 03-2022
DOI: 10.1158/1055-9965.EPI-21-1056
Abstract: Persistent oral human papillomavirus (HPV) infection is a risk factor for oropharyngeal squamous cell carcinoma (OPSCC). Indigenous Australians have a higher rate of OPSCC than non-Indigenous Australians. Risk factors for oral HPV persistence among Indigenous Australians are poorly understood. Participants provided information on sociodemographic characteristics, health-related behaviors including tobacco and alcohol use, and sexual history. Participants additionally provided saliva s les for microbial genotyping. Negative log binomial regression models were used to evaluate associations of sociodemographic, health behavior, and sexual behavior indicators on incident, persistent, and cleared oral HPV infection at 12-month follow-up. Estimates were quantified as rate ratios (RR). Of the 1,011 participants recruited at baseline, 911 provided saliva s les that were β-globin positive (a DNA integrity check), with 321 (35.3%) testing positive for any oral HPV infection. At 12-month follow up, saliva s les were obtained from 743 of the original 1,011 participants (73.5%). Among the 584 participants who provided β-globin–positive saliva s les at baseline and 12-month follow-up, 24 (42.6%) had no oral HPV infection at both time points, 130 (22.2%) had new (incident) oral HPV infection at 12 months, 130 (22.2%) had persistent oral HPV infection (i.e., present at both baseline and 12 months), and 75 (12.8%) had oral HPV infection clearance from baseline to 12 months. Age of first giving oral sex and unsafe (unprotected) oral sexual behaviors were significantly associated with incidence rural location of residence and ever received oral sex were significantly associated with persistence and, rural location of residence and ever received oral sex were significantly associated with clearance of oral HPV infection. The incidence of oral HPV infection at both baseline and 12-month follow-up was high. Factors associated with persistence and clearance of oral HPV infections included location of residence and unsafe oral sexual behaviors. There are currently no studies available which have assessed oral HPV infection incidence, persistence, and clearance amongst Indigenous populations in Australia or even at a global level. The study has been able to identify risk factors associated with potential malignant changes in the oropharynx among Indigenous Australians.
Publisher: JMIR Publications Inc.
Date: 17-05-2023
DOI: 10.2196/44593
Abstract: Human papillomavirus (HPV) infection, a common sexually transmitted disease, is associated with cancers of the cervix, vulva, vagina, penis, anus, and head and neck. Oropharyngeal squamous cell carcinoma (OPSCC throat cancer) is a type of cancer involving the head and neck area that is rapidly increasing across the globe. There are higher rates of OPSCC among Indigenous populations relative to non–Indigenous Australian populations, although the HPV-attributable fraction remains unknown. For the first time at a global level, we plan to extend an Indigenous Australian adult cohort to monitor, screen, and ultimately prevent HPV-associated OPSCC and to undertake extensive cost-effectiveness modelling around HPV vaccination. This study aims to (1) extend follow-up to a minimum of 7 years post recruitment to describe the prevalence, incidence, clearance, and persistence of oral HPV infection and (2) conduct clinical examinations of the head and neck, oral cavity, and oropharynx and collect saliva s les for early-stage OPSCC testing. We will continue to implement a longitudinal design for the next study phase, where we will ascertain the prevalence, incidence, clearance, and persistence of oral HPV infection at 48, 60, and 72 months undertake clinical examinations/saliva assessments to detect early-stage OPSCC and refer for treatment. The primary outcome measures are changes in oral HPV infection status, biomarker measures of early HPV-related cancer, and clinical evidence of early-stage OPSCC. Participant 48-month follow-up will commence in January 2023. The first results are expected to be submitted for publication 1 year after 48-month follow-up begins. Our findings have potential to change the way in which OPSCC among Australian Indigenous adults is managed, with desired impacts including cost-savings on expensive cancer treatments improved nutritional, social, and emotional outcomes and improved quality of life for both Indigenous adults and the Indigenous community more broadly. Continuing a large, representative Indigenous adult cohort to track oral HPV infection and monitor early OPSCC is essential to yield critical information to include in the management armamentarium of health and well-being recommendations for Australia’s First Nations. PRR1-10.2196/44593
Publisher: JMIR Publications Inc.
Date: 16-12-2022
DOI: 10.2196/39685
Abstract: Dialysis for end-stage kidney disease (ESKD) is the leading cause of hospitalization among Aboriginal and Torres Strait Islander in iduals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving kidney transplant. This study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander in iduals with ESKD in South Australia through the following objectives: investigate the facilitators of and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia investigate the facilitators of and barriers to maintaining oral health among Aboriginal and Torres Strait Islander people with ESKD in South Australia facilitate access to and completion of culturally secure dental care for Aboriginal and Torres Strait Islander in iduals with ESKD and their families provide oral health promotion training for Aboriginal health workers (AHWs) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD generate co-designed strategies to better facilitate access to and provision of culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD and evaluate participant progress and AHW oral health training program. This collaborative study is ided into 3 phases: exploratory phase (baseline), intervention phase (baseline), and evaluation phase (after 6 months). The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops and the evaluation phase will involve 6-month follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training. Stakeholder interviews were initiated in November 2021, and participant recruitment commenced in February 2022. The first results are expected to be submitted for publication in December 2022. Expected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges regarding oral health for in iduals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant-identified and stakeholder-identified challenges to ensure accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander in iduals with ESKD. PRR1-10.2196/39685
Publisher: JMIR Publications Inc.
Date: 08-06-2018
DOI: 10.2196/10503
Publisher: Informa UK Limited
Date: 07-09-2023
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
Publisher: JMIR Publications Inc.
Date: 18-05-2022
Abstract: ialysis for End Stage Kidney Disease (ESKD) is the leading cause of hospitalization for Aboriginal and Torres Strait Islander in iduals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving a kidney transplant. his study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander in iduals with ESKD in South Australia through the following objectives (1) Investigate the facilitators and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia (2) Investigate the facilitators and barriers to maintaining oral health for Aboriginal and Torres Strait Islander people with ESKD in South Australia (3) Facilitate access to, and completion of, culturally secure dental care for Aboriginal and Torres Strait Islander in iduals with ESKD and their families (4) Provide oral health promotion training for Aboriginal Health Workers (AHW) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD (5) Generate co-designed strategies to better facilitate access to, and provision of, culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD and (6) evaluate participant progress and the AHW oral health training program. his collaborative research study is ided into three phases: exploratory phase, intervention phase, and evaluation phase. The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops the evaluation phase will involve follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training. takeholder interviews were initiated in November 2021, with participant recruitment commencing February 2022. The first results are expected to be submitted for publication in December, 2022. xpected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges to oral health for in iduals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant and stakeholder identified challenges to ensuring accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander in iduals with ESKD.
No related grants have been discovered for Joanne Hedges.