ORCID Profile
0000-0002-3299-0411
Current Organisation
University of Sydney
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Communications Technologies | Wireless Communications | Coding and Information Theory |
Communication Networks and Services not elsewhere classified | Mobile Data Networks and Services | Mobile Telephone Networks and Services
Publisher: AMPCo
Date: 05-1991
DOI: 10.5694/J.1326-5377.1991.TB121265.X
Abstract: To determine whether case-survival rates for infiltrating ductal carcinomas diagnosed in South Australia during 1980-1986 have varied by hospital of attendance at diagnosis. A null hypothesis was tested. All 2589 cases notified to the State Cancer Registry were included. The date of censoring for survival analyses was June 30, 1989. Multivariate analyses were undertaken adjusting for age at diagnosis, diameter of tumour, and extent of nodal involvement. After adjusting for differences in age, diameter and nodal status, there was not a significant difference in case outcome between large public hospitals, large private hospitals and smaller hospitals (P greater than 0.05). Although protocols for treatment of breast cancer are in a transitional phase and differences exist, case-survival rates have not shown a substantial variation by hospital of attendance at diagnosis.
Publisher: IEEE
Date: 06-2020
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2010
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2007
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2019
Publisher: Springer Science and Business Media LLC
Date: 06-06-2017
DOI: 10.1038/PCAN.2017.28
Abstract: Radical prostatectomy is a common surgical procedure performed to treat prostate cancer. Patient-reported outcomes after surgery include urinary incontinence, erectile dysfunction, decreased quality of life and psychological effects. Predictive tools to assess the likelihood of an in idual experiencing various patient-reported outcomes have been developed to aid decision-making when selecting treatment. A systematic review was undertaken to identify all papers describing tools for the prediction of patient-reported outcome measures in men with prostate cancer treated with radical prostatectomy. To be eligible for inclusion, papers had to provide a summary measure of accuracy. PubMed and EMBASE were searched from July 2007. Title/abstract screening, and full-text review were undertaken by two reviewers, while data extraction and critical appraisal was performed by a single reviewer. The search strategy identified 3217 potential studies, of which 191 progressed to full-text review and 14 were included. From these studies, 27 tools in total were identified, of which 18 predicted urinary symptoms, six predicted erectile function and one predicted freedom from a group of three outcomes ('trifecta') (biochemical recurrence, incontinence and erectile dysfunction). On the basis of tool accuracy (>70%) and external validation, two tools predicting incontinence and two tools predicting erectile dysfunction are ready for implementation. A small number of tools for the prediction of patient-reported outcomes following radical prostatectomy have been developed. Four tools were found to have adequate accuracy and validation and are ready for implementation for the prediction of urinary incontinence and erectile dysfunction.
Publisher: Institution of Engineering and Technology (IET)
Date: 2009
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2018
Publisher: Springer Science and Business Media LLC
Date: 07-1991
DOI: 10.1007/BF00052136
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2017
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 15-07-2022
Publisher: Wiley
Date: 12-2009
Publisher: IEEE
Date: 09-2010
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2017
Publisher: BENTHAM SCIENCE PUBLISHERS
Date: 19-03-2012
Publisher: SAGE Publications
Date: 2018
Abstract: The development of comorbidities has become increasingly relevant with longer-term cancer survival. To assess the pattern of comorbidities among Australian women with breast cancer treated with tamoxifen or an aromatase inhibitor. Retrospective cohort study using Pharmaceutical Benefits Scheme (PBS) data (10% s le) from January 2003 to December 2014. Dispensing claims data were used to identify comorbidities and classified with the Rx-Risk-V model. The breast cancer cohort had tamoxifen or an aromatase inhibitor dispensed between 2004 and 2011 with no switching between types of endocrine therapy. Comparisons were made between the breast cancer cohort and specific control groups (age- and sex-matched at 1:10 ratio without any dispensing of anti-neoplastic agents during the study period) for the development of five in idual comorbidities over time using Cox regression models. Women treated with tamoxifen had a higher incidence of cardiovascular conditions, diabetes, and pain or pain-inflammation, but a lower incidence of hyperlipidaemia compared with non-cancer control groups, as indicated by PBS data. Women treated with aromatase inhibitors were more likely to develop cardiovascular conditions, osteoporosis, and pain or pain-inflammation compared with non-cancer control groups. The risks of hyperlipidaemia and osteoporosis were significantly lower among tamoxifen users compared with aromatase inhibitor users. Women with hormone-dependent breast cancer treated with an endocrine therapy had a higher risk of developing specified comorbid conditions than women without cancer, with different comorbidity profiles for those on tamoxifen versus aromatase inhibitors. Further research into the causes and mechanism of development and management of comorbidities after cancer is needed.
Publisher: MDPI AG
Date: 20-09-2022
DOI: 10.3390/S22197118
Abstract: In this paper, we develop innovative digital twins of cattle status that are powered by artificial intelligence (AI). The work is built on a farm IoT system that remotely monitors and tracks the state of cattle. A digital twin model of cattle based on Deep Learning (DL) is generated using the sensor data acquired from the farm IoT system. The physiological cycle of cattle can be monitored in real time, and the state of the next physiological cycle of cattle can be anticipated using this model. The basis of this work is the vast amount of data that is required to validate the legitimacy of the digital twins model. In terms of behavioural state, this digital twin model has high accuracy, and the loss error of training reach about 0.580 and the loss error of predicting the next behaviour state of cattle is about 5.197 after optimization. The digital twins model developed in this work can be used to forecast the cattle’s future time budget.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2009
DOI: 10.1200/JCO.2009.27.15_SUPPL.E11517
Abstract: e11517 Background: The causes of variation in breast cancer survival remain uncertain. Care provided to women with breast cancer may vary in relation to both the care setting and characteristics of the clinicians. Methods: To compare the outcomes of management of breast cancer treated in rural and metropolitan centers, a prospective audit of breast cancer in a region of Australia was undertaken. Over a nine-year observation period 2102 women with invasive breast cancer underwent potentially curative surgery. Treatments received, including systemic adjuvant therapy, were compared to contemporary guideline-based indicators. Breast cancer specific mortality was analyzed using Cox proportional hazards models. Results: Overall agreement of received treatment with the indicators was high. Women treated within rural centers were, however, much less likely to receive post operative radiotherapy after breast conserving surgery (86.4% vs. 97.0% p .001). The overall recurrence rate, including distant metastases, for all women was 11.6%. Local or regional recurrence was more frequent in rural centers compared with metropolitan centers (4.1% versus 2.1% p=0.05). Breast cancer mortality was increased in women with large tumors, high grade disease, and positive axillary lymph nodes. Non-compliance with treatment guidelines was associated with a trend towards increased breast cancer mortality (HR=1.55 p=0.056). After adjustment for these factors and patient age, undergoing surgery in rural centers was associated with increased breast cancer mortality (HR=1.84 p .001). Although women treated in rural centers were older, their cancer stage and tumour characteristics were similar to those of women treated in metropolitan centers. Non-cancer related mortality was elevated in women treated in rural centers compared with women travelling to a city for surgery (HR=2.08 p=0.005). Conclusions: Increased non-cancer related mortality in rural treated women suggests increased medical co-morbidity in this group, which may have influenced treatment choices and outcomes. Low rates of adjuvant radiotherapy were noted for women treated in rural centers. In addition, clinically significant differences in outcome, including breast cancer mortality, were observed. No significant financial relationships to disclose.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1111/J.1753-6405.2007.00033.X
Abstract: To investigate trends in cervical cancer incidence, mortality and survival by histology for benchmarking purposes ahead of practice change and the introduction of Human Papilloma Virus (HPV) vaccine. Using data from the South Australian Cancer Registry, age-standardised rates are presented for four-year periods from 1977 to 2004. Socio-demographic and secular predictors of glandular as opposed to squamous cancers are investigated, using multivariable logistic regression. Disease-specific survivals are analysed using Kaplan-Meier product-limit estimates and Cox proportional hazards regression. Incidence and mortality rates reduced by 55.1% and 59.3% respectively between 1977-80 and 2001-04, with larger reductions for squamous than glandular cancers. The ratio of squamous to glandular cancer incidence reduced from 5.4:1 in 1977-88 to 2.8:1 in 1993-2004, with a corresponding reduction from 5.2:1 to 3.0:1 for mortality. Compared with squamous cancers, glandular lesions were more common in patients from higher socio-economic areas, but less common in those over 70 years of age, Aboriginal patients, and those born in Southern Europe. The proportion of cancers comprising glandular lesions has increased, possibly reflecting prevention of squamous cancers through treatment of screen-detected preinvasive lesions. Additional mortality reductions from screening may be limited where the proportion of glandular lesions is high, with vaccination offering the best prospects for gains in the long term. Priority should be given to Aboriginal and Torres Strait Islander women in vaccination programs in view of their high death rate from cervical cancer.
Publisher: Elsevier BV
Date: 08-2005
DOI: 10.1016/J.CLON.2005.04.005
Abstract: To evaluate trends in colorectal cancer survival and treatment at South Australian teaching hospitals and degree of adherence to treatment guidelines which recommend adjuvant chemotherapy for Dukes' C colon cancers and combined chemotherapy and radiotherapy for high-risk rectal cancers. Trends in disease specific survival and primary treatment were analysed, and comparisons drawn between diagnostic epochs, using cancer registry data from South Australian teaching hospitals. Statistical methods included univariate and multivariable disease specific survival analyses. Five-year survival increased from 48% in 1980-1986 to 56% in 1995-2002. Largest gains were for stage C, where survivals were higher when chemotherapy was part of the primary treatment. By comparison, gains in 1-year survival were largest for stage D. Chemotherapy was provided for 4% of patients with colorectal cancers in 1980-1986, increasing to 32% in 1995-2002. Among stage C cases below 70 years at diagnosis, the proportion having chemotherapy increased to 83% in 1995-2002. The most common chemotherapy was fluorouracil (5FU) as a single agent in 1980-1986 and 5FU with leucovorin in 1995-2002. As expected, radiotherapy was used more frequently for rectal than colon cancers, and particularly for stage C. Among stage C rectal cases below 70 years, the proportion having radiotherapy increased from 10% in 1980-1986 to 57% in 1995-2002. Approximately 93% of colorectal cancers were treated surgically. Patients not treated surgically tended to be aged 80 years or more and to present with distant metastases. Trends in chemotherapy and radiotherapy accord with evidence-based recommendations. There have been reassuring gains in survivals after adjusting for stage, grade and other prognostic indicators. The data show survival gains and treatment patterns that in idual hospitals can use as benchmarks when evaluating their own experience.
Publisher: IEEE
Date: 04-2019
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2023
Publisher: IEEE
Date: 12-2017
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2014
Publisher: Elsevier BV
Date: 08-2014
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2022
Publisher: IEEE
Date: 06-2015
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.BREAST.2010.03.032
Abstract: The study examines the management and outcomes of women with early invasive breast cancer treated in rural and metropolitan centres over a nine-year observation period. A prospective audit of the treatment and outcomes of 2081 women with early breast cancer who underwent potentially curative surgery between 1997 and 2006 in metropolitan Canberra or in the surrounding rural region was completed. Overall, there was good agreement between published guidelines and the treatment received by the women in the study. However, women treated in rural centres were less likely to receive postoperative radiotherapy after breast-conserving surgery, or to undergo axillary lymph node surgery or sentinel lymph node biopsy compared with women treated in metropolitan centres. Surgery in a rural centre was associated with increased breast cancer recurrence (HR = 1.54, p < 0.001) and increased breast cancer mortality (HR = 1.84, p < 0.001), after adjustment for age and tumour characteristics. Non-cancer related mortality was increased in women treated in rural centres compared with women travelling to a metropolitan centre for surgery (HR = 2.08 p = 0.005). There were differences in both the care provided and treatment outcomes between women treated in rural centres and women treated in metropolitan centres. However, the increased non-cancer related mortality in women treated in rural centres suggests an increased medical comorbidity in this group. Initiatives supporting rural-based surgeons to adopt new procedures such as sentinel node biopsy may help to optimise rural breast cancer treatment.
Publisher: Wiley
Date: 02-08-2017
DOI: 10.1111/JEP.12612
Abstract: Short-term outcomes (unplanned readmission, post-surgical complication rates, 30-day and 90-day post-surgical mortality) are often used as indicators of quality of surgical care for colorectal cancer (CRC). Differences in these immediate outcomes can highlight disparities in care across patient subpopulations. This study aimed to document short-term outcomes following major surgery for CRC and to identify whether there were any sociodemographic differences across South Australia (SA). This population-based study included all CRC resections among SA residents diagnosed with CRC aged 50-79 years in 2003-2008 (n = 3940). Clinical, treatment, comorbidity and outcomes data were compiled through linkage of administrative and surveillance datasets across SA. A retrospective cohort design was used to examine short-term outcomes including post-operative complications, 28-day emergency readmission and 30-day and 90-day mortality. We used multivariable logistic regression to identify factors associated with each outcome. Post-operative complications occurred in 28% of cases. Thirty-day and ninety-day mortality were 1.3% and 3%, respectively. Later stage, older age, multiple comorbidities and emergency admissions were associated with poorer short-term outcomes. Risk of complications was lower among patients from higher socio-economic areas (OR = 0.77, 95%CI 0.62-0.98). Risk of 30-day mortality was higher among non-metropolitan patients (OR = 2.33, 95%CI 1.22-4.46). Post-operative complications increased the risk of emergency readmission and short-term mortality. Short-term outcomes following CRC surgery may be improved through strategies to increase earlier detection and reduce emergency admissions. Socioeconomic and regional disparities require further examination of health system factors.
Publisher: IEEE
Date: 04-2020
Publisher: Wiley
Date: 23-12-2015
DOI: 10.1111/JGH.12792
Abstract: The average age at diagnosis for colorectal cancer (CRC) in Australia is 69, and the age-specific incidence rises rapidly after age 50 years. The incidence has stabilized or is declining in older age groups in Australia during recent decades, possibly related to the increased uptake of screening and high-risk surveillance. In the same time frame, a rising incidence of CRC in younger adults has been well-documented in the United States. This rise in incidence in the young has not been reported from other countries that share long-term exposure to westernised urban lifestyles. Using data from the Australian Institute of Health and Welfare, we examined trends in national incidence rates for CRC under age 50 years and observed that rates in people under age 40 years have been rising for the last two decades. We further performed a review of the literature regarding CRC in young adults to outline the extent of current understanding, explore potential risk factors such as obesity, alcohol, and sedentary lifestyles, and to identify the questions remaining to be addressed. Although absolute numbers might not justify a population screening approach, the dispersal of young adults with CRC across the primary health-care system decreases probability of their recognition. Patient and physician awareness, aided by stool and emerging blood-screening tests and risk profiling tools, have the potential to aid in identification of those young adults who would most benefit from a colonoscopy through early detection of CRCs or by removal of advanced polyps.
Publisher: Wiley
Date: 12-1974
DOI: 10.1111/J.1834-7819.1974.TB02371.X
Abstract: The genetic basis of hearing loss in humans is relatively poorly understood. In recent years, experimental approaches including laboratory studies of early onset hearing loss in inbred mouse strains, or proteomic analyses of hair cells or hair bundles, have suggested new candidate molecules involved in hearing function. However, the relevance of these genes/gene products to hearing function in humans remains unknown. We investigated whether single nucleotide polymorphisms (SNPs) in the human orthologues of genes of interest arising from the above-mentioned studies correlate with hearing function in children. 577 SNPs from 13 genes were each analysed by linear regression against averaged high (3, 4 and 8 kHz) or low frequency (0.5, 1 and 2 kHz) audiometry data from 4970 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth-cohort at age eleven years. Genes found to contain SNPs with low p-values were then investigated in 3417 adults in the G-EAR study of hearing. Genotypic data were available in ALSPAC for a total of 577 SNPs from 13 genes of interest. Two SNPs approached s le-wide significance (pre-specified at p = 0.00014): rs12959910 in CBP80/20-dependent translation initiation factor (CTIF) for averaged high frequency hearing (p = 0.00079, β = 0.61 dB per minor allele) and rs10492452 in L-plastin (LCP1) for averaged low frequency hearing (p = 0.00056, β = 0.45 dB). For low frequencies, rs9567638 in LCP1 also enhanced hearing in females (p = 0.0011, β = -1.76 dB males p = 0.23, β = 0.61 dB, likelihood-ratio test p = 0.006). SNPs in LCP1 and CTIF were then examined against low and high frequency hearing data for adults in G-EAR. Although the ALSPAC results were not replicated, a SNP in LCP1, rs17601960, is in strong LD with rs9967638, and was associated with enhanced low frequency hearing in adult females in G-EAR (p = 0.00084). There was evidence to suggest that multiple SNPs in CTIF may contribute a small detrimental effect to hearing, and that a sex-specific locus in LCP1 is protective of hearing. No in idual SNPs reached s le-wide significance in both ALSPAC and G-EAR. This is the first report of a possible association between LCP1 and hearing function.
Publisher: IEEE
Date: 12-2014
DOI: 10.1109/FGCN.2014.12
Publisher: AMPCo
Date: 06-1982
DOI: 10.5694/J.1326-5377.1982.TB124172.X
Abstract: Survival rates for cancer patients derived from population-based data are a fundamental means of monitoring the effectiveness of treatment for the community at large. We used South Australian Cancer Registry data to study survival by cancer site from date of diagnosis in 1977-79 to August 1980. One-year and two-year cumulative percentage survival rates for all types of invasive cancer were 64% (+/- 0.5%) and 54% (+/- 0.5%) respectively. We anticipate that these findings will provide a yardstick for intra-hospital survival analyses.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2022
Publisher: IEEE
Date: 11-2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2023
Publisher: BMJ
Date: 07-2017
Publisher: American Society of Clinical Oncology (ASCO)
Date: 07-1995
DOI: 10.1200/JCO.1995.13.7.1572
Abstract: To determine the predictive value of androgen receptor (AR) levels in primary tumors of women who undergo medroxyprogesterone acetate (MPA) therapy for advanced breast cancer after relapse on tamoxifen adjuvant therapy. Between 1984 and 1987 at Flinders Medical Centre, South Australia, 136 postmenopausal women received adjuvant tamoxifen therapy for lymph node-positive breast cancer. Estrogen receptor (ER), progesterone receptor (PgR), and AR levels, tumor size, and degree of axillary node involvement were determined at the time of diagnosis. The median follow-up period was 81 months 89 women developed metastatic disease, 83 of whom subsequently received MPA (500 mg/d). The objective response rate ([RR] ie, complete response [CR] and partial response [PR]) and progression-free interval (PFI) were assessed in response to MPA therapy. Associations between RR, PFI, and primary tumor characteristics including ER, PgR, and AR levels were examined using the Mann-Whitney U test, Kaplan-Meier product-limit estimator, and Cox proportional hazards regression, as appropriate. Thirty-two of 83 patients (38.6%) responded to MPA. RR was significantly associated with the presence of AR (P .001), but not with other primary tumor characteristics or duration of tamoxifen therapy. After initiation of MPA treatment, PFI increased with increasing concentration of AR in the primary tumor. Response to MPA after adjuvant tamoxifen treatment for lymph node-positive breast cancer was positively associated with AR level in the primary tumor. This finding suggests that MPA action in breast cancer may be mediated in part by the AR.
Publisher: IEEE
Date: 06-2014
Publisher: AMPCo
Date: 06-1988
DOI: 10.5694/J.1326-5377.1988.TB93810.X
Abstract: Five-year relative case-survival rates for all cancers collectively are similar in South Australia (49%) and the United States (50%). This suggests that outcomes of cancer treatment do not vary appreciably between the two populations. There is an indication of higher survival rates in South Australia for melanoma, Hodgkin's disease, multiple myeloma and gastric cancer, but lower survival rates for cancers of the thyroid, corpus uteri, prostate, colon, kidney and lung. The differences in point estimates of the rates were most conspicuous for Hodgkin's disease, multiple myeloma and prostatic cancer. The reasons for a cautious interpretation of these findings are discussed and some possible explanations are suggested. South Australian data point to an upward trend in survival rates between the diagnostic periods 1977-1980 and 1981-1985 for patients with Hodgkin's disease, diffuse large-cell lymphomas, melanomas and cancers of the prostate and rectum.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2018
DOI: 10.1200/JCO.2018.36.4_SUPPL.759
Abstract: 759 Background: Microsatellite instability (MSI) has been associated with improved survival outcomes in early stage CRC. In stage IV disease, MSI represents only 3-5% of cases and currently the prognostic implications are less clear. There is however evolving evidence that treatment pathways should include anti-PD-1 antibodies given the encouraging results in heavily pre-treated MSI mCRC patients. We undertook an analysis of the South Australian mCRC population based registry to explore the relevance of MSI status in this population based registry. Methods: The registry was analysed to assess patient characteristics and survival outcomes comparing patients with MSI or microsatellite stable (MSS) disease. K-M survival analysis was used to assess OS. Results: 4359 patients are registered on the data base. 598 (14%) patients had been tested for MSI. 62 (10.1%) of these patients had demonstrable MSI. Patient characteristics and outcomes are summarized in the table. There are statistically higher rates of right sided primary, poorly differentiated pathology and BRAF mutation in the MSI group associated with a trend to reduced survival. Chemotherapy and biological therapy received in the MSI v MSS groups was as follows 5FU 31% v 25%, 5FU/irinotecan 17% v 12%, 5FU/oxaliplatin 52% v 58%, bevacizumab 31% v 42%, anti-EGFR 0 v 4.6%. Conclusions: The patient characteristics of MSI mCRC are in keeping with those previously reported. MSI in this population based mCRC registry is not associated with a favorable outcome as seen in earlier stage disease compared to patients with MSS disease. The trend to poorer outcomes may support routine testing and potentially an alternate treatment pathway, which may include PD-1 inhibitors.[Table: see text]
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2016
Publisher: Elsevier BV
Date: 08-1997
DOI: 10.1111/J.1467-842X.1997.TB01739.X
Abstract: We investigated differentials and time trends in perinatal mortality and perinatal risk factors by geographic area of residence in South Australia during 1981-1994, to assess whether sociodemographic inequalities had lessened. The areas analysed were Adelaide and the country region of South Australia, with Adelaide being ided by socioeconomic status into two ares. Subjects were 267,116 singleton births of at least 400 g birthweight (or at least 20 weeks' gestation) notified to the state's perinatal data collection. Year of birth, residential area, and interactions between year of birth and residential area were analysed as predictors of perinatal risk factors and deaths. There was a statistically significant decline in the perinatal death rate in all residential areas (mainly because of a decrease in neonatal deaths), which did not vary significantly by area. The frequency of low birthweight (< 2500 g) increased in the country areas and in the lower socioeconomic areas of Adelaide, but not in the higher socioeconomic areas. Although premature births increased in all areas, the increase was less pronounced for the higher socioeconomic areas of Adelaide. By comparison, although all areas showed an increase in the proportions of mothers aged 35 years or over, the increase was larger for the higher socioeconomic areas. Australia has a national policy of reducing social inequalities in health status. Perinatal mortality rates declined in Adelaide and country residential areas from 1981 to 1994. This trend is favourable, but from the relativities of these rates by residential area, there is not compelling evidence of a reduction in inequalities.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2023
Publisher: IEEE
Date: 08-2015
Publisher: Wiley
Date: 29-01-2007
Publisher: Wiley
Date: 08-10-2017
DOI: 10.1111/JEP.12819
Abstract: Clinical registry data from major South Australian public hospitals were used to investigate trends in invasive breast‐cancer treatment and survival by age. Disease‐specific survival was calculated for the 1980 to 2013 diagnostic period using Kaplan‐Meier product‐limit estimates, with a censoring of live cases on December 31, 2014. Cox proportional hazards regression was used to examine differences in survival by age and tumour characteristic. First‐round treatments following diagnosis were analysed, using multiple logistic regression to adjust for confounding. Five‐year survival increased from 75% in the 1980s to 87% in 2000 to 2013, consistent with national trends, and with increases occurring irrespective of age. There was an increased use of breast conserving surgery, radiotherapy, chemotherapy, and hormone treatments. Five‐year survival was lower for women aged 80+ years, increasing from 65% in the 1980s to 74% in 2000 to 2013. Lower survival in these older women persisted after adjusting for TNM stage, other clinical variables, and diagnostic year, without evidence of a reduced disparity over time. Older women were less likely to have surgery, radiotherapy, and chemotherapy throughout 1980 to 2013. By comparison, their use of hormone therapy was elevated. The adjusted relative odds of mastectomy (as opposed to breast conserving surgery) were lower for the 80+ year age range. Breast‐cancer survival increases applied to all ages, including 80+ years, but poorer outcomes persisted in this older group and the gap did not reduce. A key question is whether the best trade‐off now exists between optimally therapeutic cancer treatment and accommodations for frailty and co‐morbidity in the aged, or whether opportunities exist for better trade‐offs and better survival. Local registry data are important for describing local service activity and outcomes by age for local service providers, health administrations and consumer groups monitoring disparities and indicating effects of local initiatives.
Publisher: Wiley
Date: 02-1991
DOI: 10.1111/J.1445-5994.1991.TB03007.X
Abstract: About one third of adults surveyed in South Australia have shown evidence of past silent infection with Legionella pneumophila serogroup 1. However, the annual notification rate for symptomatic disease is only about 0.5 per 100,000 residents in non-epidemic years. The male to female ratio is 2.5 to one and approximately 50% of the cases are at least 60 years of age. Cases have presented more in summer and in the metropolitan areas. Twenty cases of Legionnaires' disease occurred during the summer of 1985-86. A cooling tower was held to be the principal source with aerosols being dispersed up to three kilometers away during an atmospheric thermal inversion. A subsequent outbreak of 22 L. longbeachae serogroup 1 infections had no marked geographic clustering. The outbreak commenced in spring and cases were distinguished as active gardeners. L. longbeachae was found in garden soil and it is hypothesised that this soil inhabitant can become aerosolised and inhaled during gardening. The potential for primary prevention of Legionnaires' disease is discussed in relation to water-handling equipment and the need for early precautionary treatment of all community-acquired pneumonia as suspect Legionnaires' disease is emphasised.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2017
Publisher: Springer Science and Business Media LLC
Date: 23-09-2011
Publisher: Elsevier BV
Date: 02-2004
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2016
Publisher: IEEE
Date: 04-2018
Publisher: IEEE
Date: 2005
Publisher: IEEE
Date: 04-2013
Publisher: Springer Science and Business Media LLC
Date: 31-01-2014
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2021
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2023
Publisher: IEEE
Date: 2005
Publisher: IEEE
Date: 12-2016
Publisher: Wiley
Date: 07-1995
Abstract: As part of the South Australian asthma mortality survey, we examined 30 cases of near-fatal asthma attacks in children under 15 years of age who were seen over a 3-year period from May 1988 to June 1991. Subjects presented with asthma and either respiratory arrest, PaCO2 above 50 mm Hg, and/or an altered state of consciousness or inability to speak on presentation at a metropolitan Adelaide teaching hospital. A standardized interview and questionnaire was completed with subjects arents and medical practitioners. Data were reviewed by the assessment panel which made collective judgments based on predetermined criteria. Seventeen patients (57%) were male, 20% were less than 7 years of age, and the majority (53%) were aged between 12 and 15 years. The majority (83%) had severe asthma and only one case (3.3%) had mild asthma. Half of the subjects were waking every night due to asthma and 79% had significant exercise limitation. A quarter of the subjects had a previous ICU admission and 70% had a hospital admission in the last 12 months. Primary care was carried out by a general practitioner in 57% of cases, and 70% of subjects had a crisis plan. Only 46% of those older than 7 years of age had ever used a peak-flow meter. Eighty percent of subjects or their families had high denial scores, and in 73% of cases psychosocial factors were considered to be significant. Eighty percent of cases experienced acute progressive respiratory distress, and 63% of cases delayed seeking medical care.(ABSTRACT TRUNCATED AT 250 WORDS)
Publisher: Informa UK Limited
Date: 06-02-2014
DOI: 10.1080/13557858.2014.883368
Abstract: Migrants generally have more favourable mortality outcomes than the Australian-born population. The aim of this study is to update knowledge and inform future research in this field by examining mortality from musculoskeletal conditions, asthma, cardiovascular disease, diabetes mellitus, injuries and mental conditions between 1981 and 2007 among migrants in Australia. Average annual sex- and age-standardised mortality rates were calculated for each migrant group, period of death registration and cause of death. Mortality rates decreased among most groups for asthma, cardiovascular disease and motor vehicle accidents, with rates erging in the later time periods. The reverse was true for mental disorders, where Australian-born in iduals experienced the greatest increase in mortality. Migrants generally displayed more favourable mortality outcomes than their Australian-born counterparts. Migrants from Southern Europe appeared to have the greatest advantage. However, some migrants appeared to be over-represented in the areas of diabetes, suicide and mental health.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2008
DOI: 10.1007/S10552-008-9177-Y
Abstract: This study investigated associations of degree of spread at diagnosis of breast cancer and socio-demographic factors with the risk of death among NSW females diagnosed in 1980-2003. Trends by diagnostic period, socio-demographic differences, and the implications for cancer control were considered. NSW Central Cancer Registry data were analyzed using regression and rank-order tests to show predictors of death from breast cancer and trends in degree of spread. Compared with localized disease, case fatality was thrice and 14 times higher for cancers with regional spread and distant metastases, respectively. After adjusting for degree of spread and socio-demographic differences, the relative risk of death from breast cancer has declined in recent diagnostic periods compared with the 1980-1983 baseline, reaching a low of 0.38 (0.35, 0.40) for 1999-2003. Age-specific analyses indicated that relative risks were lower in 1999-2003 for 50-69 year olds (RR = 0.31) than younger (RR = 0.40), or older (RR = 0.46) females. Regional or distant disease at diagnosis was lowest in the older age groups, the highest socio-economic stratum and in more recent periods. Females born in non-English speaking countries presented with more advanced disease, as did metropolitan women with the highest access to health services. Degree of spread of cancer at diagnosis is a powerful predictor of case fatality. Case fatalities from breast cancer have declined by diagnostic period, after adjusting for degree of spread, which may reflect treatment and screening advances. Attention should be directed at reducing disparities by socio-economic status and encouraging migrant women to present earlier.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2021
Publisher: IEEE
Date: 04-2013
Publisher: Springer Science and Business Media LLC
Date: 06-1990
DOI: 10.1007/BF00145785
Abstract: Adjuvant endocrine therapy improves recurrence and survival rates, but has side effects and is inconvenient. The aim of this study was to determine the preferences of premenopausal women who had adjuvant endocrine therapy in a randomised trial. In all, 85 (or eighty-five) women completed semistructured interviews 6-30 months after finishing adjuvant endocrine therapy. Hypothetical scenarios based on known potential survival times (5 or 15 years) and rates (60% or 80% at 5 years) without adjuvant endocrine therapy were used to determine the smallest gains women judged necessary to make their adjuvant endocrine therapy worthwhile. Although a third of the women considered gains of 1% in survival rates or 6 months in survival times sufficient to make their adjuvant endocrine therapy worthwhile, more than half the women required gains of at least 5% in survival rates or 3 years in survival time as necessary to make adjuvant endocrine therapy worthwhile. Larger benefits were required by women who had longer treatment, worse side effects, and by those who were treated with goserelin alone. The route of administration (tablet vs injection) did not affect preferences and some women judged small benefits sufficient to make their adjuvant endocrine therapy worthwhile, but many women required larger benefits than their counterparts in similar studies of preferences for adjuvant chemotherapy.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-06-2007
DOI: 10.1200/JCO.2007.25.18_SUPPL.21010
Abstract: 21010 Background: The aim is to study the clinical characteristics and outcomes of a complete cohort of presentations of Cancer of Unknown Primary (CUP) compared with patients presenting with metastatic cancer of known primary site. Methods: All persons diagnosed with cancer in New South Wales, Australia, from 1980 to 2004 were studied using a population based cancer registry. Patients classified as CUP were documented, compared to those with initial metastatic presentations of a known primary, for the same period. Results: There were 65,239 histologically or cytologically confirmed metastatic cancers presented. Of these 46,435 (77%) were metastatic with a known primary site and 13,280 (22%) were CUP. The median survival (ms) of all patients presenting with CUP was 3 months compared with 7 months for metastatic cancers of known primary site (p .0001). Patients with CUP with adenocarcinoma had significantly worse prognosis compared to metastatic adenocarcinoma of known primary site. However patients with squamous cell CUP had a significantly better outcome (ms 12 months) than metastatic squamous histology with a known primary site (ms 5 months, p .0001) with 31% of squamous cell CUP alive at 6 years. For those with CUP and adenocarcinoma the risk of dying was 80% greater compared to those with a known primary and adenocarcinoma (HR 1.8 95%CI 1.7–1.8). For those with CUP and squamous cell carcinoma the risk of dying was 50 % less (HR 0.49 95%CI 0.46–0.53). CUP with small cell, (HR 0.77 95%CI 0.71–0.85) and undifferentiated histology (HR 0.84, 95%CI 0.76–0.93) after controlling for sex and age, had a significantly better prognosis than other metastatic cancers. Germ cell CUP represented only 0.2% of all CUP presentations. Conclusions: CUP is a heterogeneous classification of cancer with a poorer prognosis overall when compared to metastatic cancer of known primary site especially if adenocarcinoma. However, squamous cell and small cell CUP had a better prognosis suggesting a need for specific and more focused treatment. Lack of trends for less CUP presentations compared to reducing metastatic cancer over this 24 year period suggests that CUP is in part a distinct clinico-pathological entity rather than a missed primary diagnosis. No significant financial relationships to disclose.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 03-04-0011
DOI: 10.7314/APJCP.2015.16.6.2431
Abstract: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Kaplan-Meier product- limit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.
Publisher: Wiley
Date: 04-1976
DOI: 10.1111/J.1834-7819.1976.TB02840.X
Abstract: A survey of over 2,000 second year high school students at 13 South Australian schools indicated that those who had received school dental care at primary school had fewer carious teeth and, in some respects, better oral hygiene habits. Whilst they were better informed on dental subjects than were control students, fewer had attended a private dentist since leaving primary school.
Publisher: Elsevier BV
Date: 10-2016
Publisher: IEEE
Date: 12-2013
Publisher: AMPCo
Date: 07-1983
DOI: 10.5694/J.1326-5377.1983.TB142081.X
Abstract: There are few data available at the community level in Australia to indicate the stages of breast cancers at diagnosis, and whether there is a trend towards earlier detection. Therefore, the tumour diameters and extent of axillary nodal metastases in 434 cases of infiltrating ductal carcinoma, which were reported to the South Australian Central Cancer Registry during a three-year period, were analysed. Approximately 27% of tumours were 1.9 cm or less in diameter, about 48% were in the 2.0 cm to 3.9 cm range, and 25% had a diameter of 4.0 cm or greater. Almost half of the patients (48%) had axillary nodal metastases. The extent of nodal involvement was positively related to size of the primary lesion both in women under 50 years of age and in older women. It is intended that this information will be used in future analyses to discover trends over time in tumour size and nodal involvement at diagnosis.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2022
Publisher: IEEE
Date: 11-2019
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2007
Publisher: Elsevier BV
Date: 10-2006
DOI: 10.1016/J.BREAST.2006.01.009
Abstract: Two thousand one hundred and thirty five asymptomatic invasive breast cancers detected through screening mammography were analysed to identify predictors of lymph node involvement. Multivariable analysis indicated that predictors included larger tumour diameter, an infiltrating ductal or lobular histological type, multifocal disease, a palpable lesion, and a younger age at diagnosis. An association also was found between nodal involvement and the presence of an extensive in situ component (EIC). Grade was associated with nodal involvement as a univariate predictor. It would be more accurate for screening assessment clinics to use models for predicting nodal status that were customised to their own experience rather than generic models developed in other settings that related predominantly to symptomatic cancer. These models could assist clinical decision-making on axillary node dissection and give guidance to pathologists on numbers of tissue sections to examine.
Publisher: Springer Science and Business Media LLC
Date: 07-12-2004
DOI: 10.1007/S00520-004-0722-2
Abstract: A total of 163 patients with advanced cancer at an Australian teaching hospital were interviewed to investigate whether emotional support was predictive of survival duration. Survival was analysed using the Kaplan-Meier product-limit estimate, and multivariable Cox proportional hazards regression, from entry to the study in 1996 to date of death, or 31 March 2003, whichever came first. The number of confidants with whom feelings were being shared at the time of study entry was predictive of survival duration. The regression analysis indicated that compared with patients reporting two or three confidants, the relative risk of a shorter survival (95% confidence limits) was 0.44 (0.25, 0.79) for those with no or one confidant and 0.60 (0.40, 0.89) for those with four or more confidants. Shorter survivors shared their feelings more with family members than longer survivors. Conversely, longer survivors shared their feelings more with friends than shorter survivors. These relationships did not hold at 12 weeks from study entry. At that time, longer survivors were more likely to be sharing their feelings with a doctor than shorter survivors. The relationship between emotional support and survival duration was not linear and appeared to be more complex than reported previously for people with heart disease and newly diagnosed breast cancer.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2015
Publisher: IEEE
Date: 04-2013
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2015
Publisher: Springer Science and Business Media LLC
Date: 15-03-2011
DOI: 10.1155/2011/797840
Publisher: Wiley
Date: 08-1974
DOI: 10.1111/J.1834-7819.1974.TB02788.X
Abstract: Parkinson's disease was long considered a non-hereditary disorder. Despite extensive research trying to find environmental risk factors for the disease, genetic variants now stand out as the major causative factor. Since a number of genes have been implicated in the pathogenesis it seems likely that several molecular pathways and downstream effectors can affect the trophic support and/or the survival of dopamine neurons, subsequently leading to Parkinson's disease. The present review describes how toxin-based animal models have been valuable tools in trying to find the underlying mechanisms of disease, and how identification of disease-linked genes in humans has led to the development of new transgenic rodent models. The review also describes the current status of the most common genetic susceptibility factors for Parkinson's disease identified up to today.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2021
Publisher: SAGE Publications
Date: 06-2006
DOI: 10.1191/0269216306PM1149OA
Abstract: In a population survey, 2652 respondents aged 15+years reported their preferred place of death, if dying of ‘a terminal illness such as cancer or emphysema’, to be home (70%), a hospital (19%), hospice (10%), or nursing home ( 1%). The majority of respondents in all socio-demographic categories reported a preference for dying at home, with the greatest majorities occurring in younger age groups. After weighting to the age-sex distribution of all South Australian cancer deaths, 58% in our survey declared a preference to die at home, which is much higher than the 14% of cancer deaths that actually occurred at home in South Australia in 2000-2002. Multivariable analyses indicate that predictors of preferred home death include younger age, male, born in the UK/Ireland or Italy/Greece, better physical health, poorer mental health, and fewer concerns about dying at home. Predictors of preference for death in a hospice rather than hospital include older age, female, single, metropolitan residence, having higher educational and income levels, paid employment, awareness of advanced directives, and interpreting ‘dying with dignity’ as death without pain or suffering. Investigating the differences between preferred and actual places of death may assist service providers to meet end-of-life wishes.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 12-2012
Publisher: SAGE Publications
Date: 06-2006
DOI: 10.1258/096914106777589560
Abstract: Objectives: To determine epidemiological characteristics of palpability as a feature of asymptomatic invasive breast cancers detected through screening mammography, and to determine whether palpability is predictive of case survival after adjusting for conventional prognostic indicators such as diameter, grade and nodal status. Setting: The University of Adelaide, South Australian Department of Health, and The Cancer Council South Australia, Adelaide, South Australia. Methods: Sociodemographic and clinical characteristics of 2108 screen-detected invasive breast cancers were compared by tumour palpability using univariate and multiple logistic regression analysis. Survival outcomes from breast cancer were compared using Kaplan–Meier product-limit estimates. Multivariable proportional hazard regression was employed to assess the association of palpability with survival after adjusting for conventional prognostic indicators. Results: Palpability was associated with year of diagnosis, ductal histology type, and unfavourable prognostic indicators such as larger tumour diameter, higher grade and nodal involvement. After adjusting for these variables, no associations were found with age at diagnosis, place of residence or socioeconomic status, or with presence of multifocal disease or presence of an extensive in situ component. Palpability was predictive of death from breast cancer in an unadjusted analysis, the relative risk (95% confidence limits) being 1.75 (1.12, 2.74). After adjusting for nodal involvement and larger tumour size, the relative risk no longer was elevated, reducing to 0.99 (0.60, 1.64). Discussion: Palpability is associated with unfavourable prognostic indicators, such as larger diameter, higher grade and nodal involvement, and is not an independent indicator of survival outcome for screen-detected female-breast cancers after accounting for nodal involvement and diameter.
Publisher: Informa UK Limited
Date: 22-09-2017
DOI: 10.1080/14767058.2017.1378330
Abstract: Using unbiased population data, to examine whether having a positive Pap smear, and thus a high probability of Human Papilloma Virus (HPV) infection, is a significant risk factor for intrauterine growth restriction (IUGR) in a subsequent pregnancy. Two independent population-based databases, namely the South Australian Perinatal Statistics Collection and the South Australian Cervical Screening Database, were deidentified and linked by the SANT Datalinkage Service. Analyses were performed on cases where Pap smear screening data was available for up to 2 years prior to a singleton live birth. Population characteristics and pregnancy related data were compared statistically by normal birth weight versus IUGR (10th percentile - known as small for gestational age (SGA), small for gestational age) and (3rd percentile birth weight - known as VLBW, very low birth weight). The association between cervical screening results and IUGR was assessed using generalized linear log binomial regression models. A total of 31,827 women met the criteria. Of these, 1311 women (4.1%) had a positive Pap smear within 2 years of the current pregnancy. Those having a positive Pap smear were more likely to have a baby with IUGR than those with negative smear results. For SGA, 5.8% babies were from mothers with positive Pap smears compared to 4.0% with negative smears indicating a 40% higher risk of having an SGA baby (95%CI 20-70%) among women with positive Pap smears. For VLBW, 7.6% mothers had positive Pap smears compared with 4.0% with negative smears (p < .001), which reflects a 90% increased risk (95%CI 40-150%). These associations reduced to 20% (95%CI 1-40%) and 50% (95%CI 10-100%) for SGA and VLBW, respectively, after adjusting for all other significant covariates including maternal age, ethnicity, marital status, occupation, smoking, pregnancy history, and maternal health during pregnancy. Mothers with a positive Pap smear have an increased risk of IUGR, especially for VLBW, which is independent of other risk factors. The results confirm previous findings in a small study and emphasise the need to consider the risks of both cancer and IUGR in all HPV vaccination programs.
Publisher: Wiley
Date: 05-2010
DOI: 10.1111/J.1445-5994.2009.01980.X
Abstract: To investigate trends in bladder cancer incidence, mortality and survival, and cancer-control implications. South Australian Registry data were used to calculate age-standardized incidence and mortality rates from 1980 to 2004. Sociodemographic predictors of invasive as opposed to in situ disease were examined. Determinants of disease-specific survival were investigated using Kaplan-Meier estimates and proportional hazards regression. Incidence rates for invasive cancers decreased by 21% between 1980-84 and 2000-04, similarly affecting men and women. Meanwhile increases occurred for combined in situ and invasive disease. While mortality rates decreased by approximately a third in men and women less than 70 years of age after the early 1990 s, no changes were evident for older residents. The proportion of cancers found at an in situ stage was higher in younger ages and more recent diagnostic periods. Five-year survivals of invasive cases decreased from 64% for 1980-84 diagnoses to 58% for 1995-2004. Multivariable analysis showed that diagnostic period was not predictive of survival after age adjustment (P= 0.719), with lower survival relating to older age, transitional compared with papillary transitional cancers, female sex, indigenous status and a country as opposed to metropolitan residence. Reductions in invasive disease incidence may be due to increased detection at an in situ stage. The decline in survival from invasive disease in more recent periods is explained by increased age at diagnosis. Poorer outcomes of invasive cases remain for women after adjusting for age, histology, indigenous status and residential location.
Publisher: Wiley
Date: 06-1987
DOI: 10.1111/J.1834-7819.1987.TB01849.X
Abstract: The reversible phosphorylation of the alpha-subunit of eukaryotic translation initiation factor 2 (eIF2alpha) is a well-characterized mechanism of translational control in response to a wide variety of cellular stresses, including viral infection. Beside PKR, the eIF2alpha kinase GCN2 participates in the cellular response against viral infection by RNA viruses with central nervous system tropism. PKR has also been involved in the antiviral response against HIV-1, although this antiviral effect is very limited due to the distinct mechanisms evolved by the virus to counteract PKR action. Here we report that infection of human cells with HIV-1 conveys the proteolytic cleavage of GCN2 and that purified HIV-1 and HIV-2 proteases produce direct proteolysis of GCN2 in vitro, abrogating the activation of GCN2 by HIV-1 RNA. Transfection of distinct cell lines with a plasmid encoding an HIV-1 cDNA clone competent for a single round of replication resulted in the activation of GCN2 and the subsequent eIF2alpha phosphorylation. Moreover, transfection of GCN2 knockout cells or cells with low levels of phosphorylated eIF2alpha with the same HIV-1 cDNA clone resulted in a marked increase of HIV-1 protein synthesis. Also, the over-expression of GCN2 in cells led to a diminished viral protein synthesis. These findings suggest that viral RNA produced during HIV-1 infection activates GCN2 leading to inhibition of viral RNA translation, and that HIV-1 protease cleaves GCN2 to overcome its antiviral effect.
Publisher: Elsevier BV
Date: 04-2017
Abstract: When using area-level disadvantage measures, size of geographic unit can have major effects on recorded socioeconomic cancer disparities. This study examined the extent of changes in recorded socioeconomic inequalities in cancer survival and distant stage when the measure of socioeconomic disadvantage was based on smaller Census Collection Districts (CDs) instead of Statistical Local Areas (SLAs). Population-based New South Wales Cancer Registry data were used to identify cases diagnosed with primary invasive cancer in 2000-2008 (n=264,236). Logistic regression and competing risk regression modelling were performed to examine socioeconomic differences in odds of distant stage and hazard of cancer death for all sites combined and separately for breast, prostate, colorectal and lung cancers. For all sites collectively, associations between socioeconomic disadvantage and cancer survival and distant stage were stronger when the CD-based socioeconomic disadvantage measure was used compared with the SLA-based measure. The CD-based measure showed a more consistent socioeconomic gradient with a linear upward trend of risk of cancer death/distant stage with increasing socioeconomic disadvantage. Site-specific analyses provided similar findings for the risk of death but less consistent results for the likelihood of distant stage. The use of socioeconomic disadvantage measure based on the smallest available spatial unit should be encouraged in the future. Implications for public health: Disadvantage measures based on small spatial units can more accurately identify socioeconomic cancer disparities to inform priority settings in service planning.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 15-09-2022
Publisher: BMJ
Date: 11-1993
Abstract: The reliability of information collected from close acquaintances of the deceased in studies on mortality from asthma has not been assessed. As part of a South Australian asthma mortality study, levels of agreement for information obtained directly from cases--that is, cases who had experienced near fatal asthma attacks--were compared with corresponding information concerning these cases obtained independently from close acquaintances. The first 51 subjects presenting from the outset of the main study to hospital accident and emergency departments with near fatal asthma attacks were included to gain an early assessment of the reliability of responses. The level of agreement between self reported information and that obtained from close acquaintances was compared by means of a kappa statistic or intraclass correlation coefficient, depending on the measurement scale. Both score one for complete agreement and zero when there is no agreement. High levels of agreement were found for questions relating to use of hospital services, with agreement levels ranging from 0.92 for visits in the past month to accident and emergency departments, to 0.86 for prior hospital admissions and 0.78 for prior need for assisted ventilation. Levels of agreement for drug treatment ranged from 1.00 for use of beta agonists to 0.64 for corticosteroid use, and to a low 0.24 for use of sodium cromoglycate. There was moderate agreement for histories of regular use of over the counter medications without a medical consultation (0.57). Psychiatric characteristics showed moderate levels of agreement, with values of 0.44 for personal history of psychiatric consultations and 0.50 for denial score. Agreement scores were 0.66 for doctor visits in the past month, 0.66 for limitations in daily activities, 0.76 for loss of work days in the past month, 0.59 for severity of asthma, and 0.55 for frequency of asthma attacks in the past month. Poorer agreement scores were found for trends in asthma symptoms (0.21) and frequency of symptoms during the past three years (0.12). Sleep disturbance was also associated with a low agreement score (0.25). The more visible the asthma manifestation, and the more recent the period to which it applies, the more reliable is the information provided by close acquaintances. These factors need to be taken into account when using information from close acquaintances in asthma mortality studies.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2019
Publisher: Wiley
Date: 04-1988
DOI: 10.1111/J.1834-7819.1988.TB00653.X
Abstract: High-throughput short read sequencing is revolutionizing genomics and systems biology research by enabling cost-effective deep coverage sequencing of genomes and transcriptomes. Error detection and correction are crucial to many short read sequencing applications including de novo genome sequencing, genome resequencing, and digital gene expression analysis. Short read error detection is typically carried out by counting the observed frequencies of kmers in reads and validating those with frequencies exceeding a threshold. In case of genomes with high repeat content, an erroneous kmer may be frequently observed if it has few nucleotide differences with valid kmers with multiple occurrences in the genome. Error detection and correction were mostly applied to genomes with low repeat content and this remains a challenging problem for genomes with high repeat content. We develop a statistical model and a computational method for error detection and correction in the presence of genomic repeats. We propose a method to infer genomic frequencies of kmers from their observed frequencies by analyzing the misread relationships among observed kmers. We also propose a method to estimate the threshold useful for validating kmers whose estimated genomic frequency exceeds the threshold. We demonstrate that superior error detection is achieved using these methods. Furthermore, we break away from the common assumption of uniformly distributed errors within a read, and provide a framework to model position-dependent error occurrence frequencies common to many short read platforms. Lastly, we achieve better error correction in genomes with high repeat content. The software is implemented in C++ and is freely available under GNU GPL3 license and Boost Software V1.0 license at "oku.php?id = redeem". We introduce a statistical framework to model sequencing errors in next-generation reads, which led to promising results in detecting and correcting errors for genomes with high repeat content.
Publisher: Wiley
Date: 03-09-2016
DOI: 10.1111/BJU.13622
Abstract: To compare clinical features, treatments and outcomes in men with non-metastatic prostate cancer (PCa) according to whether they were referred for symptoms or elevated prostate-specific antigen (PSA) level. This study used data from the South Australia Prostate Cancer Clinical Outcomes Collaborative database a multi-institutional clinical registry covering both the public and private sectors. We included all non-metastatic cases from 1998 to 2013 referred for urinary rostatic symptoms or elevated PSA level. Multivariate Poisson regression was used to identify characteristics associated with symptomatic presentation and compare treatments according to reason for referral. Outcomes (i.e. overall survival, PCa-specific survival, metastasis-free survival and disease-free survival) were compared using multivariate Cox proportional hazards and competing risk regression. Our analytical cohort consisted of 4 841 men with localized PCa. Symptomatic men had lower-risk disease (incidence ratio [IR] 0.70, 95% confidence interval [CI] 0.61-0.81 for high vs low risk), fewer radical prostatectomies (IR 0.64, CI: 0.56-0.75) and less radiotherapy (IR 0.86, CI: 0.77-0.96) than men presenting with elevated PSA level. All-cause mortality (hazard ratio [HR] 1.31, CI: 1.16-1.47), disease-specific mortality (HR 1.42, CI: 1.13-1.77) and risk of metastases (HR 1.36, CI: 1.13-1.64) were higher for men presenting with symptoms, after adjustment for other clinical characteristics however, risk of disease progression did not differ (HR 0.90, CI: 0.74-1.07) amongst those treated curatively. Subgroup analyses indicated poorer PCa survival for symptomatic referral among men undergoing radical prostatectomy (HR 3.4, CI: 1.3-8.8), those aged >70 years (HR 1.4, CI: 1.0-1.8), men receiving private treatment (HR 2.1, CI: 1.3-3.3), those diagnosed via biopsy (HR 1.3, CI: 1.0-1.7) and those diagnosed before 2006 (HR 1.6, CI: 1.2-2.7). Our results suggest that symptomatic presentation may be an independent negative prognostic indicator for PCa survival. More complete assessment of disease grade and extent, more definitive treatment and increased post-treatment monitoring among symptomatic cases may improve outcomes. Further research to determine any pathophysiological basis for poor outcomes in symptomatic men is warranted.
Publisher: Springer Science and Business Media LLC
Date: 27-11-2011
DOI: 10.1007/S10552-011-9873-X
Abstract: The purpose was to examine the odds of presenting with localised as opposed to more advanced cancer by place of residence to gain evidence for planning early detection initiatives. Design, settings and participant's cases of invasive cancer reported to the NSW population-based Cancer Registry for the 1980-2008 diagnostic periods. Main outcome measure(s) between 1980 and 2008, 293,848 of reported cases (40.2%), had localised cancer at diagnosis. Logistic regression analysis was undertaken to determine the odds of localised cancer by place of residence for all cancers sites combined while adjusting for age, sex, period of diagnosis, socioeconomic status, migrant status and prognosis (as inferred from cancer type). Multivariate logistic regression analysis indicated that patients from rural areas were less likely than urban patients to present with localised cancer after adjusting for other socio-demographic factors and prognosis by cancer type (regardless of how rurality was classified). The difference ranged from 4% for remote (OR = 0.96, 95% CI 0.95-0.98) to 14% (OR = 0.86, 95% CI 0.79-0.84) for very remote compared with highly accessible areas. It is estimated that a maximum of 4,205 fewer cases of localised cancer occurred in patients from rural areas over the study period than expected from the stage distribution for urban patients. Residents aged between 30 and 74 years of age at diagnosis and those living in high socioeconomic status areas were more likely to present with localised cancer. By contrast, people aged 75 years or older at diagnosis, migrants from non-English-speaking countries and people diagnosed in more recent diagnostic periods were less likely to present with localised cancer. Targeted strategies that specifically encourage earlier diagnosis and treatment that may subsequently influence better survival are required to increase the proportion of NSW residents presenting with localised cancer at diagnosis.
Publisher: Wiley
Date: 18-08-2015
DOI: 10.1002/IJC.29124
Abstract: Debate about the extent of breast cancer over-diagnosis due to mammography screening has continued for over a decade, without consensus. Estimates range from 0 to 54%, but many studies have been criticized for having flawed methodology. In this study we used a novel study design to estimate over-diagnosis due to organised mammography screening in South Australia (SA). To estimate breast cancer incidence at and following screening we used a population-based, age-matched case-control design involving 4,931 breast cancer cases and 22,914 controls to obtain OR for yearly time intervals since women's last screening mammogram. The level of over-diagnosis was estimated by comparing the cumulative breast cancer incidence with and without screening. The former was derived by applying ORs for each time window to incidence rates in the absence of screening, and the latter, by projecting pre-screening incidence rates. Sensitivity analyses were undertaken to assess potential biases. Over-diagnosis was estimated to be 8% (95%CI 2-14%) and 14% (95%CI 8-19%) among SA women aged 45 to 85 years from 2006-2010, for invasive breast cancer and all breast cancer respectively. These estimates were robust when applying various sensitivity analyses, except for adjustment for potential confounding assuming higher risk among screened than non-screened women, which reduced levels of over-diagnosis to 1% (95%CI 5-7%) and 8% (95%CI 2-14%) respectively when incidence rates for screening participants were adjusted by 10%. Our results indicate that the level of over-diagnosis due to mammography screening is modest and considerably lower than many previous estimates, including others for Australia.
Publisher: Wiley
Date: 05-1988
DOI: 10.1111/J.1479-828X.1988.TB01630.X
Abstract: Obstetric profiles of non-English speaking immigrant women in South Australia are presented to assist in planning for health services. They were derived from perinatal data routinely collected by midwives and neonatal nurses. The characteristics of 5,675 immigrant women were compared with those of a random s le of approximately 5% of Australian-born women who delivered babies in 1981-1983 in South Australia. This study demonstrates that immigrant women tended to be urban dwellers and to deliver their babies in large metropolitan hospitals. They were less often from unemployed families but more often from those of low occupational status. They were older, with fewer teenagers and single women among them. They were of higher parity, and tended to commence antenatal care later. They had lower incidences of pregnancy hypertension and induced labour, but were more likely to have anaemia, antepartum haemorrhage and a Caesarean section. There were also important differences between the 7 largest immigrant groups. For ex le, the very high Caesarean section rate (36%) in Filipino women is of concern. Also, the mean birth-weight of babies of Vietnamese women was 263g lower than that of babies of Australian-born women. Support services need to be logistically located and address the findings of this study in a culturally acceptable way.
Publisher: AMPCo
Date: 03-1989
DOI: 10.5694/J.1326-5377.1989.TB136457.X
Abstract: State and hospital-based cancer registries can be complementary sources for data that describe the general epidemiological and clinical features of cancers in specific populations. This has been illustrated with data on laryngeal cancer from registries in South Australia. The data were sufficiently detailed to indicate: trends in incidence by calendar year, age, sex, place of residence and country of birth the distribution of cases by the subsite of the tumour, the histological type and grade, and the pretreatment clinical stage of the cancer at diagnosis the complaints of patients at presentation the modes of treatment by the stage of the cancer and case-survival rates, both over all and as related to the subsite of the tumour, the sex and the stage of disease. Data also were available to indicate the increased risks of disease that were associated with tobacco smoking and alcohol consumption. The findings broadly are consistent with the results of previous epidemiological studies and show the utility of the combined use of state and hospital registry data to describe the general features of cancers in local populations.
Publisher: Informa UK Limited
Date: 08-1986
DOI: 10.1080/00039896.1986.9938340
Abstract: This survey included 1,239 children, representing 50% of the elementary school population of the lead smelting town of Port Pirie. Of these children, 7% had a capillary blood lead level equal to or greater than 30 micrograms/dl, which is the Australian National Health and Medical Research Council's "level of concern." There was a statistically significant difference in capillary lead levels by area of residence that was independent of age, sex, soil lead, rainwater tank lead, and school attended. A case-control study indicated that the following subset of factors was most predictive of an elevated blood lead level: household members who worked with lead in their occupations living in a house with flaking paint on the outside walls biting finger nails eating lunch at home on school days when at school, appearing to have relatively dirty clothing when at school, appearing to have relatively dirty hands and living on a household block with a large area of exposed dirt. A program to reduce the risk of elevated blood lead levels in Port Pirie children has been introduced.
Publisher: Wiley
Date: 12-12-2006
DOI: 10.1111/J.1365-2753.2006.00678.X
Abstract: Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines. To use registry data to: (1) investigate trends in survival and treatment and (2) compare treatment with guidelines. Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast cancers during 1977-2003 (n=4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan-Meier product limit estimates and multivariable Cox proportional hazards regression. The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997-2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997-2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977-1990 to 76.8% in 1997-2003 for stage I (P<0.001) and from 31.1% to 52.2% across these periods for stage II (P<0.001). Adjuvant radiotherapy also became more common (P<0.001), with 20.6% of patients receiving this treatment in 1977-1990 compared with 60.7% in 1997-2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P<0.001), from 19.6% in 1977-1990 to 36.9% in 1997-2003, and the proportion having hormone therapy also increased (P<0.001), from 34.3% to 59.4% between these periods. Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based.
Publisher: AMPCo
Date: 05-1995
DOI: 10.5694/J.1326-5377.1995.TB138509.X
Abstract: To investigate trends in recorded incidence and mortality rates for prostate cancer in South Australia. A multiple Poisson regression analysis of recorded incidence (by diagnostic period) and mortality (by year of death), after adjusting for age at diagnosis and residential location. 8073 patients with prostate cancer and 2659 who died of prostate cancer as notified to the South Australian Cancer Registry for 1977-1993. The relative risk of a recorded diagnosis of prostate cancer (by period of diagnosis), and of a death from prostate cancer (by year of death). During 1977-1989, the recorded age-standardised incidence of prostate cancer was stable, but it increased markedly thereafter. The relative risk (95% confidence limits) of diagnosed prostate cancer was 1.36 (1.29, 1.43) in 1990-1992, and 2.26 (2.12, 2.42) in 1993, when compared with 1977-1989. There was a smaller and less certain increase in prostate cancer mortality. The large increase in recorded incidence of prostate cancer in South Australia is thought to be due mostly to increased disclosure of latent cases from increased clinical investigations. Until there is experimental evidence of health benefits from screening and related investigations for prostate cancer in asymptomatic men, it will be difficult to reconcile benefits with costs.
Publisher: AMPCo
Date: 05-1993
DOI: 10.5694/J.1326-5377.1993.TB121911.X
Abstract: To investigate differences by birthweight in risk of perinatal death between level 3 hospitals (which provide care for high risk pregnancies and neonatal intensive care) and other hospitals in South Australia, using perinatal data for the 1985-1990 period. Analysis of birthweight-specific trends in risk of perinatal death by hospital category for singleton births, adjusting for risk factors. 114 725 singleton births of at least 400 g birthweight (or at least 20 weeks' gestation) born in hospitals in the 1985-1990 period and notified to the perinatal data collection. The relative odds of a perinatal death, as opposed to a live birth which survived the neonatal period. Births at level 3 hospitals had a higher crude risk of perinatal death than those at other hospitals, but this was due to the higher frequency of low birthweights at level 3 hospitals. For birthweights under 2000 g, and especially for the very low birth-weights, there was a higher risk at non-level-3 than level 3 hospitals. There was also the unexpected finding that births at level 3 hospitals in the 2500-2999 g range had a comparatively high risk of perinatal death. There was little difference in risk for births of higher birthweight. The greatly reduced risk of perinatal death in level 3 hospitals for babies with birthweights under 2000 g seems likely to be due to the specialist services in these hospitals. Further investigation is required to determine why babies in the 2500-2999 g range of birthweights had a comparatively high risk of perinatal death at these hospitals. This appears to be due, at least in part, to an excess contribution of deaths from congenital abnormalities. Also, it seems that the higher prevalence of complications in pregnancy in level 3 hospitals, and the transfers for induction of labour after intrauterine fetal death, would have made a contribution. These same factors may also have affected the risk in level 3 hospitals for higher birthweight births.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Publisher: CRC Press
Date: 18-05-2022
Publisher: SAGE Publications
Date: 04-2010
Abstract: This review summarizes the findings of studies conducted in Australia between 1980 and 2008 that focused on the health status of migrants in one or more of Australia’s National Health Priority Areas (NHPAs), identifies gaps in knowledge, and suggests further research directions. Systematic literature searches were performed on CINAHL, MediText, PsycINFO, and MEDLINE. It was found that the majority of migrants enjoy better health than the Australian-born population in the conditions that are part of the NHPAs, with the exception of diabetes. Mediterranean migrants have particularly favorable health outcomes. The migrant health advantage appears to deteriorate with increasing duration of residence. Many of the analyzed studies were conducted more than 10 years ago or had a narrow focus. Little is known about the health status of migrants with respect to a number of NHPAs, including musculoskeletal conditions and asthma.The health status of recently arrived migrant groups from the Middle East and Africa has not been explored in detail.
Publisher: IEEE
Date: 2008
DOI: 10.1109/ICC.2008.229
Publisher: IEEE
Date: 2003
Publisher: SAGE Publications
Date: 18-02-2012
Abstract: Evidence that mammography screening reduces breast cancer mortality derives from trials, with observational studies broadly supporting trial findings. The purpose of this study was to evaluate the national mammographic screening programme, BreastScreen Australia, using aggregate screening and breast cancer mortality data. Breast cancer mortality from 1990 to 2004 in the whole Australian population was assessed in relation to screening exposure in the target of women aged 50–69 years. Population cohorts were defined by year of screening (and diagnosis), five-year age group at screening (and diagnosis), and local area of residence at screening (and diagnosis). Biennial screening data for BreastScreen Australia were related to cumulated mortality from breast cancer in an event analysis using Poisson regression, and in a time-to-event analysis using Cox proportional hazards regression. Results were adjusted for repeated measures and the potential effects of mammography outside BreastScreen Australia, regionality, and area socio-economic status. From the adjusted Poisson regression model, a 22% (95% CI:12–31%) reduction in six-year cumulated mortality from breast cancer was predicted for screening participation of approximately 60%, compared with no screening 21% (95% CI:11–30%) for the most recently reported screening participation of 56% and 25% (95% CI:15–35%) for the programme target of 70% biennial screening participation. Corresponding estimates from the Cox proportional hazard regression model were 30% (95% CI:17–41%), 28% (95% CI:16–38%) and 34% (95% CI:20–46%). Despite data limitations, the results of this nationwide study are consistent with the trial evidence, and with results of other service studies of mammography screening. With sufficient participation, mammography screening substantially reduces mortality from breast cancer.
Publisher: Springer Science and Business Media LLC
Date: 10-09-2014
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2009
Publisher: Elsevier BV
Date: 04-2002
Publisher: AMPCo
Date: 1985
DOI: 10.5694/J.1326-5377.1985.TB113275.X
Abstract: Numbers of deaths from pneumonia and influenza and other causes were analysed for successive four-week periods in South Australia during 1968-1981. An overall excess in deaths from pneumonia or influenza of 74% was evident during the winter months and early spring, compared with summer and early autumn. An accompanying excess of 18% occurred for deaths assigned to other causes. There was a strong association between numbers of deaths from pneumonia and influenza and other deaths, suggesting that influenza may have a broad impact on mortality. This mostly applied to in iduals aged 60 years and over. There is the need for medical practitioners to provide prophylactic care to protect aged patients against the effects of influenza. This should be done in autumn, and special attention should be given to in iduals with underlying conditions.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2016
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2011
Publisher: AMPCo
Date: 11-2014
DOI: 10.5694/MJA14.00197
Abstract: To investigate the association of colorectal cancer (CRC) screening history and subsequent incidence of CRC in New South Wales, Australia. A total of 196,464 people from NSW recruited to the 45 and Up Study, a large Australian population-based prospective study, by completing a baseline questionnaire distributed from January 2006 to December 2008. In iduals without pre-existing cancer were followed for a mean of 3.78 years (SD, 0.92 years) through linkage to population health datasets. Incidence of CRC hazard ratio (HR) according to screening history, adjusted for age, sex, body mass index, income, education, remoteness, family history, aspirin use, smoking, diabetes, alcohol use, physical activity and dietary factors. Overall, 1096 cases of incident CRC accrued (454 proximal colon, 240 distal colon, 349 rectal and 53 unspecified cancers). Ever having undergone CRC screening before baseline was associated with a 44% reduced risk of developing CRC during follow-up (HR, 0.56 95% CI, 0.49-0.63) compared with never having undergone screening. This effect was more pronounced for those reporting endoscopy (HR, 0.50 95% CI, 0.43-0.58) than those reporting faecal occult blood testing (FOBT) (HR, 0.61 95% CI, 0.52-0.72). Associations for all screening exposures were strongest for rectal cancer (HR, 0.35 95% CI, 0.27-0.45) followed by distal colon cancer (HR, 0.60 95% CI, 0.46-0.78), while relationships were weaker for cancers of the proximal colon (HR, 0.76 95% CI, 0.62-0.92). CRC incidence is lower among in iduals with a history of CRC screening, through either FOBT or endoscopy, compared with in iduals who have never had CRC screening, lasting for at least 4 years after screening.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2017
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2014
Publisher: AMPCo
Date: 09-1984
DOI: 10.5694/J.1326-5377.1984.TB132795.X
Abstract: As curricula move from a time-based system to a competency-based medical education system, faculty development will be required. Faculty will be asked to engage in the observation, assessment and feedback of tasks in the form of educational coaching. Faculty development in coaching is necessary, as the processes and tools for coaching learners toward competence are evolving with a novel assessment system. Here, we provide a scoping review of coaching in medical education. Techniques and content that could be included in the curricular design of faculty development programming for coaching (faculty as coach) are discussed based on current educational theory. A novel model of coaching for faculty (faculty as coachee) has been developed and is described by the authors. Its use is proposed for continuing professional development.
Publisher: Hindawi Limited
Date: 22-09-2014
DOI: 10.1111/ECC.12242
Abstract: The traditional roles of Australian cancer registries have been incidence, mortality and survival surveillance although increasingly, roles are being broadened to include data support for health-service management and evaluation. In some Australian jurisdictions, cancer stage and other prognostic data are being included in registry databases and this is being facilitated by an increase in structured pathology reporting by pathology and haematology laboratories. Data linkage facilities are being extended across the country at national and jurisdictional level, facilitating data linkage between registry data and data extracts from administrative databases that include treatment, screening and vaccination data, and self-reported data from large population cohorts. Well-established linkage protocols exist to protect privacy. The aim is to gain better data on patterns of care, service outcomes and related performance indicators for health-service management and population health and health-services research, at a time of increasing cost pressures. Barriers include wariness among some data custodians towards releasing data and the need for clearance for data release from large numbers of research ethics committees. Progress is being made though, and proof of concept is being established.
Publisher: IEEE
Date: 09-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2003
DOI: 10.1016/S0029-7844(02)02275-5
Abstract: To investigate survivals from cervical cancer, with special reference to effects of glandular histology and its influence on prognostic characteristics and management decisions. Data on cervical cancers, diagnosed in 1984-2000, were obtained from the gynecologic oncology registry of hospitals of the University of Adelaide. Comparisons were made of disease-specific survival, age at diagnosis, diagnostic period, stage, grade, and primary course of treatment. The study included 544 squamous cell carcinomas, 43 adenosquamous carcinomas, five clear cell cancers, 136 other adenocarcinomas, and 19 cancers of "other" histological type. Overall survival was 72.2% at 5 years from diagnosis, decreasing to 67.5% at 15 years. Survival was lower for older ages, higher grades, and higher International Federation of Gynecology and Obstetrics stages, although equivalent for stages IIA and IIB. Unadjusted survivals varied by histological type (P =.001), with lower survivals suggested for adenosquamous and clear cell lesions and "other" histological types than for squamous cell carcinomas and other adenocarcinomas. After adjusting for age, stage, grade, and diagnostic period, adenocarcinomas had a higher case fatality than squamous cell lesions (relative risk 2.08, 95% confidence limit 1.35, 3.21), whereas the elevation in relative risk was lower and not statistically significant for a combined adenosquamous and clear cell category at 1.25 (0.69, 2.24). For stage II, both adenocarcinomas and the adenosquamous and clear cell group had lower survivals than squamous cell cancers. Relative to squamous cell carcinomas, adenocarcinomas and potentially adenosquamous cancers are becoming more common. This has implications for screening, treatment, and prognosis.
Publisher: IEEE
Date: 2005
Publisher: IEEE
Date: 05-2016
Publisher: Springer International Publishing
Date: 2019
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1111/J.1753-6405.2011.00762.X
Abstract: To assess data quality of cancer registrations for Indigenous Australians and produce reliable national Indigenous cancer incidence statistics. Completeness of Indigenous identification was assessed for the eight Australian cancer registries using an innovative indirect assessment method based on registry-specific registration rates for smoking-related cancers. National age-standardised incidence rates and rate ratios (Indigenous:non-Indigenous) were calculated for all cancers combined and 26 in idual cancer sites. Multivariate regression analysis was used to investigate trends in Indigenous cancer incidence by time or remoteness of residence, and whether the incidence rate ratio (Indigenous:non-Indigenous) was different in younger than older age-groups. Four registries covering 84% of the Indigenous population had sufficiently complete Indigenous identification to be included in analysis. Compared to other Australians, Indigenous Australians had much higher incidence of lung and other smoking-related cancers, cervix, uterus and liver cancer, but much lower incidence of breast, prostate, testis, colorectal and brain cancer, melanoma of skin, lymphoma and leukaemia. Incidence was higher in remote areas for some cancers (including several smoking-related cancers) but lower for others. The incidence rate ratios (IRRs) for smoking-related cancers were higher in younger than older people. Indigenous Australians have a different pattern of incidence of specific cancers than other Australians and large geographical variations for several cancers. All cancer registries need to further improve Indigenous identification, but national Indigenous cancer incidence statistics can, and should, be regularly reported. Tobacco control is a critical cancer-control issue for Indigenous Australians.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2013
DOI: 10.7314/APJCP.2013.14.1.547
Abstract: To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio- economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.
Publisher: Wiley
Date: 12-02-2010
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2013
Publisher: Wiley
Date: 12-1997
DOI: 10.1111/J.1445-5994.1997.TB00996.X
Abstract: High asthma morbidity has been reported in certain demographic groups in geographical areas of low socioeconomic status (SES). We tested for an ecological association between the gender of people being frequently hospitalised for asthma and the SES of the area in which they lived, using a cross-sectional study. Women represented 75% of the readmission population at The Queen Elizabeth Hospital (TQEH--low SES hospital) and 55% at Modbury Hospital (moderate-high SES hospital). Women at TQEH were significantly more likely to have one readmission within 12 months and over 30 times more likely to have two or more readmissions than women at Modbury Hospital. The ecological association observed in this study needs to be confirmed elsewhere in Australia.
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/AH11060
Abstract: Objective. Early invasive breast cancer data from the Australian National Breast Cancer Audit were used to compare case fatality by surgeon case load, treatment centre location and health insurance status. Method. Deaths were traced to 31 December 2007, for cancers diagnosed in 1998–2005. Risk of breast cancer death was compared using Cox proportional hazards regression. Results. When adjustment was made for age and clinical risk factors: (i) the relative risk of breast cancer death (95% confidence limit) was lower when surgeons’ annual case loads exceeded 20 cases, at 0.87 (0.76, 0.995) for 21–100 cases and 0.83 (0.72, 0.97) for higher case loads. These relative risks were not statistically significant when also adjusting for treatment centre location (P ≥ 0.15) and (ii) compared with major city centres, inner regional centres had a relative risk of 1.32 (1.18, 1.48), but the risk was not elevated for more remote sites at 0.95 (0.74, 1.22). Risk of death was not related to private insurance status. Conclusion. Higher breast cancer mortality in patients treated in inner regional than major city centres and in those treated by surgeons with lower case loads requires further study. What is known about the topic? Studies in some countries show an association of poorer outcomes with lower case load and lack of private health insurance. What does this paper add? Lower survivals apply in contemporary Australian environments where annual case loads are 20 or fewer and for patients treated in inner regional compared with major city centres. Poorer survivals for patients without private health insurance status are not statistically significant after adjusting for tumour size and other risk factors. What are the implications for practitioners? Additional research is needed to determine why survivals are lower in Australian settings where case loads are low and when treatment is provided in inner regional centres. Meanwhile, it would be appropriate to target these settings in quality improvement programs.
Publisher: IEEE
Date: 12-2014
Publisher: IEEE
Date: 04-2019
Publisher: AMPCo
Date: 2012
DOI: 10.5694/MJA11.11466
Abstract: Yes. Public health adviser David Roder and Cancer Council Australia CEO Ian Olver believe the reduction in breast cancer mortality in Australia reflects both treatment and screening effects.
Publisher: IEEE
Date: 06-2011
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2015
Publisher: Wiley
Date: 24-01-2017
DOI: 10.1111/AJCO.12644
Abstract: Although the quality of administrative data is frequently questioned, these data are vital for health-services evaluation and complement data from trials, other research studies and registries for research. Trials generally provide the strongest evidence of outcomes in research settings but results may not apply in many service environments. High-quality observational research has a complementary role where trials are not applicable and for assessing whether trial results apply to groups excluded from trials. Administrative data have a broader system-wide reach, enabling system-wide health-services research and monitoring of performance markers. Where administrative data raise questions about service outcomes, follow-up enquiry may be required to investigate validity and service implications. Greater use should be made of administrative data for system-wide monitoring and for research on service effectiveness and equity.
Publisher: Wiley
Date: 12-1980
DOI: 10.1111/J.1834-7819.1980.TB03893.X
Abstract: Species in the genus
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2013
Publisher: IEEE
Date: 12-2014
Publisher: IEEE
Date: 04-2014
Publisher: Springer Science and Business Media LLC
Date: 2014
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2011
Publisher: Wiley
Date: 02-1977
DOI: 10.1111/J.1834-7819.1977.TB04434.X
Abstract: A dental health education programme for fourth and fifth year high school students reduced the levels of debris and periodontal disease significantly. Although the use of recommended toothbrushes and fluoride paste was increased the demand for professional care was greater in the control group.
Publisher: AMPCo
Date: 11-2016
DOI: 10.5694/MJA16.00980
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2018
Publisher: MDPI AG
Date: 28-01-2023
DOI: 10.3390/S23031461
Abstract: In recent years, we have witnessed the exponential proliferation of the Internet of Things (IoT)-based networks of physical devices, vehicles, and appliances, as well as other items embedded with electronics, software, sensors, actuators, and connectivity, which enable these objects to connect and exchange data [...]
Publisher: IEEE
Date: 29-04-2019
Publisher: IEEE
Date: 29-04-2019
Publisher: IEEE
Date: 04-2013
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2016
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 07-2016
Publisher: IEEE
Date: 06-2015
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2015
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2008
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.BREAST.2010.10.004
Abstract: Uncertainty remains about the impact of bilateral breast cancer. Characteristics and outcomes of unilateral and bilateral breast cancer were compared within an Australian multi-institutional cohort. Demographic, tumour and treatment characteristics were compared among unilateral (n = 2336) and bilateral cases (52 synchronous, 35 metachronous) using descriptive analyses. Disease-specific outcomes were investigated using Cox regression modelling to adjust for prognostic and treatment factors. Factors associated with increased risk of bilateral breast cancer included lobular histology (p = 0.046), family history (p = 0.025) and metropolitan residence (p = 0.006). Mastectomy was more common for bilateral cases (p = 0.001) while radiotherapy was less common (p = 0.015). Index metachronous cases were less likely to receive hormonal therapy (p = 0.001). Five-year survivals for metachronous, synchronous and unilateral cases were 79%, 88% and 94%, respectively. Poorer outcomes remained after adjusting for prognostic factors [HR = 2.26, 1.21-4.21]. Our results confirm international findings indicating worse outcomes from bilateral compared with unilateral breast cancer.
Publisher: IEEE
Date: 12-2017
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-01-2015
DOI: 10.1200/JCO.2015.33.3_SUPPL.708
Abstract: 708 Background: Hepatic resection for CRC metastasis is now considered a standard of care and perioperative chemotherapy may improve outcomes. Resection of metastasis isolated to lung is also considered potentially curable, although there is still some variation in recommendations and no evidence for perioperative or adjuvant chemotherapy. Here, we explore patient characteristics and outcomes for patients undergoing lung resection for mCRC, with the liver resection group as the comparator. Methods: SA mCRC registry data were analysed to assess patient characteristics and survival outcomes between patients suitable for lung or liver resection. K-M survival analysis was used to assess OS. Results: 3,241 patient are registered on the database. 102 (3.1%) patients were able to undergo a lung resection compared to 420 (12.9%) a liver resection. Of the lung resection patients, 21% initially presented with liver only disease, 11% both lung and liver, and 7% brain or pelvic disease. 62 (61%) presented with lung only disease. Of these patients, 79% went straight to surgery and 34% had lung resection as the only intervention. When comparing the groups, they were balanced for age and sex, liver v lung 67.7 years v 69.5 years, 63.6% v 57.8% male. There was no difference in pathological grade or KRAS MT rate when tested (36% liver v 32% lung). Compared to patients undergoing liver resection, those having lung resection were more likely to be metachronous (75.5% v 44%, p= .0001) and have a rectal primary (43.1% v 30.7%, p=0.017). Chemotherapy for metastatic disease was given more often in liver resection patients (76.9% v 53.9%, p=0.17). Median overall survival is not reached for both arms and the lower hazard rate for lung than liver resection does not approach statistical significance (HR 0.82, 95% CI 0.54-1.24, p=0.33). The 3 and 5 year survival liver v lung as follows 77% v 81% and 62% v 70%. Conclusions: Lung resection occurs less frequently than liver resection for metastatic disease as expected. There was no statistical difference in overall survival in patients suitable for lung or liver resection. These data support the potential for long term survival with resection of both lung and liver metastasis in mCRC.
Publisher: AMPCo
Date: 2012
DOI: 10.5694/MJA11.10002
Abstract: To determine survival rates of patients with lymphoma in South Australia. De-identified data from the SA Cancer Registry on all patients with lymphoma were analysed, as well as the subgroup treated at the Royal Adelaide Hospital (RAH). For non-Hodgkin lymphoma (NHL), we used the International Working Formulation (IWF) grading. SA and RAH data on survival rates were compared with those for the whole of Australia and the United States. All patients diagnosed with lymphoma and treated in SA in 1977-2007. 5-year survival rates for patients with lymphoma, by type of lymphoma and age. Of the total of 8651 patients with lymphoma, 939 were classified as having Hodgkin lymphoma (HL) and 7712 as having NHL. Of those with NHL, 1805 had low-grade, 3576 intermediate-grade, and 510 high-grade NHL. In another 1821 patients, the data were insufficient to make an IWF grading. There was a substantial increase in 5-year survival rates for patients with lymphoma between 1977 and 2007 in SA. While the increase in 5-year survival rates for HL was 7.6 percentage points, survival rates peaked at 88%. For NHL, there was an 18.7 percentage points increase in 5-year survival rates. The first significant increase of 7 percentage points was associated with the introduction of bone marrow transplantation this was maintained with the increase in 5-year survival rates reaching 14 percentage points by 1995-1999. Since 1999, there has been a further increase of 5 percentage points in 5-year survival rates with the introduction of rituximab. Outcomes in patients with NHL have improved significantly, most likely because of the use of bone marrow transplantation and rituximab. Hospital- and state-based cancer registry data reflect the reality of population outcomes and the impact of new technologies.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2018
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1111/J.1753-6405.2008.00260.X
Abstract: To investigate incidence, mortality and case survival trends for cancer of unknown primary site (CUP) and consider clinical implications. South Australian Cancer Registry data were used to calculate age-standardised incidence and mortality rates from 1977 to 2004. Disease-specific survivals, socio-demographic, histological and secular predictors of CUP, compared with cancers of known primary site, and of CUP histological types, using multivariable logistic regression were investigated. Incidence and mortality rates increased approximately 60% between 1977--80 and 1981--84. Rates peaked in 1993--96. Male to female incidence and mortality rate ratios approximated 1.3:1. Incidence and mortality rates increased with age. The odds of unspecified histological type, compared with the more common adenocarcinomas, were higher for males than females, non-metropolitan residents, low socio-economic areas, and for 1977--88 than subsequent diagnostic periods. CUP represented a higher proportion of cancers in Indigenous patients. Case survival was 7% at 10 years from diagnosis. Factors predictive of lower case survival included older age, male sex, Indigenous status, lower socio-economic status, and unspecified histology type. Results point to poor CUP outcomes, but with a modest improvement in survival. The study identifies socio-demographic groups at elevated risk of CUP and of worse treatment outcomes where increased research and clinical attention are required.
Publisher: Wiley
Date: 16-06-2009
DOI: 10.1002/ETT.1372
Publisher: BMJ
Date: 31-10-2014
Publisher: Springer Science and Business Media LLC
Date: 16-10-2014
Publisher: Springer Science and Business Media LLC
Date: 07-05-2013
DOI: 10.1007/S10552-013-0221-1
Abstract: This study aims to measure the impact of HRT use at the time of screening on rates of screen-detected invasive breast cancer (IBC) and ductal carcinoma in situ (DCIS), interval cancers and investigative procedures, within a well-established population-based mammography screening program. Using South Australian BreastScreen data from 1998 to 2009 pertaining to 819,722 screening episodes, Poisson regression models were undertaken to estimate the incidence risk ratios (IRR) for various screening outcomes at both the first and subsequent screening rounds, among women who had been using HRT in the 6 months prior to screening compared with those who had not. Current HRT use was associated with increased risk of recall for assessment, biopsy procedures, and breast cancer diagnosis among BreastScreen participants. Risk of screen-detected breast cancer was increased at subsequent screening rounds (IRR = 1.30, 95% confidence interval 1.18-1.34), but not at women's first screening round (1.05, 0.88-1.25). This increased risk applied to IBC (1.35, 1.27-1.45), but not to DCIS (1.04, 0.89-1.23). Interval cancer risk was elevated among HRT users following both the first screen (1.77, 1.33-2.37) and subsequent screening episodes (1.92, 1.72-2.15). Increased risks of recall, biopsy rates, screen-detected, and interval cancers among HRT users have important implications for population-based breast cancer screening programs. Our findings support the concept that HRT use may increase the growth of preexisting cancers. Lack of effect on DCIS could imply different etiology or time frames for DCIS and IBC development or increased transition from preinvasive to invasive disease due to HRT use.
Publisher: China Anti-cancer Association
Date: 2016
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2015
Publisher: Wiley
Date: 12-10-1973
DOI: 10.1111/J.1834-7819.1973.TB03492.X
Abstract: Efferocytosis, the process by which dying or dead cells are removed by phagocytosis, has an important role in development, tissue homeostasis and innate immunity. Efferocytosis is mediated, in part, by receptors that bind to exofacial phosphatidylserine (PS) on cells or cellular debris after loss of plasma membrane asymmetry. Here we show that a bacterial pathogen, Listeria monocytogenes, can exploit efferocytosis to promote cell-to-cell spread during infection. These bacteria can escape the phagosome in host cells by using the pore-forming toxin listeriolysin O (LLO) and two phospholipase C enzymes. Expression of the cell surface protein ActA allows L. monocytogenes to activate host actin regulatory factors and undergo actin-based motility in the cytosol, eventually leading to formation of actin-rich protrusions at the cell surface. Here we show that protrusion formation is associated with plasma membrane damage due to LLO's pore-forming activity. LLO also promotes the release of bacteria-containing protrusions from the host cell, generating membrane-derived vesicles with exofacial PS. The PS-binding receptor TIM-4 (encoded by the Timd4 gene) contributes to efficient cell-to-cell spread by L. monocytogenes in macrophages in vitro and growth of these bacteria is impaired in Timd4(-/-) mice. Thus, L. monocytogenes promotes its dissemination in a host by exploiting efferocytosis. Our results indicate that PS-targeted therapeutics may be useful in the fight against infections by L. monocytogenes and other bacteria that use similar strategies of cell-to-cell spread during infection.
Publisher: Hindawi Limited
Date: 26-02-2016
DOI: 10.1111/ECC.12466
Publisher: AMPCo
Date: 11-1989
Publisher: IEEE
Date: 05-2019
Publisher: Wiley
Date: 12-1976
DOI: 10.1111/J.1834-7819.1976.TB05778.X
Abstract: An examination was made of 817 children, mean age 6.9 years. Of their first permanent molars 42.4 per cent were assessed as suitable for fissure sealant. Of these teeth 522 were sealed and compared with contra-lateral controls after one year. The retention rate of and the mean application time for the sealant are presented and discussed.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.EJSO.2013.10.024
Abstract: The natural history of lobular carcinoma in-situ (LCIS) suggests that women are at increased risk of subsequent invasive breast cancer. Questions of effective management for women with this lesion have led to the need for evidence-based guidance and, in particular, guidance regarding management after LCIS is found at core needle biopsy (CNB). A systematic review was conducted to determine the most appropriate management for women with LCIS found at CNB. A comprehensive search of the scientific literature was conducted to identify the literature pertaining to this population. Critical appraisal of the literature, data extraction and a narrative synthesis of the results were conducted. The outcome of interest was upgrade of diagnosis to invasive breast cancer or ductal carcinoma in-situ (DCIS). Sparse data, with limited generalisability and considerable uncertainty, are available for women with LCIS at CNB. Nine studies were identified that met pre-specified inclusion criteria. The reported estimates of upgrade of diagnosis from LCIS to invasive breast cancer or DCIS ranged from 2% to 25%. The body of evidence was limited by its retrospective nature, risk of selection bias and poor generalisability to all women with LCIS at CNB. Further, higher quality research is required to determine the best approach for women with LCIS at CNB with any certainty.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 12-2020
Publisher: Springer International Publishing
Date: 2023
Publisher: IEEE
Date: 05-2010
Publisher: IEEE
Date: 06-2014
Publisher: IEEE
Date: 04-2015
Publisher: Wiley
Date: 12-1975
DOI: 10.1111/J.1600-0528.1975.TB00325.X
Abstract: A survey of approximately 8,300 subjects in the State of South Australia indicated that approximately 228,400 South Australians aged 15 years and over (26%) were edentulous and, of these, 95% wore full maxillary and mandibular dentures. The proportion of edentulous subjects increased with age and was lower in males, upper socioeconomic groups, immigrants and in the State capital.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.CANEP.2017.04.002
Abstract: Death Certificate Only (DCO) cancer cases are commonly excluded from survival analyses due to unknown survival time. This study examines whether socio-demographic factors are associated with DCO diagnosis, and the potential effects of excluding DCO cases on socio-demographic cancer survival disparities in NSW, Australia. NSW Cancer Registry data for cases diagnosed in 2000-2008 were used in this study. Logistic regression was used to estimate the odds of DCO registration by socio-demographic sub-group (socio-economic disadvantage, residential remoteness, country of birth, age at diagnosis). Cox proportional hazard regression was used to estimate the probability of death from cancer by socio-demographic subgroup when DCO cases were included and excluded from analyses. DCO cases consisted of 1.5% (n=4336) of all cases (n=299,651). DCO diagnosis was associated with living in socio-economically disadvantaged areas (most disadvantaged compared with least disadvantaged quintile: odds ratio OR 1.25, 95%CI 1.12-1.40), living in inner regional (OR 1.16, 95%CI 1.08-1.25) or remote areas (OR 1.48, 95%CI 1.01-2.19), having an unknown country of birth (OR 1.63, 95%CI 1.47-1.81) and older age. Including or excluding DCO cases had no significant impact on hazard ratios for cancer death by socio-economic disadvantage quintile or remoteness category, and only a minor impact on hazard ratios by age. Socio-demographic factors were associated with DCO diagnosis in NSW. However, socio-demographic cancer survival disparities remained unchanged or varied only slightly irrespective of including/excluding DCO cases. Further research could examine the upper limits of DCO proportions that significantly alter estimated cancer survival differentials if DCOs are excluded.
Publisher: IEEE
Date: 12-2017
Publisher: IEEE
Date: 07-2008
Publisher: BMJ
Date: 12-2016
Publisher: Wiley
Date: 04-1975
DOI: 10.1111/J.1834-7819.1975.TB04336.X
Abstract: Analysis of data derived from the pattern of treatment for first permanent molars in New Zealand school children from fluoridated and non-fluoridated areas shows that occlusal surfaces became carious at a later age in the former and in such areas sealants could further reduce the need for occlusal restorations. Since occlusoproximal restorations are rare, retention of sealants for long periods is needed.
Publisher: Springer Science and Business Media LLC
Date: 05-06-2021
Publisher: Wiley
Date: 06-1993
DOI: 10.1111/J.1445-5994.1993.TB01725.X
Abstract: The increasing numbers of cancer patients, the high costs of terminal care, and the development of palliative care services have led to a growing interest in patterns of terminal cancer care. These patterns are relevant to the formulation and evaluation of health services policy. To investigate trends in the place of death of South Australian cancer patients between 1981 and 1990, and to examine associations of socio-demographic and clinical variables with the place of death. Data relating to 2715 deaths attributed to cancer in 1990 were extracted from the Central Cancer Registry. To assess trends, these data were directly standardised to the age-sex distribution of cancer deaths in 1981 and 1985 which were investigated in a previous study. Unconditional logistic regression was used to investigate predictors of place of death. The proportion of deaths which occurred in major metropolitan public hospitals decreased from 40% in 1981 to 28% in 1990. Conversely, the proportion which occurred in hospice units increased from 5% to 20% over the same period. There was a decline in the proportion of deaths which occurred in private hospitals, but there was no significant change in the proportion which occurred in country hospitals or nursing homes. The proportion of deaths at home remained around 14%. Associated with place of death were age, sex, type of malignancy, survival time from diagnosis to death, Aboriginality, and area of residence. Further research to assess the clinical appropriateness of terminal care patterns is suggested.
Publisher: Springer Science and Business Media LLC
Date: 21-03-2017
Publisher: BENTHAM SCIENCE PUBLISHERS
Date: 19-03-2012
Publisher: SAGE Publications
Date: 23-10-2013
Abstract: There is considerable interest in whether mammography screening leads to over-diagnosis of breast cancer. However self-selection into screening programmes may lead to risk differences that affect estimates of over-diagnosis. This study compares the breast cancer risk profiles of participants and non-participants of population-based mammography screening. Risk profiles are also compared between those who have and have not used private screening services. This study involved 1162 women aged 40–84 who participated in the 2012 Health Omnibus, an annual face-to-face interview-based survey of a representative s le of the population in the state of South Australia. Data were collected on participation in mammography screening, demographic characteristics and breast cancer risk factors (including reproductive, familial and lifestyle factors). Missing data were multiply imputed. Factors independently associated with ever having been screened were identified using multivariable logistic regression, for population-based and ad hoc, private mammography screening separately. Compared with non-participants, participants of population-based screening were more likely to have used hormone replacement therapy (odds ratio [OR] = 3.72), experienced breast biopsy or surgery (OR = 2.22), and be overweight or obese (OR = 1.57). They were less likely to be sufficiently active (OR = 0.57) or be born in a non-English speaking country (OR = 0.50) or aged under 50 (OR = 0.09). Women who were screened privately were more likely to have a family history of breast cancer (OR = 1.66) and have experienced breast biopsy or surgery (OR = 3.17) than those who had not. South Australian women who participated in the population-based mammography screening have a slightly higher prevalence of breast cancer risk factors. This also applies to those who undertook private screening.
Publisher: IEEE
Date: 04-2014
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2016
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2012
DOI: 10.7314/APJCP.2012.13.1.147
Abstract: Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment had an elevated ductal carcinoma in situ but not invasive cancer detection rate had larger breast cancers and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Wiley
Date: 10-1995
DOI: 10.1111/J.1440-1754.1995.TB00855.X
Abstract: To assess changes in perinatal mortality and risk factors for births to Aboriginal mothers in South Australia in 1981-92. All 4013 singleton Aboriginal births in the South Australian perinatal data collection were included. Trends in proportions with specific maternal and infant characteristics, and perinatal mortality by year of birth, were investigated by logistic regression analysis. Changes found included an increase in the proportion of mothers aged 35 years and over, preterm births and births of very low birthweight (< 1500 g), but a decrease in the proportions of births to women under 20 years of age, and of births with a birth defect. There was no statistically significant change in the crude perinatal mortality rate nor in the risk of perinatal death after adjusting for risk factors. The perinatal mortality rate among Aboriginal births, which is three times higher than the rate for all South Australian births, is not declining, in contrast to the State rate overall. This highlights the need for a concerted approach to Aboriginal perinatal health.
Publisher: IEEE
Date: 04-2009
Publisher: Hindawi Limited
Date: 06-2015
DOI: 10.1111/ECC.12330
Publisher: Springer Science and Business Media LLC
Date: 20-02-2008
DOI: 10.1007/S10552-008-9118-9
Abstract: To examine the effects of different Pap screening patterns in preventing invasive cervical cancer among women in New South Wales, Australia. A total of 877 women aged 20-69 years diagnosed with invasive cervical cancer during 2000-2003 were matched with 2,614 controls by month and year of birth. Screening behavior patterns in 4 years preceding the time of cancer diagnosis in the cases were classified into none (no Pap test in the 4 years), 'irregular' (1 of the 4 years with Pap test(s)), and 'regular' (2 or more of the 4 years with a Pap test), and compared with those in the matched non-cases over the same period. Conditional logistic regression modeling was used to estimate the relative risk, approximated by the odds ratio, of invasive cervical cancer for regular and irregular cervical screening compared with no screening in the previous 4 years, before and after controlling for potential confounders including the first recorded Pap test result in the preceding 6-year reference period. Compared with no screening, irregular Pap screening in the 4 years preceding the cancer diagnosis is estimated to reduce the risk of invasive cervical cancer by about 85% (RR = 0.15, 95% CI: 0.120-0.19) regular Pap screening reduces the risk by about 96% (RR = 0.04, 95% CI: 0.03-0.05). After adjusting for the index Pap test result, the relative risks for invasive cervical cancer were 0.19 (95% CI: 0.13-0.27) for irregular screening and 0.07 (95% CI: 0.04-0.10) for regular Pap screening. Regular and irregular Pap tests among women aged 20-69 years were highly effective in preventing invasive cancer. At-risk women with no Pap test history should be encouraged to undergo a Pap test every 2 years, but any Pap screening over a 4-year period remains highly protective against future invasive cervical cancer.
Publisher: Elsevier BV
Date: 09-2017
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-04-2012
DOI: 10.7314/APJCP.2012.13.4.1413
Abstract: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand were investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/ vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.
Publisher: SAGE Publications
Date: 07-2002
DOI: 10.1191/0269216302PM571OA
Abstract: Our aims were to determine the extent of coverage by designated palliative care services of the population of terminally ill cancer patients in South Australia, and to identify the types of patients who receive these services and the types who do not. All designated hospice and palliative care services in South Australia notified to the State Cancer Registry the identifying details of all their patients who died in 1999. This information was cross-referenced with the data for all cancer deaths (n=3086) recorded on the registry for 1999. We found that the level of coverage by designated palliative services of patients who died with cancer in 1999 was 68.2%. This methodology was previously used to show that the level of coverage had increased from 55.8% for cancer deaths in 1990 to 63.1% for those in 1993. Patients who died at home had the largest coverage by palliative services (74.7%), whereas patients who died in nursing homes had the lowest coverage (48.4%). Patients who did not receive care from these palliative services tended to be 80 years of age or older at death, country residents, those with a survival time from diagnosis of three months or less, and those diagnosed with a prostate, breast, or haematological malignancy. Gender, socioeconomic status of residential area, and race were not related to coverage by a designated palliative service, whereas migrants to Australia from the UK, Ireland, and Southern Europe were relatively high users of these services. We conclude that the high level of palliative care coverage observed in this study reflects widespread support for the establishment of designated services. When planning future care, special consideration should be given to the types of patients who most miss out on these services.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 12-2016
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2015
Publisher: Wiley
Date: 10-1980
DOI: 10.1111/J.1834-7819.1980.TB05199.X
Abstract: About 90 per cent of children have received school dental care at South Australian schools where this care has been available. However, following recent extension of the dental programme to metropolitan schools without clinics located in their grounds, lower participation rates of about 74 per cent have emerged. A pilot study of 161 children not included in the school dental programme at 13 of these metropolitan schools without clinics was conducted to evaluate their dental health status and determine why they were not enrolled for school dental care.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2013
DOI: 10.7314/APJCP.2013.14.1.539
Abstract: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery and (2) to consider service delivery implications. Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (<10) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.
Publisher: Springer Science and Business Media LLC
Date: 03-04-2017
DOI: 10.1007/S11764-017-0607-2
Abstract: This systematic narrative review describes and compares the development and operational approaches of monitoring systems without a clinical care component that collect patient-reported outcome (PRO) data from cancer survivors. Searches were conducted using Medline, PubMed, PsycINFO, the Cochrane Library, CINAHL, Scopus, Joanna Briggs Institute EBP Database and Google Scholar (Advanced). Sources of grey literature and websites of relevant organisations were also searched for relevant published and unpublished material. Articles were included if they described the development (including piloting) of monitoring systems with ongoing recruitment that collect PRO at more than one time point, from 6 months post-diagnosis onward. The initial searches returned 7290 unique citations. After screening titles and abstracts, 39 full-text articles were retrieved for more detailed examination. Eleven articles were included in the review, representing seven international monitoring systems. Systems varied in their scope, implementation process, governance and administration, recruitment and data collection, consent rates, PRO collection, use of PRO and translation strategies. The most suitable approach for setting-up and implementing a monitoring system for ongoing surveillance will differ depending on the unique requirements, aims and level of resourcing available within a particular context. Better specification and consideration of how PRO data will be used, for what purpose, and by whom, is required to inform effective translational strategies to improve outcomes for cancer survivors. The findings from this review may inform the future development of survivorship monitoring systems in varied environments, which in turn may improve practices that lead to better outcomes for survivors.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2016
Publisher: AMPCo
Date: 1985
Publisher: BMJ
Date: 05-2009
Publisher: Wiley
Date: 12-02-2010
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.EJCA.2011.09.029
Abstract: Age is a major risk factor for development of sporadic colorectal cancer but elderly patients are underrepresented in clinical trials and are potentially offered chemotherapy less often. Data were obtained from South Australian Clinical Registry for advanced colorectal cancer between 1st February 2006 and 9th September 2010. Patients who received chemotherapy were analysed to assess the impact of single versus combination chemotherapy and to assess the outcome in two age cohorts, age < 70 years and ≥ 70 years. Out of a total of 1745 patients in the database during this time period, 951 (54.5%) received systemic chemotherapy. 286 (30%) received first line therapy (median age 74 years) with single agent fluoropyrimidine and 643 patients (68%) received first line combination chemotherapy (median age 64 years). The median overall survival of patients receiving first line combination chemotherapy was 23.9 months compared to 17.2 months for those who received single agent fluoropyrimidine (p<0.001). Combination chemotherapy was given to 81% of patients aged < 70 years compared to 53% of those ≥ 70 years. There was no significant difference in median overall survival of patients receiving chemotherapy by age cohort, 21.3 months for age <70 years and 21.1 months for age ≥ 70 years (p = 0.4). Treatment outcomes are comparable in both the elderly and younger patients. Patients who received initial combination chemotherapy were younger and had a longer median overall survival. In our study, age appeared to influence the treatment choices but not necessarily outcome.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2017
Publisher: Elsevier BV
Date: 08-2015
Publisher: Wiley
Date: 27-12-2010
DOI: 10.1111/J.1445-2197.2010.05589.X
Abstract: The aims of the South Australian Clinical Registry for Metastatic Colorectal Cancer are to record case outcomes according to site of recurrence and mode of clinical practice and to utilize the accumulated information for quality assurance activities. All patients who had a diagnosis of synchronous or metachronous metastatic colorectal cancer (CRC) after 1 February 2006 were eligible to be included in the registry. Data on patient details, disease characteristics, investigations, histopathology and treatment were collected. Disease-specific survival data were assessed using Kaplan-Meier product moment estimates and the log-rank test of equality was used for comparisons. 1544 patients have been entered as of 22 March 2010. In addition, 54.7% of primary CRCs were in the rectosigmoid area, 92.9% of them adenocarcinomas. Also, 52.6% of patients received chemotherapy and 15% had radiotherapy. Two hundred five patients underwent liver resection, nine had radiofrequency ablation and seven had selective internal radiotherapy. The overall 3-year survival from time of diagnosis of metastatic CRC was 29.5%. There was no significant survival difference between patients with synchronous and metachronous metastatic CRC. Patients with lung- or liver-only metastases have significantly improved survival if they underwent surgical resection. The treatment of patients with metastatic CRC continues to progress with modern medical and surgical developments. Important insights into the current patterns of care and clinical outcomes for metastatic CRC are provided by these data. In addition, this registry provides a feasible and useful database for the evaluation of current treatments established as best evidence in this population.
Publisher: IEEE
Date: 09-2014
Publisher: IEEE
Date: 06-2014
Publisher: Hindawi Limited
Date: 28-02-2012
DOI: 10.1111/J.1365-2354.2012.01325.X
Abstract: This review aimed to address studies of cancer control in Indigenous populations, with a focus on: (1) the nature and extent of community engagement and (2) the extent to which community engagement has facilitated successful outcomes. Articles addressing Indigenous cancer control using some degree of community engagement were identified by a search of the following electronic databases: MEDLINE (via Ovid and Pubmed), psycINFO, CINAHL and Google Scholar. Relevant studies were scored and analysed according to Green et al.'s guidelines for participatory research. Studies often engaged the community only minimally. Where studies resulted in successful outcomes, they tended to have included Indigenous community members in genuine research roles, from planning, to implementation, to presentation of results at conferences. Studies with positive health outcomes were often initiated by a combination of academic researchers and community members or organisations. This narrative review highlighted significant scope for improvement in community-based studies addressing Indigenous cancer control. Increased attention to the philosophical underpinnings of community engagement is required to ensure that the benefits of this approach are translated to achieve improved cancer control outcomes. An increased awareness of the benefits of community engagement may prove effective in conducting cancer control research that leads to improved outcomes in Indigenous communities.
Publisher: IEEE
Date: 11-2018
Publisher: IEEE
Date: 06-2014
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 12-2019
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2023
Publisher: IEEE
Date: 09-2012
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2014
Publisher: IEEE
Date: 09-2013
Publisher: Wiley
Date: 18-09-2012
DOI: 10.1002/CNCR.27802
Abstract: Life expectancy is increasing, and more patients are presenting with cancer at an advanced age (≥80 years). Optimal management for this group of patients has not been well defined. The South Australian Clinical Registry for Metastatic Colorectal Cancer (mCRC) collects data on all patients diagnosed since February 2006 in South Australia. The authors examined cancer characteristics, treatments administered, and outcomes for patients aged ≥80 years compared with patients aged <80 years. Data from 2314 patients were evaluable, and 29.2% of these patients were aged ≥80 years. The majority had moderately differentiated tumors. Poorly differentiated tumors were reported in fewer patients aged ≥80 years (20.1% vs 26.1% P < .005). Overall, 28.1% of patients aged ≥80 years received chemotherapy, and 74.2% received single-agent fluoropyrimidines as first-line treatment. By comparison, 68.2% of patients aged <80 years received chemotherapy, 74.3% received combination chemotherapy, and 25.7% received single-agent fluoropyrimidine as first-line treatment. No treatment was received by 38.2% of patients aged ≥80 years compared with 11.4% of those aged <80 years. Participation in clinical trials was lower in patients aged ≥80 years (2% vs 13%). The median survival was worse for patients aged ≥80 years (8.2 months vs 19.2 months P < .001), and the median survival of patients who received chemotherapy was 19.0 months for those aged ≥80 years and 22.3 months for those aged <80 years (P = .139). Patients who did not receive treatment had a poor median survival regardless of age (2.6 months for patients aged ≥80 years vs 2.7 months for patients aged <80 years). Patients aged ≥80 years were less likely to receive intervention for their metastatic colorectal cancer and had poorer survival. The survival of selected patients aged ≥80 years who received chemotherapy was similar to the survival of those aged <80 years despite the receipt of single-agent therapy. Patients aged ≥80 years with metastatic colorectal cancer are less likely to receive intervention for their disease and have poorer survival. Survival for selected patients aged ≥80 years who receive chemotherapy is similar to the survival of patients aged <80 years despite the receipt of single-agent therapy.
Publisher: Elsevier BV
Date: 08-1985
DOI: 10.1016/0022-3913(85)90294-X
Abstract: Of 521 patients referred to a specialist prosthodontic practice for complete dentures, 274 were considered as candidates for simple surgery to smooth prominent mylohyoid ridges before denture construction. Of these, 183 were thus treated. The remaining 91 did not receive surgery because of personal preference, underlying medical conditions, or other reasons. The percent who required three or more postinsertion visits to achieve comfort with their dentures was 7% for those who received surgery, 27% for those who required but did not receive surgery, and 17% for those not deemed to require surgery. This suggests that the surgical smoothing of prominent mylohyoid ridges may markedly improve patients' tolerance of dentures in the short term. However, the potential for confounding from extraneous factors in these nonexperimental circumstances must be considered.
Publisher: Wiley
Date: 02-04-2008
DOI: 10.1002/ETT.1283
Publisher: IEEE
Date: 06-2014
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2016
Publisher: Springer Science and Business Media LLC
Date: 12-2002
DOI: 10.1007/S10120-002-0203-6
Abstract: Gastric cancer mortality has declined markedly around the world. In South Australia, the reduction approximated 40% over the last 20 years. Possible reasons include: better refrigeration reduced consumption of salted, smoked, and chemically preserved foods increased intake of fruit and vegetables and improved living standards and a greater use of antibiotics, which may have reduced Helicobacter pylori infection. Reductions generally have been greater for intestinal than diffuse histopathologies. Gastric cancer remains the second leading cause of cancer death worldwide, probably accounting for about 10% of newly diagnosed cancers. High rates apply to Japan, China. Central and South America, Eastern Europe, and parts of the Middle East, and low rates to North America, Australia and New Zealand, Northern Europe, and India. Rates usually are higher in lower socioeconomic groups. Five-year relative survivals of around 20% or less are frequently reported. A figure of 50% or more has been cited for Japan, where there has been radiological screening, although this exceptional figure could have been affected artificially by lead-time and related effects. Male-to-female incidence ratios generally are in the 1.5-2.5 range, with higher ratios for intestinal than diffuse cancers and higher-risk populations. In South Australia, the ratio has been 1.8 to one, although higher at 4.6 to one for cardia lesions. Recent increases in cardia cancers, especially in males in populations of European extraction, often are accompanied by increases for esophageal adenocarcinoma. It is estimated that the global burden of gastric cancer could be reduced by up to 50% by dietary changes that included an increased intake of fruit and vegetables.
Publisher: American Association for Cancer Research (AACR)
Date: 11-2014
DOI: 10.1158/1055-9965.EPI-14-0206
Abstract: Background: Quantifying the risk of colorectal cancer for in iduals is likely to be useful for health service provision. Our aim was to develop and externally validate a prediction model to predict 5-year colorectal cancer risk. Methods: We used proportional hazards regression to develop the model based on established personal and lifestyle colorectal cancer risk factors using data from 197,874 in iduals from the 45 and Up Study, Australia. We subsequently validated the model using 24,233 participants from the Melbourne Collaborative Cohort Study (MCCS). Results: A total of 1,103 and 224 cases of colorectal cancer were diagnosed in the development and validation s le, respectively. Our model, which includes age, sex, BMI, prevalent diabetes, ever having undergone colorectal cancer screening, smoking, and alcohol intake, exhibited a discriminatory accuracy of 0.73 [95% confidence interval (CI), 0.72–0.75] and 0.70 (95% CI, 0.66–0.73) using the development and validation s le, respectively. Calibration was good for both study s les. Stratified models according to colorectal cancer screening history, that additionally included family history, showed discriminatory accuracies of 0.75 (0.73–0.76) and 0.70 (0.67–0.72) for unscreened and screened in iduals of the development s le, respectively. In the validation s le, discrimination was 0.68 (0.64–0.73) and 0.72 (0.67–0.76), respectively. Conclusion: Our model exhibited adequate predictive performance that was maintained in the external population. Impact: The model may be useful to design more powerful cancer prevention trials. In the group of unscreened in iduals, the model may be useful as a preselection tool for population-based screening programs. Cancer Epidemiol Biomarkers Prev 23(11) 2543–52. ©2014 AACR.
Publisher: IEEE
Date: 06-2014
Publisher: IEEE
Date: 10-2007
Publisher: Association for Computing Machinery (ACM)
Date: 03-02-2023
DOI: 10.1145/3501296
Abstract: Recent advances in communication technologies and the Internet-of-Medical-Things (IOMT) have transformed smart healthcare enabled by artificial intelligence (AI). Traditionally, AI techniques require centralized data collection and processing that may be infeasible in realistic healthcare scenarios due to the high scalability of modern healthcare networks and growing data privacy concerns. Federated Learning (FL), as an emerging distributed collaborative AI paradigm, is particularly attractive for smart healthcare, by coordinating multiple clients (e.g., hospitals) to perform AI training without sharing raw data. Accordingly, we provide a comprehensive survey on the use of FL in smart healthcare. First, we present the recent advances in FL, the motivations, and the requirements of using FL in smart healthcare. The recent FL designs for smart healthcare are then discussed, ranging from resource-aware FL, secure and privacy-aware FL to incentive FL and personalized FL. Subsequently, we provide a state-of-the-art review on the emerging applications of FL in key healthcare domains, including health data management, remote health monitoring, medical imaging, and COVID-19 detection. Several recent FL-based smart healthcare projects are analyzed, and the key lessons learned from the survey are also highlighted. Finally, we discuss interesting research challenges and possible directions for future FL research in smart healthcare.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2013
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.CLON.2008.04.014
Abstract: Significant improvements in the outcome for patients with advanced colorectal cancer (CRC) have been achieved. The median survival for advanced CRC reported in clinical trials now approaches 2 years, but there is often a question as to whether this partly represents patient selection. We aimed to explore whether the availability of new chemotherapy drugs (irinotecan and oxaliplatin) and surgical advances have affected survival in a normal clinical setting. A review of the Queen Elizabeth and Lyell McEwin health service prospective CRC database from 1992 to 2004 was carried out to assess outcome differences between two time cohorts (1 January 1992-31 December 1997 and 1 January 1998-31 December 2004). For all patients (n = 744) overall survival was seen to improve over time and is maintained out to 5 years. There have been a number of trends over time (1992-1997 vs 1998-2004) that have probably contributed to this gain increased overall chemotherapy use (33% vs 43%) use of combination chemotherapy (i.e. oxaliplatin and irinotecan regimens) increased hepatic resection rates (1.9% vs 10.8%) and increased clinical trial uptake (0.6% vs 14.5%). This current analysis confirms an improvement in survival over time for advanced CRC and this is seen in unselected patients including those over 70 years of age.
Publisher: Wiley
Date: 10-1979
DOI: 10.1111/J.1834-7819.1979.TB05809.X
Abstract: Approximately 25--30 per cent of operational time in the School Dental Programme is assigned to dental health education, representing a sizeable investment of public resources. If the full potential of dental health education is to be realized, the respective effectiveness of various dental health education activities need to be identified so that the more effective activities can be emphasized and developed further. As an essential prerequisite there is a need to refine the evaluation process by introducing: (1) improved dental indices (2) improved methods of classifying and maintaining records of the dental health education activities undertaken (3) better methods of quantifying dental care items and other social and environmental covariables and (4) more sophisticated forms of multivariate analysis.
Publisher: Hindawi Limited
Date: 07-03-2017
DOI: 10.1111/ECC.12673
Abstract: Monitoring screening mammography effects in small areas is often limited by small numbers of deaths and delayed effects. We developed a risk score for breast cancer death to circumvent these limitations. Screening, if effective, would increase post-diagnostic survivals through lead-time and related effects, as well as mortality reductions. Linked cancer and BreastScreen data at four hospitals (n = 2,039) were used to investigate whether screened cases had higher recorded survivals in 13 small areas, using breast cancer deaths as the outcome (M1), and a risk of death score derived from TNM stage, grade, histology type, hormone receptor status, and related variables (M2). M1 indicated lower risk of death in screened cases in 12 of the 13 areas, achieving statistical significance (p < .05) in 5. M2 indicated lower risk scores in screened cases in all 13 areas, achieving statistical significance in 12. For cases recently screened at diagnosis (<6 months), statistically significant reductions applied in 8 areas (M1) and all 13 areas (M2). Screening effects are more detectable in small areas using these risk scores than death itself as the outcome variable. An added advantage is the application of risk scores for providing a marker of screening effect soon after diagnosis.
Publisher: Public Library of Science (PLoS)
Date: 11-04-2016
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-04-2012
DOI: 10.7314/APJCP.2012.13.4.1675
Abstract: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29 p<0.001) and (2) although not approaching statistical significance p≥ 0.200), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.
Publisher: Informa UK Limited
Date: 09-1993
Publisher: AMPCo
Date: 06-2012
DOI: 10.5694/MJA12.10026
Abstract: To estimate the incidence of metastatic breast cancer (MBC) in Australian women with an initial diagnosis of non-metastatic breast cancer. A population-based cohort study of all women with non-metastatic breast cancer registered on the New South Wales Central Cancer Register (CCR) in 2001 and 2002 who received care in a NSW hospital. 5-year cumulative incidence of MBC prognostic factors for MBC. MBC was recorded within 5 years in 218 of 4137 women with localised node-negative disease (5-year cumulative incidence, 5.3% 95% CI, 4.6%-6.0%) and 455 of 2507 women with regional disease (5-year cumulative incidence, 18.1% 95% CI, 16.7%-19.7%). The hazard rate for developing MBC was highest in the second year after the initial diagnosis of breast cancer. Determinants of increased risk of MBC were regional disease at diagnosis, age less than 50 years and living in an area of lower socio-economic status. Our Australian population-based estimates are valuable when communicating average MBC risks to patients and planning clinical services and trials. Women with node-negative disease have a low risk of developing MBC, consistent with outcomes of adjuvant clinical trials. Regional disease at diagnosis remains an important prognostic factor.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2021
Publisher: Springer Science and Business Media LLC
Date: 02-06-2017
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2017
DOI: 10.1200/JCO.2017.35.15_SUPPL.3560
Abstract: 3560 Background: Although liver is the commonest site of mets in pts with CRC, pattern of spread is variable and may reflect different biology in different subsets of pts. Methods: This is a retrospective analysis to explore the outcome of pts with mCRC based on their site of mets at diagnosis and to identify tumor characteristics which could predict the site of mets. Pts from 2 Australian databases, BioGrid (BG) and South Australian Cancer Registry (SA), from 01/2006 to 12/2015 were grouped into 5 cohorts lung only, liver only or any pts with brain, bone or peritoneal mets. Overall survival (OS) for each group was compared with the rest of the s le using Kaplan Meier analysis and the log rank test separately in each dataset. Mantel-Haenszel Chi-squared test was performed in pooled data to assess the association between KRAS, BRAF, Micro satellite instability (MSI), site of primary and site of mets. Results: 5967 pts were included. In both datasets median OS was significantly higher when mets were limited to lung or liver and shorter for those with brain, bone or peritoneal mets. BRAF, KRAS and MSI data were available for 20%, 37% and 21% of the s le. In the pooled analysis BRAF mutation was associated with brain (Relative Risk=5.2) and peritoneal mets (RR=1.8) with lower incidence of lung (RR=0.3) and liver (RR=0.7) limited mets. KRAS mutation was associated with lung only mets(RR=1.4). Left colon tumors were associated with bone (RR=1.6) and lung only mets (RR=2.3) while peritoneal spread was less frequent compared with right colon tumors(RR=0.6). Rectal cancer was strongly associated with brain, bone and lung mets (RR=1.7, 1.7, 2.0). MSI status was not associated with site of mets though liver only mets was less frequent in MSI high tumors. Conclusions: Survival duration with mCRC is related to the site of mets. OS was significantly better when mets were confined to either lung or liver. BRAF mutation and primary rectal cancer were associated with poor prognostic metastatic sites like brain and bone. [Table: see text]
Publisher: AMPCo
Date: 09-1990
DOI: 10.5694/J.1326-5377.1990.TB136894.X
Abstract: Kernohan grade III and IV astrocytomas are usually fetal and in the past have had a case survival rate of only about 10% two years from diagnosis. Data on 285 cases registered at the Royal Adelaide Hospital in 1977-1986 showed a median survival of approximately six months. The survival rate was 25% at one year and 15% at two years. Survival reduced markedly with increase in age at diagnosis from a two-year rate of 53% for patients under 40 years of age to 5% for patients aged 70 years or more. This may have been due in part to the more frequent treatment of younger patients by decompression and radiotherapy. Apart from age and treatment mode, factors related to extended survival included a longer duration of symptoms before diagnosis and location of the tumour in the frontal lobes. Notwithstanding prospects for an increase in short-term survival from the use of radiotherapy as an adjunct to surgery, long-term outcomes for these neoplasms are still very poor.
Publisher: Springer Science and Business Media LLC
Date: 19-04-2017
Publisher: IEEE
Date: 04-2014
Publisher: Elsevier BV
Date: 08-2004
DOI: 10.1111/J.1467-842X.2004.TB00435.X
Abstract: To investigate trends towards early detection of infiltrating ductal carcinomas, possible effects on patients' prognosis, and characteristics of women still at high risk of late detection. South Australian Cancer Registry data were analysed to compare breast tumour diameters for the 1980-86 and 1997-2002 diagnostic periods by age. Relative survivals for 1980-86 were compared with corresponding survival estimates for 1997-2000, obtained by weighting diameter-specific survivals for 1980-86 to equate with the diameter distribution for 1997-2002. Multivariable logistic regression was used to determine socio-demographic predictors of large diameters (> or =30 mm) in 1997-2002. The proportion of tumours with diameters smaller than 15 mm increased from 13.0% in 1980-86 to 36.7% in 1997-2002, whereas the proportion with large diameters reduced from 43.0% to 18.6%. Estimated changes in 20-year survivals equated with a 33% reduction in breast-cancer mortality among patients aged 50-69 years at diagnosis. Data for 1997-2002 indicate that early diagnosis is not evenly distributed, with large diameters more common in age ranges outside the 50-69 year target for mammography screening low socio-economic areas non-Caucasians patients born in northern/eastern Europe and potentially Asia/Middle East and in some country locations. Increased emphasis on early detection should be directed at sectors of the population where delays in diagnosis and poorer prognosis are evident. Projected reductions in breast-cancer mortality among patients are indicative of effects of earlier detection on patients' prognosis, but require confirmation with follow-up data. More particularly, parallel studies of effects on population-based mortality are warranted.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.CANEP.2017.04.013
Abstract: This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977-2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990-2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p<0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas.
Publisher: IEEE
Date: 08-2015
Publisher: IEEE
Date: 12-2019
Publisher: IEEE
Date: 04-2016
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2000
DOI: 10.1109/18.887877
Publisher: IEEE
Date: 12-2013
Publisher: Wiley
Date: 12-02-2010
Publisher: Springer International Publishing
Date: 2021
Publisher: Hindawi Limited
Date: 10-02-2017
DOI: 10.1111/ECC.12662
Abstract: This systematic review examines variations in outcomes along the breast cancer continuum for Australian women by Indigenous status. Multiple databases were systematically searched for peer-reviewed articles published from 1 January 1990 to 1 March 2015 focussing on adult female breast cancer patients in Australia and assessing survival, patient and tumour characteristics, diagnosis and treatment by Indigenous status. Sixteen quantitative studies were included with 12 rated high, 3 moderate and 1 as low quality. No eligible studies on referral, treatment choices, completion or follow-up were retrieved. Indigenous women had poorer survival most likely reflecting geographical isolation, advanced disease, patterns of care, comorbidities and disadvantage. They were also more likely to be diagnosed when younger, have advanced disease or comorbidities, reside in disadvantaged or remote areas, and less likely to undergo mammographic screening or surgery. Despite wide heterogeneity across studies, an overall pattern of poorer survival for Indigenous women and variations along the breast cancer continuum of care was evident. The predominance of state-specific studies and small numbers of included Indigenous women made forming a national perspective difficult. The review highlighted the need to improve Indigenous identification in cancer registries and administrative databases and identified key gaps notably the lack of qualitative studies in current literature.
Publisher: Springer International Publishing
Date: 2021
Publisher: Oxford University Press (OUP)
Date: 1983
Publisher: BMJ
Date: 05-1998
DOI: 10.1136/GUT.42.5.669
Abstract: Background— Somatic mutations in K- ras and TP53 may be associated with both acetylator status and prognosis in colorectal cancer. Aims— To determine whether cancers with somatic mutations are more frequent in fast acetylators and whether mutations or acetylator status influence prognosis after colorectal surgery. Patients— One hundred consecutive subjects undergoing elective surgery for colorectal cancer. Methods— Acetylator status was determined by polymerase chain reaction (PCR) genotyping for polymorphism in the N-acetyltransferase 2 ( NAT 2) gene. Mutations in K- ras (codon 12) and TP53 were determined by PCR analysis using restriction enzyme digestion and single strand conformation polymorphism respectively. Survival from colorectal cancer for up to five years after diagnosis was analysed using the Kaplan-Meier product limit estimator. Cox proportional hazards regression was used to compare survival rates after adjusting for tumour stage. Results— Mutations in K- ras and TP53 were independent of acetylator status. By log rank test, survival was significantly reduced in subjects with TP53 mutations (p=0.003) but was not significantly related to acetylator status or the presence of K- ras mutations. After adjustment for tumour stage, subjects with both TP53 and K- ras mutations had a 4.2-fold case fatality (95% confidence interval 1.5 to 11.6) when compared with that of a TP53 negative reference group. Conclusion— The presence of both TP53 and K- ras mutations in colorectal tumours is an adverse prognostic marker which is independent of tumour stage.
Publisher: Wiley
Date: 06-1973
DOI: 10.1111/J.1834-7819.1973.TB03456.X
Abstract: Neurogenesis, the process of generating new neurons in the brain, fascinates researchers for its promise to affect multiple cognitive and functional processes in both health and disease. Many cellular pathways are involved in the regulation of neurogenesis, a complexity exemplified by the extensive regulation of this process during brain development. Toll-like receptors (TLRs), hallmarks of innate immunity, are increasingly implemented in various central nervous system plasticity-related processes including neurogenesis. As TLRs are involved in neurodegenerative disorders, understanding the involvement of TLRs in neurogenesis may hold keys for future therapeutic interventions. Herein, we describe the current knowledge on the involvement of TLRs in neurogenesis and neuronal plasticity and point to current knowledge gaps in the field.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2014
Publisher: IEEE
Date: 04-2018
Publisher: Wiley
Date: 12-1978
DOI: 10.1111/J.1600-0528.1978.TB01169.X
Abstract: There is a pressing need for a reliable, low-cost method of assessing the gingival and periodontal status of large population groups. Existing indexes, despite their value in dental public health, are still too subject to examiner variability for use by uncalibrated examiners. This study describes an evaluation of a quick, inexpensive, extraoral colorimetric test for gingival inflammation, based on a reaction between saliva and the test material. It could probably be applied by non-professional personnel. In this study, the test was applied to a population of elementary schoolchildren, dental hygiene students and faculty, and adult inmates of two correctional institutions. These populations were chosen on the assumption that they would exhibit varying intensities of gingival inflammation. Values obtained from the colorimetric test carried out by one researcher were compared with Gingival Index (GI) scores observed by a different examiner. Results suggest that the colorimetric test may be a valid, reliable means of detecting major differences in the prevalence of gingival inflammation in most adult populations, although having little, if any, useful application among children at the mixed dentition stage.
Publisher: IEEE
Date: 09-2017
Publisher: IEEE
Date: 09-2012
Publisher: IEEE
Date: 04-2014
Publisher: IEEE
Date: 04-2015
Publisher: Wiley
Date: 23-09-2013
DOI: 10.1111/JEP.12081
Abstract: It is uncertain whether survival increases from melanoma recorded by some population registries include a treatment effect. The US Surveillance, Epidemiology and End Results (SEER) programme has good data quality control, large numbers of cases enabling high statistical precision and summary stage plus thickness, which we consider to be a best-case population registry scenario to investigate potential for a treatment effect. We have investigated SEER data to indicate whether survivals increases are fully attributable to earlier diagnosis and other non-treatment factors. Through relative survival regression, the effects of diagnostic period on 5-year excess mortality were investigated, adjusting for socio-demographic factors, lesion sub-site, histology, thickness and stage at diagnosis in 1990-2009 (n = 99 690 cases). The reduction in excess mortality (95% confidence interval) between 1990-1999 and 2000-2009 was 31 (20-41)% for localised melanoma, 18 (12-22)% for regional melanoma and 3 (-5-10)% for melanomas with distant spread. Younger age was predictive of a greater percentage reduction. Treatment benefits are inferred from the higher survivals in 2000-2009 but uncertainty remains due to incomplete data to adjust for non-treatment factors and a lack of treatment data. Registries should use new information systems to collect more complete data on stage, other prognostic indicators, co-morbidities and treatment, to provide more definitive and detailed information on population effects of cancer control.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2018
DOI: 10.1200/JCO.2018.36.4_SUPPL.739
Abstract: 739 Background: The benefit of primary tumour resection (PTR) in patients with synchronous mCRC is not clear. The influence of tumour location on PTR benefit is also uncertain. Methods: SAMCRC is a population based registry collating data from all patients in South Australia diagnosed with mCRC from February 2006. We examined outcomes according to whether the primary colorectal tumour was excised within 3 months of diagnosis or remained in situ we also examined whether outcomes were affected by tumour side (right v left). Registry data was included for patients with synchronous metastic adenocarcinoma from colon or rectum. Exclusion criteria included metastasectomy, tumour resection within 7 days or death within 3 months of mCRC diagnosis. Kaplan Meier analysis was used for Survival. Tumour sidedness and PTR were analysed with a multivariate Cox proportional hazards model. Survival was measured from the landmark date (3 months from date of diagnosis). Results: 2575 patients with synchronous mCRC have entered the database, of which 1869 patients were eligible for the PTR analysis. 50.2% (n = 938) underwent PTR. 481 patients (51.3%) of the PTR analysis group had left-sided primary tumours whilst 436 had right sided tumours (46.5%) which was significant (p 0.001). 63% of the PTR cohort were male (n = 1006). Site and age metastases were included in the multivariate analysis. PTR was associated with improved survival from landmark compared to no resection (15.0 mo vs 11.2 mo, 95% CI 15.0 – 16.3 vs 11.2 – 12.3, p = 0.031). In the entire synchronous mCRC group, left-sided tumours (62.1%) had a longer median survival (17.8 mo vs 10.4 mo, 95% CI 15.7 – 19.5 vs 10.4 – 11.7 p = 0.001). An interaction test was performed for sidedness and was not significant. Conclusions: PTR was associated was associated with improvement in survival in this large population based registry. This finding did not differ signifcantly between right and left sided tumours. Survival was superior for patients with left sided tumours, in keeping with established data. Criteria for selection of patients with mCRC who benefit from PTR need to be defined.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2013
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-06-2006
DOI: 10.1200/JCO.2006.24.18_SUPPL.6124
Abstract: 6124 Background: Significant improvements in the outcome for patients with advanced CRC have been achieved. We have reviewed the prospective CRC database at our institution from 1992 to 2004 to explore whether the availability of new chemotherapy drugs (irinotecan & oxaliplatin) and surgical advances has impacted on survival in the normal population. Earlier results had suggested a trend to improved survival (1). Methods: In Australia the first of these drugs became available at the end of 1997 thus we have taken this as the time point to compare outcomes pre and post. Disease-specific survivals were analysed from the date of diagnosis for stage D, and from the date of distant recurrence for stages A, B and C, with a date of censoring of live cases at December 31st, 2004. The Kaplan-Meier product-limit estimate was used for univariate analyses and Cox proportional hazards regression for multivariable analyses. Results: The current analysis is of 744 patients 92–97 n=313, 98–04 n=431. Survival for the respective time periods were 47.6% and 54.9% 12 mths 28.0% and 34.8% 24 mths 18.9% and 23.0% 36 mths 12.6% and 17.2% 48 mths and 10.4% and 14.9% 60 mths. Cox proportional hazards regression indicated a lower risk of case fatality for 1998–2004 than 1992–1997 cases (p=0.048) after adjusting for age measured in years. The key predictors of case fatality in a multivariate analysis were found to be period (i.e., 1992–97/1998–04), age, and stage of disease at time of initial diagnosis. While an upward trend in survival was recorded for all ages, it was most pronounced for 70–79 year olds (n=272), where the increase in 24 mth survival was from 21.1% for 1992–97 to 36.1% for 1998–2004 (p=0.015). For patients aged 80 years and over (1992–97 n=40 & 1998–2004 n=67) the 24mth survivals were 18.6% (6.7%) and 26.4% (6.9%) respectively (p .200). Conclusions: Clinical trials have shown improvements in survival for highly selected patients. This current analysis confirms an improvement in survival over time for advanced CRC and this is seen in unselected patients including the elderly. Preliminary data has suggested that a number of factors have contributed to the trend of improved survival. Final analysis, including updated chemotherapy trends, will be presented at the meeting. (1) Proc ASCO 2004, #3707 No significant financial relationships to disclose.
Publisher: Wiley
Date: 21-07-2009
Publisher: SAGE Publications
Date: 09-1983
DOI: 10.3109/00048678309161281
Abstract: Australian suicide rates were compared for the 1969–73 and 1976–80 periods by age, sex and State. Rates for males were generally at least twice those for females. The sex difference was marked, irrespective of age, State and time period. Middle-aged and older Australians generally had higher rates than 20–29-year-olds, although this finding was not consistent by State for males. The national age-standardised suicide rate for all age groups combined decreased between the 1969–73 period and 1976–80 both for males and (more so) for females. However, there was a 24% Increase for 20–29-year-old males. While the suicide rate for 20–29-year-old females decreased between the 1969–73 period and 1976–80, an analysis of yearly trends within the 1976–80 period revealed an upward trend for in iduals aged 20–29 years, for both females and males.
Publisher: Wiley
Date: 07-2012
DOI: 10.1111/J.1445-2197.2012.06114.X
Abstract: Background: The study aim was to determine whether age is an independent risk factor for survival from early invasive breast cancer in contemporary Australian clinical settings. Methods: The study included 31 493 breast cancers diagnosed in 1998–2005. Risk of death from breast cancer was compared by age, without and with adjustment for clinical risk factors, using Cox proportional hazard regression. Results: Risk of breast cancer death was elevated for cancers of larger size, higher grade, positive nodal status, oestrogen receptor negative status, vascular invasion and multiple foci. Ductal lesions presented a higher risk than other lesions. Adjusting for these factors, the relative risk of breast cancer death (95% confidence limits) was lower for 40–49‐year‐olds at 0.80 (0.66, 0.96) than for the reference category under 40 years, but higher for 70–79‐year‐olds at 1.64 (1.36, 1.98) and women aged 80 years or more at 2.19 (1.79, 2.69). The risk for 50–69‐year‐olds and women under 40 years was similar. Risk‐factor adjustment reduced the difference in risk between the reference category under 40 years and 40–49‐year‐olds, largely eliminated the lower relative risk for 50–69‐year‐olds, and increased the relative risks for women aged 70–79 years and older. Discussion: Survivals in women under 40 and over 70 years of age are poorer than for 40–69‐year‐olds. Research is needed into the best treatment modalities for younger women and older women with co‐morbidity.
Publisher: IEEE
Date: 12-2012
Publisher: Wiley
Date: 15-12-1994
Abstract: Data from 2 Australian cancer registries covering a population of 1.7 million people were combined for the purposes of analysing brain cancer incidence, mortality and survival patterns for the time period 1978 through 1992. A total of 1,752 cases of primary brain cancer were registered, representing age-standardised incidence rates of 6.7 per 100,000 in men and 4.6 in women. Histological confirmation was available for 94% of cases. The incidence rate among persons aged 75 or over was higher during 1986-1992 than during 1978-1985, the rate for men increasing from 16.3 to 26.2 and that for women increasing from 9.7 to 18.0. The largest increases in this age group occurred for cases of glioblastoma multiforme. During the study period, 1,411 brain cancer deaths were notified to the 2 registries at age-standardised rates of 5.3 in men and 3.4 in women. Mortality rates among persons aged 75 years or older were higher during 1986-1992 than 1978-1985, increasing from 15.7 to 28.4 in men and from 10.1 to 15.3 in women. Only among men aged 15-49 years was a decline in mortality rates observed, from 3.3 to 2.4. Survival analyses indicated that age and histological type were the most powerful prognostic indicators. There was no improvement in 5-year survival for any of the age groups or histological types. An improvement in 36-month survival was noted for the 15-49 year age group diagnosed with gliomas other than glioblastoma multiforme.
Publisher: Wiley
Date: 22-09-2017
DOI: 10.1111/JEP.12640
Abstract: Screening has been found to reduce breast cancer mortality at a population level in Australia, but these studies did not address local settings where numbers of deaths would generally have been too low for evaluation. Clinicians, administrators, and consumer groups are also interested in local service outcomes. We therefore use more common prognostic and treatment measures and survivals to gain evidence of screening effects among patients attending 4 local hospitals for treatment. To compare prognostic, treatment, and survival measures by screening history to determine whether expected screening effects are occurring. Employing routine clinical registry and linked screening data to investigate associations of screening history with these measures, using unadjusted and adjusted analyses. Screened women had a 10-year survival from breast cancer of 92%, compared with 78% for unscreened women and 79% of screened surgical cases had breast conserving surgery compared with 64% in unscreened women. Unadjusted analyses indicated that recently screened cases had earlier tumor node metastasis stages, smaller diameters, less nodal involvement, better tumor differentiation, more oestrogen and progesterone receptor positive lesions, more hormone therapy, and less chemotherapy. Radiotherapy tended to be more common in screening participants. More frequent use of adjunctive radiotherapy applied when breast conserving surgery was used. Results confirm the screening effects expected from the scientific literature and demonstrate the value of opportunistic use of available registry and linked screening data for indicating to local health administrations, practitioners, and consumers whether local screening services are having the effects expected.
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1111/J.1467-842X.2003.TB00605.X
Abstract: In response to reported increases in ratios of adenocarcinomas to squamous cell carcinomas of the lung in other populations, to investigate and consider public health and clinical implications of time trends in lung cancer incidence by histological type in South Australia. 11,898 lung cancers, diagnosed during 1982-2000, were analysed to determine age-adjusted incidence rates by sex, diagnostic epoch, and histological type, and changes in histological distribution at diagnosis. The age-adjusted incidence of squamous cell carcinoma reduced by 47.1% in males between 1982-86 and 1997-2000, with larger reductions applying to younger age groups. A 34.1% reduction also occurred for small cell lesions in males, whereas a 55.6% incidence increase applied for large cell lesions, and in the age range of 70 years and over, a 29.9% incidence increase for adenocarcinomas. Larger increases were observed for adenocarcinomas and large cell lesions in females. There was also a 48.0% incidence increase in squamous cell carcinomas in females aged 70 years or more. In general, adverse incidence trends were less pronounced and favourable trends more pronounced in the younger age groups of both sexes. The more favourable incidence trends by histology in younger age groups are a positive sign that hopefully will prove to be cohort effects that extend to older ages. Incidence trends have led to an increased proportion among diagnosed cancers of adenocarcinomas and large cell lesions, but this is unlikely to have more than a marginal effect on overall survivals and treatment requirements.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2017
DOI: 10.1200/JCO.2017.35.4_SUPPL.752
Abstract: 752 Background: With improved healthcare we now face an ageing population worldwide. More patients with metastatic colorectal cancer (mCRC) will present at advanced age. Patients with mCRC now have the potential of living longer due to surgery, chemotherapeutic agents and monoclonal antibodies. Australian data (2011) indicated 1.3% of the population are aged over 90 years*. Medical oncologists are now being referred patients in their 90’s and the optimal management for this group is unknown. Methods: The population based South Australian Clinical Registry for mCRC includes all patients with metastatic CRC diagnosed since the 1st February 2006. We examined cancer characteristics, treatments administered and outcomes for patients aged 90 years. Results: 130 patients of 4199 (3%) were aged 90 years or older. The median age was 92.1 years (range 90-104.8 years). 61% were female, 70% presented with synchronous disease. Organ involvement was as follows 58% liver, 32% lung, 8% peritoneal and 7% bone. Primary site was: right 46%, left 28%, rectum 20%, unknown 6%. Only 4 patients had KRAS testing (all WT). 44.6% overall have had no surgery for their CRC primary. 24% of those with synchronous disease at diagnosis had resection of primary lesion and 3% had stoma formed for palliation. One patient had lung resection for metastasis. Only 4 patients received systemic therapy (age range 90-93). Lines of therapy delivered one in 2 patients, two lines in one and 4 lines in one. Aside single agent 5FU, combination therapy (oxaliplatin/FU+/- bevacizumab) was given to two patients and cetuximab single agent in 2 (WT one, unknown one). The median survival overall was 3 months (95% CI 1.4-4.6 months). Two year survival was 10%. Conclusions: This analysis gives us some insight into the management of the very old. Female sex and right sided cancers are more frequent. Systemic therapy is rarely offered and the outlook is poor. Further research to understand whether active therapy is possible or warranted in this age group should be considered. *www.abs.gov.au/ausstats/abs@.nsf
Publisher: IEEE
Date: 04-2018
Publisher: Elsevier BV
Date: 03-1992
DOI: 10.1016/S0161-6420(92)31960-8
Abstract: Risk factors for graft failure after penetrating keratoplasty were investigated in 961 patients from records collected prospectively by the Australian Corneal Graft Registry. The most common cause of graft failure was irreversible rejection. A multivariate proportional hazards regression analysis indicated that the key predictors of graft failure were: an indication for graft other than keratoconus or corneal dystrophy a failed previous graft (ipsilateral eye) aphakia inflammation at the time of graft presence of an anterior chamber or iris-clip intraocular lens graft size outside the range of 7.0 to 7.9 mm diameter and corneal vascularization occurring in the postoperative period.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2022
Publisher: Wiley
Date: 08-1989
DOI: 10.1111/J.1479-828X.1989.TB01717.X
Abstract: Approximately 90% of cervical cancers are considered preventable through regular screening and the treatment of precursor lesions, but fewer than 20% of South Australian women were found to have been screened in 1984. Data from the State Cancer Registry have shown an increase in cervical cancer incidence of approximately 80% in women under 50 years of age in the 9-year period to 1986, but a decrease of about 25% in older women. Mortality data have shown similar patterns by age, although the increase in younger women tended to extend to an older age. Case survival was unchanged between the diagnostic periods 1977-1981 and 1982-1987 and there was little change in the proportion of cases that were adenocarcinomas.
Publisher: Springer Science and Business Media LLC
Date: 09-1992
DOI: 10.1007/BF00145388
Publisher: IEEE
Date: 12-2010
Publisher: BMJ
Date: 30-05-2006
Publisher: Springer Science and Business Media LLC
Date: 09-1989
DOI: 10.1007/BF00144832
Publisher: IEEE
Date: 06-2014
Publisher: Springer Science and Business Media LLC
Date: 22-05-2008
DOI: 10.1007/S10549-007-9609-5
Abstract: Efficacy of breast screening may differ in practice from the results of randomized trials. We report one of the largest case-control evaluations of a screening service. Subjects included 491 breast-cancer deaths affecting 45-80-year-old South Australian females during 2002-2005 (diagnosed after BreastScreen commencement) and 1,473 live controls (three per death) randomly selected from the State Electoral Roll after birth-date matching. Cancer Registry and BreastScreen records provided cancer and screening details. Risk estimates were calculated by BreastScreen participation, using conditional logistic regression. Interpretation was assisted by a population survey of risk factor prevalence by BreastScreen participation in 1,684 females aged > or =40 years. The relative odds (OR) (95% confidence limits) of breast-cancer death in BreastScreen participants compared with non-participants were 0.59 (0.47, 0.74). Compared with non-participants, the OR was 0.70 (0.47, 1.05) for women last screened through BreastScreen more than 3 years before diagnosis of the index case, and 0.57 (0.44, 0.72) for women screened more recently. The OR of 0.47 (0.34, 0.65) for women screened more frequently in the pre-diagnosis phase was lower than the 0.64 (0.50, 0.82) for other screened women. The overall OR of 0.59 approximated 0.70 when corrected for the screening self-selection bias observed in five randomized trials. However, multivariable analysis of survey data did not indicate a lower prevalence of breast-cancer risk factors among BreastScreen participants, suggesting that this correction may be inappropriate. Participation in screening was associated with a breast-cancer mortality reduction of between 30 and 41%, depending on assumptions about screening self-selection bias. A downward mortality risk by recency of last screen prior to cancer diagnosis, and frequency of recent screening, is consistent with a screening effect.
Publisher: Elsevier BV
Date: 10-1987
Publisher: Wiley
Date: 02-1992
DOI: 10.1111/J.1479-828X.1992.TB01885.X
Abstract: Multiple regression analysis was used to measure associations of maternal age, race, gravidity, marital status and socioeconomic status with medical problems and pregnancy outcomes. The study population comprised all singleton births to residents of metropolitan Adelaide (in South Australia) during 1988 that were included in the State's perinatal statistics collection. The results indicate that in metropolitan Adelaide, low socioeconomic status is related to a higher risk profile of mothers and babies. It also highlights that there is a strong association of orce and separation with medical problems and an adverse pregnancy outcome. Poorer outcomes are also seen in never married women, teenage women, older women, non-Caucasian women and primigravid women. These poorer outcomes in older women and primigravidas include higher risks of low birth-weight and prematurity of their babies. The study also demonstrates that groups that are less likely to have choice of obstetric care, eg. teenage women, non-Caucasian women, and women of low socioeconomic status, have a lower odds of obstetric intervention as characterized by nonspontaneous labour and elective Caesarean section.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2013
Publisher: Wiley
Date: 28-01-2015
DOI: 10.1111/AJCO.12338
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 22-01-2014
DOI: 10.7314/APJCP.2014.15.24.10665
Abstract: We wished to analyse patterns of use of needle biopsy procedures by BreastScreen Australia (BSA) accredited programs to identify areas for improvement. BSA services provided anonymous data regarding percutaneous needle biopsy of screen detected lesions assessed between 2005-2009. 12 services, from 5 of 7 Australian states and territories provided data for 18212 lesions biopsied. Preoperative diagnosis rates were 96.84% for lesion other than microcalcification (LOTM) and 93.21% for microcalcifications. At surgery 97.9% impalpable lesions were removed at the first procedure. Of 11548 Microcalcification (LOTM) biopsied, 46.9% were malignant. The final diagnosis was reached by conventional core biopsy (CCB) in 72.46%, FNAB in 21.33%, VACB in 1.69% and open biopsy in 4.52% of lesions. FNA is being limited to LOTM with benign imaging After FNAB, core biopsy was required for 38% of LOTM. In LOTM the mean false positive rate (FPR) was 0.36% for FNAB, 0.06% for NCB and 0% for VACB. Diagnostic accuracy was 72.75% for FNAB and 92.1% for core biopsies combined. Of 6441 microcalcifications biopsied 2305 (35.8%) were malignant. Microcalcifications are being assessed primarily by NCB but 6.57% underwent FNAB, 45.6% of which required NCB. False positive diagnoses were rare. FNR was 5% for NCB and 1.53% for VACB. Diagnostic accuracy was 73.52% for FNAB, 86.29% for NCB and 88.63% for VACB. Only 8 of 12 services had access to VACB facilities. BSA services are selecting lesions effectively for biopsy and are achieving high preoperative diagnosis rates. Gaps in the present accreditation standards require further consideration.
Publisher: Springer Science and Business Media LLC
Date: 06-2016
DOI: 10.1245/S10434-016-5290-4
Abstract: Hepatic resection for colorectal (CRC) metastasis is considered a standard of care. Resection of metastasis isolated to lung also is considered potentially curable, although there is still some variation in recommendations. We explore outcomes for patients undergoing lung resection for mCRC, with the liver resection group as the comparator. South Australian (SA) metastatic CRC registry data were analysed to assess patient characteristics and survival outcomes for patients suitable for lung or liver resection. A total of 3241 patients are registered on the database to December 2014. One hundred two (3.1 %) patients were able to undergo a lung resection compared with 420 (12.9 %) who had a liver resection. Of the lung resection patients, 62 (61 %) presented with lung disease only, 21 % initially presented with liver disease only, 11 % had both lung and liver, and 7 % had brain or pelvic disease resection. Of these patients, 79 % went straight to surgery without any neoadjuvant treatment and 34 % had lung resection as the only intervention. Chemotherapy for metastatic disease was given more often to liver resection patients: 76.9 versus 53.9 %, p = 0.17. Median overall survival is 5.6 years for liver resection and has not been reached for lung resection (hazard ratio 0.82, 95 % confidence interval 0.54-1.24, p = 0.33). Lung resection was undertaken in 3.1 % of patients with mCRC in our registry. These data provide further support for long-term survival after lung resection in mCRC, survival that is at least comparable to those who undergo resection for liver metastasis in mCRC.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.CLCC.2013.11.008
Abstract: Whether metastatic colorectal cancer (mCRC) that presents synchronously with the primary lesion behaves differently from mCRC that appears metachronously to the primary disease is not clear. The South Australian Clinical Registry for mCRC collects data for patients diagnosed after February 2006. Data from 2502 patients, available on October 22, 2012, were analyzed according to stage at initial diagnosis (SAID) to compare outcomes between metachronous tumors (MTs) (stages I, II, III) and synchronous tumors (STs) (stage IV). Overall survival (OS) was calculated from the date of mCRC diagnosis. Patients with ST had more liver-only metastases, and patients with MT had more lung-only, non-lung and non-liver, and non-lung metastases. The median time to recurrence differed significantly according to SAID: stage I, 49.3 mo (n = 29), stage II, 25.2 mo (n = 346) and stage III, 18.4 mo (n = 497). The median OS was longer for patients with MT than for those with ST (19.0 vs.14.9 mo, P = .003). For patients who received any treatment for mCRC, the OS was longer for patients with MT than for those with ST (19.2 vs. 15.3 mo, P = .005). In patients who received only chemotherapy for mCRC, the median OS was longer for patients with MT than for those with ST (15.2 vs. 9.9 mo, P < .0001). No difference in OS between the MT and ST groups for patients who did not receive treatment for mCRC (1.6 vs. 2.6 mo P = .95). Patients with MT have a longer OS than those with ST, independent of treatment. Classification of patients according to whether they have metachronous or synchronous presentation of mCRC is prognostic. These results may add further support for population screening with the aim to reduce de novo metastatic disease.
Publisher: AMPCo
Date: 02-2017
DOI: 10.5694/MJA16.00255
Abstract: To investigate time to follow-up (clinical investigation) for Indigenous and non-Indigenous women in Queensland after a high grade abnormality (HGA) being detected by Pap smear. Population-based retrospective cohort analysis of linked data from the Queensland Pap Smear Register (PSR), the Queensland Hospital Admitted Patient Data Collection, and the Queensland Cancer Registry. 34 980 women aged 20-68 years (including 1592 Indigenous women) with their first HGA Pap smear result recorded on the PSR (index smear) during 2000-2009 were included and followed to the end of 2010. Time from the index smear to clinical investigation (histology test or cancer diagnosis date), censored at 12 months. The proportion of women who had a clinical investigation within 2 months of a HGA finding was lower for Indigenous (34.1% 95% CI, 31.8-36.4%) than for non-Indigenous women (46.5% 95% CI, 46.0-47.0% unadjusted incidence rate ratio [IRR], 0.65 95% CI, 0.60-0.71). This difference remained after adjusting for place of residence, area-level disadvantage, and age group (adjusted IRR, 0.74 95% CI, 0.68-0.81). However, Indigenous women who had not been followed up within 2 months were subsequently more likely to have a clinical investigation than non-Indigenous women (adjusted IRR for 2-4 month interval, 1.21 95% CI, 1.08-1.36) by 6 months, a similar proportion of Indigenous (62.2% 95% CI, 59.8-64.6%) and non-Indigenous women (62.8% 95% CI, 62.2-63.3%) had been followed up. Prompt follow-up after a HGA Pap smear finding needs to improve for Indigenous women. Nevertheless, slow follow-up is a smaller contributor to their higher cervical cancer incidence and mortality than their lower participation in cervical screening.
Publisher: Wiley
Date: 04-1980
DOI: 10.1111/J.1834-7819.1980.TB03679.X
Abstract: In 1977, after six years of fluoridation in South Australia, 337 six year-olds with continuous fluoride-drinking-water histories had DMFT values 53.2 per cent lower and df values 48.5 per cent lower than base-line values. For five to six year-olds presenting for follow-up care in the School Dental Service in 1977, continuous intake of fluoridated water evidently had reduced: (1) the number of teeth needing restorations by 40.0 per cent (2) the total care items required by 32.6 per cent (3) the total time required for care by 37.5 per cent and (4) the fee-for-service value of care required by 34.3 per cent.
Publisher: IEEE
Date: 2008
DOI: 10.1109/ICC.2008.629
Publisher: Wiley
Date: 21-03-2016
DOI: 10.1111/JEP.12536
Abstract: Stratification of women with screen-detected ductal carcinoma in situ (DCIS) by risk of subsequent invasive breast cancer (IBC) could assist treatment planning and selection of surveillance protocols that accord with risk. We assessed the utility of routinely collected administrative data for stratifying by IBC risk following DCIS detection in a population-based screening programme to inform ongoing surveillance protocols. A retrospective cohort design was used, employing linked data from the South Australian breast screening programme and cancer registry. Women entered the study at screening commencement and were followed until IBC diagnosis, death or end of the study period (1 December 2010), whichever came first. Routinely collected administrative data were analyzed to identify predictors of invasive breast cancer. Proportional hazards regression confirmed that the DCIS cohort had an elevated risk of IBC after adjustment for relevant confounders (HR = 4.0 (95% CL 3.4, 4.8)), which accorded with previous study results. Within the DCIS cohort, conservative breast surgery and earlier year of screening commencement were both predictive of an elevated invasive breast cancer risk. These linked cancer registry and administrative data gave plausible estimates of IBC risk following DCIS diagnosis, but were limited in coverage of key items for further risk stratification. It is important that the research utility of administrative datasets is maximized in their design phase in collaboration with researchers.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2021
Publisher: Springer Science and Business Media LLC
Date: 29-12-2015
DOI: 10.1007/S40291-015-0179-7
Abstract: Patients with metastatic colorectal cancer (mCRC) with BRAF mutation (BRAF MT) generally have a poorer prognosis. BRAF MT may also have implications for treatment strategy. Despite this, inclusion of BRAF in routine molecular testing varies. Here we report the frequency of BRAF reporting in the South Australian (SA) mCRC registry reflecting community practice, together with the survival outcomes based on mutation status. The SA population-based mCRC registry was analysed to assess the number of patients where a BRAF MT result was available. The patient characteristics are reported and overall survival was analysed using the Kaplan-Meier method. Of the 3639 patients who have been entered in the registry, only 6.2% (227) have BRAF MT results available. Of the patients tested, the BRAF MT rate is 12.7%. The mutation rate was highest in rightsided primary right colon 23 versus left colon 8.9% and rectum 7%. There was no significant difference in median age or male/female proportion. The median overall survival (mOS) for BRAF MT versus wild-type (WT) patients is 14.0 versus 32.9 months (p = 0.003). For patients who have chemotherapy (plus or minus surgery) the mOS is 14.6 months BRAF MT versus 36.1 months (p ≤ 0.001) WT. Liver or lung resection was performed on only 8% of the BRAF MT group versus 26.5% of the WT group. Results in a population setting confirm our understanding that BRAF MT is more frequently right sided and of lower frequency in rectal cancer. Survival is lower for patients with mCRC that have BRAF MT, regardless of the therapy. BRAF testing is currently performed infrequently in an Australian setting despite its importance as a significant prognostic factor, and the implications for alternate therapeutic approaches.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
Publisher: Elsevier BV
Date: 10-1991
DOI: 10.1016/0140-6736(91)91773-N
Abstract: Attempts to relate presence and type of human papillomavirus in cervical carcinoma with prognosis have yielded conflicting results. To further investigate this relation, the association between survival of cervical cancer patients after diagnosis and the presence of human papillomavirus (HPV) RNA within the tumour was assessed retrospectively. Formalin-fixed biopsy specimens from 212 patients with cervical carcinoma who had been followed for up to 6 years were tested by in-situ hybridisation with 125I-labelled riboprobes. HPV-RNA-positive women were 11.9 years younger than HPV-negative women at diagnosis (p less than 0.001). Case-fatality rates from cervical cancer rose with absence of HPV RNA, age at diagnosis, or FIGO stage. Multivariate analysis confirmed that absence of detectable HPV RNA and advanced FIGO stage were independent risk factors. No differences in survival between HPV types 16, 18, 31, or 33 were seen. These observations suggest that cervical carcinoma patients fall into two groups--a younger, HPV-RNA-positive group, with a better prognosis, and an older, HPV-RNA-negative group with poorer prognosis. Treatment regimens for the two groups may need to differ.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 03-2014
DOI: 10.7314/APJCP.2014.15.5.1895
Abstract: Cancer registries have fundamental roles in cancer surveillance, research, and health services planning, monitoring and evaluation. Many are now assuming a broader role by contributing data for health-service management, alongside data inputs from other registries and administrative data sets. These data are being integrated into de-identified databases using privacy-protecting data linkage practices. Structured pathology reporting is increasing registry access to staging and other prognostic descriptors. Registry directions need to vary, depending on local need, barriers and opportunities. Flexibility and adaptability will be essential to optimize registry contributions to cancer control.
Publisher: Wiley
Date: 03-1978
DOI: 10.1111/J.1752-7325.1978.TB03715.X
Abstract: Cross-reaction agglutinin titers to Brucella abortus antigen were found in 42 of 128 tularemia serum specimens, and cross-reaction titers to Francisella tularensis antigen were found in 8 of 34 brucellosis serum specimens. The cross-reaction titers were reduced to 10 or less by dithiothreitol, suggesting that the titers are due to immunoglobulin M antibody.
Publisher: IEEE
Date: 04-2013
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2021
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2014
Publisher: BMJ
Date: 07-2016
Publisher: Informa UK Limited
Date: 2006
Publisher: IEEE
Date: 12-2016
Publisher: Wiley
Date: 02-1971
DOI: 10.1111/J.1834-7819.1971.TB00978.X
Abstract: Oxidative stress contributes to the loss of neurons in many disease conditions as well as during normal aging however, small-molecule agents that reduce oxidation have not been successful in preventing neurodegeneration. Moreover, even if an efficacious systemic reduction of reactive oxygen and/or nitrogen species (ROS/NOS) could be achieved, detrimental side effects are likely, as these molecules regulate normal physiological processes. A more effective and targeted approach might be to augment the endogenous antioxidant defense mechanism only in the cells that suffer from oxidation. Here, we created several adeno-associated virus (AAV) vectors to deliver genes that combat oxidation. These vectors encode the transcription factors NRF2 and/or PGC1a, which regulate hundreds of genes that combat oxidation and other forms of stress, or enzymes such as superoxide dismutase 2 (SOD2) and catalase, which directly detoxify ROS. We tested the effectiveness of this approach in 3 models of photoreceptor degeneration and in a nerve crush model. AAV-mediated delivery of NRF2 was more effective than SOD2 and catalase, while expression of PGC1a accelerated photoreceptor death. Since the NRF2-mediated neuroprotective effects extended to photoreceptors and retinal ganglion cells, which are 2 very different types of neurons, these results suggest that this targeted approach may be broadly applicable to many diseases in which cells suffer from oxidative damage.
Publisher: Association for Computing Machinery (ACM)
Date: 05-03-2022
DOI: 10.1145/3436755
Abstract: The newly emerged machine learning (e.g., deep learning) methods have become a strong driving force to revolutionize a wide range of industries, such as smart healthcare, financial technology, and surveillance systems. Meanwhile, privacy has emerged as a big concern in this machine learning-based artificial intelligence era. It is important to note that the problem of privacy preservation in the context of machine learning is quite different from that in traditional data privacy protection, as machine learning can act as both friend and foe. Currently, the work on the preservation of privacy and machine learning are still in an infancy stage, as most existing solutions only focus on privacy problems during the machine learning process. Therefore, a comprehensive study on the privacy preservation problems and machine learning is required. This article surveys the state of the art in privacy issues and solutions for machine learning. The survey covers three categories of interactions between privacy and machine learning: (i) private machine learning, (ii) machine learning-aided privacy protection, and (iii) machine learning-based privacy attack and corresponding protection schemes. The current research progress in each category is reviewed and the key challenges are identified. Finally, based on our in-depth analysis of the area of privacy and machine learning, we point out future research directions in this field.
Publisher: IEEE
Date: 06-2013
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1111/J.1467-842X.2006.TB00842.X
Abstract: To measure the association between major causes of mortality and tobacco use and the association between major causes of mortality and alcohol use, after adjusting for tobacco use. Employees of Australian Institute of Petroleum member companies were enrolled in the cohort in four industry-wide surveys between 1981 and 1999. Mortality of 16,547 men was determined up to 31 December 2001 and cancer incidence to 31 December 2000. Relative mortality and cancer incidence rates were computed for smoking categories compared with never smokers, and for alcohol consumption compared with total abstainers. The highest category of smoking, more than 30 cigarettes per day, was associated with more than a threefold increase in all-cause mortality, a 60% increase in cancer incidence, a 43-fold increase in lung cancer incidence, and a more than fourfold increase in mortality from ischaemic heart disease. There were only four cancers in lifelong non-smokers. Moderate alcohol consumption provided a protective effect from death from all causes combined, relative to nil or low consumption, and relative to heavy alcohol consumption. The main contributor to the protective effect was protection against death from ischaemic heart disease. Lifelong avoidance of tobacco and moderate alcohol consumption confer significant improvements on life expectancy.
Publisher: IEEE
Date: 05-2016
Publisher: AMPCo
Date: 06-1986
DOI: 10.5694/J.1326-5377.1986.TB113693.X
Abstract: Data from the South Australian Cancer Registry on malignant melanoma of the skin showed that case survival rates were higher for lentigo maligna melanomas and superficial spreading lesions than for nodular and other histological classifications. Lower case survival rates applied to the thicker melanomas and those at a more invasive level at diagnosis. After adjusting for differences in thickness and level in this study, no statistically significant differences were apparent between case survival rates for the nodular lesions and the lentigo maligna and superficial spreading melanomas.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2009
Publisher: IEEE
Date: 07-2017
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 08-2012
DOI: 10.1007/S10552-012-0040-9
Abstract: To develop and validate a method for estimating numbers of people with distant cancer metastases, for evidence-based service planning. Estimates were made employing an illness-death model with distant metastatic cancer as the illness state- and site-specific mortality as an outcome, using MIAMOD software. To demonstrate the method, we estimated numbers of females alive in Australia following detection of distant metastatic breast cancer during 1980-2004, using data on patient survival from an Australian population-based cancer registry. We validated these estimates by comparing them with direct prevalence counts. Relative survival at 10 years following detection of distant metastases was low (5-20 %), with better survival experienced by: (1) females where distant metastatic disease was detected at initial diagnosis rather than subsequently (e.g., at recurrence) (2) those diagnosed in more recent calendar years and (3) younger age groups. For Australian females aged less than 85 years, the modeled cumulative risk of detection of distant metastatic breast cancer (either at initial diagnosis or subsequently) declined over time, but numbers of cases with this history rose from 71 per 100,000 in 1980 to 84 per 100,000 in 2004. The model indicated that there were approximately 3-4 prevalent distant metastatic breast cancer cases for every breast cancer death. Comparison of estimates with direct prevalence counts showed a reasonable level of agreement. The method is straightforward to apply and we recommend its use for breast and other cancers when registry data are insufficient for direct prevalence counts. This will provide estimates of numbers of people who would need ongoing medical surveillance and care following detection of distant metastases.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 03-04-2015
DOI: 10.7314/APJCP.2015.16.6.2465
Abstract: The Quality Audit (BQA) program of the Breast Surgeons of Australia and New Zealand (NZ) collects data on early female breast cancer and its treatment. BQA data covered approximately half all early breast cancers diagnosed in NZ during roll-out of the BQA program in 1998-2010. Coverage increased progressively to about 80% by 2008. This is the biggest NZ breast cancer database outside the NZ Cancer Registry and it includes cancer and clinical management data not collected by the Registry. We used these BQA data to compare socio-demographic and cancer characteristics and survivals by ethnicity. BQA data for 1998-2010 diagnoses were linked to NZ death records using the National Health Index (NHI) for linking. Live cases were followed up to December 31st 2010. Socio-demographic and invasive cancer characteristics and disease-specific survivals were compared by ethnicity. Five-year survivals were 87% for Maori, 84% for Pacific, 91% for other NZ cases and 90% overall. This compared with the 86% survival reported for all female breast cases covered by the NZ Cancer Registry which also included more advanced stages. Patterns of survival by clinical risk factors accorded with patterns expected from the scientific literature. Compared with Other cases, Maori and Pacific women were younger, came from more deprived areas, and had larger cancers with more ductal and fewer lobular histology types. Their cancers were also less likely to have a triple negative phenotype. More of the Pacific women had vascular invasion. Maori women were more likely to reside in areas more remote from regional cancer centres, whereas Pacific women generally lived closer to these centres than Other NZ cases. NZ BQA data indicate previously unreported differences in breast cancer biology by ethnicity. Maori and Pacific women had reduced breast cancer survival compared with Other NZ women, after adjusting for socio-demographic and cancer characteristics. The potential contributions to survival differences of variations in service access, timeliness and quality of care, need to be examined, along with effects of co- morbidity and biological factors.
Publisher: Elsevier BV
Date: 05-2001
Publisher: IEEE
Date: 06-2020
Publisher: IEEE
Date: 09-2010
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2014
Publisher: Elsevier BV
Date: 09-2014
Publisher: Springer Science and Business Media LLC
Date: 09-02-2017
DOI: 10.1038/BJC.2017.6
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13080
Abstract: Objective To investigate patient, cancer and treatment factors associated with the residence of female breast cancer patients in lower socioeconomic areas of Australia to better understand factors that may contribute to their poorer cancer outcomes. Methods Bivariable and multivariable analyses were performed using the Breast Quality Audit database of Breast Surgeons of Australia and New Zealand. Results Multivariable regression indicated that patients from lower socioeconomic areas are more likely to live in more remote areas and to be treated at regional than major city centres. Although they appeared equally likely to be referred to surgeons from BreastScreen services as patients from higher socioeconomic areas, they were less likely to be referred as asymptomatic cases from other sources. In general, their cancer and treatment characteristics did not differ from those of women from higher socioeconomic areas, but ovarian ablation therapy was less common for these patients and bilateral synchronous lesions tended to be less frequent than for women from higher socioeconomic areas. Conclusions The results indicate that patients from lower socioeconomic areas are more likely to live in more remote districts and have their treatment in regional rather than major treatment centres. Their cancer and treatment characteristics appear to be similar to those of women from higher socioeconomic areas, although they are less likely to have ovarian ablation or to be referred as asymptomatic patients from sources other than BreastScreen. What is known about this topic? It is already known from Australian data that breast cancer outcomes are not as favourable for women from areas of socioeconomic disadvantage. The reasons for the poorer outcomes have not been understood. Studies in other countries have also found poorer outcomes in women from lower socioeconomic areas, and in some instances, have attributed this finding to more advanced stages of cancers at diagnosis and more limited treatment. The reasons are likely to vary with the country and health system characteristics. What does this paper add? The present study found that in Australia, women from lower socioeconomic areas do not have more advanced cancers at diagnosis, nor, in general, other cancer features that would predispose them to poorer outcomes. The standout differences were that they tended more to live in areas that were more remote from specialist metropolitan centres and were more likely to be treated in regional settings where prior research has indicated poorer outcomes. The reasons for these poorer outcomes are not known but may include lower levels of surgical specialisation, less access to specialised adjunctive services, and less involvement with multidisciplinary teams. Women from lower socioeconomic areas also appeared more likely to attend lower case load surgeons. Little difference was evident in the type of clinical care received, although women from lower socioeconomic areas were less likely to be asymptomatic referrals from other clinical settings (excluding BreastScreen). What are the implications for practitioners? Results suggest that poorer outcomes in women from lower socioeconomic areas in Australia may have less to do with the characteristics of their breast cancers or treatment modalities and more to do with health system features, such as access to specialist centres. This study highlights the importance of demographic and health system features as potentially key factors in service outcomes. Health system research should be strengthened in Australia to augment biomedical and clinical research, with a view to best meeting service needs of all sectors of the population.
Publisher: Elsevier BV
Date: 1984
Publisher: IEEE
Date: 12-2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 12-2005
Publisher: Springer Science and Business Media LLC
Date: 11-2003
DOI: 10.1023/B:CACO.0000003838.48507.8B
Abstract: To determine the extent to which increases in survival from melanoma are explained by changes in thickness, level, histological type, site of lesion, and sociodemographic characteristics. Analyses of changes in survival among 9519 South Australians with melanoma reported to the State's population-based cancer registry during the 1980-2000 diagnostic period, using proportional hazards regression to adjust for thickness, level and other characteristics. Lower survivals applied for thicker lesions, deeper Clark levels, lesions on the trunk and scalp/neck, and for older cases and males. After adjusting for these characteristics, the relative risk (95% confidence limits) of case fatality for the 1994-2000 diagnostic period was 0.79 (0.63, 0.99), when compared with the 1980-1986 baseline. Prior to adjusting, the relative risk for these cases was 0.58 (0.47, 0.72). An unexpected finding was a secular change for deeper Clark levels within Breslow thickness categories. Approximately half the survival increase was not explained by changes in thickness, level, lesion site, and age and sex. Other possible contributors warranting further study include changes in ulceration, nodal or more distant site involvement, treatment gains and changes in tumour biology. The trend for deeper Clark levels within Breslow thickness categories requires independent confirmation.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-01-2014
DOI: 10.1200/JCO.2014.32.3_SUPPL.596
Abstract: 596 Background: Previous reports have described differences in biology and outcome based on whether the primary is R or L sided. Possible differences in response to biological agents have also been reported based on side of primary lesion (SY Brule et al., JCO31, 2013 (supp #3528). Methods: We explored the SA mCRC registry to assess if there were any differences in patient characteristics, treatment received and outcomes based on whether the primary was R (caecum to transverse colon) or L (splenic flexure to rectum) sided (JA Bufill, Ann Int Med. 113, 1990, 779-788). KM was used for survival outcomes and Cox proportional hazards regression modeling was used to assess defined prognostic markers. Results: 2,877 patients were analysed. 33% had R sided primary. Major differences between R and L respectively are as follows Female 51.3% vs. 37.9% (p = .0001), Med age 75.8 yrs vs. 70.5yrs (p = .0001), poorly differentiated pathology 34.3% vs. 20.8% (p = .0001), KRAS mutation 48% vs. 37% (p = 0.023), and liver surgery 10.5% vs. 16.3% (p = .0001). Analysis of chemotherapy (defined as either cytotoxic and/or molecular-targeted) revealed similar rates of first-line therapy, but differences in rates of therapy beyond first-line R vs. L respectively second-line 46% vs. 60.4%, third-line 17% vs. 30%, fourth-line 7% vs. 13%. There was however no difference in single agent vs. combination first-line therapy. The median overall survival (mOS) for the entire group R vs. L was 9.6 vs. 20.3 months (p .0001). For the group who had active therapy defined as chemotherapy (+/- metastasis resection), mOS was R 18.2 months vs. L 29.4 months (p .0001). For those (n = 123) who underwent liver resection (+/- chemotherapy) mOS was 6.2 years for both R and L (p = 0.32). Patients who were treated with only chemotherapy, the mOS was 10.7 mths vs. 15.3 mths for R v L (p = 0.0005). Conclusions: Patients with R sided primary have more negative prognostic factors and indeed have inferior outcomes when compared with those with a L sided primary. This did not appear to be the case for patients who were suitable for hepatic surgery.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.CANEP.2011.10.011
Abstract: Previous studies have shown that migrants have lower cancer mortality rates compared to the Australian-born population, particularly for colorectal and breast cancers, which are associated with an affluent lifestyle. This study seeks to update knowledge in this field by examining mortality from colorectal, stomach, lung, melanoma, breast and bladder cancers, as well as all cancers combined between 1981 and 2007. Data were obtained from the Australian Bureau of Statistics. Average annual age and sex-standardised mortality rates were calculated for each region of birth, period of death registration and cancer site. Generally, mortality rates declined over the study period for most conditions for the majority of migrant groups. Notable exceptions included migrants from South Eastern Europe and Eastern Europe who experienced a significant increase in mortality due to all cancers combined and Australian-born in iduals who recorded a significant increase in mortality due to melanoma of the skin. Migrants generally had more favourable cancer mortality outcomes, particularly for colorectal cancer and melanoma. Migrants from Southern Europe, South Eastern Europe, Chinese Asia and Southern Asia had the greatest advantage. However, migrants displayed higher rates of stomach, lung and bladder cancers than the Australian-born population. The migrant advantage can in part be explained by the protective effects of diet, lifestyle and reproductive behaviours. Possible explanations for why some migrants display greater mortality from stomach and bladder cancer include the consumption of abrasive, salted and preserved foods and higher rates of smoking. Greater emphasis should be placed on targeting at-risk migrant groups through screening and education programs at migrant resource centres and community groups. The study calls for further research to explain the observed trends, which has the potential to uncover important risk and protective factors.
Publisher: AMPCo
Date: 10-2014
DOI: 10.5694/MJA14.00365
Abstract: To investigate opportunities to reduce lung cancer mortality after diagnosis of localised non-small cell lung cancer (NSCLC) in New South Wales through surgical resection. In this cohort study, resection rates and lung cancer mortality risk were explored using multivariate logistic regression and competing risk regression, respectively. Data for 3040 patients were extracted from the NSW Central Cancer Registry for the diagnostic period 1 January 2003 to 31 December 2007. Subset analyses for patients at low surgical risk indicated resection rates and outcomes under ideal circumstances. Resection rates and lung cancer mortality. The resection rate in NSW was estimated to be between 38% and 43%, peaking at 59% by local health district (LHD) of residence. Not having a resection was associated with older age, lower socioeconomic status, lack of private health insurance, and residence by LHD. Adjusted 5-year cumulated probabilities of death were 76% in absence of resection, 30% for wedge resection, 18% for segmental resection, 22% for lobectomy and 45% for pneumonectomy. Of 255 "low surgical risk" patients, 71% had a resection. Those not receiving a resection had a higher probability of death (adjusted subhazard ratio, 14.1 95% CI, 7.2-27.5). If the low overall resection rate of 38%-43% in NSW were increased to 59% (the highest LHD resection rate), the proportion of all patients with localised NSCLC dying of NSCLC in the 5 years from diagnosis would decrease by about 10%, based on differences in probabilities of death by resection estimated in this study. Potential exists to reduce deaths from NSCLC in NSW through increased resection.
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/SH07043
Abstract: Background: The cost-effectiveness of adding a human papillomavirus (HPV) vaccine to the Australian National Cervical Screening Program compared to screening alone was examined. Methods: A Markov model of the natural history of HPV infection that incorporates screening and vaccination was developed. A vaccine that prevents 100% of HPV 16/18-associated disease, with a lifetime duration of efficacy and 80% coverage offered through a school program to girls aged 12 years, in conjunction with current screening was compared with screening alone using cost (in Australian dollars) per life-year (LY) saved and quality-adjusted life-year (QALY) saved. Sensitivity analyses included determining the cost-effectiveness of offering a catch-up vaccination program to 14–26-year-olds and accounting for the benefits of herd immunity. Results: Vaccination with screening compared with screening alone was associated with an incremental cost-effectiveness ratio (ICER) of $51 103 per LY and $18 735 per QALY, assuming a cost per vaccine dose of $115. Results were sensitive to assumptions about the duration of vaccine efficacy, including the need for a booster ($68 158 per LY and $24 988 per QALY) to produce lifetime immunity. Accounting for herd immunity resulted in a more attractive ICER ($36 343 per LY and $13 316 per QALY) for girls only. The cost per LY of vaccinating boys and girls was $92 052 and the cost per QALY was $33 644. The cost per LY of implementing a catch-up vaccination program ranged from $45 652 ($16 727 per QALY) for extending vaccination to 14-year-olds to $78 702 ($34 536 per QALY) for 26-year-olds. Conclusions: These results suggest that adding an HPV vaccine to Australia’s current screening regimen is a potentially cost-effective way to reduce cervical cancer and the clinical interventions that are currently associated with its prevention via screening alone.
Publisher: Institution of Engineering and Technology (IET)
Date: 2003
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2023
Publisher: Elsevier BV
Date: 06-2002
Publisher: IEEE
Date: 05-2018
Publisher: American Society of Clinical Oncology (ASCO)
Date: 02-2011
DOI: 10.1200/JCO.2011.29.4_SUPPL.514
Abstract: 514 Background: Life expectancy is increasing and more patients (pts) with mCRC are presenting at an advanced age ( ). Optimal management approach for this group of pts is not well defined as they are under-represented in clinical trials. Methods: The SACR for mCRC collects data on mCRC pts diagnosed after 1/2/2006. We examined cancer characteristics, treatments administered and outcomes for pts aged yrs. Comparison was made with pts yrs. Results: Data from 1737 mCRC pts has been entered to date of which 522 (30%) pts were aged ≥ 80. Key patient characteristics and treatments are reported in the table. The majority had grade 2 tumours. Grade 3 differentiation was reported in lower proportion of pts ≥80 yrs than the younger group (18% v 26%, p 0.001). Only 23.6% of pts received chemotherapy (CT). Of these, 63% received single agent CT (mostly capecitabine) while 37% received combination CT as first line treatment. In contrast, 67% of pts received CT, 73% of which received combination CT and 27% single agent (majority capecitabine) as their first line CT. Pts aged ≥ 80 had fewer liver resections and were also less likely to receive radiotherapy or monoclonal antibodies. Median survival was 7.1 mths for yrs v 17.4 mths for yrs, p 0.001. Median survival for pts treated with chemotherapy was 19 mths for and 21.7 mths for , p = 0.141. Pts without any treatment had a poor survival regardless of their age (median survival 2.9 mths yrs v 2.4 mths yrs). Conclusions: Older pts (≥ 80 yrs) were less likely to receive intervention for their mCRC and had poorer survival. However, survival for selected elderly pts, who received CT, was similar to those , despite most receiving single agent therapy. [Table: see text] [Table: see text]
Publisher: Wiley
Date: 22-05-2014
DOI: 10.1111/JEP.12183
Abstract: Population level data on colorectal cancer (CRC) management in Australia are lacking. This study assessed broad level patterns of care and concordance with guidelines for CRC management at the population level using linked administrative data from both the private and public health sectors across South Australia. Disparities in CRC treatment were also explored. Linking information from the South Australian Cancer Registry, hospital separations, radiotherapy services and hospital-based cancer registry systems provided data on the socio-demographic, clinical and treatment characteristics for 4641 CRC patients, aged 50-79 years, diagnosed from 2003 to 2008. Factors associated with receiving site/stage-specific treatments (surgery, chemotherapy and radiotherapy) and overall concordance with treatment guidelines were identified using Poisson regression analysis. About 83% of colon and 56% of rectal cancer patients received recommended treatment. Provision of neo-adjuvant/adjuvant therapies may be less than optimal. Radiotherapy was less likely among older patients (prevalence ratio 0.7, 95% confidence interval 0.5-0.8). Chemotherapy was less likely among older patients (0.7, 0.6-0.8), those with severe or multiple co-morbidities (0.8, 0.7-0.9), and those from rural areas (0.9, 0.8-1.0). Overall discordance with treatment guidelines was more likely among rectal cancer patients (3.0, 2.7-3.3), older patients (1.6, 1.4-1.8), those with multiple co-morbid conditions (1.3, 1.1-1.4), and those living in rural areas (1.2, 1.0-1.3). Greater emphasis should be given to ensure CRC patients who may benefit from neo-adjuvant/adjuvant therapies have access to these treatments.
Publisher: Wiley
Date: 28-08-2011
DOI: 10.1111/J.1743-7563.2011.01426.X
Abstract: Evidence supporting improved outcomes for small cell lung cancer (SCLC) in recent decades is limited. This study aimed to identify patterns of care and survival over two time periods 1 January 1987 to 31 December 1996 (cohort A) and 1 January 1997 to 31 December 2006 9 (cohort B). Patients' characteristics, management and outcome data were extracted from the Hospital Cancer Registry and clinical records. Survival analysis was determined using the Kaplan-Meier method and the log-rank test. Factors influencing survival outcome were assessed using Cox proportional hazards regression. The total number of patients was 392 (224 in cohort A, 168 in cohort B). Overall 38% patients in cohort A and 24% in cohort B had limited stage (LS) disease at diagnosis. Combined chemoradiotherapy for LS increased from 5% in cohort A to 65% in cohort B. Overall 19% of patients in cohort A and 24% in cohort B received symptomatic treatment alone (STA). Median survival for LS in cohort B was significantly higher (19.5 months), than in cohort A (11.8 months) (P = 0.03). In extensive stage (ES) disease, median survival was 6.2 months in cohort A and 4.3 months in cohort B (P = 0.7). Variables for poorer outcome were STA, male gender, poor performance status, ES and whether the diagnosis was made in the earlier time period in cohort A. Outcomes for LS SCLC have improved with combined chemoradiotherapy, in keeping with worldwide data. The trends may also reflect recent improvements in staging and standardization of treatment. The outcome for ES-SCLC remains poor.
Publisher: AMPCo
Date: 11-1984
DOI: 10.5694/J.1326-5377.1984.TB113226.X
Abstract: Survival rates for cancers of the lung, colon and female breast, and for invasive lesions of the cervix have been analysed according to age, place of residence, country of birth, socioeconomic status, and where applicable, by sex and histological type and were found to be negatively related to age. For patients with cancers of the colon and cervix, survival rates were lower in country residents than in those of metropolitan Adelaide. Low socioeconomic status was associated with a lower survival rate for patients with colonic cancers and female breast cancers a similar trend was suggested for those with cancers of the cervix. Higher survival rates were found for patients with squamous cell carcinomas and adenocarcinomas of the lung, and mucinous tumours of the breast. Higher survival rates for patients with breast tumours were associated with small tumour size at diagnosis. In some overseas-born populations, survival rates for patients with lung cancers and cervical cancers were higher than those in the Australian-born population. This warrants further investigation.
Publisher: Springer Science and Business Media LLC
Date: 24-04-2010
DOI: 10.1007/S10552-010-9519-4
Abstract: The aim was to explore incidence, mortality and case survivals for invasive neuroendocrine cancers in an Australian population and consider cancer control implications. Directly age-standardised incidence and mortality rates were investigated from 1980 to 2006, plus disease-specific survivals. Annual incidence per 100,000 increased from 1.7 in 1980-1989 to 3.3 in 2000-2006. A corresponding mortality increase was not observed, although numbers of deaths were low, reducing statistical power. Increases in incidence affected both sexes and were more evident for female lung, large bowel (excluding appendix), and unknown primary site. Common sites were lung (25.9%), large bowel (23.3%) (40.9% were appendix), small intestine (20.6%), unknown primary (15.0%), pancreas (6.5%), and stomach (3.7%). Site distribution did not vary by sex (p = 0.260). Younger ages at diagnosis applied for lung (p = 0.002) and appendix (p < 0.001) and older ages for small intestine (p < 0.001) and unknown primary site (p < 0.001). Five-year survival was 68.5% for all sites combined, with secular increases (p < 0.001). After adjusting for age and diagnostic period, survivals were higher for appendix and lower for unknown primary site, pancreas, and colon (excluding appendix). Incidence rates are increasing. Research is needed into possible aetiological factors for lung and large-bowel sites, including tobacco smoking, and excess body weight and lack of exercise, respectively and Crohn's disease as a possible precursor condition.
Publisher: CSIRO Publishing
Date: 2009
DOI: 10.1071/AH090645
Abstract: Quality of care from the patient?s perspective is an increasingly important outcome measure for cancer services. Patients? and carers? perceptions of cancer care were assessed through structured telephone interviews, 4?10 months post-discharge, which focused on experiences during the most recent hospital admission. A total of 481 patients with a primary diagnosis of cancer (ICD-10 C codes) were recruited, along with 345 carers nominated by the patients. Perceptions of clinical care were generally positive. Less positive aspects of care included not being asked how they were coping, not being offered counselling, and not receiving written information about procedures. Results also highlighted inadequate discharge processes. Carers were more likely than patients to report negative experiences. Perceptions of care also differed by cancer type.
Publisher: Elsevier BV
Date: 09-2015
Publisher: IEEE
Date: 08-2018
Publisher: AMPCo
Date: 08-1982
DOI: 10.5694/J.1326-5377.1982.TB124303.X
Abstract: A total of 658 cases of c ylobacter enteritis was reported in South Australia in the 18 months from March, 1980. Although C ylobacter sp. may cause more gastrointestinal disease than Salmonella sp. during some time periods, our data suggest that the reverse applies over all. However, since c ylobacter enteritis tends to affect older persons who possibly are investigated less frequently, the relative prevalence of c ylobacter infection may have been understated. Both diseases are notified among preschoolers to a disproportionate extent however, C ylobacter sp. show a greater predisposition that Salmonella sp. for affecting teenagers and young adults. Persons with c ylobacter infection are more likely to be residents of metropolitan areas than their counterparts with salmonella enteritis. Virtually all persons with c ylobacter infection experience some diarrhoea three-quarters have abdominal pain approximately one-third report blood, and a similar proportion mucus in their stools. Children are more likely than adults to have mucus, and possibly blood, in their stools.
Publisher: IEEE
Date: 06-2013
Publisher: IEEE
Date: 05-2018
Publisher: Elsevier BV
Date: 12-2014
Publisher: IEEE
Date: 06-2016
Publisher: Wiley
Date: 25-10-2010
DOI: 10.1111/J.1445-2197.2010.05341.X
Abstract: he National Breast Cancer Audit (NBCA) of the Royal Australasian College of Surgeons has collected data on early breast cancer since 1998. In this project, deaths were traced by linkage of NBCA patient identifiers (first three digits of surname and date of birth) with the National Death Index that covers all deaths in Australia. Death data were traced to 31 December 2007. Invasive cancers diagnosed in 1998-2005 were included in survival analyses to allow enough follow-up for assessment. Survivals were compared with survivals for similar stages recorded by the New South Wales (NSW) Cancer Registry and USA Surveillance Epidemiology and End Results (SEER) programme. Survivals were analysed by conventional clinical risk factors to see if expected differences presented. The 5-year survival from breast cancer of 93% for NBCA cases was the same as the SEER figure for local and regional cases combined in 1996-2004. The NBCA figure for localized cases was 97%, which was the same as for NSW. Node-positive NBCA cancers had a 5-year survival of 89%, which was slightly higher than the corresponding 86% for NSW, which may reflect exclusion from the NBCA of some cases with a poorer prognosis, including those with positive fixed nodes. As expected, lower survivals presented for older cases and those with conventional clinical risk factors. These survivals are credible both overall and by clinical risk factor. Opportunities present to use these data for survival monitoring and to investigate survival by socio-demographic characteristic, treatment protocol, case volume and provider characteristics.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2016
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 02-2019
Publisher: IEEE
Date: 04-2020
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2014
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-07-2014
DOI: 10.7314/APJCP.2014.15.14.5901
Abstract: Data from BreastScreen Australia Screening and Assessment Services (SAS) for 2002-2010 were analysed to determine whether some SAS characteristics were more conducive that others to high screening performance, as indicated by high priority performance indicators and standards. Indicators investigated related to: numbers of benign open biopsies, screen-detected invasive cancers, and interval cancers, and wait times between screening and assessment. Multivariate Poisson regression was undertaken using as candidate predictors of performance, SAS size (screening volume), urban or rural location, year of screening, accreditation status, and percentages of clients from culturally and linguistically erse backgrounds, rural and remote areas, and socio-economically disadvantaged areas. Performance standards for benign biopsies and invasive cancer detection were uniformly met irrespective of SAS location and size. The interval cancer standard was also met, except in 2003 when the 95% confidence interval of the rate still incorporated the national standard. Performance indicators improved over time for: benign open biopsy for second or subsequent screening rounds rates of invasive breast cancer detection for second or subsequent screening rounds and rates of small cancer detection. No differences were found over time in interval cancer rates. Interval cancer rates did not differ between non-metropolitan and metropolitan SAS, although state-wide SAS had lower rates. The standard for wait time between screening and assessment (being assessed <28 days) was mostly unmet and this applied in particular to SAS with high percentages of culturally and linguistically erse women in their screening populations. Gains in performance were observed, and all performance standards were met irrespective of SAS characteristics, except wait times to assessment. Additional descriptive data should be collected on SAS characteristics, and their associations with favourable screening performance, as these may be important when deciding on SAS design.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 15-09-2023
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2016
Publisher: IEEE
Date: 04-2018
Publisher: Wiley
Date: 04-05-2018
DOI: 10.1111/JEP.12757
Abstract: Adjuvant care for colorectal cancer (CRC) has increased over the past 3 decades in South Australia (SA) in accordance with national treatment guidelines. This study explores the (1) receipt of adjuvant therapy for CRC in SA as related to national guideline recommendations, with a focus on stage C colon and stage B and C rectal cancer (2) timing of these adjuvant therapies in relation to surgery and (3) comparative survival outcomes. Data from the SA Clinical Cancer Registry from 4 tertiary referral hospitals for 2000 to 2010 were examined. Patterns of care were compared with treatment guidelines using multivariable logistic regression. Disease-specific survivals were calculated by treatment pathway. Four hundred forty-three (60%) patients with stage C colon cancer and 363 (46%) with stage B and C rectal cancer received guideline-recommended care. While an overall increase in proportion receiving adjuvant care was not evident across the study period, the proportion having neoadjuvant care increased substantially. Older age was an independent predictor of not receiving adjuvant care. Patients with stage C colon cancer who received recommended adjuvant care had a higher 5-year survival than those not receiving this care, ie, 71.2% vs 53.2%. Similarly adjuvant therapy was associated with better outcomes for stage C rectal cancers. The median time for receiving adjuvant care was 8 weeks. Survival was better for stage C CRC treated according to guidelines. Adjuvant care should be provided except where clear contraindications present. Other possible contributors to guideline adherence warranting additional investigation include co-morbidity status, multidisciplinary team involvement, and choice.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2020
Publisher: Wiley
Date: 26-03-2010
DOI: 10.1111/J.1753-6405.1984.TB00521.X
Abstract: Acute myocardial infarction (AMI) and the heart failure (HF) that often complicates this condition, are among the leading causes of death and disability worldwide. To reduce myocardial infarct (MI) size and prevent heart failure, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). In this regard, targeting cardiac innervation may provide a novel therapeutic strategy for cardioprotection. A number of cardiac neural pathways mediate the beneficial effects of cardioprotective strategies such as ischaemic preconditioning and remote ischaemic conditioning, and nerve stimulation may therefore provide a novel therapeutic strategy for cardioprotection. In this article, we provide an overview of cardiac innervation and its impact on acute myocardial IRI, the role of extrinsic and intrinsic cardiac neural pathways in cardioprotection, and highlight peripheral and central nerve stimulation as a cardioprotective strategy with therapeutic potential for reducing MI size and preventing HF following AMI. This article is part of a Cardiovascular Research Spotlight Issue entitled 'Cardioprotection Beyond the Cardiomyocyte', and emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225.
Publisher: Springer Science and Business Media LLC
Date: 02-01-2021
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.BREAST.2015.01.006
Abstract: Few population-based data are available indicating the breast cancer risk following detection of atypia within a breast screening program. Prospectively collected data from the South Australian screening program were linked with the state cancer registry. Absolute and relative breast cancer risk estimates were calculated for ADH and ALH separately, and by age at diagnosis and time since diagnosis. Post-hoc analysis was undertaken of the effect of family history on breast cancer risk. Women with ADH and ALH had an increase in relative risk for malignancy (ADH HR 2.81 [95% CI 1.72, 4.59] and (ALH HR 4.14 [95% CI 1.97, 8.69], respectively. Differences in risk profile according to time since diagnosis and age at diagnosis were not statistically significant. Estimates of the relative risk of breast cancer are necessary to inform decisions regarding clinical management and/or treatment of women with ADH and ALH.
Publisher: Wiley
Date: 06-1996
DOI: 10.1111/J.1445-5994.1996.TB01922.X
Abstract: Self-reported prior morbidity levels and medication use among survivors of a near-fatal asthma attack (NFA) were studied. To identify deficiencies in asthma management and opportunities for intervention. A hundred and twenty-seven consecutive patients aged 15 years or more presenting with a NFA to accident and emergency departments of teaching hospitals were interviewed. High levels of morbidity due to asthma were reported. Most cases (79%) reported symptoms occurring at least weekly in the three months before their NFA. A mean of 20.8 days was reportedly lost from work, school or other usual daily activity in the 12 months before these events. Regular use of beta agonist as nebuliser solution was reported by 27% of cases, increasing to 34.5% in response to increased symptoms, while 41% reported use of nebulised beta agonist in response to the NFA event. Less than half of all cases (46%) reported using an inhaled corticosteroid on a regular basis. Oral corticosteroids were used by 33% of cases at times of increased symptoms in the preceding 12 months. However, only 7% of cases reported initiating or increasing oral corticosteroids at the time of the NFA. Despite high levels of prior asthma morbidity, regular preventive inhaled corticosteroid use was not widespread in this series of NFA asthmatics. By comparison, over-reliance on regular beta agonist medication was common. Oral corticosteroids were rarely commenced in response to the NFA.
Start Date: 10-2012
End Date: 12-2014
Amount: $240,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2019
End Date: 12-2022
Amount: $460,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 04-2012
End Date: 12-2015
Amount: $330,000.00
Funder: Australian Research Council
View Funded Activity