ORCID Profile
0000-0001-8576-8868
Current Organisations
Lund University
,
Cancer Council Queensland
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Applied Statistics | Statistics | Biostatistics | Statistical Theory | Cancer Diagnosis |
Cancer and related disorders | Evaluation of health outcomes | Expanding Knowledge in the Mathematical Sciences | Mathematical sciences
Publisher: BMJ
Date: 2008
DOI: 10.1111/J.1525-1438.2007.01122.X
Abstract: Due to the higher risk of morbidity and perioperative mortality compared to younger patients, elderly patients with advanced ovarian cancer are challenging to treat. A population-based analysis was performed to predict treatment outcomes and establish risk factors for early death of elderly patients with advanced ovarian cancer using a cohort of 3994 women diagnosed with stage III or IV ovarian cancer between 1992 and 1999, registered with the Surveillance, Epidemiology and End Results Cancer Registries. A multivariate accelerated failure time model allowed estimation of a risk factor model for overall survival. Patient's age, stage at presentation, presence of comorbidities, and oncology treatment facility were independently associated with overall survival at 12 months from diagnosis. Patients were assigned to low (0–7 points), moderate (8–14 points) or high (≥15 points) risk groups according to accumulation of risk factors, which showed good ability to predict 12-month mortality (receiver–operator characteristics curve [ROC] derivation cohort = 0.763 ROC validation cohort = 0.756). Across all three risk groups, patients who received both surgery and chemotherapy showed significantly improved survival as compared to patients who received only surgery or chemotherapy. For patients 80 years and over who had upfront surgery, perioperative mortality was significantly greater in the high-risk group (21% 95% CI = 16–26%) compared to patients within the moderate (8% 95% CI = 5–12%) and low-risk groups (0% 95% CI = 0–11%). The risk factor profile established could be helpful to plan future clinical trials to establish optimal treatment for elderly patients with advanced stage ovarian cancer
Publisher: Springer Science and Business Media LLC
Date: 02-03-2012
DOI: 10.1007/S10552-012-9931-Z
Abstract: To examine the relation between socio-demographic and clinical factors, and time from consultation to diagnosis and treatment for men with prostate cancer. Men diagnosed with prostate cancer (n = 1,064, response rate = 82%) were recruited through participating urologists and hospital outpatient clinics in Queensland, Australia, and completed telephone interviews and self-administered questionnaires. Outcome measures were the diagnostic interval (initial consultation to definitive diagnosis) and treatment interval (definitive diagnosis to start of treatment). Median time to diagnosis was 73 days (IQR = 41-144) and median treatment interval was 65 days (IQR = 36-107). After adjustment, men were more likely to wait more than 70 days for their definitive diagnosis when they initially presented with symptoms (compared with a general checkup) or did not have private health insurance. For treatment interval, men without private health insurance or who were treated with radiotherapy alone were more likely to wait more than 70 days. Treatment intervals were shorter when men received androgen deprivation therapy combined with radiotherapy. Differences in waiting times for diagnosis and treatment related to access to private hospital care suggest that there are inequities in health-care service provision that are system based.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2020
Publisher: JMIR Publications Inc.
Date: 14-02-2022
DOI: 10.2196/36908
Abstract: Mobile teledermatology is increasingly being used in clinical practice and offers the opportunity to counsel the general public about sun protection and skin cancer early detection. Growing evidence suggests that SMS text messaging interventions are an effective way to reach a large number of people and promote sun protection behaviors. Many medical practices already have SMS text message systems in place to communicate with patients, especially for appointment reminders and information. However, could we use these systems for even better outcomes? If so, how? This presentation will outline the results of the SunText study, a theory-based SMS text messaging intervention designed to evaluate how often and in what way we could communicate with people at risk of skin cancer to have a beneficial effect on sun protection behaviors, sunburn, and participant engagement. The SunText study was conducted between February-July 2019 in Queensland, Australia. Volunteer participants aged 18 to 40 years were randomized to 4 different intervention schedules using a Latin square design. The schedules included personalized or interactive messages with constant frequency and personalized and interactive messages with either increasing or decreasing frequency. Outcomes measured were reduction in sunburn and engagement with interactive messages, defined as responding to messages by return text. Compared to baseline, the self-reported sun protection habits index was significantly higher in all 4 interventions (P .01). Overall, sunburn rates decreased from baseline to the end of the intervention (40.3% to 7.0%), and remained significantly below baseline levels (23.5%) at the 6-month follow-up (P .01). All 4 interventions achieved reductions in sunburn rates (18%-48% reduction) during the intervention period. The overall engagement rate with interactive messages was 71%. The intervention involving interactive messages with constant frequency achieved the highest engagement rate. The intervention with personalized and interactive messages with increasing frequency had the lowest engagement rate. This study adds to the evidence that text messages targeting sun protection are effective in improving sun protection behaviors and reducing sunburn. Results also suggest higher engagement with constant or decreasing message frequency. Although many clinics already use SMS text messaging for scheduling, this presentation may encourage its extended use to raise awareness of sun protection. Interactive messages could also be integrated into sun protection mobile health apps, and provide an opportunity for engaging in health promotion content. This study was funded by a research grant from the Harry J Lloyd Charitable Trust. HPS is a shareholder of MoleMap NZ Limited and e-derm consult GmbH, and undertakes regular teledermatological reporting for both companies. HPS is a Medical Consultant for Canfield Scientific Inc, MoleMap Australia Pty Ltd, Blaze Bioscience Inc, Revenio Research Oy and a Medical Advisor for First Derm. All other authors declare no conflicts of interest.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2016
DOI: 10.1007/S00520-016-3475-9
Abstract: The purposes of the present study are to describe changes over time in the prevalence of unmet supportive care needs of Indigenous Australians newly diagnosed with cancer and to identify factors associated with greater needs at diagnosis. Unmet needs were assessed by the Supportive Care Needs Assessment Tool for Indigenous People (SCNAT-IP) within 3 months and at 6 months post-diagnosis. Overall needs and specific need domains were modelled using generalized estimating equations. Associations between risk factors and moderate-high unmet needs at diagnosis were assessed using multivariable logistic regression analyses. Over half (54%) of the participants (n = 82) experienced at least one moderate-high unmet need at diagnosis which reduced to 34% at 6 months post-diagnosis. This improvement mainly reflected the decrease in needs from the physical sychological domain (p = 0.042). The median overall unmet need score and most domain scores were significantly lower at 6 months. Eighteen percent experienced multiple (5+) moderate-high unmet needs at diagnosis (60% continued to report needs at 6 months). The top unmet needs at diagnosis were money worries (27%), concerns about the worries of those close to you (16%) and worry about your illness spreading/getting worse (15%). Having a higher education and having received cancer treatment in the last 30 days were significantly associated with greater needs at diagnosis. While unmet needs decreased over time, some patients continued to experience moderate-high unmet needs. This study indicates that needs should be monitored throughout the patient's journey. Coordination of support, particularly for those with multiple needs, may be important for this group.
Publisher: Hindawi Limited
Date: 19-09-2015
DOI: 10.1111/TBJ.12499
Publisher: Springer Science and Business Media LLC
Date: 02-2016
DOI: 10.1007/S11136-016-1233-6
Abstract: Health-related quality of life (HRQoL) and associated factors were assessed among 155 Indigenous Australian adult cancer patients 6 months post-diagnosis. The Assessment of Quality of Life-4D Questionnaire was used to assess HRQoL. Differences in the median utility score among subgroups of interest were examined using nonparametric tests. Factors associated with excellent HRQoL were assessed through logistic regression. Participants' mean age was 52 years (range 20-78), and the majority were female (60 %), unemployed (72 %), and recruited from outpatients clinics (64 %). Breast cancer (27 %) was the most common diagnosis. The median HRQoL score was 0.62 14 % of participants reported excellent HRQoL (>0.90). After adjusting for age, admission status, and treatment, excellent HRQoL was more likely among participants of Torres Strait Islander origin [adjusted odds ratio (AOR) 3.68 95 % CI 1.23-11.01], those living in regional areas (AOR 5.59 95 % CI 1.42-22.06), and those whose main language spoken at home was not English (AOR 3.60 95 % CI 1.08-11.99) and less likely among those reporting less contact with Indigenous people (AOR 0.23 95 % CI 0.68-0.81). Assessing HRQoL is important to identifying and improving the length and quality of cancer survivorship, especially in groups that have significantly poorer cancer outcomes, such as Indigenous Australians. Acknowledging the study's observational nature, we found HRQoL was lower than reported for other Australians, and we identified some socio-demographic factors that were associated with excellent HRQoL. Such assessments are an important component of identifying and evaluating appropriate interventions to improve the health and well-being of Indigenous cancer patients.
Publisher: Elsevier BV
Date: 09-2013
Publisher: Wiley
Date: 08-04-2015
DOI: 10.1002/PBC.25517
Abstract: Childhood acute myeloid leukaemia (AML) requires intensive therapy and is associated with survival rates that are substantially inferior to many other childhood malignancies. We undertook a retrospective analysis of Australian Paediatric Cancer Registry data from 1997 to 2008 together with a single-centre audit during the same period assessing burden on service delivery at a tertiary children's hospital (Royal Children's Hospital, Brisbane). Although survival improved from 54.3% (1997-2002) to 69.2% (2003-2008), childhood AML caused a disproportionate number of childhood cancer deaths, accounting for 5.5% of all childhood cancer diagnoses yet 7.9% of all childhood cancer mortality. Furthermore, treatment was associated with significant toxicity requiring intensive use of local health resources. Novel therapeutic strategies aimed at improving survival and reducing toxicity are urgently required.
Publisher: Oxford University Press (OUP)
Date: 24-11-2019
DOI: 10.1111/BJD.18560
Abstract: Thin cutaneous melanomas (≤ 1·00 mm) are increasing worldwide, causing around a quarter of all melanoma deaths in the U.S.A. and Australia. Identification of predictive factors for potentially fatal thin melanomas could allow better use of resources for follow-up. To identify the clinicopathological factors associated with fatal thin melanomas. This large, nested case-case study extracted data from the population-based Queensland Cancer Registry, Australia. Our cohort consisted of Queensland residents aged 0-89 years who were diagnosed with a single, locally invasive thin melanoma (≤ 1·00 mm) between 1995 and 2014. Fatal cases (eligible patients who died from melanoma) were in idually matched to three nonfatal cases (eligible patients who were not known to have died from melanoma) according to sex, age, year of diagnosis and follow-up interval. Using conditional logistic regression, we calculated odds ratios (ORs) for melanoma-specific death, adjusting for all collected clinicopathological variables. In the cohort, 27 660 eligible patients were diagnosed with a single, thin melanoma. The final case-case series included 424 fatal cases and 1189 nonfatal cases. Fatal cases were sixfold as likely to arise on the scalp as on the back [OR 6·39, 95% confidence interval (CI) 2·57-15·92] and six times as likely to be of thickness 0·80-1·00 mm as of < 0·30 mm (OR 6·00, 95% CI 3·55-10·17). Scalp location is a strong prognostic factor of death from thin melanoma. Further, this study provides support that melanomas with a thickness of 0·80-1·00 mm are the more hazardous thin lesions. Patients with these tumour characteristics require specific attention during follow-up. What's already known about this topic? Thin invasive melanomas (≤ 1·00 mm) contribute a substantial proportion of melanoma fatalities, owing to the high volume of disease. There is a need to find prognostic factors that will better identify fatal thin melanomas at the time of diagnosis. What does this study add? In this large population-based study, fatal thin tumours were sixfold as likely to be located on the scalp as on the back. Thin melanomas of 0·80-1·00 mm thickness were six times as likely to be associated with death as tumours < 0·30 mm. Scalp location and increasing thickness are strong predictive factors of fatal thin melanomas, indicating that patients with these tumour characteristics require close follow-up.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.SSTE.2016.08.002
Abstract: Despite improvements in cancer survival across many developed countries, it is unclear how survival is changing over time in small areas. This study investigated changes in breast and colorectal cancer survival across 478 areas over 11 years (2001-2011), and the influence of early diagnosis on changes. Queensland Cancer Registry data were analysed using an introduced Bayesian spatio-temporal flexible parametric relative survival model. All areas showed survival improvements between 2001-2003 and 2008-2011. The median absolute 5-year survival improvement for localised breast cancer was small (1.8%), compared to advanced (4.8%) and unknown (7.9%) breast cancer, as well as localised (2.6%), advanced (5.0%) and unknown (4.8%) colorectal cancers. Improvements in non-diagnostic factors, such as patient treatment and management, appear to be the main influence on recent survival increases for breast and colorectal cancers. Important inequalities in cancer survival between small areas remain.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.HEALTHPLACE.2012.07.006
Abstract: This study examines the influence of cancer stage, distance to treatment facilities and area disadvantage on breast and colorectal cancer spatial survival inequalities. We also estimate the number of premature deaths after adjusting for cancer stage to quantify the impact of spatial survival inequalities. Population-based descriptive study of residents aged <90 years in Queensland, Australia diagnosed with primary invasive breast (25,202 females) or colorectal (14,690 males, 11,700 females) cancers during 1996-2007. Bayesian hierarchical models explored relative survival inequalities across 478 regions. Cancer stage and disadvantage explained the spatial inequalities in breast cancer survival, however spatial inequalities in colorectal cancer survival persisted after adjustment. Of the 6,019 colorectal cancer deaths within 5 years of diagnosis, 470 (8%) were associated with spatial inequalities in non-diagnostic factors, i.e. factors beyond cancer stage at diagnosis. For breast cancers, of 2,412 deaths, 170 (7%) were related to spatial inequalities in non-diagnostic factors. Quantifying premature deaths can increase incentive for action to reduce these spatial inequalities.
Publisher: MDPI AG
Date: 27-09-2019
Abstract: Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.
Publisher: Wiley
Date: 03-03-2009
DOI: 10.1002/CNCR.24162
Abstract: Worldwide, the incidence of thick melanoma has not declined, and the nodular melanoma (NM) subtype accounts for nearly 40% of newly diagnosed thick melanoma. To assess differences between patients with thin ( or=2.01 mm) nodular melanoma, the authors evaluated factors such as demographics, melanoma detection patterns, tumor visibility, and physician screening for NM alone and compared clinical presentation and anatomic location of NM with superficial spreading melanoma (SSM). The authors used data from a large population-based study of Queensland (Australia) residents diagnosed with melanoma. Queensland residents aged 20 to 75 years with histologically confirmed first primary invasive cutaneous melanoma were eligible for the study, and all questionnaires were conducted by telephone (response rate, 77.9%). During this 4-year period, 369 patients with nodular melanoma were interviewed, of whom 56.7% were diagnosed with tumors <or=2.00 mm. Men, older in iduals, and those who had not been screened by a physician in the past 3 years were more likely to have nodular tumors of greater thickness. Thickest nodular melanoma (4 mm+) was also most common in persons who had not been screened by a physician within the past 3 years (odds ratio, 3.75 95% confidence interval, 1.47-9.59). Forty-six percent of patients with thin nodular melanoma ( 2.00 mm). Awareness of factors related to earlier detection of potentially fatal nodular melanomas, including the benefits of a physician examination, should be useful in enhancing public and professional education strategies. Particular awareness of clinical warning signs associated with thin nodular melanoma should allow for more prompt diagnosis and treatment of this subtype.
Publisher: Wiley
Date: 21-11-2018
DOI: 10.1002/IJC.31141
Abstract: Public c aigns encouraging sun protection for skin cancer prevention began in Queensland, Australia, in the early 1980s. We examined recent trends to assess whether earlier evidence of stabilizing melanoma incidence in young people has persisted. Anonymized incidence and mortality data for in situ and invasive melanoma for the 20 years 1995-2014 were obtained from the Queensland Cancer Registry. Time trends were analyzed using JoinPoint regression. Birth cohort patterns were assessed using age-period-cohort models. Melanoma incidence in Queensland remains the highest recorded in the world (age-standardized incidence of invasive melanoma (2010-2014) = 72/100,000/annum). Over the 20-year period, incidence of in situ melanoma increased in all age groups. Incidence of both thin (≤1 mm) and thick (>1 mm) invasive melanoma was either stable or decreased in people under 60, while it increased in those aged 60 and above, particularly in men. Age-period-cohort analysis revealed decreasing age-specific incidence of invasive melanoma under 40 years of age, beginning with the birth cohort born around the mid-1960s, with steepest falls for those born around 1980 and later. Age-specific incidence was stable between 40 and 59 years of age from the 1945 birth cohort onwards. Melanoma mortality over the period was stable or decreased in all groups except in men aged 60 or over. These findings are evidence of real advances in the prevention and early detection of invasive melanoma in this very high-risk population. They make a compelling case for continued public health efforts to reduce the burden of melanoma in susceptible populations.
Publisher: Elsevier BV
Date: 05-2006
DOI: 10.1016/J.JAAD.2005.08.065
Abstract: Early detection of melanoma has been encouraged in Queensland for many years, yet little is known about the patterns of detection and the way in which they relate to tumor thickness. Our purpose was to describe current patterns of melanoma detection in Queensland. This was a population-based study, comprising 3772 Queensland residents diagnosed with a histologically confirmed melanoma between 2000 and 2003. Almost half (44.0%) of the melanomas were detected by the patients themselves, with physicians detecting one fourth (25.3%) and partners one fifth (18.6%). Melanomas detected by doctors were more likely to be thin (<0.75 mm) than those detected by the patient or other layperson. Melanomas detected during a deliberate skin examination were thinner than those detected incidentally. Although a participation rate of 78% was achieved, as in any survey, nonresponse bias cannot be completely excluded, and the ability of the results to be generalized to other geographical areas is unknown. There are clear differences in the depth distribution of melanoma in terms of method of detection and who detects the lesions that are consistent with, but do not automatically lead to, the conclusion that promoting active methods of detection may be beneficial.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814173.V1
Abstract: Supplementary Figure S2 shows article's study period in years
Publisher: S. Karger AG
Date: 2010
DOI: 10.1159/000321177
Publisher: Springer Science and Business Media LLC
Date: 2008
DOI: 10.1007/S10552-007-9106-5
Abstract: To describe the incidence of second primary invasive melanoma. Data describing 52,997 subjects with melanoma notified to The Queensland Cancer Registry between 1982 and 2003. We calculated incidence rates of second primary invasive melanoma (per 1,000 person-years) by sex, age, and characteristics of the first primary. The rate of second primary invasive melanoma was relatively constant over 20 years of follow-up at 6.01 per 1,000 person-years indicating a high, constant lifetime risk of second primary invasive melanoma. Rates were 62% higher in males than in females and increased with age at first diagnosis with the rate in older patients (80+ years) more than double the rate observed in younger patients (40-49 years). Rates in patients with melanomas thicker than 2 mm were over 50% higher than in patients with thinner melanomas. Melanoma patients are at high risk of a second primary invasive melanoma. This risk does not diminish with time and does not differ significantly between patients first diagnosed with lentigo maligna, in situ melanoma or invasive melanoma. These results indicate that all melanoma patients require lifetime surveillance. Current treatment guidelines should be modified to reflect this.
Publisher: Cambridge University Press (CUP)
Date: 09-02-2021
DOI: 10.1017/S1368980021000562
Abstract: Mandatory fortification of bread flour with folic acid has helped to reduce the incidence of neural tube defects in several countries. However, it has been suggested that folic acid may have potential adenoma-promoting effects, and reports from some countries have suggested that mandatory folic acid food fortification programmes have increased the incidence of colorectal cancer. The objective of this study was to evaluate colorectal cancer incidence patterns before and after introduction of mandatory folic acid fortification of bread flour in Australia in 2009. Data from the Australian Cancer Database were used to plot age-standardised incidence of colorectal cancer. We calculated age-adjusted rate ratios with 95 % CIs. Australia. We used population-level aggregate data obtained from cancer registries. Age-standardised colorectal cancer incidence generally decreased between 1999 and 2016. Although there was a slight increase in rates in 2010 compared with 2009 (62·8 v . 61·6 cases per 100 000, age-adjusted rate ratio 1·02 (95 % CI 0·99, 1·04), joinpoint regression indicated decreases of –0·4 % (95 % CI –0·7, 0·0) per year from 1999 to 2010 and –2·2 % (95 % CI –3·1, –1·3) per year from 2010 to 2016. While causation cannot be assessed from these population-level data, our observations indicate that there is no evidence that introduction of mandatory folic acid fortification of bread flour has influenced colorectal cancer incidence in Australia.
Publisher: American Medical Association (AMA)
Date: 03-2019
Publisher: AMPCo
Date: 12-2011
DOI: 10.5694/MJA11.11310
Publisher: Wiley
Date: 03-12-2019
DOI: 10.1002/IJC.31943
Abstract: Globally, 39% of the world's adult population is overweight or obese and 23% is insufficiently active. These percentages are even larger in high-income countries with 58% overweight/obese and 33% insufficiently active. Fourteen cancer types have been declared by the World Cancer Research Fund to be causally associated with being overweight or obese: oesophageal adenocarcinoma, stomach cardia, colon, rectum, liver, gallbladder, pancreas, breast, endometrium, ovary, advanced/fatal prostate, kidney, thyroid and multiple myeloma. Colon, postmenopausal breast and endometrial cancers have also been judged causally associated with physical inactivity. We aimed to quantify the proportion of cancer cases that would be potentially avoidable in Australia if the prevalence of overweight/obesity and physical inactivity in the population could be reduced. We used the simulation modelling software PREVENT 3.01 to calculate the proportion of avoidable cancers over a 25-year period under different theoretical intervention scenarios that change the prevalence of overweight/obesity and physical inactivity in the population. Between 2013 and 2037, 10-13% of overweight/obesity-related cancers in men and 7-11% in women could be avoided if overweight and obesity were eliminated in the Australian population. If everyone in the population met the Australian physical activity guidelines for cancer prevention (i.e. engaged in at least 300 min of moderate-intensity physical activity per week), an estimated 2-3% of physical inactivity-related cancers could be prevented in men (colon cancer) and 1-2% in women (colon, breast and endometrial cancers). This would translate to the prevention of up to 190,500 overweight/obesity-related cancers and 19,200 inactivity-related cancers over 25 years.
Publisher: American Medical Association (AMA)
Date: 11-2006
DOI: 10.1001/ARCHDERM.142.11.1422
Abstract: To examine the relationship between melanoma thickness and reported time from first recognition and from first physician contact to the diagnosis of invasive melanoma. Telephone survey of patients recently diagnosed as having melanoma, combined with relevant pathological data (including melanoma thickness and morphologic structure) from the population-based Queensland Cancer Registry. A test-retest study (n = 176) was also conducted. Population-based study in Queensland. Residents of Queensland (n = 3772) who had been diagnosed as having invasive melanoma between January 1, 2000, and December 31, 2003. Prepresentation time (time between first noticing a suspicious spot and the first physician visit), postpresentation time (time between the first physician visit and diagnosis), and total time to diagnosis (time from initial detection of the melanoma to diagnosis). With 1 exception, we found no significant association between melanoma thickness and reported time to diagnosis for all melanomas combined, superficial spreading melanomas, or nodular melanomas. The exception was a positive association between melanoma thickness and postpresentation delay of physician-detected nodular melanomas. The reliability study gave intraclass correlation coefficients of 0.85 to 0.90 for the measures of intervals. This large study demonstrates no clear relationship between the melanoma thickness when diagnosed and the time from first recognition of changes or from first physician examination to diagnosis. This may be because of varying biological characteristics of melanomas, as well as methodological limitations of retrospective studies when trying to measure this complex association.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2011
DOI: 10.1158/1055-9965.EPI-11-0432
Abstract: Background: It is not known whether improvements in cancer survival over recent decades have benefited children from different geographic locations equally. This is the first study to produce national survival estimates for childhood cancer in Australia by remoteness of residence and area-based socioeconomic status. Methods: The study utilized population-based data from the Australian Paediatric Cancer Registry for children diagnosed with cancer from 1996 onward who were at risk of mortality between January 2001 and December 2006 (n = 6,289). Remoteness was specified according to the Australian Standard Geographical Classification Remoteness Areas, whereas an index of area disadvantage was obtained from census information. Five-year relative survival estimates were produced by the period method for all cancers and the most common diagnostic groups, with corresponding age–sex adjusted mortality hazard ratios calculated using Poisson regression. Results: Overall, children with cancer from remote/very remote areas had a significantly lower survival rate than their counterparts in major cities (HR = 1.55, 95% CI = 1.08–2.23). Survival was also lower for children with leukemia living in inner regional (HR = 1.52, 95% CI = 1.11–2.08) or outer regional areas (HR = 1.53, 95% CI = 1.03–2.28). There was weak evidence (Pgrad = 0.051) of a trend toward poorer survival by greater area disadvantage for all childhood cancers. Conclusions: Some variation in prognosis by place of residence was present for children with cancer in Australia, particularly among leukemia patients. Impact: Treatment, clinical or area-related factors that contribute to these survival differentials need to be identified. Cancer Epidemiol Biomarkers Prev 20(8) 1649–56. ©2011 AACR.
Publisher: Springer Science and Business Media LLC
Date: 20-05-2012
Publisher: Springer Science and Business Media LLC
Date: 31-10-2014
DOI: 10.1007/S12020-013-0078-9
Abstract: An Australian state database was used to test the validity of the Quantitative tumor/node/metastasis (QTNM) staging system for assessing prognosis of differentiated thyroid cancer (DTC) on the basis of four variables quantified at diagnosis (histopathology, age, node involvement, and tumor size). Using the Queensland Cancer Registry (QCR), we identified 788 cases of DTC diagnosed from 1982 to 2006 with complete staging information. Causes of death were ascertained by linking the QCR database with the Australian National Death Index. Subjects were staged according to AJCC TNM 7th edition and QTNM, and cancer-specific survival (CSS) was calculated by the Kaplan-Meier method. Cancer-specific mortality was observed in 22 (2.8 %) patients, with 10-year CSS for the cohort of 97.0 % at a median follow-up of 262.8 months. QTNM stage specific cancer survival at 10 years was 99.6, 97.0, and 78.6 % for low-, intermediate-, and high-risk groups, respectively. This was comparable to the original US dataset in which the QTNM was initially studied, and it fared better at discriminating survival than the standard TNM system, where there was overlap in survival between stages. The current study validates the QTNM system in an Australian cohort and shows at least equivalent discriminatory capacity to the current TNM staging system. The QTNM utilized prognostic variables of significance to produce an optimal three-stage stratification scheme. Given, its advantage in clearly discriminating between prognostic groups, clinical relevance and simplicity of use, we recommend that TNM be replaced with QTNM for risk stratification for both recurrence and CSS.
Publisher: Elsevier BV
Date: 08-2005
DOI: 10.1111/J.1467-842X.2005.TB00211.X
Abstract: To assess whether the stabilisation in melanoma mortality rates observed from 1985 to 1994 has progressed to a statistically significant decrease. Joinpoint trends analyses of Australian melanoma mortality data between 1950 and 2002, stratified by age. The latest data showed statistically significant decreases in mortality rates for both men and women younger than 55 years (percentage change per year, men 35-55 years: -2.4% 95% CI -3.5% -- -1.3% women: -2.9% 95% CI -4.7%-- -1.1%). For ages 55-79 years, rates are now stable for both men (+0.3% 95% CI -0.6%-- +1.1%) and women (-0.5% 95% CI -1.4%-- +0.4%), whereas previously the rates were increasing. For both men and women 80 years or older, rates have continued their statistically significant increase of 3-4% per year. Since no similar reductions in incidence have been reported, the most likely cause of the recent statistically significant decreases in mortality is early detection. Although it may be too early to be seeing the full benefits of primary prevention programs that started in the 1980s, they have the potential to lead to large reductions in mortality in the future.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 05-2012
Abstract: The 20-year survival rates are unknown for the majority of melanoma patients—those with thin melanomas. We determined 20-year survival rates of patients diagnosed with thin melanomas (≤ 1.00 mm) in the general population and also determined the main prognostic factors. Available clinical and histologic data from the Queensland Cancer Registry were obtained for all patients diagnosed with a single thin invasive melanoma from 1982 to 2006 and matched against national death registration data. Melanoma-specific survival estimates to December 31, 2007, were assessed, and subgroup differences in prognosis were determined by fitting multivariate Cox proportional hazard models. Among 26,736 people in the state of Queensland diagnosed with thin melanomas, the 20-year survival was 96%. The most influential determinants of prognosis were tumor thickness ≥ 0.75 mm (adjusted hazard ratio [HR], 4.33 95% CI, 2.8 to 6.8 compared with tumors 0.25 mm) and patient age at diagnosis older than 65 years (HR, 2.8 95% CI, 1.8 to 4.5) compared with age younger than 25 years. Acral lentiginous and nodular tumors, male sex, tumor site on the scalp or neck, or tumor invasion of the entire papillary dermis each independently increased the risk of dying from thin invasive melanoma. The outlook for patients with thin invasive melanoma is positive, although continued clinical vigilance is warranted for patients with nodular melanoma and those with the thickest tumors.
Publisher: Wiley
Date: 22-05-2015
DOI: 10.1111/LIV.12853
Abstract: Incidence and mortality of hepatocellular carcinoma (HCC) is increasing globally, but varies between countries and regions. To target scarce resources to most need, clinical services must be informed by regional epidemiology. Using population-based data, we sought to document the incidence and mortality of HCC in Queensland, Australia, a state occupying a vast land area with erse at-risk subpopulations. Using population-based data from 1996 to 2011, the age-standardised incidence rate (ASR), annual percentage change (APC) and survival of HCC in Queensland were assessed with negative binomial regression, Kaplan-Meier and Cox survival analysis. Spatial patterns of HCC incidence and survival and relevant predictors were mapped. Thousand six hundred and twenty HCCs were diagnosed during this study period, with an overall ASR of 2.00-cases/1000 population. ASR increased by 3.5% per year, (95% CI: 2.1 to 5.0), P < 0.001) among males to 5.6/100,000 in 2011 and a non-significant increase of 2.6% per year, (95% CI = -0.7 to 6.0), P = 0.111) among females to 1.6/100,000 in 2011. Higher incidence was associated with male gender, older age, major city residence and proportionally higher area Indigenous population. Thousand and two hundred and eighty-seven patients died. Median survival was approximately 10 months. Five-year survival improved from 18% in 1996-2000 to 24% in 2006-2011 (P < 0.001). Poorer survival was associated with older age, less recent period of diagnosis, lower hepatitis B prevalence in country of origin and greater area-level social disadvantage. Over this study period, HCC incidence increased significantly. HCC survival improved but remains poor. Social determinants are critical to HCC epidemiology.
Publisher: Oxford University Press (OUP)
Date: 14-11-2017
DOI: 10.1111/BJD.15863
Publisher: Elsevier BV
Date: 04-2018
Publisher: Public Library of Science (PLoS)
Date: 05-05-2016
Publisher: Springer Science and Business Media LLC
Date: 17-01-2017
Publisher: MDPI AG
Date: 19-07-2016
Publisher: Springer Science and Business Media LLC
Date: 09-12-2012
DOI: 10.1007/S10549-011-1899-Y
Abstract: A major priority for cancer control agencies is to reduce geographical inequalities in cancer outcomes. While the poorer breast cancer survival among socioeconomically disadvantaged women is well established, few studies have looked at the independent contribution that area- and in idual-level factors make to breast cancer survival. Here, we examine relationships between geographic remoteness, area-level socioeconomic disadvantage and breast cancer survival after adjustment for patients' socio-demographic characteristics and stage at diagnosis. Multilevel logistic regression and Markov chain Monte Carlo simulation were used to analyze 18,568 breast cancer cases extracted from the Queensland Cancer Registry for women aged 30-70 years diagnosed between 1997 and 2006 from 478 Statistical Local Areas in Queensland, Australia. Independent of in idual-level factors, area-level disadvantage was associated with breast cancer survival (P = 0.032). Compared to women in the least disadvantaged quintile (quintile 5), women diagnosed while resident in one of the remaining four quintiles had significantly worse survival (OR 1.23, 1.27, 1.30, 1.37 for quintiles 4, 3, 2, and 1, respectively). Geographic remoteness was not related to lower survival after multivariable adjustment. There was no evidence that the impact of area-level disadvantage varied by geographic remoteness. At the in idual-level, Indigenous status, blue collar occupations and advanced disease were important predictors of poorer survival. A woman's survival after a diagnosis of breast cancer depends on the socio-economic characteristics of the area where she lives, independently of her in idual-level characteristics. It is crucial that the underlying reasons for these inequalities be identified to appropriately target policies, resources and effective intervention strategies.
Publisher: S. Karger AG
Date: 08-12-2007
DOI: 10.1159/000097851
Abstract: Recent studies in the USA and elsewhere have identified a possible association between Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS) and melanoma. However, empirical evidence is very limited. We conducted a study of all people diagnosed as having melanoma in Australia since 1982 (n = 127,037). The subjects, excluding those who had died within 12 months of diagnosis, were followed until 31 December 2001. We then compared their mortality risk of ALS and PD to that of the general population. There were a total of 53 ALS deaths and 129 deaths due to PD. Although the absolute risk is small, the melanoma cohort had a risk of death due to ALS 70% higher (standardised mortality ratio = 169.4, 95% CI = 127–221) than the general population, and nearly a 3-fold increased risk of dying from PD (standardised mortality ratio = 266.3, 95% CI = 222–317). These increased risks continued for long-term survivors, arguing against a surveillance effect (particularly for ALS). The consistency of these results in 2 separate populations (Australia and USA) strengthens the evidence for an association between melanoma and each of the 2 neurodegenerative diseases.
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: Wiley
Date: 05-11-2013
DOI: 10.1002/PON.3210
Abstract: Heightened psychological distress after cancer is common but likely highly heterogeneous. This raises potential challenges in how and when to target services however, data describing longitudinal patterns of distress are limited. This study describes the long term psychological outcomes for colorectal cancer (CRC) survivors and trajectories of adjustment over time. A prospective survey of a population-based s le of 1966 CRC survivors assessed sociodemographic variables, perceived social support and psychological distress, including distress subtypes of anxiety, depression and somatization, at six time points from 5 months to 5 years post-diagnosis. Over the 5-year trajectory, the prevalence of high overall distress ranged between 44% and 32% but was greater for men compared with women (p < 0.001). Four distress trajectory styles within clusters were identified for overall distress and for each distress subtype with a constant low distress group providing the basis for comparison. Higher distress trajectories varied for overall distress and distress subtypes but were generally differentiated by gender, younger age, lower education, poor socioeconomic advantage, late disease stage and poor social support. For global distress, by comparison with women, men with CRC are vulnerable to distress, with men who are younger and with low education and poor social support being a priority for targeted intervention. While distress screening early in the cancer experience will identify those with a constant high distress trajectory, others with late emerging distress or caseness may be missed. On this basis, distress screening through the illness trajectory into long term survivorship seems warranted.
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Wiley
Date: 03-09-2019
DOI: 10.1111/ANS.15389
Abstract: High hospital-volume and service capability are associated with improved mortality following complex cancer surgery. Using a population-based study in Queensland, we assessed differences in mortality following oesophagectomy and pancreaticoduodenectomy, comparing high- and low-volume hospitals stratified by service capability. Data on all patients undergoing oesophagectomy and pancreaticoduodenectomy for cancer in Queensland between 2001 and 2015 were obtained from the Queensland Oncology Repository. Hospital service capability was defined using the 2015 Australian Institute of Health and Welfare hospital peer groupings. Hospitals were grouped into 'high-volume (≥6 oesophagectomies or pancreaticoduodenectomies annually) with high service capability' 'low-volume (<6) with high service capability' and 'low-volume with low service capability'. Multivariate Poisson models were used to estimate differences in 30- and 90-day mortality between hospital groups adjusting for age, sex, socioeconomic status, Charlson and American Society of Anesthesiologists scores, chemotherapy, radiotherapy, stage and time-period. For oesophagectomy, adjusted 90-day mortality was higher in low-volume compared with high-volume hospitals, regardless of service capability (low-volume, high service: incident rate ratio (IRR) 3.86, 95% confidence interval (CI) 1.74-8.57 low-volume, low service: IRR 3.40, 95% CI 1.16-10.00). For pancreaticoduodenectomy, mortality was higher in low-volume compared with high-volume centres regardless of service capability: 30-day mortality (low-volume, high service: IRR 2.32, 95% CI 1.07-5.03 low-volume, low service: IRR 3.92, 95% CI 1.45-10.61) 90-day mortality (low-volume, high service: IRR 2.36, 95% CI 1.29-4.30 low-volume, low service: IRR 3.32, 95% CI 1.64-6.71). High hospital resection volumes are associated with lower post-operative mortality following oesophagectomy and pancreaticoduodenectomy regardless of hospital service capability. This data supports centralization of these procedures to high-volume centres.
Publisher: Wiley
Date: 17-02-2016
DOI: 10.1111/CEN.12724
Abstract: Thyroid cancer incidence has been increasing worldwide. Some suggest greater ascertainment of indolent tumours is the only driver, but others suggest there has been a true increase. Increases in Australia appear to have been among the largest in the world, so we investigated incidence trends in the Australian state of Queensland to help understand reasons for the rise. Thyroid cancers diagnoses in Queensland 1982-2008 were ascertained from the Queensland Cancer Registry. We calculated age-standardized incidence rates (ASR) and used Poisson regression to estimate annual percentage change (APC) in thyroid cancer incidence by socio-demographic and tumour-related factors. Thyroid cancer ASR in Queensland increased from 2·2 to 10·6/100 000 between 1982 and 2008 equating to an APC of 5·5% [95% confidence interval (CI) 4·7-6·4] in men and 6·1% (95% CI 5·5-6·6) in women. The rise was evident, and did not significantly differ, across socio-economic and remoteness-of-residence categories. The largest increase seen was in the papillary subtype in women (APC 7·9%, 95% CI 7·3-8·5). Incidence of localized and more advanced-stage cancers rose over time although the increase was greater for early-stage cancers. There has been a marked increase in thyroid cancer incidence in Queensland. The increase is evident in men and women across all adult age groups, socio-economic strata and remoteness-of-residence categories as well as in localized and more advanced-stage cancers. Our results suggest 'overdiagnosis' may not entirely explain rising incidence. Contemporary aetiological data and in idual-level information about diagnostic circumstances are required to further understand reasons for rising thyroid cancer incidence.
Publisher: Springer Science and Business Media LLC
Date: 07-03-2016
Publisher: Springer Science and Business Media LLC
Date: 21-02-2023
DOI: 10.1007/S12282-023-01439-4
Abstract: Interval breast cancers (BC) are those diagnosed within 24 months of a negative mammogram. This study estimates the odds of being diagnosed with high-severity BC among screen-detected, interval, and other symptom-detected BC (no screening history within 2 years) and explores factors associated with being diagnosed with interval BC. Telephone interviews and self-administered questionnaires were conducted among women ( n = 3,326) diagnosed with BC in 2010–2013 in Queensland. Respondents were categorised into screen-detected, interval, and other symptom-detected BCs. Data were analysed using logistic regressions with multiple imputation. Compared with screen-detected BC, interval BC had higher odds of late-stage (OR = 3.50, 2.9–4.3), high-grade (OR = 2.36, 1.9–2.9) and triple-negative cancers (OR = 2.55, 1.9–3.5). Compared with other symptom-detected BC, interval BC had lower odds of late stage (OR = 0.75, 0.6–0.9), but higher odds of triple-negative cancers (OR = 1.68, 1.2–2.3). Among women who had a negative mammogram ( n = 2,145), 69.8% were diagnosed at their next mammogram, while 30.2% were diagnosed with an interval cancer. Those with an interval cancer were more likely to have healthy weight (OR = 1.37, 1.1–1.7), received hormone replacement therapy (2–10 years: OR = 1.33, 1.0–1.7 10 years: OR = 1.55, 1.1–2.2), conducted monthly breast self-examinations (BSE) (OR = 1.66, 1.2–2.3) and had previous mammogram in a public facility (OR = 1.52, 1.2–2.0). These results highlight the benefits of screening even among those with an interval cancer. Women-conducted BSE were more likely to have interval BC which may reflect their increased ability to notice symptoms between screening intervals.
Publisher: Wiley
Date: 04-08-2017
DOI: 10.1111/ANS.13710
Abstract: Breast reconstruction (BR) following mastectomy for breast cancer has been shown to improve quality of life and body image however, there is significant geographic variation in BR rates. We explored factors associated with BR following mastectomy. This is a population-based data linkage study consisting of cancer registry records linked to hospital inpatient episodes for 4104 women aged 20 years and over-diagnosed with a first primary invasive localized stage breast cancer between 1997 and 2012 in Queensland, Australia, who underwent a mastectomy. Multivariate logistic regression was used to model predictors of BR. Overall, 481 women (11.7%) underwent reconstruction. Proportions increased over time and were higher for younger women. Younger age, more recent diagnosis, living in high or very high accessibility areas or less disadvantaged areas, smaller tumours and attending a private or high-volume hospital independently increased the odds of reconstruction. The geographical disparity reduced significantly over time. Geographical barriers to accessing BR have reduced however, continued monitoring and further research to inform strategies to further reduce subgroup disparities remain a priority.
Publisher: Springer Science and Business Media LLC
Date: 04-2006
DOI: 10.1007/S10552-005-0530-0
Abstract: To investigate whether people diagnosed with cancer have an increased risk of death from non-cancer causes compared to the general population. The non-cancer mortality of people diagnosed with cancer in Queensland (Australia) between 1982 and 2002 who had not died before 1 January 1993 was compared to the mortality of the total Queensland population, matching by age group and sex, and reporting by standardised mortality ratios. Compared to the non-cancer mortality in the general population, cancer patients (all cancers combined) were nearly 50% more likely to die of non-cancer causes (SMR = 149.9, 95% CI = [147-153]). This varied by cancer site. Overall melanoma patients had significantly lower non-cancer mortality, female breast cancer patients had similar non-cancer mortality to the general population, while increased non-cancer mortality risks were observed for people diagnosed with cervical cancer, colorectal cancer, prostate cancer, non-Hodgkin lymphoma and lung cancer. Although cancer-specific death rates underestimate the mortality directly associated with a diagnosis of cancer, quantifying the degree of underestimation is difficult due to various competing explanations. There remains an important role for future research in understanding the causes of morbidity among cancer survivors, particularly those looking at both co-morbid illnesses and reductions in quality of life.
Publisher: EpiSmart Science Vector Ltd
Date: 11-2018
Publisher: Wiley
Date: 11-04-2016
DOI: 10.1002/CNCR.29954
Publisher: Springer Science and Business Media LLC
Date: 31-01-2014
Publisher: Wiley
Date: 04-09-2023
DOI: 10.5694/MJA2.52091
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.JID.2016.03.014
Abstract: The prognosis of melanoma patients who are diagnosed with multiple primary lesions remains controversial. We used a large population-based cohort to re-examine this issue, applying a delayed entry methodology to avoid survival bias. Of 32,238 eligible patients diagnosed between 1995 and 2008, 29,908 (93%) had a single invasive melanoma, 2,075 (6%) had two, and 255 (1%) had three. Allowing for differences in entry time, 10-year cause-specific survival for these three groups was 89% (95% confidence interval [CI] = 88-90%), 83% (95% CI = 80-86%), and 67% (95% CI = 54-81%), respectively. After adjustment for key prognostic factors, the hazard ratio of death within 10 years from melanoma was two times higher for those with two melanomas (hazard ratio = 2.01, 95% CI = 1.57-2.59 P < 0.001) and nearly three times higher when three melanomas were diagnosed (hazard ratio = 2.91, 95% CI = 1.64-5.18 P < 0.001) compared with people with a single melanoma. Melanoma-specific mortality remained elevated after adjusting for maximum thickness or ulceration of any melanoma regardless of the index tumor. After appropriately accounting for the interval between diagnosis of the first and subsequent melanomas, patients with multiple invasive melanomas have significantly poorer survival than patients with a single invasive melanoma.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2007
Publisher: Oxford University Press (OUP)
Date: 03-2019
Abstract: This study will assess the relationship between vitamin D concentration at melanoma diagnosis and melanoma tumor characteristics, in in iduals in a high ultraviolet radiation (UVR) environment. We aim to recruit 600 recently diagnosed melanoma patients from Queensland, Australia, a high UVR location with one of the world’s highest melanoma incidence rates. Patients are recruited through general practitioner, skin cancer specialist, dermatological and hospital-based practices. As close as possible to diagnosis, participants provide a blood s le for vitamin D analysis and have their sun exposure/sun protection behavior, melanoma risk factors and dietary vitamin D intake assessed by questionnaire and phone interview. Details of tumor pathology, including tumor level, thickness, and ulceration, are abstracted from cancer registry records. Here, we describe the study methods and present preliminary findings from early participants. As of December 2017, we have recruited 128 participants (48% male, mean age 60.2 years, mean Breslow thickness 0.63 mm). When complete, this study will give insights into the association between vitamin D at diagnosis and melanoma tumor characteristics whilst adjusting for recent sun exposure and sun protection use. This study may impact military sun exposure and nutrition policies as vitamin D may play a role in melanomagenesis.
Publisher: Wiley
Date: 07-06-2022
DOI: 10.1111/PPE.12895
Abstract: Large improvements in childhood cancer survival have been reported over recent decades. Data from cancer registries have the advantage of providing a ‘whole of population’ approach to gauge the success of cancer control efforts. The aim of this study was to investigate recent survival estimates for children diagnosed with cancer Australia and to examine the extent of changes in survival over the last 35 years. For the first time, we also estimated the number of deaths among Australian children that were potentially avoided due to improvements in survival. A retrospective, population‐based cohort study design was used. Case information was extracted from the Australian Childhood Cancer Registry for 1983–2016, with follow‐up to 31 December 2017. Eligible children were aged 0–14 with a basis of diagnosis other than autopsy or death certificate only. Five‐year relative survival was calculated using the semi‐complete cohort method for three diagnosis periods (1983–1994, 1995–2006 and 2007–2016), and changes in survival over time were assessed via flexible parametric models. Avoided deaths within 5 years for those diagnosed between 1995 and 2016 were estimated under the assumption that survival rates remained the same as for 1983–1994. Overall 5‐year survival within the study cohort ( n = 20,871) increased from 72.8% between 1983 and1994 to 86.1% between 2007 and 2016, equating to an adjusted excess mortality hazard ratio of 1.82 (95% confidence interval 1.67, 1.97). Most cancers showed improvements in survival other gliomas, hepatoblastoma and osteosarcoma were exceptions. Among children diagnosed between 1995 and 2016, 38.7% of expected deaths within 5 years of diagnosis ( n = 1537 of 3970) were avoided due to temporal improvements in survival. Survival for childhood cancer has continued to improve over recent years, thanks mainly to ongoing progress in treatment development combined with improved supportive care. Providing innovative measures of survival, such as avoided deaths, may assist with understanding outcome data produced by cancer registries.
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1111/J.1467-842X.2003.TB00610.X
Abstract: Trends in the median age at death (MAAD) are now being reported in some official government publications. Because trends in MAAD are being published and are being used to support discussions about policy, information is needed about its strengths and limitations. We conducted a simulation study based on a Markov model to investigate the relationship between the MAAD and mortality rates. The main time horizon was five years because this is the interval that is relevant for the purposes of reviewing and debating policies and programs, but we also continued the models out to 50 years. The simulations brought to light three problems with the MAAD. First, for populations with different age structures but the same age-specific mortality rates, the MAAD can differ by more than 20 years. Second, for Indigenous Australians, a two-year increase in the MAAD after five years represents a 30% decrease in the mortality rates, but the same increase in the MAAD for non-Indigenous Australians would mean only a 15% decrease in mortality. Third, large s le sizes are needed to show that trends in the MAAD are statistically significant. In the absence of better information, trends in the MAAD for Indigenous Australians may provide a way of assessing whether mortality rates are decreasing, but large s le sizes are needed to distinguish real change from statistical noise. Comparisons of trends in the MAAD between Indigenous and non-Indigenous Australians are even more difficult to interpret. Resources should be directed towards improving the validity of rates, for ex le, through linkage of routine data or investing in additional data collection.
Publisher: Wiley
Date: 28-02-2020
DOI: 10.1002/IJC.32930
Publisher: Springer Science and Business Media LLC
Date: 20-02-2011
DOI: 10.1007/S10552-011-9743-6
Abstract: There is some evidence that people diagnosed with cancer have increased risks of dying from other diseases. This may particularly be so for cancers such as the lymphohaematopoietic neoplasms (LHN) which are now managed more as chronic diseases than acute events. The non-cancer mortality of people diagnosed with LHN in Australia between 1982 and 2006 was compared to the mortality of the age- and sex-matched Australian population. Australians diagnosed with LHN had about an 80% higher risk (SMR = 1.82 95% CI = 1.79-1.85) of dying from a non-cancer cause of death than the general population, with this increased risk particularly evident in the first 3-12 months after diagnosis. While the relative risk varied by LHN subtypes, all had an inflated relative risk. Despite younger patients having a lower absolute mortality risk, their relative mortality risk was particularly high this decreased as age increased. The causes of death with the highest relative risks were infections and diseases of blood and blood-forming organs. The consistently increased risks of non-cancer causes of death compared to the general population for patients diagnosed with LHN highlight the importance that general practitioners and haematologists should bear in mind the patient's other medical conditions as well as the LHN diagnosis.
Publisher: Springer Science and Business Media LLC
Date: 23-08-2010
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.YPMED.2014.12.009
Abstract: To test the impact of a theory-based, SMS (text message)-delivered behavioural intervention (Healthy Text) targeting sun protection or skin self-examination behaviours compared to attention control. Overall, 546 participants aged 18-42 years were randomised using a computer-generated number list to the skin self-examination (N=176), sun protection (N=187), or attention control (N=183) text messages group. Each group received 21 text messages about their assigned topic over 12 months (12 weekly messages for 3 months, then monthly messages for the next 9 months). Data were collected via telephone survey at baseline, 3, and 12 months across Queensland from January 2012 to August 2013. One year after baseline, the sun protection (mean change 0.12 P=0.030) and skin self-examination groups (mean change 0.12 P=0.035) had significantly greater improvement in their sun protection habits (SPH) index compared to the attention control group (reference mean change 0.02). The increase in the proportion of participants who reported any skin self-examination from baseline to 12 months was significantly greater in the skin self-examination intervention group (103/163 63% P<0.001) than the sun protection (83/173 48%) or attention control (65/165 36%) groups. There was no significant effect of the intervention for participants' self-reported whole-body skin self-examination, sun tanning, or sunburn behaviours. The Healthy Text intervention was effective in inducing significant improvements in sun protection and any type of skin self-examination behaviours. The Australian and New Zealand Clinical Trials register (ACTRN12612000577819). Cancer Australia 1011999.
Publisher: MDPI AG
Date: 19-11-2016
Publisher: Springer Science and Business Media LLC
Date: 11-12-2007
Publisher: Elsevier BV
Date: 06-1999
DOI: 10.1016/S1031-170X(99)80019-1
Abstract: Perineal trauma is the most frequently reported complication of labour and delivery in the Qld Perinatal Data Collection. It is documented that some in idual accoucheurs seem to be particularly skillful in assisting at birth in a way that minimises perineal trauma. Recent trends within the Qld health industry have emphasised the importance of quality improvement activities focussing on health outcomes. Midwives accoucheur most of the "normal" deliveries in public hospitals, thus it is important that midwives play a leading part in the development and improvement of tools which identify quality outcomes and pinpoint areas for improvement. This study aims to benchmark current practices regarding perineal outcomes. Moreover, the authors aim to initiate discussion towards the development of the first clinical indicators appropriate to midwifery care.
Publisher: Wiley
Date: 24-05-2018
Publisher: Springer Science and Business Media LLC
Date: 04-10-2014
Publisher: Mary Ann Liebert Inc
Date: 15-03-2019
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.CANEP.2016.05.002
Abstract: The survival inequality faced by Indigenous Australians after a cancer diagnosis is well documented what is less understood is whether this inequality has changed over time and what this means in terms of the impact a cancer diagnosis has on Indigenous people. Survival information for all patients identified as either Indigenous (n=3168) or non-Indigenous (n=211,615) and diagnosed in Queensland between 1997 and 2012 were obtained from the Queensland Cancer Registry, with mortality followed up to 31st December, 2013. Flexible parametric survival models were used to quantify changes in the cause-specific survival inequalities and the number of lives that might be saved if these inequalities were removed. Among Indigenous cancer patients, the 5-year cause-specific survival (adjusted by age, sex and broad cancer type) increased from 52.9% in 1997-2006 to 58.6% in 2007-2012, while it improved from 61.0% to 64.9% among non-Indigenous patients. This meant that the adjusted 5-year comparative survival ratio (Indigenous: non-Indigenous) increased from 0.87 [0.83-0.88] to 0.89 [0.87-0.93], with similar improvements in the 1-year comparative survival. Using a simulated cohort corresponding to the number and age-distribution of Indigenous people diagnosed with cancer in Queensland each year (n=300), based on the 1997-2006 cohort mortality rates, 35 of the 170 deaths due to cancer (21%) expected within five years of diagnosis were due to the Indigenous: non-Indigenous survival inequality. This percentage was similar when applying 2007-2012 cohort mortality rates (19% 27 out of 140 deaths). Indigenous people diagnosed with cancer still face a poorer survival outlook than their non-Indigenous counterparts, particularly in the first year after diagnosis. The improving survival outcomes among both Indigenous and non-Indigenous cancer patients, and the decreasing absolute impact of the Indigenous survival disadvantage, should provide increased motivation to continue and enhance current strategies to further reduce the impact of the survival inequalities faced by Indigenous people diagnosed with cancer.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 04-2009
Abstract: Increased physical activity in patients with colorectal cancer is related to improved recurrence-free and overall survival. Psychological distress after cancer may place patients at risk of reduced physical activity, but paradoxically may also act as a motivator for lifestyle change. The relationship between psychological distress and physical activity after cancer over time has not been described. Methods A prospective survey of 1,966 (57% response) colorectal cancer survivors assessed the psychological distress variables of anxiety, depression, somatization, and cancer threat appraisal as predictors of physical activity at 5, 12, 24, and 36 months postdiagnosis 978 respondents had valid data for all time points. Higher somatization was associated with greater physical inactivity (relative risk ratio [RRR] = 1.12 95% CI, 1.1 to 1.2) and insufficient physical activity (RRR = 1.05 95% CI, 0.90 to 1.0). Respondents with a more positive appraisal of their cancer were significantly (P = .031) less likely to be inactive (RRR = 0.95 95% CI, 0.90 to 1.0) or insufficiently active (RRR = 0.96). Fatigued and obese respondents and current smokers were more inactive. Respondents whose somatization increased between two time periods were less likely to increase their physical activity over the same period (P .001). Respondents with higher anxiety at one time period were less likely to have increased their activity at the next assessment (P = .004). There was no association between depression and physical activity. Cancer survivors who experience somatization and anxiety are at greater risk of physical inactivity. The lack of a clear relationship between higher psychological distress and increasing physical activity argues against distress as a motivator to exercise in these patients.
Publisher: American Association for Cancer Research (AACR)
Date: 16-03-2022
DOI: 10.1158/1055-9965.EPI-21-1390
Abstract: This study quantified differences in remaining life expectancy (RLE) among Aboriginal and Torres Strait Islander and other Australian patients with cancer. We assessed how much of this disparity was due to differences in cancer and noncancer mortality and calculated the population gain in life years for Aboriginal and Torres Strait Islanders cancer diagnoses if the cancer survival disparities were removed. Flexible parametric relative survival models were used to estimate RLE by Aboriginal and Torres Strait Islander status for a population-based cohort of 709,239 persons (12,830 Aboriginal and Torres Strait Islanders), 2005 to 2016. For all cancers combined, the average disparity in RLE was 8.0 years between Aboriginal and Torres Strait Islanders (12.0 years) and other Australians (20.0 years). The magnitude of this disparity varied by cancer type, being & years for cervical cancer versus & years for lung and pancreatic cancers. For all cancers combined, around 26% of this disparity was due to differences in cancer mortality and 74% due to noncancer mortality. Among 1,342 Aboriginal and Torres Strait Islanders diagnosed with cancer in 2015 an estimated 2,818 life years would be gained if cancer survival disparities were removed. A cancer diagnosis exacerbates the existing disparities in RLE among Aboriginal and Torres Strait Islanders. Addressing them will require consideration of both cancer-related factors and those contributing to noncancer mortality. Reported survival-based measures provided additional insights into the overall impact of cancer over a lifetime horizon among Aboriginal and Torres Strait Islander peoples.
Publisher: Elsevier BV
Date: 10-2016
Publisher: AMPCo
Date: 26-12-2020
DOI: 10.5694/MJA2.50456
Publisher: Springer Science and Business Media LLC
Date: 14-03-2013
Abstract: This longitudinal study describes the five year trajectories of health-related quality of life (HR-QOL) and life satisfaction in long term colorectal cancer survivors. A population-based s le of 1966 colorectal cancer survivors were surveyed at six time points from five months to five years post-diagnosis. Predictor variables were: socio-demographic variables, optimism cancer threat appraisal perceived social support. Quality of life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HR-QOL) and the Satisfaction with Life Scale. Growth mixture models were applied to identify trajectory classes and their predictors. Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. Lower optimism, poorer social support, a more negative cognitive appraisal, and younger age were associated with poorer life satisfaction, while survivors with less than 8 years of education had higher life satisfaction. This pattern was similar for overall HR-QOL except that educational level was not a significant predictor and later stage disease and female gender emerged as related to poorer outcomes. One in five survivors reported poorer constant HR-QOL (19.2%) and a small group had poor life satisfaction (7.2%) 26.2% reported constant high HR-QOL and 48.8% had high constant life satisfaction. Socioeconomic disadvantage and remoteness of residence uniquely predicted poorer outcomes in the colorectal cancer specific HR-QOL sub domain. Although HR-QOL and subjective cognitive QOL share similar antecedents their trajectory patterns suggested they are distinct adjustment outcomes with life satisfaction emerging as temporally stable phenomenon. Unique patterns of risk support suggest the need to account for heterogeneity in adjustment in longitudinal QOL studies with cancer survivors.
Publisher: Wiley
Date: 17-05-2015
DOI: 10.1002/IJC.28956
Publisher: Wiley
Date: 18-07-2006
DOI: 10.1002/IJC.22052
Abstract: Sunlight is essential for the production of vitamin D in the body. Evidence exists to suggest that vitamin D metabolites may have a role in tumor growth suppression. In this large study, involving over a million cancer patients from the United Kingdom, we have analyzed the role of season of diagnosis and sunlight exposure in cancer survival for cancers of the breast, colorectum, lung, prostate and at all sites combined. We used population-based data from the Thames Cancer Registry to analyze cancer survival in periods 0-1 and 0-5 years after diagnosis. The analysis was performed using Cox proportional regression analysis adjusting for age and period at diagnosis and including season of diagnosis and sunlight exposure in the preceding months as factors in the analysis. We found evidence of substantial seasonality in cancer survival, with diagnosis in summer and autumn associated with improved survival compared with that in winter, especially in female breast cancer patients and both male and female lung cancer patients (hazard ratios 0.86 [95% CI 0.83-0.89], 0.95 [95% CI 0.92-0.97] and 0.95 [95% CI 0.93-0.98] respectively). Cumulative sunlight exposure in the months preceding diagnosis was also a predictor of subsequent survival, although season of diagnosis was a stronger predictor than cumulative sunlight exposure. We found seasonality in cancer survival to be stronger in women than in men. Our results add to a growing body of evidence that vitamin D metabolites play an important role in cancer survival.
Publisher: Springer Science and Business Media LLC
Date: 02-2016
Publisher: Elsevier BV
Date: 02-2006
DOI: 10.1111/J.1467-842X.2006.TB00089.X
Abstract: To assess how much of the urban-rural disparity in melanoma survival in Queensland is due to later diagnosis. Data were obtained from the population-based Queensland Cancer Registry. We used incident cases for the six years 1996 to 2001 with follow-up to the end of 2002, so that all patients were followed for at least 12 months with a median follow-up time of 41 months. Cox regression models were used to compare urban versus rural case-fatality rates, after adjusting for thickness, level, subsite, age and sex. The adjusted case-fatality rate was 20% higher in rural versus urban areas (hazard ratio 1.20, 95% CI 1.02-1.43). There is some characteristic of living in an urban area, other than earlier diagnosis, that improves melanoma survival. In the first instance, differences in access to services and variation in management practices deserve investigation and exclusion.
Publisher: Medical Journals Sweden AB
Date: 2015
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.CANEP.2015.03.001
Abstract: Preventing risk factor exposure is vital to reduce the high burden from lung cancer. The leading risk factor for developing lung cancer is tobacco smoking. In Australia, despite apparent success in reducing smoking prevalence, there is limited information on small area patterns and small area temporal trends. We sought to estimate spatio-temporal patterns for lung cancer risk factors using routinely collected population-based cancer data. The analysis used a Bayesian shared component spatio-temporal model, with male and female lung cancer included separately. The shared component reflected lung cancer risk factors, and was modelled over 477 statistical local areas (SLAs) and 15 years in Queensland, Australia. Analyses were also run adjusting for area-level socioeconomic disadvantage, Indigenous population composition, or remoteness. Strong spatial patterns were observed in the underlying risk factor estimates for both males (median Relative Risk (RR) across SLAs compared to the Queensland average ranged from 0.48 to 2.00) and females (median RR range across SLAs 0.53-1.80), with high risks observed in many remote areas. Strong temporal trends were also observed. Males showed a decrease in the underlying risk across time, while females showed an increase followed by a decrease in the final 2 years. These patterns were largely consistent across each SLA. The high underlying risk estimates observed among disadvantaged, remote and indigenous areas decreased after adjustment, particularly among females. The modelled underlying risks appeared to reflect previous smoking prevalence, with a lag period of around 30 years, consistent with the time taken to develop lung cancer. The consistent temporal trends in lung cancer risk factors across small areas support the hypothesis that past interventions have been equally effective across the state. However, this also means that spatial inequalities have remained unaddressed, highlighting the potential for future interventions, particularly among remote areas.
Publisher: BMJ
Date: 06-2017
Publisher: Hindawi Limited
Date: 15-05-2001
DOI: 10.1111/ECC.13080
Abstract: This study describes and compares the unmet supportive care needs between Indigenous and Non-Indigenous people with cancer. Data from two cross-sectional supportive care needs studies were matched in a 1:1 ratio for Indigenous (n = 125) and Non-Indigenous (n = 125) Australian adults diagnosed with cancer. Descriptive statistics were used to compare type and prevalence of 24 need items measured by the SCNS-SF34 and SCNAT-IP. A higher proportion of Non-Indigenous participants compared to Indigenous participants reported having any moderate-to-high level of unmet needs (70% vs. 54%, p = 0.013) and the difference was consistently observed across non-matched characteristics. While concerns for caregivers, fear of recurrence and pain were central needs for both Indigenous participants and Non-Indigenous participants, there were some key differences in the specific unmet needs between groups. Physical issues including doing usual daily activities and dealing with fatigue were the top priorities for Non-Indigenous people, while money worries, dealing with psychological issues such as how to keep their spirit strong or hope about their future appeared to be priorities for Indigenous people. Variations in the unmet supportive care needs between Indigenous and Non-Indigenous people with cancer may guide health professionals to target specific needs when preparing care plans.
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.CANEP.2013.09.014
Abstract: This paper reviews international patterns in sinonasal cancer incidence and mortality in light of changes in exposure to known risk factors. Sinonasal tumours are relatively rare, but they have the second highest occupational attributable fraction of all types of cancer, with a well-established link for workers exposed to wood dust. Data for a variety of countries, mainly in Europe, North America and the Asia-Pacific region, were obtained from publicly accessible sources and supplemented with information requested from selected cancer registries. Rates were directly age-standardised to the World Health Organization Standard Population. The average annual incidence of sinonasal cancer was typically between 5 and 10 per million in males and between 2 and 5 per million in females between 2004 and 2008. Denmark reported the highest rates, with incidence continuing to increase, in contrast to trends in other countries which either remained relatively stable, or were decreasing slightly. There were significant recent decreases in sinonasal cancer mortality rates within two-thirds of the included countries. Our observations are generally consistent with efforts to limit exposure to wood dust and other potentially causal substances in the workplace, as well as a reduction in the prevalence of smoking in many developed countries. Of concern is that occupational and behavioural risks related to sinonasal cancer are likely to increase among people in less developed countries into the future. However the incentive to intervene in these countries is limited by the lack of accurate and reliable cancer data.
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA10.11204
Abstract: To determine whether an association exists between distance from radiotherapy facilities and survival outcomes of people diagnosed with rectal cancer. Descriptive population-based study using data from the Queensland Cancer Registry. All patients aged 20-79 years (n = 6848) diagnosed with invasive rectal cancer between 1 January 1996 and 31 December 2006. Cause-specific survival. The 5-year cause-specific survival was 62% (95% CI, 61%-64%) it was strongly influenced by stage at diagnosis (American Joint Committee on Cancer, Stages I-IV), ranging from 86% (Stage I) to 9% (Stage IV). After adjusting for age, sex, and stage at diagnosis, patients who lived 100-199 km, 200-399 km and 400 km or more from a radiotherapy facility were 16%, 30%, and 25%, respectively, more likely to die from rectal cancer than patients living within 50 km of such a facility. On average, there was a 6% increase in mortality risk (95% CI, 3%-8% P < 0.001) for each 100 km increment in distance from the nearest radiotherapy facility. Shared frailty models showed that this association persisted after adjusting for the correlation between in idual cancer patients living in the same remoteness or area-level socioeconomic status categories. While centralisation of cancer treatment services has merit, our study provides evidence of a shorter survival for people with rectal cancer who live relatively far from radiotherapy facilities. It remains a priority to develop and implement policy, cultural and clinical measures to reduce the burden faced by rural and remote patients with rectal cancer.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 10-2019
DOI: 10.1186/S12942-019-0185-9
Abstract: It is well known that the burden caused by cancer can vary geographically, which may relate to differences in health, economics or lifestyle. However, to date, there was no comprehensive picture of how the cancer burden, measured by cancer incidence and survival, varied by small geographical area across Australia. The Atlas consists of 2148 Statistical Areas level 2 across Australia defined by the Australian Statistical Geography Standard which provide the best compromise between small population and small area. Cancer burden was estimated for males, females, and persons separately, with 50 unique sex-specific (males, females, all persons) cancer types analysed. Incidence and relative survival were modelled with Bayesian spatial models using the Leroux prior which was carefully selected to provide adequate spatial smoothing while reflecting genuine geographic variation. Markov Chain Monte Carlo estimation was used because it facilitates quantifying the uncertainty of the posterior estimates numerically and visually. The results of the statistical model and visualisation development were published through the release of the Australian Cancer Atlas ( atlas.cancer.org.au ) in September, 2018. The Australian Cancer Atlas provides the first freely available, digital, interactive picture of cancer incidence and survival at the small geographical level across Australia with a focus on incorporating uncertainty, while also providing the tools necessary for accurate estimation and appropriate interpretation and decision making. The success of the Atlas will be measured by how widely it is used by key stakeholders to guide research and inform decision making. It is hoped that the Atlas and the methodology behind it motivates new research opportunities that lead to improvements in our understanding of the geographical patterns of cancer burden, possible causes or risk factors, and the reasons for differences in variation between cancer types, both within Australia and globally. Future versions of the Atlas are planned to include new data sources to include indicators such as cancer screening and treatment, and extensions to the statistical methods to incorporate changes in geographical patterns over time.
Publisher: Wiley
Date: 26-04-2020
DOI: 10.1111/PPE.12671
Publisher: Oxford University Press (OUP)
Date: 21-06-2022
DOI: 10.1093/JXB/ERAC221
Abstract: Crop multi-model ensembles (MME) have proven to be effective in increasing the accuracy of simulations in modelling experiments. However, the ability of MME to capture crop responses to changes in sowing dates and densities has not yet been investigated. These management interventions are some of the main levers for adapting cropping systems to climate change. Here, we explore the performance of a MME of 29 wheat crop models to predict the effect of changing sowing dates and rates on yield and yield components, on two sites located in a high-yielding environment in New Zealand. The experiment was conducted for 6 years and provided 50 combinations of sowing date, sowing density and growing season. We show that the MME simulates seasonal growth of wheat well under standard sowing conditions, but fails under early sowing and high sowing rates. The comparison between observed and simulated in-season fraction of intercepted photosynthetically active radiation (FIPAR) for early sown wheat shows that the MME does not capture the decrease of crop above ground biomass during winter months due to senescence. Models need to better account for tiller competition for light, nutrients, and water during vegetative growth, and early tiller senescence and tiller mortality, which are exacerbated by early sowing, high sowing densities, and warmer winter temperatures.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2010
Publisher: American Association for Cancer Research (AACR)
Date: 07-2011
DOI: 10.1158/1055-9965.EPI-11-0079
Abstract: Background: Few studies have investigated the impact of body mass index (BMI) and physical activity (PA) on mortality among colorectal cancer (CRC) patients and the results are inconsistent. We aimed to examine the impact of these lifestyle factors on all-cause and disease-specific mortality. Methods: Population-based longitudinal study followed 1,825 patients diagnosed with stages I to III primary CRC during 2003 to 2004 in Queensland, Australia for 5 years. Sociodemographics and clinical characteristics were obtained via questionnaires and medical records. Results: Participants with some level of PA following diagnosis had 25% to 28% lower risk of all-cause mortality within 5 years of diagnosis than sedentary participants [insufficiently active: HR = 0.72, 95% CI = 0.57–0.91 sufficiently active: HR = 0.75 (0.60–0.94)] however, the differential for CRC-specific mortality was not significant. Increases in PA from five to 12 months postdiagnosis was associated with reduced CRC-specific mortality by 32% to 36% (increase ≤ 2 hour per week: HR = 0.68 (0.48–0.97) increase & 2 hour per week: HR = 0.64 (0.44–0.93) and 31% for all-cause mortality (increase & hour per week: HR = 0.69 (0.50–0.94). Compared with participants with healthy BMI, significant higher mortality risk was observed in underweight patients (all-cause: HR = 2.29 (1.47–3.59) CRC: HR = 1.74 (1.00–3.04), although lower risk in overweight (all-cause: HR = 0.75 (0.61–0.94) CRC: HR = 0.75 (0.59–0.97) and no difference in obese. Excessive weight loss was associated with increased mortality risk by three-fold but no difference in those who gained weight. Conclusions: Protective effects of being physically active and increasing that activity underlines the importance of interventions to increase activity levels among people being diagnosed with CRC. Impact: Increased mortality risks associated with being underweight or having weight loss over time is an important indicator for which clinicians, patients, and support personnel can monitor. Cancer Epidemiol Biomarkers Prev 20(7) 1410–20. ©2011 AACR.
Publisher: Wiley
Date: 16-12-2020
DOI: 10.1111/ANS.15616
Abstract: Improved post-operative mortality following gastrectomy for cancer in hospitals with higher resection volumes has not been reported in Australia. Using a population-based study in Queensland, we aimed to compare post-operative mortality following gastrectomy between high- and low-volume hospitals stratified by their service capability. All patients undergoing gastrectomy for adenocarcinoma in Queensland between 2001 and 2015 were obtained from the Queensland Oncology Repository. Hospital service capability was defined using the 2015 Australian Institute of Health and Welfare hospital peer groupings. Hospitals were grouped into 'high-volume (≥5 gastrectomies annually), high service capability' (HVHS) 'low-volume (<5), high service capability' and 'low-volume, low service capability' (LVLS). Negative binomial regression models were used to compare 30- and 90-day mortality rates between hospital groups adjusting for age, sex, socio-economic status, Charlson and American Society of Anesthesiologists scores, treatment regimen, stage and time-period. Potential mediation of mortality differences between hospital groups due to differences in the type of gastrectomy performed was also examined. LVLS hospitals have higher adjusted 30-day (incidence rate ratio (IRR) 2.97, 95% confidence interval (CI) 1.65-5.35) and 90-day (IRR 1.95, 95% CI 1.23-3.09) mortality rates compared with HVHS hospitals. There is no significant difference in adjusted 30-day (IRR 1.16, 95% CI 0.48-2.79) and 90-day (IRR 1.12, 95% CI 0.59-2.13) mortality rates comparing low-volume, high service capability hospitals with HVHS hospitals. The type of gastrectomy performed did not significantly influence differences in mortality compared between hospital groups. In the Australian environment, post-operative mortality following gastric cancer surgery may be optimized by centralizing gastrectomy away from hospitals characterized by LVLS.
Publisher: Oxford University Press (OUP)
Date: 26-05-2011
DOI: 10.1111/J.1365-2133.2011.10337.X
Abstract: Concern about skin cancer is a common reason for people from predominantly fair-skinned populations to present to primary care doctors. To examine the frequency and body-site distribution of malignant, pre-malignant and benign pigmented skin lesions excised in primary care. This prospective study conducted in Queensland, Australia, included 154 primary care doctors. For all excised or biopsied lesions, doctors recorded the patient's age and sex, body site, level of patient pressure to excise, and the clinical diagnosis. Histological confirmation was obtained through pathology laboratories. Of 9650 skin lesions, 57·7% were excised in males and 75·0% excised in patients ≥ 50 years. The most common diagnoses were basal cell carcinoma (BCC) (35·1%) and squamous cell carcinoma (SCC) (19·7%). Compared with the whole body, the highest densities for SCC, BCC and actinic keratoses were observed on chronically sun-exposed areas of the body including the face in males and females, the scalp and ears in males, and the hands in females. The density of BCC was also high on intermittently or rarely exposed body sites. Females, younger patients and patients with melanocytic naevi were significantly more likely to exert moderate/high levels of pressure on the doctor to excise. More than half the excised lesions were skin cancer, which mostly occurred on the more chronically sun-exposed areas of the body. Information on the type and body-site distribution of skin lesions can aid in the diagnosis and planned management of skin cancer and other skin lesions commonly presented in primary care.
Publisher: Elsevier BV
Date: 04-2020
Publisher: American Association for Cancer Research (AACR)
Date: 10-2006
DOI: 10.1158/1055-9965.EPI-06-0122
Abstract: Background: Despite considerable knowledge about the effect of cancer during the early stages of treatment and survivorship, understanding the longer-term effect of cancer has only recently become a priority. This study investigated the health implications of longer-term cancer survivorship in an Australian, population-based s le. Methods: Using the Australian National Health Survey, 968 longer-term cancer survivors were identified, along with 5,808 age- and sex-matched respondents without a history of cancer. Four measures of health effect were compared (quality of life, health status, days out of role, and mental well-being), using polytomous and logistic regression analyses controlling for other selected chronic conditions. These models were applied across both groups overall, across groups stratified by presence/absence of cancer, and other chronic conditions, as well as by tumor site. Results: Compared with matched respondents without cancer, longer-term cancer survivors reported significant decrements in health status, days out of role, and mental well-being (all P & 0.02), but not in quality of life. The likelihood of poor health outcomes (including quality of life) was much higher among survivors who also reported comorbid chronic conditions. Despite mixed results across tumor site, melanoma and prostate cancer survivors fared better across most outcomes. Conclusions: Clear evidence of excess morbidity among Australian longer-term cancer survivors seems to be further exacerbated by the presence of comorbid chronic conditions. Consistent with recent U.S. studies, these results further support the importance of ongoing surveillance of the growing number of cancer survivors worldwide along with increased attention to interventions to improve long-term health outcomes. (Cancer Epidemiol Biomarkers Prev 2006 (10):1969–76)
Publisher: Elsevier BV
Date: 04-2020
Publisher: Wiley
Date: 29-05-2015
DOI: 10.1002/IJC.29598
Abstract: White populations in Australia and England share many genetic and phenotypic characteristics due to common ancestry, but Australians experience far higher rates of melanoma due to higher ambient ultraviolet radiation (UVR) levels. To gain insight into the role of UVR on melanoma development early in life, we used national cancer registration data and compared recent incidence rates and long-term trends of primary invasive cutaneous melanoma in Australian and English youth aged 0-24 years diagnosed 1990-2010. Incidence rates and standardized rate ratios (SRRs) with 95% confidence intervals (CIs) for 2006-2010 were calculated and incidence trends across the whole period were examined using JoinPoint regression. In Australian youth, overall melanoma incidence was double that in English youth (2.2 and 1.1 per 100,000, respectively). While melanoma rates were similarly rare among children <10 years in both countries, in subsequent 5-year age groups, incidence was significantly higher in Australia compared to England. Melanoma incidence among 15-24 year olds significantly increased by more than 2% per year in both sexes in England. However, after an initial non-significant increase, Australian rates for this older age group significantly decreased by 6.0% (95% CI, -8.2 to -3.8) per year in females from 1997 and decreased by 12.4% (95% CI, -20.3 to -3.8) per year in males from 2004. Long-standing primary prevention strategies targeted at curbing UVR exposure appear to have been effective in mitigating incidence trends in Australian youth, but decreases in incidence in English youth are yet to be observed.
Publisher: Elsevier BV
Date: 10-2016
Publisher: Springer Science and Business Media LLC
Date: 06-07-2021
Publisher: Wiley
Date: 10-08-2006
DOI: 10.1002/CNCR.22051
Abstract: The screening behavior and screening outcomes of men age > or =50 years was investigated within a randomized controlled trial of a community-based intervention of screening for melanoma, consisting of a community education program, an education program for medical practitioners, and the provision of dedicated skin-screening clinics. Data from cross-sectional telephone surveys before (559 completed interviews), at the end (591 completed interview), and at 2 years after the intervention (445 completed interviews) were analyzed. In addition, the authors analyzed data from skin-screening clinics within the intervention program (3355 men age > or =50 years participated). During the intervention period men age > or =50 years increased both their screening behavior and intention to screen. Those men age > or =50 years who reported a past history of removal of a mole as well as other risk factors for skin cancer and positive attitudes toward screening were more likely to participate in skin screening across time. Men age > or =50 years accounted for 20.5% of all skin-screening clinic attendees, 31.3% of those referred for a suspicious lesion, 48.5% of melanomas, and 45% of all keratinocyte carcinomas diagnosed within the screening program, respectively. The intervention program successfully motivated men age > or =50 years to attend screening for skin cancer, resulting in the highest yield of skin cancer within this subgroup of the population. Messages addressing skin cancer risk factors and attitudes toward skin cancer and screening could be used to target a screening program for melanoma toward men age > or =50 years.
Publisher: Springer Science and Business Media LLC
Date: 28-07-2022
DOI: 10.1007/S10549-022-06682-5
Abstract: Prognostic models can help inform patients on the future course of their cancer and assist the decision making of clinicians and patients in respect to management and treatment of the cancer. In contrast to previous studies considering survival following treatment, this study aimed to develop a prognostic model to quantify breast cancer-specific survival at the time of diagnosis. A large ( n = 3323), population-based prospective cohort of women were diagnosed with invasive breast cancer in Queensland, Australia between 2010 and 2013, and followed up to December 2018. Data were collected through a validated semi-structured telephone interview and a self-administered questionnaire, along with data linkage to the Queensland Cancer Register and additional extraction from medical records. Flexible parametric survival models, with multiple imputation to deal with missing data, were used. Key factors identified as being predictive of poorer survival included more advanced stage at diagnosis, higher tumour grade, “triple negative” breast cancers, and being symptom-detected rather than screen detected. The Harrell’s C-statistic for the final predictive model was 0.84 (95% CI 0.82, 0.87), while the area under the ROC curve for 5-year mortality was 0.87. The final model explained about 36% of the variation in survival, with stage at diagnosis alone explaining 26% of the variation. In addition to confirming the prognostic importance of stage, grade and clinical subtype, these results highlighted the independent survival benefit of breast cancers diagnosed through screening, although lead and length time bias should be considered. Understanding what additional factors contribute to the substantial unexplained variation in survival outcomes remains an important objective.
Publisher: Wiley
Date: 11-01-2017
DOI: 10.1002/PON.4342
Publisher: Wiley
Date: 24-05-2012
DOI: 10.1002/PON.1991
Abstract: Cancer survivor identity has become a dominant paradigm in describing people with cancer and in driving the focus of programmes and research in supportive care. This study investigated antecedents of survivor identity adoption and population-based prevalence. A prospective survey of a population-based s le of 1966 (57% response) patients with colorectal cancer assessed socio-demographic variables, health behaviours, optimism, benefit finding, cancer threat appraisal, psychological distress and satisfaction with life at 5 months post-diagnosis as predictors of survivor identity 5 years subsequently. Prevalence of survivor identity at 5 years post-diagnosis and psychological and lifestyle outcomes (n = 786) were later assessed. Fifty-five per cent of people identified as a cancer survivor, 39.4% as a person who had had (or has) cancer, 1.4% as a cancer patient and 1.2% as a cancer victim. People who were older and who reported higher personal growth after diagnosis were more likely to assume a survivor identity at 5 years. At 5 years, survivors had higher benefit finding and better satisfaction with life. Cancer survivors uniquely reported a significant decrease in somatization and acceptance, and increases in satisfaction with life and physical activity over time. For patients with colorectal cancer, the cancer survivor identity is common but not universal 5 years after diagnosis and may evolve from looking for benefit after cancer through personal growth. People who adopt a cancer survivor identity report more positive adjustment outcomes after cancer and this has implications for the design of clinical and community support interventions. Copyright © 2011 John Wiley & Sons, Ltd.
Publisher: Wiley
Date: 05-11-2021
DOI: 10.1111/ANS.16397
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.CANEP.2019.02.013
Abstract: Stage of cancer at diagnosis is one of the strongest predictors of survival and is essential for population cancer surveillance, comparison of cancer outcomes and to guide national cancer control strategies. Our aim was to describe, for the first time, the distribution of cases by stage at diagnosis and differences in stage-specific survival on a population basis for a range of childhood solid cancers in Australia. The study cohort was drawn from the population-based Australian Childhood Cancer Registry and comprised children (<15 years) diagnosed with one of 12 solid malignancies between 2006 and 2014. Stage at diagnosis was assigned according to the Toronto Paediatric Cancer Stage Guidelines. Observed (all cause) survival was calculated using the Kaplan-Meier method, with follow-up on mortality available to 31 December 2015. Almost three-quarters (1256 of 1760 cases, 71%) of children in the study had localised or regional disease at diagnosis, varying from 43% for neuroblastoma to 99% for retinoblastoma. Differences in 5-year observed survival by stage were greatest for osteosarcoma (localised 85% (95% CI = 72%-93%) versus metastatic 37% (15%-59%)), neuroblastoma (localised 98% (91%-99%) versus metastatic 60% (52%-67%)), rhabdomyosarcoma (localised 85% (71%-93%) versus metastatic 53% (34%-69%)), and medulloblastoma (localised 69% (61%-75%) versus metastases to spine 42% (27%-57%)). The stage-specific information presented here provides a basis for comparison with other international population cancer registries. Understanding variations in survival by stage at diagnosis will help with the targeted formation of initiatives to improve outcomes for children with cancer.
Publisher: Wiley
Date: 24-01-2022
DOI: 10.1002/IJC.33931
Abstract: Our study measures the impact of diagnosing cancers early before they metastasise on reducing the burden of cancer death. A cohort of 716 501 people aged 15 to 89 years diagnosed with a solid cancer in New South Wales, Australia, during 1985 to 2014 were followed‐up to December 2015. Crude probabilities of cancer death by stage at diagnosis were calculated for all solid cancers combined and five in idual cancers using flexible parametric relative survival models. These probabilities were used to estimate the number of avoided cancer deaths within 10 years of diagnosis in three 10‐year diagnostic periods if all cases with known distant stage were instead diagnosed at an earlier stage. Cancers are known to be diagnosed at distant stage composed ~16% of all solid cancers diagnosed during 2005 to 2014. Assuming all these cases were instead diagnosed at regional stage, an annual average of 2064 cancer deaths would have been potentially avoided within 10 years of diagnosis. This equated to ~21% of modelled observed deaths. Alternatively, if half of all known distant cases diagnosed during 2005 to 2014 were diagnosed as regional and half as localised, the average number of deaths avoided per year would increase to 2677 (~28%). Estimates varied by diagnostic period, sex and cancer type, reflecting both the different stage distributions for the cancer types, and the respective survival differences between cancer stages. While prevention is the most effective pillar of cancer control, these findings quantify the potential benefits of diagnosing all cancer types when they are less advanced to reduce the burden of cancer mortality.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516009.V1
Abstract: Supplementary Figure S2 shows article's study period in years
Publisher: Wiley
Date: 27-09-2012
Publisher: AMPCo
Date: 19-11-2020
DOI: 10.5694/MJA2.50425
Abstract: To investigate the incidence of second primary cancers in people diagnosed with cancer during childhood. Retrospective, population-based study analysis of Australian Childhood Cancer Registry data. People alive at least two months after being diagnosed before the age of 15 years with a primary cancer, 1983-2013, followed until 31 December 2015 (2-33 years' follow-up). Risks of second primary cancer compared with the general population, expressed as standardised incidence ratios (SIRs). Among 18 230 people diagnosed with cancer during childhood, 388 (2%) were later diagnosed with second primary cancers the estimated 30-year cumulative incidence of second cancers was 4.4% (95% CI, 3.8-5.0%). The risk of a new primary cancer was five times as high as for the general population (SIR, 5.13 95% CI, 4.65-5.67). Relative risk of a second primary cancer was greatest for people who had childhood rhabdomyosarcoma (SIR, 19.9 95% CI, 14.4-27.6). Relative risk was particularly high for children who had undergone both chemotherapy and radiotherapy (SIR, 9.80 95% CI, 8.35-11.5). Relative risk peaked during the 5 years following the first diagnosis (2 to less than 5 years: SIR, 10.3 95% CI, 8.20-13.0), but was still significant at 20-33 years (SIR, 2.58 95% CI, 2.02-3.30). The most frequent second primary cancers were thyroid carcinomas (65 of 388, 17%) and acute myeloid leukaemias (57, 15%). Survivors of childhood cancer remain at increased risk of a second primary cancer well into adulthood. As the late effects of cancer treatment probably contribute to this risk, treatments need to be refined and their toxicity reduced, without reducing their benefit for survival.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1038/JID.2014.452
Publisher: The Royal Society
Date: 08-2020
DOI: 10.1098/RSOS.192151
Abstract: Analysis of spatial patterns of disease is a significant field of research. However, access to unit-level disease data can be difficult for privacy and other reasons. As a consequence, estimates of interest are often published at the small area level as disease maps. This motivates the development of methods for analysis of these ecological estimates directly. Such analyses can widen the scope of research by drawing more insights from published disease maps or atlases. The present study proposes a hierarchical Bayesian meta-analysis model that analyses the point and interval estimates from an online atlas. The proposed model is illustrated by modelling the published cancer incidence estimates available as part of the online Australian Cancer Atlas (ACA). The proposed model aims to reveal patterns of cancer incidence for the 20 cancers included in ACA in major cities, regional and remote areas. The model results are validated using the observed areal data created from unit-level data on cancer incidence in each of 2148 small areas. It is found that the meta-analysis models can generate similar patterns of cancer incidence based on urban/rural status of small areas compared with those already known or revealed by the analysis of observed data. The proposed approach can be generalized to other online disease maps and atlases.
Publisher: Wiley
Date: 08-03-2011
DOI: 10.1002/IJC.25540
Abstract: Survival from melanoma is inversely related to tumour thickness and is less favorable for those in lower socioeconomic (SES) strata. Reasons for this are unclear but may relate to a lower prevalence of skin screening. Our aim was to examine the association between melanoma thickness, in idual-level SES and clinical skin examination (CSE) using a population-based case-control study. Cases were Queensland (Australia) residents aged 20-75 years with a histologically confirmed first primary invasive cutaneous melanoma diagnosed between January 2000 and December 2003. Telephone interviews were completed by 3,762 cases (77.7%) and 3,824 (50.4%) controls. Thickness was dichotomized to thin (≤2 mm) and thick (>2 mm). Compared with controls, the risk of thick melanoma was significantly increased among men [relative risk ratio (RRR) = 1.56, 95% CI = 1.22-2.00], older participants (RRR = 1.76, 95% CI = 1.10-2.82), those educated to primary level (RRR = 1.70, 95% CI = 1.08-2.66), not married/living as married (RRR = 1.47, 95% CI = 1.15-1.88), retired (RRR = 1.39, 95% CI = 1.01-1.94) and not having a CSE in past 3 years (RRR = 1.45, 95% CI = 1.12-1.86). There was a significant trend to increasing prevalence of CSE with higher education (p < 0.01) and the benefit of CSE in reducing the risk of thick melanoma was most pronounced among that subgroup. There were no significant associations between cases with thin melanoma and controls. Melanoma thickness at presentation is significantly associated with educational level, other measures of SES and absence of CSE. Public health education efforts should focus on identifying new avenues that specifically target those subgroups of the population who are at increased risk of being diagnosed with thick melanoma.
Publisher: Springer Science and Business Media LLC
Date: 27-12-2012
DOI: 10.1007/S11136-011-0067-5
Abstract: Long-term (≥5 years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5 years to describe changes over time and antecedents of long-term outcomes. A prospective survey of a population-based s le of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5 months post-diagnosis as predictors of QOL and psychological distress 5 years post-diagnosis. QOL improved over time (P 0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, being single, low social support, low optimism, and a more negative cancer threat appraisal. Being women, having a pet, having a private health insurance, and receiving both surgery and adjuvant treatment were protective. Consistent with response shift theory, the antecedents of QOL after colorectal cancer are multifactorial and include predisposing socio-demographic, medical, and psychological variables. Psychosocial interventions that target both social support and threat appraisal may be effective for this patient group. Additional stepped-up support may be needed for people from a poorer social environment who have multiple risk factors for poorer adjustment. Health system effects require further investigation.
Publisher: Elsevier BV
Date: 2009
Abstract: Clinical trials frequently report acute myeloid leukemia (AML) as a complication of adjuvant chemotherapy for breast cancer (BC). This retrospective population-based study investigated AML risk after a prior BC diagnosis and compared the results with women after a prior diagnosis of hematological malignancies (HM), other cancers combined (OCC), and the age-matched Australian female population. Women with a prior BC diagnosis had 2.56 times the risk of developing AML compared with the Australian female population (P<0.001). AML risk was also elevated after prior HM and OCC diagnoses (4.73, P<0.001, and 1.70, P<0.001, respectively). Although the incidence of AML rose sharply with age in all cohorts, the age-specific relative risk was highest in the 30- to 49-age-group and decreased with increasing age. AML risk increased with the duration of follow-up but there was no change of risk during the 23 years of this study. AML risk was elevated after a prior diagnosis of BC but there was no evidence of an increasing risk of AML after a BC diagnosis or, in any of the other cancer cohorts, during this era of expansion of the evidence base for more intensive treatments.
Publisher: Wiley
Date: 03-10-2014
DOI: 10.1002/IJC.29227
Abstract: Limited population-based cancer registry data available in China until now has h ered efforts to inform cancer control policy. Following extensive efforts to improve the systematic cancer surveillance in this country, we report on the largest pooled analysis of cancer survival data in China to date. Of 21 population-based cancer registries, data from 17 registries (n = 138,852 cancer records) were included in the final analysis. Cases were diagnosed in 2003-2005 and followed until the end of 2010. Age-standardized relative survival was calculated using region-specific life tables for all cancers combined and 26 in idual cancers. Estimates were further stratified by sex and geographical area. The age-standardized 5-year relative survival for all cancers was 30.9% (95% confidence intervals: 30.6%-31.2%). Female breast cancer had high survival (73.0%) followed by cancers of the colorectum (47.2%), stomach (27.4%), esophagus (20.9%), with lung and liver cancer having poor survival (16.1% and 10.1%), respectively. Survival for women was generally higher than for men. Survival for rural patients was about half that of their urban counterparts for all cancers combined (21.8% vs. 39.5%) the pattern was similar for in idual major cancers except esophageal cancer. The poor population survival rates in China emphasize the urgent need for government policy changes and investment to improve health services. While the causes for the striking urban-rural disparities observed are not fully understood, increasing access of health service in rural areas and providing basic health-care to the disadvantaged populations will be essential for reducing this disparity in the future.
Publisher: Wiley
Date: 17-08-2021
DOI: 10.1111/ANS.17132
Abstract: International literature recommends centralising gastric cancer surgery, however, with volumes that define ‘high‐volume resection’ being higher than those in most major centres in Australia and New Zealand. These reports rarely focus on the difference between total (TG) and partial gastrectomy (PG). We assessed the impact of resection volume and service capability on operative mortality, morbidity and surgical quality in patients who had a PG and TG. Patients who had gastrectomy for adenocarcinoma, between 2001 and 2015, were collected from the Queensland Oncology Repository. Hospitals were characterised by cases‐per‐annum (high‐volume [HV] ≥ 5 and low‐volume [LV] 5) and hospital service capability as (high‐service [HS] and low‐service [LS]), giving three hospital groups: HVHS, LVHS and LVLS. Chi‐squared tests were used to compare post‐operative mortality, morbidity, failure to rescue (FTR) from complications and surgical quality between these three groups. There were 426 patients who had a TG and 827 having PG. HVHS centres performed 59% of PG with high surgical quality rates of: HVHS = 53%, LVHS = 34% and LVLS = 46% ( p 0.01). Surgical complications were highest in LVLS (LVLS = 19%, LVHS = 11%, HVHS = 11% p = 0.02). There was no difference in 30‐day mortality nor in FTR. For TG, HVHS performed 67% of these procedures, with lower 30‐day mortality (2%) and FTR rates (5%) compared with LVHS (7%, 22%) and LVLS (12%, 28% p 0.01). There was no difference in operative morbidity and surgical quality between hospital groups. Despite the ‘high‐volume’ threshold for gastrectomy being the lowest described in the literature, we have shown that centralisation to HVHS centres was associated with lower operative mortality for TG and improved quality of surgery for PG.
Publisher: Oxford University Press (OUP)
Date: 19-02-2020
DOI: 10.1111/BJD.18900
Publisher: BMJ
Date: 03-2002
Publisher: Elsevier BV
Date: 08-2017
Publisher: Public Library of Science (PLoS)
Date: 08-05-2018
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 04-03-2015
DOI: 10.7314/APJCP.2015.16.3.1259
Abstract: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the in iduals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.
Publisher: Wiley
Date: 27-05-2017
DOI: 10.1111/AJCO.12508
Abstract: Our previous population-based research found prophylactic surgery (hysterectomy and bilateral salpingo-oophorectomy [BSO]) halved the mortality risk for premenopausal breast cancer patients. Here we aim to replicate findings in a Western Australia dataset. Data from the Western Australia Cancer Registry of 15 395 women 20-79 years diagnosed with primary breast cancer (1997-2011) was categorized into four groups: neither hysterectomy nor BSO, hysterectomy only, BSO only, or hysterectomy + BSO. We fitted flexible parametric breast cancer-specific and overall survival models with 95% confidence intervals (also known as Royston-Parmar models) to assess the impact of prophylactic surgery. A total of 12 630 (82.0%) patients had no surgery, 1799 (11.7%) had a hysterectomy only, 337 (2.2%) had BSO only and 629 (4.1%) had both a hysterectomy and BSO. For all-causes mortality, unadjusted 10-year survival was highest for women who had either a hysterectomy + BSO (84.7%) or a hysterectomy only (84.2%). After adjusting for covariates, the survival advantage compared to women without any surgery remained significant for the hysterectomy only group (hazard ratio [HR] = 0.89 95% confidence interval [CI], 0.81-0.98 P = 0.02). A similar pattern emerged in breast cancer-specific survival with significantly improved survival for women who had a hysterectomy only (HR = 0.83 95% CI, 0.74-0.94 P = 0.003). However, for non-breast cancer-related survival, having a BSO alone increased risk of death (HR = 1.83 95% CI, 1.14-2.93 P = 0.01). We observed significantly improved overall and breast cancer-specific survival among women who had a hysterectomy only, but increased non-breast cancer-related risk after BSO only. Breast cancer patients must weigh up pros and cons of prophylactic surgery.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JID.2018.11.001
Abstract: Survivors of invasive melanoma have an increased risk of developing second primary cancers however, similar risks associated with in situ melanoma have not been established. We evaluated 39,872 survivors of first primary in situ melanoma diagnosed from 1982 through 2012 in Queensland, Australia. Relative risk of second nonmelanoma primary cancers was estimated from standardized incidence ratios with 95% confidence intervals. A total of 4,823 (12%) in situ melanoma survivors developed a second primary cancer. A small increased risk (6%) compared with the general population was found. In those younger than 50 years, risk was increased by 14% for all cancers combined. In situ melanoma survivors had significantly increased risks of developing lip, thyroid, pancreatic, and brain cancers and decreased risks of head and neck, and lung cancers. Male in situ melanoma survivors had a significantly increased risk of prostate cancer female survivors had an increased risk of thyroid cancer and lymphoid leukemia. Findings indicate that in situ melanoma may predict the diagnosis of certain second primary cancers. This altered risk may be due to biological, behavioral, or genetic factors or increased medical surveillance, and it requires further investigation, particularly among people younger than 50 years.
Publisher: Springer Science and Business Media LLC
Date: 23-04-2019
DOI: 10.1038/S41598-019-42774-X
Abstract: Esophageal cancer (EC) is a leading cause of cancer death in China. Within Shandong Province, a geographic cluster with high EC mortality has been identified, however little is known about how area-level socioeconomic status (SES) is associated with EC mortality in this province. Multilevel models were applied to EC mortality data in 2011–13 among Shandong residents aged 40+ years. Area-level SES factors consisted of residential type (urban/rural) of the sub-county-level units (n = 262) and SES index (range: 0–10) of the county-level units (n = 142). After adjustment for age and sex, residents living in rural areas had a 22% (95% CI: 13–32%) higher risk of dying from EC than those in urban areas. With each unit increase in the SES index, the average risk of dying from EC reduced by 10% (95% CI: 3–18%). The adjustment of area-level SES variables had little impact on the risk ratio of EC mortality between the high-mortality cluster and the rest of Shandong. In conclusion, rural residence and lower SES index are strongly associated with elevated risks of EC death. However, these factors are independent of the high mortality in the cluster area of Shandong. The underlying causes for this geographic disparity need to be further investigated.
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/J.ADDBEH.2005.04.007
Abstract: With the uptake of cigarette smoking hypothesised to occur through a series of contemplation and action stages, we sought to investigate what factors are associated with the contemplation of smoking among secondary school students in Queensland, Australia. A series of four cross-sectional surveys were conducted among secondary schools in Queensland in 1993, 1996, 1999 and 2002. Respondents (n = 9993) were asked about the stages of smoking. Nearly half (43%) of secondary school students reported some contemplation of smoking. Increased levels of smoking contemplation were observed among females, earlier survey years, Junior level students, students with average or below average scholastic ability, those prepared to go out with a smoker, those with recent alcohol experience, those who had influenced other students to smoke or had not discouraged other students smoking. The results of this study provide further information about the factors relevant to stages of smoking uptake among secondary school students and the influence that students may have on their peers.
Publisher: IOP Publishing
Date: 12-2022
Abstract: Wheat is the most widely grown food crop, with 761 Mt produced globally in 2020. To meet the expected grain demand by mid-century, wheat breeding strategies must continue to improve upon yield-advancing physiological traits, regardless of climate change impacts. Here, the best performing doubled haploid (DH) crosses with an increased canopy photosynthesis from wheat field experiments in the literature were extrapolated to the global scale with a multi-model ensemble of process-based wheat crop models to estimate global wheat production. The DH field experiments were also used to determine a quantitative relationship between wheat production and solar radiation to estimate genetic yield potential. The multi-model ensemble projected a global annual wheat production of 1050 ± 145 Mt due to the improved canopy photosynthesis, a 37% increase, without expanding cropping area. Achieving this genetic yield potential would meet the lower estimate of the projected grain demand in 2050, albeit with considerable challenges.
Publisher: Springer Science and Business Media LLC
Date: 22-05-2012
DOI: 10.1007/S10552-012-9990-1
Abstract: To quantify the demographic and clinical factors associated with an increased risk of multiple primary cancers (MPCs) among colorectal cancer survivors. Standardized incidence ratios for MPCs were calculated for residents of Queensland, Australia, who were diagnosed with a first primary colorectal cancer between 1996 and 2005 and survived for at least 2 months. Relative risk ratios were calculated for all MPCs combined and selected in idual sites using multivariate Poisson models. A total of 1,615 MPCs were observed among 15,755 study patients. The cohort had a significant excess risk of developing subsequent colorectal (SIR = 1.47, 95 % CI 1.30-1.66) or non-colorectal (SIR = 1.24, 95 % CI 1.18-1.31) cancers relative to the incidence of cancer in the general population. Age at initial diagnosis, follow-up time, initial colorectal subsite, and surgical treatment were independently associated (p < 0.01) with the overall risk of developing MPCs after adjustment. The relative risk ratio was 1.23 (95 % CI 1.07-1.41) for those aged 20-59 years compared with the 70-79 age group and 0.82 (95 % CI 0.72-0.92) for 1-5-year follow-up relative to the first year. The likelihood of being diagnosed with a MPC was 33 % higher (95 % CI 1.12-1.56) for surgically treated patients and 45 % higher (95 % CI 1.29-1.64) after proximal colon cancers relative to rectal cancer. While these population-based results do not incorporate all possible risk factors, they form an important foundation from which to further investigate the etiological causes that result in the development of MPCs among colorectal cancer survivors.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.CANEP.2016.12.010
Abstract: Comorbidity is associated with poor outcomes for cancer patients but it is less clear how it influences cancer prevention and early detection. This review synthesizes evidence from studies that have quantified the association between comorbidity and participation in breast and cervical screening. PubMed, CINAHL and EMBASE databases were systematically searched using key terms related to cancer screening and comorbidity for original research articles published between 1 January 1991 and 21 March 2016. Two reviewers independently screened 1283 studies that met eligibility criteria related to Population (adult, non-cancer populations), Exposure (comorbidity), Comparison (a 'no comorbidity' group), and Outcome (participation in breast cancer or cervical screening). Data was extracted and risk of bias assessed using a standardised tool from the 22 studies identified for inclusion (17 breast 13 cervical). Meta-analyses were performed for participation in breast and cervical screening, stratified by important study characteristics. The majority of studies were conducted in the United States. Results of in idual studies were variable. Most had medium to high risk of bias. Based on the three "low risk of bias" studies, mammography screening was less common among those with comorbidity (pooled Odds Ratio 0.66, 95%CI 0.44-0.88). The one "low risk of bias" study of cervical screening reported a negative association between comorbidity and participation. While a definitive conclusion could not be drawn, the results from high quality studies suggest that women with comorbidity are less likely to participate in breast, and possibly cervical, cancer screening.
Publisher: Acoustical Society of America (ASA)
Date: 11-1971
DOI: 10.1121/1.1912763
Abstract: The difficulties in solving many of the noise problems in an average household are as much social and economic as technical. With many different parties being involved in the noise problem of even a single appliance, plea is made for uniform sound ratings of equipment, for information proper application and installation, and for realistic criteria on acceptable sound levels. Recent standards for performance ratings and application information of the Air-Conditioning and Refrigeration Institute are cited as an ex le of what an industry can do to further the communication of acoustical data between manufacturers, installers, and users of machinery.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.CCT.2009.11.003
Abstract: Incidence and mortality from skin cancers including melanoma are highest among men 50 years or older. Thorough skin self-examination may be beneficial to improve skin cancer outcomes. To develop and conduct a randomized-controlled trial of a video-based intervention to improve skin self-examination behavior among men 50 years or older. Pilot work ascertained appropriate targeting of the 12-minute intervention video towards men 50 years or older. Overall, 968 men were recruited and 929 completed baseline telephone assessment. Baseline analysis assessed randomization balance and demographic, skin cancer risk and attitudinal factors associated with conducting a whole-body skin self-examination or receiving a whole-body clinical skin examination by a doctor during the past 12 months. Randomization resulted in well-balanced intervention and control groups. Overall 13% of men reported conducting a thorough skin self-examination using a mirror or the help of another person to check difficult to see areas, while 39% reported having received a whole-body skin examination by a doctor within the past 12 months. Confidence in finding time for and receiving advice or instructions by a doctor to perform a skin self-examination were among the factors associated with thorough skin self-examination at baseline. Men 50 years or older can successfully be recruited to a video-based intervention trial with the aim to reduce their burden through skin cancer. Randomization by computer generated randomization list resulted in good balance between control and intervention group and baseline analysis determined factors associated with skin cancer early detection behavior.
Publisher: JMIR Publications Inc.
Date: 28-01-2022
Abstract: obile teledermatology is increasingly being used in clinical practice and offers the opportunity to counsel the general public about sun protection and skin cancer early detection. Growing evidence suggests that SMS text messaging interventions are an effective way to reach a large number of people and promote sun protection behaviors. Many medical practices already have SMS text message systems in place to communicate with patients, especially for appointment reminders and information. However, could we use these systems for even better outcomes? If so, how? his presentation will outline the results of the SunText study, a theory-based SMS text messaging intervention designed to evaluate how often and in what way we could communicate with people at risk of skin cancer to have a beneficial effect on sun protection behaviors, sunburn, and participant engagement. he SunText study was conducted between February-July 2019 in Queensland, Australia. Volunteer participants aged 18 to 40 years were randomized to 4 different intervention schedules using a Latin square design. The schedules included personalized or interactive messages with constant frequency and personalized and interactive messages with either increasing or decreasing frequency. Outcomes measured were reduction in sunburn and engagement with interactive messages, defined as responding to messages by return text. ompared to baseline, the self-reported sun protection habits index was significantly higher in all 4 interventions ( i P /i & .01). Overall, sunburn rates decreased from baseline to the end of the intervention (40.3% to 7.0%), and remained significantly below baseline levels (23.5%) at the 6-month follow-up ( i P /i & .01). All 4 interventions achieved reductions in sunburn rates (18%-48% reduction) during the intervention period. The overall engagement rate with interactive messages was 71%. The intervention involving interactive messages with constant frequency achieved the highest engagement rate. The intervention with personalized and interactive messages with increasing frequency had the lowest engagement rate. his study adds to the evidence that text messages targeting sun protection are effective in improving sun protection behaviors and reducing sunburn. Results also suggest higher engagement with constant or decreasing message frequency. Although many clinics already use SMS text messaging for scheduling, this presentation may encourage its extended use to raise awareness of sun protection. Interactive messages could also be integrated into sun protection mobile health apps, and provide an opportunity for engaging in health promotion content.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.JVAL.2016.12.017
Abstract: To assess the cost-effectiveness of an educational intervention encouraging self-skin examinations for early detection of skin cancers among men older than 50 years. A lifetime Markov model was constructed to combine data from the Skin Awareness Trial and other published sources. The model incorporated a health system perspective and the cost and health outcomes for melanoma, squamous and basal cell carcinomas, and benign skin lesions. Key model outcomes included Australian costs (2015), quality-adjusted life-years (QALYs), life-years, and counts of skin cancers. Univariate and probabilistic sensitivity analyses were undertaken to address parameter uncertainty. The mean cost of the intervention was A$5,298 compared with A$4,684 for usual care, whereas mean QALYs were 7.58 for the intervention group and 7.77 for the usual care group. The intervention was thus inferior to usual care. When only survival gain is considered, the model predicted the intervention would cost A$1,059 per life-year saved. The likelihood that the intervention was cost-effective up to A$50,000 per QALY gained was 43.9%. The model was stable to most data estimates nevertheless, it relies on the specificity of clinical diagnosis of skin cancers and is subject to limited health utility data for people with skin lesions. Although the intervention improved skin checking behaviors and encouraged men to seek medical advice about suspicious lesions, the overall costs and effects from also detecting more squamous and basal cell carcinomas and benign lesions outweighed the positive health gains from detecting more thin melanomas.
Publisher: Wiley
Date: 25-02-2019
DOI: 10.1002/PBC.27683
Abstract: Information on stage at diagnosis for childhood blood cancers is essential for surveillance but is not available on a population basis in most countries. Our aim was to apply the internationally endorsed Toronto Paediatric Cancer Stage Guidelines to children (<15 years) with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), or non-Hodgkin lymphoma (NHL) and to assess differences in survival by stage at diagnosis. Stage was defined by extent of involvement of the central nervous system (CNS) for ALL and AML and using the Ann Arbor and St Jude-Murphy systems for HL and NHL, respectively. The study cohort was drawn from the population-based Australian Childhood Cancer Registry, consisting of children diagnosed with one of these four blood cancers between 2006 and 2014 with follow-up to 2015. Five-year observed survival was estimated from the Kaplan-Meier method. Stage was assigned to 2201 of 2351 eligible patients (94%), ranging from 85% for AML to 95% for ALL, HL, and NHL. Survival following ALL varied from 94% (95% CI = 93%-95%) for CNS1 disease to 89% (95% CI = 79%-94%) for CNS2 (P = 0.07), whereas for AML there was essentially no difference in survival between CNS These results provide the first population-wide picture of the distribution and outcomes for childhood blood cancers in Australia by extent of disease at diagnosis and provide a baseline for future comparisons.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814170.V1
Abstract: Supplementary Table S1 shows search terms and keywords
Publisher: BMJ
Date: 13-04-2015
Publisher: Springer Science and Business Media LLC
Date: 14-05-2008
DOI: 10.1007/S10552-008-9168-Z
Abstract: Although increasing incidence of testicular germ cell cancer has been reported in many developed nations, national estimates for Australia, with histological differentiation, are not currently available. Using data from all state and territory population-based cancer registries in Australia, this paper reports on incidence trends for seminomas and non-seminomas in Australia between 1982 and 2004 using Joinpoint and Age-Period-Cohort models. Of the 10,528 testicular germ cell cancers diagnosed during this period, 6086 (58%) were seminomas. Incidence rates have increased (2.6% per year) in Australia since 1982, with the effect stronger among seminomas (3.4% per year) rather than non-seminomas (1.4% per year). There was a strong age effect evident for both subtypes, peaking in the 25-29 year age group for non-seminomas and the 30-34 year age group for seminomas. Non-seminoma rates reflected a significant birth cohort effect, following a U-shaped pattern with the lowest risk among the 1,945 birth cohort. The differential trends observed for Australia for seminomas and non-seminomas are consistent with those reported for the United States, but slightly different to those reported for Europe. The trends may be at least partly due to changes over time in the prevalence of etiologic or protective factors around the time of birth.
Publisher: American Association for Cancer Research (AACR)
Date: 31-05-2023
DOI: 10.1158/1055-9965.EPI-23-0154
Abstract: Spatial modeling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modeling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modeling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations.
Publisher: Hindawi Limited
Date: 11-2009
DOI: 10.1111/J.1365-2354.2008.01046.X
Abstract: First-degree relatives of men with prostate cancer have a higher risk of being diagnosed with prostate cancer than men without a family history. The present review examines the prevalence and predictors of testing in first-degree relatives, perceptions of risk, prostate cancer knowledge and psychological consequences of screening. Medline, PsycInfo and Cinahl databases were searched for articles examining risk perceptions or screening practices of first-degree relatives of men with prostate cancer for the period of 1990 to August 2007. Eighteen studies were eligible for inclusion. First-degree relatives participated in prostate-specific antigen (PSA) testing more and perceived their risk of prostate cancer to be higher than men without a family history. Family history factors (e.g. being an unaffected son rather than an unaffected brother) were consistent predictors of PSA testing. Studies were characterized by s ling biases and a lack of longitudinal assessments. Prospective, longitudinal assessments with well-validated and comprehensive measures are needed to identify factors that cue the uptake of screening and from this develop an evidence base for decision support. Men with a family history may benefit from targeted communication about the risks and benefits of prostate cancer testing that responds to the implications of their heightened risk.
Publisher: Wiley
Date: 13-07-2023
DOI: 10.1002/PON.4124
Abstract: The aim of this systematic review was to examine variations in psychosocial outcomes by residential location and Indigenous status in women diagnosed with breast cancer (BC) in Australia. Systematic searches were undertaken using multiple databases covering articles between 1 January 1990 and 1 March 2015 focusing on adult women with BC in an Australian setting and measuring quality of life (QOL), psychological distress or psychosocial support. Thirteen quantitative and three qualitative articles were included. Two quantitative and one qualitative article were rated high quality, seven moderate and the remaining were low quality. No studies examining inequalities by Indigenous status were identified. Non-metropolitan women were more likely to record lower QOL relating to breast cancer-specific concerns and reported a lack of information and resources specific to their needs. Continuity of support, ongoing care and access to specialist and allied health professionals were major concerns for non-metropolitan women. Non-metropolitan women identified unmet needs in relation to travel, fear of cancer recurrence and lack of psychosocial support. Overall, there was a lack of evidence relating to variations in psychosocial outcomes for women with BC according to residential status or Indigenous status. While the review identified some specific concerns for non-metropolitan women with BC, it was limited by the lack of good quality studies using standardised measures. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1016/J.CANEP.2012.06.001
Abstract: To determine current rates of childhood cancer mortality at a national level for Australia and to evaluate recent trends. Using population-based data from the Australian Paediatric Cancer Registry, we calculated cancer-related mortality counts and rates for the 3-year period 2006-2008 and trends between 1998 and 2008 by sex, age group, and cause of death (defined according to the International Classification of Childhood Cancers, third edition). Rates were directly age-standardised to the 2000 World Standard Population, and linear regression was used to determine the magnitude and significance of trends. The standardised mortality ratio for non-cancer deaths among children with cancer was also estimated. A total of 282 children (23 per million per year) died from cancer in Australia between 2006 and 2008. Large decreases were observed in cancer mortality rates over the study period, particularly for boys (-5.5% per year p<0.001), children aged 10-14 years old (-5.5% per year p=0.001), and leukaemia patients (-9.4% per year p<0.001). However, there was no significant change in mortality due to tumours of the central nervous system. Children with cancer were twice as likely to die from non-cancer causes compared to other children (SMR=2.06 p=0.001). While ongoing improvements in childhood cancer mortality in Australia are generally encouraging, of concern is the lack of a corresponding decrease in mortality among children with certain types of tumours of the central nervous system during the past decade. The results also highlight the need for intensive monitoring of childhood cancer patients for other serious diseases that may subsequently arise.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2013
Publisher: Wiley
Date: 23-07-2012
DOI: 10.1111/J.1743-7563.2012.01567.X
Abstract: This retrospective, population-based study investigated the patterns and risks of mortality from breast cancer, other cancers and non-cancer causes according to the age at diagnosis of breast cancer. Mortality was assessed in all Australian women (n = 179,653) aged 30-79 years who were diagnosed with breast cancer between 1982 and 2004 and who survived a minimum of 1 year. The mean follow up was 6.3 years (range 0-23 years). Before December 2005, 52,934 women had died (34,459 of breast cancer, 5019 of other cancers and 13,456 of non-cancer causes). There was an inverse age-related relative risk of mortality (calculated as the standardized mortality ratio [SMR]) from breast cancer (linear trend across age P < 0.01). For breast cancer survivors the age-adjusted SMR was 0.99 for other cancers and 0.81(P < 0.01) for non-cancer causes in comparison with the general population. The SMR for other cancers and non-cancer causes was highest in the 30-39-year-old age group (2.13, P < 0.01 and 2.15, P < 0.01, respectively), and progressively decreased with increasing age, with the 70-79-year-old age group having significantly reduced SMR (0.95, P < 0.05, and 0.78, P < 0.01, respectively, compared with the age-matched general population). There was an inverse age-related relative risk of death from breast cancer, other cancers and non-cancer causes. These findings suggest that younger Australian women require long-term health surveillance and that older women with limited comorbidities require optimal treatment of their breast cancer.
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.CANEP.2016.06.001
Abstract: Area-based socioeconomic measures are widely used in health research. In theory, the larger the area used the more in idual misclassification is introduced, thus biasing the association between such area level measures and health outcomes. In this study, we examined the socioeconomic disparities in cancer survival using two geographic area-based measures to see if the size of the area matters. We used population-based cancer registry data for patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia during 2004-2008. Patients were assigned index measures of socioeconomic status (SES) based on two area-level units, census Collection District (CD) and Local Government Area (LGA) of their address at diagnosis. Five-year relative survival was estimated using the period approach for patients alive during 2004-2008, for each socioeconomic quintile at each area-level for each cancer. Poisson-regression modelling was used to adjust for socioeconomic quintile, sex, age-group at diagnosis and disease stage at diagnosis. The relative excess risk of death (RER) by socioeconomic quintile derived from this modelling was compared between area-units. We found extensive disagreement in SES classification between CD and LGA levels across all socioeconomic quintiles, particularly for more disadvantaged groups. In general, more disadvantaged patients had significantly lower survival than the least disadvantaged group for both CD and LGA classifications. The socioeconomic survival disparities detected by CD classification were larger than those detected by LGA. Adjusted RER estimates by SES were similar for most cancers when measured at both area levels. We found that classifying patient SES by the widely used Australian geographic unit LGA results in underestimation of survival disparities for several cancers compared to when SES is classified at the geographically smaller CD level. Despite this, our RER of death estimates derived from these survival estimates were generally similar for both CD and LGA level analyses, suggesting that LGAs remain a valuable spatial unit for use in Australian health and social research, though the potential for misclassification must be considered when interpreting research. While data confidentiality concerns increase with the level of geographical precision, the use of smaller area-level health and census data in the future, with appropriate allowance for confidentiality.
Publisher: Oxford University Press (OUP)
Date: 09-2004
Publisher: Wiley
Date: 29-04-2015
DOI: 10.1002/PON.3829
Abstract: Health-related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect. A self-administered cross-sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health-related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes. Forty-nine percent of patients reported elevated anxiety 41% were depressed and 51% had high global distress. Health-related stigma was significantly related to global psychological distress and quality of life with greater stigma and shame related to poorer outcomes. These effects were mediated by illness appraisals and social constraints. Health-related stigma appears to contribute to poorer adjustment by constraining interpersonal discussions about cancer and heightening feelings of threat. There is a need for the development and evaluation of interventions to ameliorate the negative effects of health-related stigma among lung cancer patients.
Publisher: BMJ
Date: 30-01-2011
Abstract: Reducing disparities in cancer outcomes is a major priority for cancer-control agencies. The authors examine the relationships between geographic remoteness, area disadvantage and risk of advanced breast cancer among women. Multilevel models were used to assess the area- and in idual-level contributions to the risk of advanced breast cancer among women aged 30-79 years diagnosed as having breast cancer in Queensland, Australia between 1997 and 2006 (n=18,658). Women who resided in the most socio-economically disadvantaged areas were significantly more likely (OR 1.21, 95% CI 1.07 to 1.37) than residents of the most advantaged areas to be diagnosed as having advanced breast cancer after adjustment for in idual-level factors. When geographic remoteness and area-disadvantage (and all the in idual-level factors) were simultaneously adjusted, the rates of advanced breast cancer were significantly higher for women residing in Outer Regional areas (OR 1.13, 95% CI 1.02 to 1.24) and those who lived in the most disadvantaged areas (OR 1.16, 95% CI 1.02 to 1.32). There was no statistically significant interaction between geographic remoteness and area disadvantage. A woman's risk of being diagnosed as having advanced breast cancer depends on where she lives, separate from the in idual characteristics of the woman herself. Both the rurality and socio-economic characteristics of the geographical area in which women lived were important. The socio-economic factors contributing to advanced breast cancer, existing in both urban and rural environments, need to be investigated.
Publisher: SAGE Publications
Date: 19-02-2015
Abstract: Evidence is needed for the acceptability and user preferences of receiving skin cancer-related text messages. We prepared 27 questions to evaluate attitudes, satisfaction with program characteristics such as timing and spacing, and overall satisfaction with the Healthy Text program in young adults. Within this randomised controlled trial (age 18–42 years), 546 participants were assigned to one of three Healthy Text message groups sun protection, skin self-examination, or attention-control. Over a 12-month period, 21 behaviour-specific text messages were sent to each group. Participants’ preferences were compared between the two interventions and control group at the 12-month follow-up telephone interview. In all three groups, participants reported the messages were easy to understand (98%), provided good suggestions or ideas (88%), and were encouraging (86%) and informative (85%) with little difference between the groups. The timing of the texts was received positively (92%) however, some suggestions for frequency or time of day the messages were received from 8% of participants. Participants in the two intervention groups found their messages more informative, and triggering behaviour change compared to control. Text messages about skin cancer prevention and early detection are novel and acceptable to induce behaviour change in young adults.
Publisher: AMPCo
Date: 03-2015
DOI: 10.5694/MJA14.00664
Abstract: To compare mortality rates for Indigenous and non-Indigenous Australians commencing renal replacement therapy (RRT) over time and by categories of remoteness of place of residence. An observational cohort study of Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data on Indigenous and non-Indigenous Australians registered with ANZDATA who commenced RRT from 1 January 1995 to 31 December 2009 and were followed until 31 December 2011. Five-year all-cause mortality for Indigenous and non-Indigenous patients in three cohorts (1995-1999, 2000-2004 and 2005-2009) and five remoteness (of place of residence) categories. Indigenous patients were younger, more likely to have diabetes, be referred late and be from a more remote area than non-Indigenous patients. Age and comorbid conditions increased with successive cohorts for both groups. Unadjusted analysis (using the log-rank test) showed an increased risk of death for Indigenous patients in the 1995-1999 (P = 0.02) and 2000-2004 (P = 0.03) cohorts, but not for the 2005-2009 cohort (P = 0.7). However, a Cox proportional hazards model adjusted for covariates (age, sex, late referral and comorbid conditions [diabetes, coronary artery disease, peripheral vascular disease, cerebrovascular disease, lung disease], and body mass index 30 kg/m(2)) showed the following Indigenous:non-Indigenous hazard ratios (with 95% CIs) for major capital cities: 1995-1999, 1.47 (1.21-1.79) 2000-2004, 1.35 (1.12-1.63) and 2005-2009, 1.37 (1.14-1.66). Although unadjusted analysis suggests that the survival gap between Indigenous and non-Indigenous patients receiving RRT has closed, there remains a significant disparity in survival after adjusting for the variables considered in our study.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.EUF.2015.04.002
Abstract: Determining whether men diagnosed with early prostate cancer (PCa) will live long enough to benefit from interventions with curative intent is difficult. Although validated instruments for predicting patient survival are available, these do not have clinical utility so are not used routinely in practice. To test the hypothesis that volunteers who provided ejaculate specimens had a high survival rate at 10 and 15 yr and beyond. A total of 290 patients investigated because of high serum prostate-specific antigen donated ejaculate specimens for research between January 1992 and May 2003. The median age at the time of ejaculation was 63.5 yr. 153 of the donors were diagnosed with PCa and followed up to December 31, 2013. Survival outcomes were compared with those for the whole population, as indicated by life expectancy tables up to 20 yr. Men in the PCa group had life expectancies comparable with values listed in life expectancy tables for the whole population. Overall, PCa-specific and relative survival were significantly better for men in the non-PCa and PCa groups in comparison with men diagnosed with PCa in Queensland during the same period. Relative survival for those aged 20-49, 50-64, and ≥65 yr was >100% for ejaculate donors and 81.5%, 82.7%, and 65.2%, respectively, for the Queensland Cancer Registry reference at 10 yr. These findings for this highly selected patient cohort support the hypothesis that an ability to provide an ejaculate specimen is associated with a high likelihood of surviving 10-20 yr after donation, whether or not PCa was detected. Life expectancy tables may serve as a quick and simple life expectancy indicator for biopsy patients who donate ejaculate. Life expectancy tables indicated survival of up to 20 yr for men who provided ejaculate specimens for prostate cancer research.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516012
Abstract: Supplementary Figure S1 shows summary of keywords extracted from articles
Publisher: American Association for Cancer Research (AACR)
Date: 23-03-2022
DOI: 10.1158/1055-9965.EPI-21-1349
Abstract: Australia provides an ideal population-base for cancer migration studies because of its multicultural society and high-quality cancer registrations. Among migrant groups there is considerable variability in the incidence of infection-related cancers thus, the patterns of three such cancers were examined among migrant groups relative to Australian-born residents. Using national incidence data for cancers of the stomach, liver, and cervix diagnosed during 2005 to 2014, incidence rates were compared for selected migrant groups with the Australian-born population using incidence rate ratios (IRR), from a negative binomial regression model. Wide variations in incidence between countries/regions of birth were observed for all three cancers (P & 0.0001). The patterns were similar for cancers of the stomach and liver, in that migrants from countries/regions with higher incidence rates maintained an increased risk in Australia, with the highest being among South American migrants (IRR = 2.35) for stomach cancer and among Vietnamese migrants (5.44) for liver cancer. In contrast, incidence rates of cervical cancer were lower for many migrant groups, with women from Southern Asia (0.39) and North Africa (0.42) having the lowest rates. The rate of cervical cancer was higher in migrants from New Zealand, Philippines, and Polynesia. Several Australian migrant groups were found to experience a disproportionate burden of infection-related cancers further studies of associated risk factors may inform the design of effective interventions to mediate these disparities. By identifying these migrant groups, it is hoped that these results will motivate and inform prevention or early detection activities for these migrant groups. See related commentary Dee and Gomez, p. 1251
Publisher: Wiley
Date: 18-01-2016
DOI: 10.1111/AJD.12429
Abstract: Using a large (N= 25 493) population-based cohort from Queensland, Australia, we compared melanoma survival among cases with a single invasive melanoma only against those who also had a diagnosis of a single in situ melanoma. After adjustment for sex, age, body site, clinicopathological subtype, thickness and ulceration, it was found that there was no difference (P = 0.99) in 10-year melanoma-specific mortality following a diagnosis of an invasive lesion, whether or not an in situ melanoma was also present. We conclude that in situ melanomas do not alter the prognosis of an invasive melanoma.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2013
DOI: 10.1007/S10552-013-0287-9
Abstract: This study assessed variation in childhood cancer survival by Indigenous status in Australia, and explored the effect of place of residence and socio-economic disadvantage on survival. All children diagnosed with cancer during 1997-2007 were identified through the Australian Pediatric Cancer Registry. Cox regression analysis was used to assess the adjusted differences in survival. Overall, 5-years survival was 75.0 % for Indigenous children (n = 196) and 82.3 % for non-Indigenous children (n = 6,376, p = 0.008). Compared to other children, Indigenous cases had 1.36 times the risk of dying within 5 years of diagnosis after adjustments for rurality of residence, socio-economic disadvantage, cancer diagnostic group, and year of diagnosis (95 % CI 1.01-1.82). No significant survival differential was found for leukemias or tumors of the central nervous system Indigenous children were 1.83 times more likely (95 % CI 1.22-2.74) than other children to die within 5 years from 'other tumors' (e.g., lymphomas, neuroblastoma). Among children who lived in 'remote/very remote/outer regional' areas, and among children with a subgroup of 'other tumors' that were staged, being Indigenous significantly increased the likelihood of death (HR = 1.69, 95 % CI 1.10-2.59 and HR = 2.99, 95 % CI 1.35-6.62, respectively) no significant differences by Indigenous status were seen among children with stage data missing. Differences in place of residence, socio-economic disadvantage, and cancer diagnostic group only partially explain the survival disadvantage of Indigenous children. Other reasons underlying the disparities in childhood cancer outcomes by Indigenous status are yet to be determined, but may involve factors such as differences in treatment.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Elsevier BV
Date: 08-1996
DOI: 10.1111/J.1467-842X.1996.TB01046.X
Abstract: The Rand Corporation medical outcomes short-form 36 health survey (SF-36) is a multidimensional measure of self-perceived general health status, which has been validated in adult populations in the United States and Great Britain, and, more recently, in an Australian population. The SF-36 is increasingly being used in health outcomes research internationally, mainly as a self-administered tool, and clearly has potential for use in Australia. This study aimed to assess the acceptability, reliability and validity of telephone administration of the instrument in the Queensland adult population, and to provide reliable population norms. We report the results of a telephone survey in which we interviewed 12,793 adults. It was the first large-scale, statewide application of the SF-36 in Australia. A response rate of 82 per cent was achieved, and the SF-36 satisfied psychometric criteria for reliability and construct validity. Population norms broken down by age and sex are provided. They will be important for the interpretation of future studies using the SF-36 in particular population or patient groups.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.CANEP.2013.12.004
Abstract: Increases in the incidence of squamous cell oropharyngeal cancer (OPC) have been reported from some countries, but have not been assessed in Australia or New Zealand. This study examines trends for squamous cell OPC and squamous cell oral cavity cancer (OCC) in two similarly sized populations, New Zealand and Queensland, Australia. Incidence data for 1982-2010 were obtained from the respective population-based cancer registries for squamous cell OPC and OCC, by subsite, sex, and age. Time trends and annual percentage changes (APCs) were assessed by joinpoint regression. The incidence rates of squamous cell OPC in males in New Zealand since 2005 and Queensland since 2006 have increased rapidly, with APCs of 11.9% and 10.6% respectively. The trends were greatest at ages 50-69 and followed more gradual increases previously. In females, rates increased by 2.1% per year in New Zealand from 1982, but by only 0.9% (not significant) in Queensland. In contrast, incidence rates for OCC decreased by 1.2% per year in males in Queensland since 1982, but remained stable for females in Queensland and for both sexes in New Zealand. Overall, incidence rates for both OCC and OPC were substantially higher in Queensland than in New Zealand. In males in both areas, OPC incidence is now higher than that of OCC. Incidence rates of squamous cell OPC have increased rapidly in men, while rates of OCC have been stable or reducing, showing distinct etiologies. This has both clinical and public health importance, including implications for the extension of human papilloma virus (HPV) vaccination to males.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2015
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.CANEP.2015.12.009
Abstract: The survival benefits of having a partner for all cancers combined is well recognized, however its prognostic importance for in idual cancer types, including competing mortality causes, is less clear. This study was undertaken to quantify the impact of partner status on survival due to cancer-specific and competing mortality causes. Data were obtained from the population-based Queensland Cancer Registry on 176,050 incident cases of ten leading cancers diagnosed in Queensland (Australia) from 1996 to 2012. Flexible parametric competing-risks models were used to estimate cause-specific hazards and cumulative probabilities of death, adjusting for age, stage (breast, colorectal and melanoma only) and stratifying by sex. Both unpartnered males and females had higher total cumulative probability of death than their partnered counterparts for each site. For ex le, the survival disadvantage for unpartnered males ranged from 3% to 30% with higher mortality burden from both the primary cancer and competing mortality causes. The cause-specific age-adjusted hazard ratios were also consistent with patients without a partner having increased mortality risk although the specific effect varied by site, sex and cause of death. For all combined sites, unpartnered males had a 46%, 18% and 44% higher risk of cancer-specific, other cancer and non-cancer mortality respectively with similar patterns for females. The higher mortality risk persisted after adjustment for stage. It is important to better understand the mechanisms by which having a partner is beneficial following a cancer diagnosis, so that this can inform improvements in cancer management for all people with cancer.
Publisher: JMIR Publications Inc.
Date: 31-01-2018
DOI: 10.2196/JMIR.8850
Publisher: Elsevier BV
Date: 04-2022
Publisher: Springer Science and Business Media LLC
Date: 04-2004
Publisher: Wiley
Date: 20-04-2012
DOI: 10.1002/IJC.25996
Abstract: This study investigated time trends and latitude differentials in the thickness distributions of invasive melanomas diagnosed in Australia between 1990 and 2006 using data from population-based cancer registries. Trends in incidence rates were calculated by sex, age group, thickness, year at diagnosis and latitude. For thin ( 4.00 mm) melanomas continued to increase over the entire period (males +2.6(+1.9,+3.4) females +1.6(+0.6,+2.6)). Recent reductions in the incidence of thin melanomas were observed among young (<50 years) males and females, contrasted by an increase in thin melanomas among older people, and increases in thick melanomas among most age groups for males and elderly (75+) females. A strong latitude gradient in incidence rates was observed, with rates being highest in northern, more tropical areas and lowest in the most southern regions. However, the magnitude of the increase in thick melanomas was most pronounced in southern parts of Australia. The observed trends in thin melanomas can most likely be attributed to the impact of early detection and skin awareness c aigns. However, these efforts have not impacted on the continued increase in the incidence of thick melanomas, although some increase may be due to earlier detection of metastasising melanomas. This highlights the need for continued vigilance in early detection processes.
Publisher: Springer Science and Business Media LLC
Date: 16-08-2011
DOI: 10.1038/BJC.2011.313
Publisher: Oxford University Press (OUP)
Date: 04-2016
DOI: 10.1111/BJD.14490
Publisher: Springer Science and Business Media LLC
Date: 14-02-2013
DOI: 10.1007/S10552-013-0166-4
Abstract: Colorectal cancer survivors are at risk of dying from other causes including comorbidities and second malignancies. This study was undertaken to identify demographic and clinical predictors of cancer-specific and competing causes of mortality. The crude probabilities of mortality attributed to colorectal cancer, other cancers, and non-cancer causes were estimated for 19,415 residents of Queensland, Australia, who were diagnosed with a first primary colorectal cancer between 1996 and 2007 when aged 20-79 years and survived at least 2 months, with follow-up to the end of 2009. Multivariate competing risk analysis was used to analyze covariate effects on the cumulative probability of the different mortality types. Five-year cumulative probabilities of colorectal cancer, other cancers, and non-cancer mortality were 29.4 % (95 % CI 29.3, 30.7), 2.0 % (95 % CI 1.8, 2.2), and 5.7 % (95 % CI 5.3, 6.0), respectively. Factors associated with an increased risk of non-cancer mortality included older age, male gender, unmarried status, localized disease, first primary colon cancers, no surgery, and the presence of comorbidities. Apart from diagnosis of a metachronous secondary cancer, being older, unmarried, or in blue-collar occupations were independent predictors of increased mortality due to other cancers. A better understanding of the role of competing events and the ability to predict risk of such events have the potential to translate into more effective in idualized strategies for colorectal cancer management. The control of comorbidities and reducing cancer risk through clinical management and lifestyle changes should be an important and attainable goal for CRC survivors.
Publisher: Oxford University Press (OUP)
Date: 20-09-2018
DOI: 10.1111/BJD.17089
Publisher: Springer Science and Business Media LLC
Date: 20-10-2023
DOI: 10.1007/S10552-022-01643-1
Abstract: In Australia, Aboriginal and Torres Strait Islander peoples (First Nations population) often have low overall cancer survival, as do all residents of geographically remote areas. This study aimed to quantify the survival disparity between First Nations and other Queenslanders for 12 common cancer types by remoteness areas. For all Queensland residents aged 20–89 years diagnosed with a primary invasive cancer during 1997–2016, we ran flexible parametric survival models incorporating age, First Nations status, sex, diagnosis time period, area-level socioeconomic status, remoteness categories and where appropriate, broad cancer type. Three survival measures were predicted: cause-specific survival, survival differences and the comparative survival ratio, each standardised to First Nations peoples’ covariate distributions. The standardised five-year cause-specific cancer survival was 60% for urban First Nations and 65% for other Queenslanders, while remote residents were 54% (First Nations) and 58% (other). The absolute survival differential between First Nations and other Queenslanders was often similar, regardless of remoteness of residence. The greatest absolute difference in five-year standardised cancer survival was for head and neck cancers, followed by cervical cancer. The five-year comparative survival ratio (First Nations: other Queenslanders) for urban cancer patients was 0.91 (95% CI 0.90–0.93), similar to outer regional, inner regional and remote areas. The greatest comparative survival differential was for oesophageal cancer. First Nations’ survival inequalities are largely independent of geographical remoteness. It remains a priority to determine the contribution of other potential factors such as the availability of culturally acceptable diagnostic, management and/or support services.
Publisher: Springer Science and Business Media LLC
Date: 08-10-2012
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.12954/PI.12014
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1111/J.1753-6405.2008.00259.X
Abstract: To investigate the reliability of collecting colorectal stage information from pathology reports and general practitioners in Queensland, Australia. A longitudinal study of colorectal cancer survivors conducted in 2003 and 2004 (n=1966, response rate=57%) obtained stage information from clinical specialists (n=1334), general practitioners (GP) (n=1417) and by extracting stage from pathology reports (n=1484). Reliability of stage information was determined by comparing stage from GPs and pathology reports with that reported by the clinical specialists, using a weighted kappa. GPs and pathology reports each had a similar level of agreement with clinical specialists, with kappa scores of 0.77 (0.75-0.80) (n=1042) and 0.78 (0.75-0.81) (n=1152), respectively. Results were similar when restricting to records staged by all three methods (n=847). GPs had similar levels of agreement with clinical specialists within each stage, although pathology reports tended to under-stage patients in Stage D (0.37). Collapsing stage into two categories (A or B, C or D) increased the reliability estimates from the pathology reports to 0.91 (0.88-0.93), but there was little change in GP estimates 0.79 (0.75-0.83). Extractions from pathology reports are a valid source of broad stage information for colorectal cancer. In the absence of clinical stage data, access to pathology records by population-based cancer registries enables a more accurate assessment of survival inequalities in colorectal cancer survival.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2006
DOI: 10.1097/01.CEJ.0000195707.89998.0C
Abstract: The objective of this analysis was to examine recent changes in prostate cancer mortality among the male population of Belgrade, Serbia, during the period 1975-2002. Mortality data (official death certificates) for prostate cancer were gathered from published and unpublished material of the Municipal Institute of Statistics in Belgrade. Mortality rates were standardized according to the European standard population. Trends in mortality rates were assessed using join-point analysis. During the period from 1975 to 2002 in the population of Belgrade the average age-adjusted mortality rate from prostate cancer during this period was 17.5/100,000 (95% confidence interval, 15.4-19.6), ranging from 8.2/100,000 in 1984 to 31.2/100,000 in 2002. Since 1986 mortality rates among men aged 50 years and over have risen by nearly 6% per year, with the increases being slightly higher among older men (70 years and over 8% per year) compared to younger men (50-69 years, 4% per year). Mortality due to prostate cancer is rising quickly among men in Belgrade. This level of increase is the highest of any reported increase internationally and contrasts sharply with the widespread decrease in prostate cancer mortality in many developed countries.
Publisher: Springer International Publishing
Date: 2020
Publisher: Elsevier BV
Date: 12-1996
DOI: 10.1111/J.1467-842X.1996.TB01079.X
Abstract: The aim of the study was to describe the appropriateness of patient-initiated skin examinations, and assess whether an awareness program leads to a greater proportion of inappropriate patient-initiated skin examinations. General practitioners (n = 27, response rate 71 per cent) from a regional town in Queensland recorded details of consultations involving a skin examination over a five-week period straddling the 1991 National Skin Cancer Awareness Week. The outcome measure was the clinical impression (benign, suspicious or malignant) of the most serious skin lesion presented by each general practice patient (n = 1183). Thirty-six per cent of patient-presented lesions were clinically suspicious or malignant. Lesions were more likely to be clinically suspicious or malignant if they were presented as the primary reason for the consultation (odds ratio OR = 1,219.95 per cent confidence interval (CI) 1.01 to 1.48) if the patient was aged over 35 years (OR = 5.594, CI 1.08 to 7.66) or male (OR = 1.634, CI 1.35 to 2.00). Following a public skin cancer awareness c aign, there was a slight nonsignificant decrease (OR 0.938, CI 0.91 or 1.25) in the proportion of clinically suspicious and malignant lesions detected. An increase in the number of skin examinations following an awareness c aign did not result in an increase in the proportion of inappropriate skin examinations. Patient-initiated skin examinations have an important role to play in the early detection of skin cancer.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814176.V1
Abstract: Supplementary Figure S1 shows summary of keywords extracted from articles
Publisher: Springer Science and Business Media LLC
Date: 02-2006
DOI: 10.1007/S10552-005-3637-4
Abstract: Queensland, the north-eastern state of Australia, has the highest incidence of melanoma in the world. Control measures started earlier here than probably anywhere else in the world early detection programmes started in the 1960s and primary prevention in the 1980s. Data from the population-based Queensland Cancer Registry therefore provide an internationally unique data source with which to assess trends for in situ and invasive melanomas and to consider the implications for early detection and primary prevention. We used Poisson regression to estimate the annual percentage change in rates across 21 years of incidence data for in situ and invasive lesions, stratified by age and sex. Joinpoint analyses were used to assess whether there had been a statistically significant change in the trends. In situ melanomas increased by 10.4% (95% CI: 10.1%, 11.1%) per year among males and 8.4% (7.9%, 8.9%) per year among females. The incidence of invasive lesions also increased, but not as quickly males 2.6% (2.4%, 2.8%), females 1.2% (0.9%, 1.5%). Valid data on thickness was only available for 1991 to 2002 and for this period thin-invasive lesions were increasing faster than thick-invasive lesions (for ex le, among males: thin 3.8%, thick 2.0%). We found some suggestive evidence of lower proportionate increase for the most recent years for both in-situ and invasive lesions, but this did not achieve statistical significance. Among people younger than 35 years, the incidence of invasive melanoma was stable and there was a suggestion of a birth cohort effect from about 1958. Mortality rates were stable across all ages, and there was a suggestion of decreasing rates among young women, although this did not achieve statistical significance. Age-standardised incidence is continuing to increase and this, in combination with a shift to proportionately more in situ lesions, suggests that the stabilisation of mortality rates is due, in large part, to earlier detection. For primary prevention, after a substantial period of sustained effort in Queensland, there is some suggestive, but not definitive, evidence that progress is being made. Incidence rates are stabilising in those younger than 35 years and the proportionate increase for both in situ and invasive lesions appears to be lower for the most recent period compared with previous periods. However, even taking the most favourable view of these trends, primary prevention is unlikely to lead to decreases in the overall incidence rate of melanoma for at least another 20 years. Consequently, the challenge for primary prevention programmes will be to maintain momentum over the long term. If this can be achieved, the eventual public-health benefits are likely to be substantial.
Publisher: Elsevier BV
Date: 1997
DOI: 10.1016/S0190-9622(97)70322-0
Abstract: Detecting melanoma early often relies on patient concern about a particular pigmented lesion. However, it is not clear what specific features the public views as being important. Our purpose was to explore the importance persons place on various features of skin lesions when looking for early signs of melanoma. This study comprised 1148 respondents (participation rate, 78%) from 60 rural communities in Queensland, Australia, who participated in a telephone interview. The following features were considered important and are listed in order of importance: change in the lesion (clearly identified as the most important), more than one color, uneven edges, elevation, large size (the last three of equal importance), and hairiness of the lesion. Age, sex, education, self-efficacy, perceived knowledge, and recent self-examination influenced importance levels, but having a recent skin examination by a family physician did not. To increase the skin self-examination skills of the community, guidelines may have to become more specific and all opportunities fully utilized to educate the public.
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.CANEP.2019.101568
Abstract: While net probabilities of death in the relative survival framework ignore competing causes of death, crude probabilities allow estimation of the real risk of cancer deaths. This study quantifies temporal trends in net and crude probabilities of death. Australian population-based cohort of 2,015,903 people aged 15-89 years, diagnosed with a single primary invasive cancer from 1984 to 2013 with mortality follow-up to 31 December 2014. Survival was analyzed with the cohort method. Flexible parametric relative survival models were used to estimate both probability measures by diagnosis year for all cancers and selected leading sites. For each site, excess mortality rates reduced over time, especially for prostate cancer. While both the 10-year net and crude probability of cancer deaths decreased over time, specific patterns varied. For ex le, the crude probability of lung cancer deaths for males aged 50 years decreased from 0.90 (1984) to 0.79 (2013) whereas the corresponding probabilities for kidney cancer were 0.64 and 0.18 respectively. Patterns for crude probabilities of competing deaths were relatively constant. Although for younger patients, both net and crude measures were similar, crude probability of competing deaths increased with age, hence for older ages net and crude measures were different except for lung and pancreas cancers. The observed reductions in probabilities of death over three decades for Australian cancer patients are encouraging. However, this study also highlights the ongoing mortality burden following a cancer diagnosis, and the need for continuing efforts to improve cancer prevention, diagnosis and treatment.
Publisher: Wiley
Date: 25-01-2016
DOI: 10.3322/CAAC.21338
Abstract: With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small s les of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year P = .1), whereas they increased significantly (+2.2% per year P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year P < .05) and females (-1.1% per year P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
Publisher: Wiley
Date: 04-2012
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.CCT.2013.03.009
Abstract: Several randomized trials have found behavior change programs delivered via text messaging to be efficacious to improve preventive health behaviors such as physical activity and stopping smoking however few have assessed its value in skin cancer prevention or early detection. The HealthyTexts study enrolled 678 participants 18-42 years, and assigned them to receive 21 text messages about skin cancer prevention, skin self-examination or physical activity (attention control) over the course of one year. Baseline data have been collected and outcomes will be assessed at three months and twelve months post-intervention. The trial aims to increase the mean overall sun protection habits index score from 2.3 to 2.7 with a standard deviation of 0.5 (effect size of 0.5) and the proportion of people who conduct a whole-body skin self-examination by an absolute 10%. This paper describes the study design and participants' baseline characteristics. In addition, participants' goals for their health, and strategies they apply to achieve those goals are summarized.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.CANEP.2012.02.007
Abstract: This paper presents the latest international descriptive epidemiological data for invasive breast cancer amongst women, including incidence, survival and mortality, as well as information on mammographic screening programmes. Almost 1.4 million women were diagnosed with breast cancer worldwide in 2008 and approximately 459,000 deaths were recorded. Incidence rates were much higher in more developed countries compared to less developed countries (71.7/100,000 and 29.3/100,000 respectively, adjusted to the World 2000 Standard Population) whereas the corresponding mortality rates were 17.1/100,000 and 11.8/100,000. Five-year relative survival estimates range from 12% in parts of Africa to almost 90% in the United States, Australia and Canada, with the differential linked to a combination of early detection, access to treatment services and cultural barriers. Observed improvements in breast cancer survival in more developed parts of the world over recent decades have been attributed to the introduction of population-based screening using mammography and the systemic use of adjuvant therapies. The future worldwide breast cancer burden will be strongly influenced by large predicted rises in incidence throughout parts of Asia due to an increasingly "westernised" lifestyle. Efforts are underway to reduce the global disparities in survival for women with breast cancer using cost-effective interventions.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.C.6695933
Abstract: Abstract Spatial modeling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modeling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modeling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations. /
Publisher: Springer Science and Business Media LLC
Date: 28-09-2011
Publisher: Public Library of Science (PLoS)
Date: 11-04-2016
Publisher: Springer Science and Business Media LLC
Date: 27-05-2009
Publisher: Public Library of Science (PLoS)
Date: 03-08-2021
DOI: 10.1371/JOURNAL.PONE.0255617
Abstract: Coal mine dust lung disease comprises a group of occupational lung diseases including coal workers pneumoconiosis. In many countries, there is a lack of robust prevalence estimates for these diseases. Our objective was to perform a systematic review and meta-analysis of published contemporary estimates on prevalence, mortality, and survival for coal mine dust lung disease worldwide. Systematic searches of PubMed, EMBASE and Web of Science databases for English language peer-reviewed articles published from 1/1/2000 to 30/03/2021 that presented quantitative estimates of prevalence, mortality, or survival for coal mine dust lung disease. Review was conducted per PRISMA guidelines. Articles were screened independently by two authors. Studies were critically assessed using Joanna Briggs Institute tools. Pooled prevalence estimates were obtained using random effects meta-analysis models. Heterogeneity was measured using the I 2 statistics and publication bias using Egger’s tests. Overall 40 studies were included, (31 prevalence, 8 mortality, 1 survival). Of the prevalence estimates, fifteen (12 from the United States) were retained for the meta-analysis. The overall pooled prevalence estimate for coal workers pneumoconiosis among underground miners was 3.7% (95% CI 3.0–4.5%) with high heterogeneity between studies. The pooled estimate of coal workers pneumoconiosis prevalence in the United States was higher in the 2000s than in the 1990s, consistent with published reports of increasing prevalence following decades of declining trends. Sub-group analyses also indicated higher prevalence among underground miners, and in Central Appalachia. The mortality studies were suggestive of reduced pneumoconiosis mortality rates over time, relative to the general population. The ongoing prevalence of occupational lung diseases among contemporary coal miners highlights the importance of respiratory surveillance and preventive efforts through effective dust control measures. Limited prevalence studies from countries other than the United States limits our understanding of the current disease burden in other coal-producing countries.
Publisher: Informa UK Limited
Date: 05-2011
DOI: 10.1586/ERA.11.28
Publisher: Wiley
Date: 09-05-2019
DOI: 10.1111/AJR.12504
Abstract: Describes the variation in prostate cancer testing by the remoteness of residence and socio-economic status groups in Australia. A national population-based descriptive study using Medicare data extracted by the Department of Health (formerly the Department of Health and Ageing). Australia. All men, with a Medicare-reimbursed prostate-specific antigen test conducted in Australia between 2002 and 2017, were included. We focused on "screening and case finding" tests (Medicare Benefits Schedule item number 66655) from 1 April 2005 to 31 December 2009, to describe testing differences in subgroups. Groups were categorised into State and Territory, socio-economic status and region of residence. A negative binomial regression model was fitted to measure the incidence rate ratios of those who had a screening prostate-specific antigen test by group. Age-standardised testing rates and incidence rate ratios. Between 2002 and 2017, 11 588 775 screening prostate-specific antigen tests were reimbursed by the Department of Human Services. During 2005-2009, 52% of all Australian men, aged 40 years and over, had a screening test. The incidence rate ratios differed by State and Territory. Men aged 40 years and over, living in very remote areas, were 43% less likely to have had a screening test than residents of major cities. Prostate-specific antigen testing rates fell in all age groups between 2007 and 2009 and 2017. The prostate-specific antigen testing behaviour differs between community groups in Australia. Men were less likely to have had a screening prostate-specific antigen test the farther they lived from the major cities. This highlights the need for a more targeted approach to achieve an equitable and evidence-based prostate cancer care across all sectors of the community.
Publisher: Elsevier BV
Date: 08-2008
Publisher: Wiley
Date: 21-12-2023
DOI: 10.1002/IJC.34395
Abstract: Rare cancers collectively account for around a quarter of cancer diagnoses and deaths. However, epidemiological studies are sparse. We describe spatial and geographical patterns in incidence and survival of rare cancers across Australia using a population‐based cancer registry cohort of rare cancer cases diagnosed among Australians aged at least 15 years, 2007 to 2016. Rare cancers were defined using site‐ and histology‐based categories from the European RARECARE study, as in idual cancer types having crude annual incidence rates of less than 6/100 000. Incidence and survival patterns were modelled with generalised linear and Bayesian spatial Leroux models. Spatial heterogeneity was tested using the maximised excess events test. Rare cancers (n = 268 070) collectively comprised 22% of all invasive cancer diagnoses and accounted for 27% of all cancer‐related deaths in Australia, 2007 to 2016 with an overall 5‐year relative survival of around 53%. Males and those living in more remote or more disadvantaged areas had higher incidence but lower survival. There was substantial evidence for spatial variation in both incidence and survival for rare cancers between small geographical areas across Australia, with similar patterns so that those areas with higher incidence tended to have lower survival. Rare cancers are a substantial health burden in Australia. Our study has highlighted the need to better understand the higher burden of these cancers in rural and disadvantaged regions where the logistical challenges in their diagnosis, treatment and support are magnified.
Publisher: Informa UK Limited
Date: 04-2013
DOI: 10.1080/08964289.2013.782851
Abstract: Early detection through whole-body Skin Self-Examination (wbSSE) may decrease mortality from melanoma. Using the Health Action Process Approach (HAPA) or Health Belief Model (HBM) we aimed to assess determinants of uptake of wbSSE in 410 men 50 years of older who participated in the control group of a randomized trial. Overall, the HAPA was a significantly better predictor of wbSSE compared to the HBM (p < .001). The construct of self-efficacy in the HBM was a significant predictor of future wbSSE (p = .001), while neither perceived threat (p = .584) nor outcome expectations (p = .220) were. In contrast, self-efficacy, perceived threat, and outcome expectations predicted intention to perform SSE, which predicted behavior (p = .015). The HAPA construct volitional self-efficacy was also associated with wbSSE (p = .046). The use of the HAPA model for future SSE interventions for this population is warranted.
Publisher: Wiley
Date: 08-08-2016
DOI: 10.1002/SIM.7071
Abstract: Most of the few published models used to obtain small-area estimates of relative survival are based on a generalized linear model with piecewise constant hazards under a Bayesian formulation. Limitations of these models include the need to artificially split the time scale, restricted ability to include continuous covariates, and limited predictive capacity. Here, an alternative Bayesian approach is proposed: a spatial flexible parametric relative survival model. This overcomes previous limitations by combining the benefits of flexible parametric models: the smooth, well-fitting baseline hazard functions and predictive ability, with the Bayesian benefits of robust and reliable small-area estimates. Both spatially structured and unstructured frailty components are included. Spatial smoothing is conducted using the intrinsic conditional autoregressive prior. The model was applied to breast, colorectal, and lung cancer data from the Queensland Cancer Registry across 478 geographical areas. Advantages of this approach include the ease of including more realistic complexity, the feasibility of using in idual-level input data, and the capacity to conduct overall, cause-specific, and relative survival analysis within the same framework. Spatial flexible parametric survival models have great potential for exploring small-area survival inequalities, and we hope to stimulate further use of these models within wider contexts. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: Springer Science and Business Media LLC
Date: 11-2010
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516009
Abstract: Supplementary Figure S2 shows article's study period in years
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516006
Abstract: Supplementary Table S1 shows search terms and keywords
Publisher: Springer Science and Business Media LLC
Date: 19-07-2007
DOI: 10.1007/S10552-007-9033-5
Abstract: With increases in cancer survival, promotion of healthy lifestyle behaviors among survivors is receiving considerable attention. This study compared health behaviors among a large s le of Australian adult cancer survivors with an age- and sex-matched cohort of people with no cancer history. Using the Australian National Health Survey, 968 cancer survivors were identified, and randomly matched by age and sex to 5,808 respondents without a history of cancer. Six health behaviors were compared (smoking, physical activity, servings of vegetables, servings of fruit, alcohol use, skin checks), along with overweight and obesity, using polytomous logistic regression analyses controlling for selected chronic conditions. Models were applied across both groups and by tumor site. Compared to the non-cancer comparison group, cancer survivors were significantly more likely to be current (OR = 1.35) smokers, particularly those under 40 years (OR = 1.69), and more likely to have regular skin checks (OR = 1.76). Although not significant, there was consistent evidence that cancer survivors were slightly more likely to be overweight or obese (p = 0.065) and have higher levels of alcohol consumption (p = 0.088). There was no evidence of differences between survivors and controls for levels of physical inactivity, vegetable consumption or fruit consumption. Women with a history of gynecological cancers were much more likely to be current smokers (OR = 2.37), while other differences by sex and cancer site were consistent with overall patterns. Cancer survivors were also significantly more likely to report having a range of co-morbid chronic medical conditions. Given their increased risk of second cancers and co-morbid chronic conditions, the lack of difference in behavioral risk factors confirms the need for a focus on improving the health behaviors of cancer survivors. Collaborative chronic disease management models may be particularly appropriate in this regard.
Publisher: Springer Science and Business Media LLC
Date: 05-01-2010
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: Elsevier BV
Date: 12-2014
DOI: 10.1038/JID.2014.266
Abstract: The relatively high incidence of Merkel cell carcinoma (MCC) in Queensland provides a valuable opportunity to examine links with other cancers. A retrospective cohort study was performed using data from the Queensland Cancer Registry. Standardized incidence ratios (SIRs) were used to approximate the relative risk of being diagnosed with another primary cancer either following or prior to MCC. Patients with an eligible first primary MCC (n = 787) had more than double the expected number of subsequent primary cancers (SIR = 2.19, 95% confidence interval (CI) = 1.84-2.60 P<0.001). Conversely, people who were initially diagnosed with cancers other than MCC were about two and a half times more likely to have a subsequent primary MCC (n=244) compared with the general population (SIR = 2.69, 95% CI = 2.36-3.05 P<0.001). Significantly increased bi-directional relative risks were found for melanoma, lip cancer, head and neck cancer, lung cancer, myelodysplastic diseases, and cancer with unknown primary site. In addition, risks were elevated for female breast cancer and kidney cancer following a first primary MCC, and for subsequent MCCs following first primary colorectal cancer, prostate cancer, non-Hodgkin lymphoma, or lymphoid leukemia. These results suggest that several shared pathways are likely for MCC and other cancers, including immunosuppression, UV radiation, and genetics.
Publisher: Wiley
Date: 11-11-2016
DOI: 10.1002/PON.4007
Abstract: Melanoma is on the rise, especially in Caucasian populations exposed to high ultraviolet radiation such as in Australia. This paper examined the psychological components facilitating change in skin cancer prevention or early detection behaviours following a text message intervention. The Queensland-based participants were 18 to 42 years old, from the Healthy Text study (N = 546). Overall, 512 (94%) participants completed the 12-month follow-up questionnaires. Following the social cognitive model, potential mediators of skin self-examination (SSE) and sun protection behaviour change were examined using stepwise logistic regression models. At 12-month follow-up, odds of performing an SSE in the past 12 months were mediated by baseline confidence in finding time to check skin (an outcome expectation), with a change in odds ratio of 11.9% in the SSE group versus the control group when including the mediator. Odds of greater than average sun protective habits index at 12-month follow-up were mediated by (a) an attempt to get a suntan at baseline (an outcome expectation) and (b) baseline sun protective habits index, with a change in odds ratio of 10.0% and 11.8%, respectively in the SSE group versus the control group. Few of the suspected mediation pathways were confirmed with the exception of outcome expectations and past behaviours. Future intervention programmes could use alternative theoretical models to elucidate how improvements in health behaviours can optimally be facilitated.
Publisher: American Medical Association (AMA)
Date: 04-2014
DOI: 10.1001/JAMADERMATOL.2013.9313
Abstract: Older men are at risk of dying of melanoma. To assess attendance at and clinical outcomes of clinical skin examinations (CSEs) in older men exposed to a video-based behavioral intervention. This was a behavioral randomized clinical trial of a video-based intervention in men aged at least 50 years. Between June 1 and August 31, 2008, men were recruited, completed baseline telephone interviews, and were than randomized to receive either a video-based intervention (n = 469) or brochures only (n = 461 overall response rate, 37.1%) and were again interviewed 7 months later (n = 870 93.5% retention). Video on skin self-examination and skin awareness and written informational materials. The control group received written materials only. Participants who reported a CSE were asked for the type of CSE (skin spot, partial body, or whole body), who initiated it, whether the physician noted any suspicious lesions, and, if so, how lesions were managed. Physicians completed a case report form that included the type of CSE, who initiated it, the number of suspicious lesions detected, how lesions were managed (excision, nonsurgical treatment, monitoring, or referral), and pathology reports after lesion excision or biopsy. Overall, 540 of 870 men (62.1%) self-reported a CSE since receiving intervention materials, and 321 of 540 (59.4%) consented for their physician to provide medical information (received for 266 of 321 [82.9%]). Attendance of any CSE was similar between groups (intervention group, 246 of 436 [56.4%] control group, 229 of 434 [52.8%]), but men in the intervention group were more likely to self-report a whole-body CSE (154 of 436 [35.3%] vs 118 of 434 [27.2%] for control group P = .01). Two melanomas, 29 squamous cell carcinomas, and 38 basal cell carcinomas were diagnosed, with a higher proportion of malignant lesions in the intervention group (60.0% vs 40.0% for controls P = .03). Baseline attitudes, behaviors, and skin cancer history were associated with higher odds of CSE and skin cancer diagnosis. A video-based intervention may increase whole-body CSE and skin cancer diagnosis in older men. anzctr.org.au Identifier: ACTRN12608000384358.
Publisher: Wiley
Date: 12-02-2019
DOI: 10.1002/AJH.25407
Publisher: SAGE Publications
Date: 21-01-2021
Abstract: Despite Australia’s National Cervical Screening Program, Indigenous women have a disproportionately high burden of cervical cancer. We describe temporal and area-level patterns in prevalence of histologically conformed high-grade cervical abnormalities (hHGA) among cytologically screened women by Indigenous status. This was a population-based study of 2,132,925 women, aged 20–69, who underwent cervical screening between 2008 and 2017, in Queensland, Australia. Of these, 47,136 were identified as Indigenous from linked hospital records. Overall patterns in hHGA prevalence by Indigenous status were quantified using prevalence rate ratios (PrRR) from negative binomial models. Bayesian spatial models were used to obtain smoothed prevalence estimates of hHGA across 528 small areas compared to the state average. Results are presented as maps and graphs showing the associated uncertainty of the estimates. Overall, screened Indigenous women had significantly higher hHGA prevalence than non-Indigenous women. However, the magnitude of the difference reduced over time ( p 0.001). Adjusted for age and area-level variables, Indigenous women had 36% higher hHGA prevalence (PrRR 1.36, 95% confidence interval [1.21–1.52]) than non-Indigenous women between 2013 and 2017. The overall effect of age decreased over time ( p = 0.021). Although there was evidence of moderate spatial variation in 10-year prevalence estimates for both groups of women, the high levels of uncertainty for many estimates, particularly for Indigenous women, limited our ability to draw definitive conclusions about the spatial patterns. While the temporal reduction in Indigenous: non-Indigenous differential in hHGA prevalence is encouraging, further research into the key drivers of the continuing higher risk among Indigenous women is warranted.
Publisher: Public Library of Science (PLoS)
Date: 20-07-2023
DOI: 10.1371/JOURNAL.PONE.0288992
Abstract: Participation in bowel cancer screening programs remains poor in many countries. Knowledge of geographical variation in participation rates may help design targeted interventions to improve uptake. This study describes small-area and broad geographical patterns in bowel screening participation in Australia between 2015–2020. Publicly available population-level participation data for Australia’s National Bowel Cancer Screening Program (NBCSP) were modelled using generalized linear models to quantify screening patterns by remoteness and area-level disadvantage. Bayesian spatial models were used to obtain smoothed estimates of participation across 2,247 small areas during 2019–2020 compared to the national average, and during 2015–2016 and 2017–2018 for comparison. Spatial heterogeneity was assessed using the maximized excess events test. Overall, screening participation rates was around 44% over the three time-periods. Participation was consistently lower in remote or disadvantaged areas, although heterogeneity was evident within these broad categories. There was strong evidence of spatial differences in participation over all three periods, with little change in patterns between time periods. If the spatial variation was reduced (so low participation areas were increased to the 80th centile), an extra 250,000 screens (4% of total) would have been conducted during 2019–2020. Despite having a well-structured evidence-based government funded national bowel cancer screening program, the substantial spatial variation in participation rates highlights the importance of accounting for the unique characteristics of specific geographical regions and their inhabitants. Identifying the reasons for geographical disparities could inform interventions to achieve more equitable access and a higher overall bowel screening uptake.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814170
Abstract: Supplementary Table S1 shows search terms and keywords
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.SSTE.2017.09.002
Abstract: Interpreting changes over time in small-area variation in cancer survival, in light of changes in cancer incidence, aids understanding progress in cancer control, yet few space-time analyses have considered both measures. Bayesian space-time hierarchical models were applied to Queensland Cancer Registry data to examine geographical changes in cancer incidence and relative survival over time for the five most common cancers (colorectal, melanoma, lung, breast, prostate) diagnosed during 1997-2004 and 2005-2012 across 516 Queensland residential small-areas. Large variation in both cancer incidence and survival was observed. Survival improvements were fairly consistent across the state, although small for lung cancer. Incidence changes varied by location and cancer type, ranging from lung and colorectal cancers remaining relatively constant over time, to prostate cancer dramatically increasing across the entire state. Reducing disparities in cancer-related outcomes remains a health priority, and space-time modelling of different measures provides an important mechanism by which to monitor progress.
Publisher: Wiley
Date: 21-03-2016
DOI: 10.1111/AJCO.12463
Abstract: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1 95% CI, 1.1-4.1). The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Oxford University Press (OUP)
Date: 08-11-2021
DOI: 10.1093/TBM/IBAB135
Abstract: There is growing evidence suggesting that text-message-based interventions are effective to promote sun protection behaviors. However, it is still unclear how engagement and adherence with the intervention messages can be optimized through intervention design. This study evaluated the effect of different combinations of personalized and two-way interactive messages on participant engagement with a theory-based skin cancer prevention intervention. In the SunText study conducted in February–July 2019 in Queensland, Australia participants 18–40 years were randomized to four different text message schedules using a Latin square design. This study analyzed if the order and intensity in which the schedules were received were associated with participants’ level of engagement, and if this differed by demographic factors. Out of the 389 participants enrolled in the study, 375 completed the intervention period and remained for analysis. The overall intervention engagement rate was 71% and decreased from the beginning to the end of the study (82.2%–61.4%). The group starting with personalized, but not interactive messaging showed the lowest engagement rate. The intervention involving interactive messages three times a week for 4 weeks achieved the highest engagement rate. The intervention with increasing frequency (personalized and interactive three times a week for 2 weeks then daily for 2 weeks) had lower engagement than intervention with constant or decreasing frequency. Engagement with two-way interactive messages was high across all intervention groups. Results suggest enhanced engagement with constant or decreasing message frequency compared to increasing frequency.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.BREAST.2018.07.005
Abstract: Understanding the burden of competing (non-breast cancer) mortality is important for the growing number of breast cancer survivors. We quantity these patterns, and the impact of two leading non-cancer causes of death, within ten years of breast cancer diagnosis. Population based cancer registry study of 23,809 women aged 50-79 diagnosed with first primary breast cancer in Queensland, Australia, 1997 to 2012 with additional data linkage to identify in idual non-cancer mortality causes. Flexible parametric competing-risks models were used to estimate the crude and adjusted probabilities of death. While overall mortality increased with age at diagnosis, this effect was strongest for non-cancer (such as cardiovascular and cerebrovascular disease) mortality. Women diagnosed with advanced breast cancer had a higher crude probability of breast cancer death (23.1% versus 4.5% for localised) but similar probability of competing mortality (11.6% versus 11.3%). Within each category of spread of disease, the probability of breast-cancer deaths remained relatively constant with age, while the probability of competing deaths increased. The 10-year probability of dying from breast cancer was 3.7%, 4.2% and 5.6% among women with localised disease aged 50 to 59, 60-69 and 70-79 respectively, but 3.1%, 7.8% and 22.9% for competing mortality. Increasing age, advanced disease and being unpartnered were independently associated with increased risk of breast cancer and competing deaths. Promotion of improved health behaviors after a cancer diagnosis and development of in idualized strategies for clinical management should be prioritized as part of optimal care for breast cancer survivors.
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.CDP.2004.06.007
Abstract: Community responses (n=925, response rate=71%) of a series of eight photographs of pigmented skin lesions were compared against those of general practitioners (n=114, response rate=77%), considered to be the most relevant gold standard. The eight photographs included three melanomas, two potentially malignant lesions and three benign pigmented lesions. Over the pool of lesions examined, the average probability that community members thought a lesion was likely to be skin cancer (0.68 [99% CI=0.66-0.69]) was higher (p<0.0001) than that of the comparison general practitioners 0.58 [99% CI=0.55-0.62]. This reflects a general (but not consistent) inflated propensity to over-diagnose among community members. The average probability that respondents indicated they would seek medical advice for a lesion was 0.71 [99% CI=0.70-0.73]. As expected, this was strongly associated with their perceptions of the skin lesion. These results suggest that the community can play a valuable role in assessing the need for medical evaluation of pigmented skin lesions.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814176
Abstract: Supplementary Figure S1 shows summary of keywords extracted from articles
Publisher: Springer Science and Business Media LLC
Date: 15-06-2016
DOI: 10.1007/S10552-016-0762-1
Abstract: To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer. The study cohort consisted of all people diagnosed with cancer in the period 1990-2000 and aged 15-89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age-sex-year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15-49, 50-69 and 70-89 years) or spread of disease (localized, regional, distant, unknown). The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (-0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (-0.21), prostate cancer (-0.17), colorectal cancer (-0.08), melanoma (-0.07) and stomach cancer (-0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis. In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814173
Abstract: Supplementary Figure S2 shows article's study period in years
Publisher: American Medical Association (AMA)
Date: 08-2014
DOI: 10.1001/JAMADERMATOL.2014.124
Abstract: Merkel cell carcinoma (MCC) is an uncommon but highly invasive form of skin cancer. The mechanisms that cause MCC are yet to be fully determined. To compare the incidence and survival rates of MCC in Queensland, Australia, known to be a high-risk area, with MCC incidence and survival elsewhere in the world. We also analyzed incidence trends and differences in survival by key demographic and clinical characteristics. Retrospective cohort study of population-based administrative data for MCC collected by the Queensland Cancer Registry and supplemented with detailed histopathologic data. Deidentified records were obtained of all Queensland residents diagnosed as having MCC during the period from 1993 to 2010. A subs le of histopathologic records were reviewed by a senior dermatopathologist to determine the potential for misclassification. A total of 879 eligible cases of MCC were included in the study. Incidence rates were directly age standardized to the 2000 United States Standard Population. Trends were examined using Joinpoint software with results expressed in terms of the annual percentage change. The period method was used to calculate 5-year relative survival, and adjusted hazard ratios were obtained from multivariate Poisson models. There were 340 cases of MCC diagnosed in Queensland between 2006 and 2010, corresponding to an incidence rate of 1.6 per 100,000 population. Men (2.5 per 100,000) had higher incidence than women (0.9 per 100,000), and rates peaked at 20.7 per 100,000 for persons 80 years or older. The overall incidence of MCC increased by an average of 2.6% per year from 1993 onwards. Relative survival was 41% after 5 years, with significantly better survival found for those younger than 70 years at diagnosis (56%-60%), those with tumors on the face or ears (51%), and those with stage I lesions (49%). Incidence rates for MCC in Queensland are at least double those of any that have been previously published elsewhere in the world. It is likely that Queensland's combination of a predominantly white population, outdoor lifestyle, and exposure to sunlight has played a role in this unwanted result. Interventions are required to increase awareness of MCC among clinicians and the public.
Publisher: Wiley
Date: 08-08-2016
DOI: 10.1111/PHP.12617
Abstract: International patterns suggest germ cell testicular cancer (GCTC) incidence may be lower in lower latitudes. To investigate this possibility, we examined GCTC incidence by latitude (population centroid in 2000) for men ≥15 years within two reasonably homogeneous countries, the United States and Australia. In the United States, we examined age-adjusted incidence/latitude trends using data from states (2001-2010) and local-area registries (1980-2011). In Australia, we evaluated incidence/latitude trends in 61 Statistical Divisions (2000-2009). In U.S. White men (68 566 cases), state incidences increased by latitude, rising 5.74% (4.45-7.05%) per 5°North latitude increment. Similar trends were found for seminoma and nonseminoma subtypes (P < 0.001). In U.S. Black men (2256 cases), the association was also seen (4.9% 0.2-9.7%). In local U.S. data, similar increases in incidence with latitude were present in each of the last three decades. In Australia (6042 cases), the incidence increased by 4.43% (95% CI: 1.54-7.39%) per 5°South, and trends for subtypes were similar. Thus, we found that incidence of GCTC in both White and Black men increased significantly with distance from the equator, approximately 1% per degree within the range of latitudes studied.
Publisher: SAGE Publications
Date: 12-11-2018
Abstract: Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516012.V1
Abstract: Supplementary Figure S1 shows summary of keywords extracted from articles
Publisher: Elsevier BV
Date: 07-2012
Publisher: Wiley
Date: 25-08-2017
DOI: 10.1111/AJCO.12570
Abstract: We examined how sociodemographic, clinical and area-level factors are related to short-term prostate cancer mortality versus mortality from other causes, a crucial distinction for this disease that disproportionately affects men older than 60 years. We applied competing risk survival models to administrative data from the Queensland Cancer Registry (Australia) for men diagnosed with prostate cancer between January 2005 and July 2007, including stratification by Gleason score. The men (n = 7393) in the study cohort had a median follow-up of 5 years 3 months. After adjustment, remoteness and area-level disadvantage were not significantly associated with prostate cancer mortality. However, area-level disadvantage had a significant negative relationship with hazard of death from a cause other than prostate cancer within 7 years compared with those living in the most advantaged areas, the likelihood of mortality was higher for those in the most disadvantaged (subhazard ratio [SHR] = 1.39 95% CI, 1.01-1.90 P = 0.041), disadvantaged (SHR = 1.51 95% CI, 1.14-2.00 P = 0.004), middle (SHR = 1.34 95% CI, 1.02-1.75 P = 0.034) and advantaged areas (SHR = 1.44 95% CI, 1.09-1.89 P = 0.009). Those with Gleason score of 7 and higher had a lower hazard of prostate cancer mortality if they were living with a partner, whereas those with lower Gleason scores and living a partner had lower hazards of other-cause mortality. Understanding why men living in more disadvantaged areas have higher risk of non-prostate cancer mortality should be a priority.
Publisher: Springer Science and Business Media LLC
Date: 18-08-2009
Publisher: Wiley
Date: 12-03-2018
DOI: 10.1002/IJC.31347
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516006.V1
Abstract: Supplementary Table S1 shows search terms and keywords
Publisher: Springer Science and Business Media LLC
Date: 24-07-2011
Publisher: BMJ
Date: 02-2016
Publisher: Elsevier BV
Date: 06-2000
DOI: 10.1016/S0277-9536(99)00395-0
Abstract: Few educational c aigns have focused on bowel cancer, though studies have indicated that members of the community need and want current information about relevant issues. In order to facilitate research in this area, reliable and valid measures of community attitudes are needed. Content validity of a survey instrument was obtained through use of a Delphi process with Directors of Education from the Australia Cancer Council and focus group discussions with informed members of the public. The subsequent survey of community perceptions about colorectal cancer included a broad range of content areas related to the risk of bowel cancer, preventing and coping with bowel cancer and beliefs about susceptibility and severity. The construct validity of these content areas was investigated by use of a factor analysis and confirmation of an association with related predictor variables. Two measures related to personal influence and anticipated coping responses showed favourable psychometric properties, including moderate to high levels of internal consistency and test-retest reliability. A test of the concurrent validity of these measures requires further development of instruments related to colorectal cancer or adaptation of measures from other areas of health research.
Publisher: AMPCo
Date: 03-2012
DOI: 10.5694/MJA11.11082
Abstract: To estimate the number of cancers to be diagnosed in 2025 that could be prevented solely due to changes in diet and physical activity. We used an Australian population-based cancer database to estimate the total number of cancers to be diagnosed in 2025, by applying published age- and sex-specific population projections to current cancer incidence rates, and multiplying the projected numbers of cancers by estimates of population-attributable fractions. Projected number of preventable cancers that would be diagnosed in 2025. Our projections suggest that there will be about 170, 000 Australians diagnosed with cancer in 2025. This represents an increase of about 60% on the 2007 incidence. Almost 43, 000 of these cancers (low estimate, 42,295 middle, 42,657 high, 43,990) could be prevented through improvements to diet and physical activity levels, including through their impact on obesity. It is likely that this is an underestimate of the true figure. The most preventable cancer types in 2025 were estimated to be bowel cancer and female breast cancer (10, 049 and 7273 preventable cases, respectively). About 25% of cancers, or about 43,000 cancers in 2025, can potentially be prevented through improvements in diet and physical activity. It is imperative that governments, clinicians and researchers act now if we are to reduce the significant future human and financial burden of cancer.
Publisher: MDPI AG
Date: 12-05-2017
Publisher: Springer Science and Business Media LLC
Date: 09-2011
DOI: 10.1038/BJC.2011.356
Publisher: Wiley
Date: 26-09-2013
DOI: 10.1002/PBC.24239
Abstract: We report cancer incidence and mortality among Indigenous children in Australia and compare the results with corresponding data for non-Indigenous children. This information is important in understanding the overall burden of cancer in this population, and where disparities exist, to plan what action is required. Age-standardized rates, and indirectly standardized incidence and mortality ratios (SIRs and SMRs) were calculated for the years 1997-2008. There were 224 cancers identified among Indigenous children (99.5 per million per year) and 52 Indigenous children died from cancer during the study period (22.9 per million per year). The SIR for all cancers was 0.64 (95% CI = 0.56-0.73 P < 0.001) while the SMR was 0.81 (95% CI = 0.61-1.07). These results provide a baseline with which to monitor cancer among Indigenous children over time.
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: 08-09-2010
DOI: 10.1002/IJC.24747
Abstract: Survival from melanoma is strongly related to tumour thickness, thus earlier diagnosis has the potential to reduce mortality from this disease. However, in the absence of conclusive evidence that clinical skin examination reduces mortality, evidence-based assessments do not recommend population screening. We aimed to assess whether clinical whole-body skin examination is associated with a reduced incidence of thick melanoma and also whether screening is associated with an increased incidence of thin lesions (possible overdiagnosis). We conducted a population-based case-control study of all Queensland residents aged 20-75 years with a histologically confirmed first primary invasive cutaneous melanoma diagnosed between January 2000 and December 2003. Telephone interviews were completed by 3,762 eligible cases (78.0%) and 3,824 eligible controls (50.4%). Whole-body clinical skin examination in the three years before diagnosis was associated with a 14% lower risk of being diagnosed with a thick melanoma (>0.75 mm) (OR = 0.86, 95% CI = 0.75, 0.98). Risk decreased for melanomas of increasing thickness: the risk of being diagnosed with a melanoma 0.76-1.49 mm was reduced by 7% (OR = 0.93, 95% CI 0.79, 1.10), by 17% for melanomas 1.50-2.99 mm (OR = 0.83, 95% CI = 0.65, 1.05) and by 40% for melanomas > or =3 mm (OR = 0.60, 95% CI = 0.43, 0.83). Screening was associated with a 38% higher risk of being diagnosed with a thin invasive melanoma (< or =0.75 mm) (OR = 1.38, 95% CI = 1.22, 1.56). This is the strongest evidence to date that whole-body clinical skin examination reduces the incidence of thick melanoma. Because survival from melanoma is strongly related to tumour thickness, these results suggest that screening would reduce melanoma mortality.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2020
DOI: 10.1158/1055-9965.EPI-20-0299
Abstract: This study quantifies the number of potentially “avoided”cancer deaths due to differences in 10-year relative survival between three time periods, reflecting temporal improvements in cancer diagnostic and/or treatment practices in Australia. National population-based cohort of 2,307,565 Australians ages 15 to 89 years, diagnosed with a primary invasive cancer from 1985 to 2014 with mortality follow-up to December 31, 2015. Excess mortality rates and crude probabilities of cancer deaths were estimated using flexible parametric relative survival models. Crude probabilities were then used to calculate “avoided cancer deaths” (reduced number of cancer deaths within 10 years of diagnosis due to survival changes since 1985–1994) for all cancers and 13 leading cancer types. For each cancer type, excess mortality (in the cancer cohort vs. the expected population mortality) was significantly lower for more recently diagnosed persons. For all cancers combined, the number of “avoided cancer deaths” (vs. 1985–1994) was 4,877 (1995–2004) and 11,385 (2005–2014) among males. Prostate (1995–2004: 2,144 2005–2014: 5,099) and female breast cancer (1,127 and 2,048) had the highest number of such deaths, whereas & were avoided for pancreatic or lung cancers across each period. Screening and early detection likely contributed to the high number of “avoided cancer deaths” for prostate and female breast cancer, whereas early detection remains difficult for lung and pancreatic cancers, highlighting the need for improved preventive and screening measures. Absolute measures such as “avoided cancer deaths” can provide a more tangible estimate of the improvements in cancer survival than standard net survival measures.
Publisher: American Medical Association (AMA)
Date: 05-2014
DOI: 10.1001/JAMADERMATOL.2013.9852
Abstract: Melanoma survivors are known to have a highly elevated risk of subsequent primary melanomas. To determine the relative risk of subsequent primary invasive melanomas following a first primary invasive or in situ melanoma, with a focus on body site. A retrospective cohort study was conducted using population-based administrative data for melanoma diagnoses collected by the Queensland Cancer Registry, Queensland, Australia. Deidentified records of all cases of melanoma among Queensland residents during the period 1982-2005 were obtained and reviewed to December 31, 2010. There were 39,668 eligible cases of first primary invasive melanoma and 22,845 cases of first primary in situ melanoma. Standardized incidence ratios (SIRs), a proxy measure for relative risk, were calculated by iding the observed number of subsequent primary invasive melanomas by the product of the strata-specific incidence rates that occurred in the general population and the cumulative time at risk for the cohort. Synchronous subsequent melanomas (diagnosed within 60 days of the first primary melanoma) were excluded. Differences between SIRs were assessed using multivariate negative binomial regression adjusted for sex, age group, time to second diagnosis, and body site and expressed in terms of adjusted SIR ratios with corresponding 95% CIs. There were 5358 subsequent primary invasive melanomas diagnosed, resulting in SIRs of 5.42 (95% CI, 5.23-5.61) and 4.59 (4.37-4.82) for persons with a first primary invasive or in situ melanoma, respectively. The SIRs remained elevated throughout the follow-up period. In general, subsequent primary invasive melanomas were more likely to occur at the same body site as the initial invasive or in situ melanoma. The largest relative risk was for females with a first primary invasive melanoma on the head followed by a subsequent primary invasive melanoma also on the head (SIR, 13.32 95% CI, 10.28-16.98). Melanoma survivors require ongoing surveillance, with particular attention required for the body site of the initial lesion. Clinical practice guidelines have recognized the importance of monitoring for people with invasive melanoma the results of the present study highlight the need for similar levels of supervision for those with a diagnosis of in situ melanoma.
Publisher: Wiley
Date: 12-2013
DOI: 10.1111/ANZS.12059
Publisher: Wiley
Date: 29-11-2012
Publisher: AMPCo
Date: 06-2014
DOI: 10.5694/MJA13.11134
Abstract: To determine whether the previously reported urban-rural differential in prostate cancer survival remains after adjusting for demographic and clinical factors, and to investigate temporal trends in this differential. Retrospective population-based survival analysis of 68 686 men diagnosed with prostate cancer from January 1982 to December 2007 in New South Wales. Survival rate and relative excess risk (RER) of death over 10 years of follow-up in relation to geographic remoteness after adjusting for other prognostic factors. Overall, 10-year survival increased during the study period, increasing from 57.5% in 1992-1996 and 75.7% in 1997-2001 to 83.7% in 2002-2007. The increasing trends were also observed across categories of geographic remoteness and socioeconomic status. Urban-rural differentials were significant (P < 0.001) after adjusting for five important prognostic factors, with men living outside major cities having higher risk of death from prostate cancer (RER, 1.18 and 1.32 for inner regional and rural areas, respectively). Socioeconomic status was also a significant factor (P < 0.001) for prostate cancer mortality, with the risk of dying being 34% to 40% higher for men living in socioeconomically disadvantaged areas than those living in least disadvantaged areas. There was no evidence that this inequality is reducing over time, particularly for men living in inner regional areas. Despite the increasing awareness of urban-rural differentials in cancer outcomes, little progress has been made. Appropriately detailed data, including details of tumour characteristics, treatment and comorbid conditions, to help understand why these inequalities exist are required urgently so interventions and policy changes can be guided by appropriate evidence.
Publisher: Springer Science and Business Media LLC
Date: 23-02-2011
Publisher: Mary Ann Liebert Inc
Date: 06-2020
Publisher: SAGE Publications
Date: 06-2004
DOI: 10.1177/001789690406300206
Abstract: Backgrourtd Melanoma can be curable if detected early. One component of detecting melanoma is an awareness of the important features of the disease. It is currently not clear which features the community view as indicative of melanoma. Objective To investigate which features of the skin members of an urban community believe may indicate skin cancer. Methods A total of 925 adults (71 per cent response rate) in Brisbane, Australia returned a completed postal questionnaire. Respondents were asked questions about their perceptions of features of skin lesions and other issues relating to skin self-examination (SSE) practices. Results The greatest proportion of respondents thought that change in the lesion, sensory features and whether a lesion was different to usual moles were most likely to indicate skin cancer. Fewer respondents thought that static features or new moles were indicative of skin cancer. The lowest proportion of respondents thought that the presence of hair was likely to indicate skin cancer. Conclusion Although change in a lesion is an important feature when looking for early melanoma, current recommendations of looking for change may need to be revised if low levels of skin self-examination continue in the community. Encouraging people to be more familiar with their skin, rather than looking for specific skin features, may improve people's ability to recognise change when it occurs, and recognise which lesions can be considered normal for their skin.
Publisher: Springer Science and Business Media LLC
Date: 24-06-2015
DOI: 10.1007/S00403-015-1585-8
Abstract: Among patients with invasive melanoma, females are known to have higher survival than males globally. However, this survival advantage has not been explored in thin melanomas, the most common form of the disease. In addition, it is unclear if this advantage is true across all age groups. We aimed to compare melanoma survival between males and females by clinical stage and within age groups. Melanomas from 1995 to 2008 were extracted from the Queensland Cancer Registry and the Surveillance, Epidemiology, and End Results (SEER) Program, and melanoma-specific deaths were ascertained up to 2011. Flexible parametric survival models compared survival between groups. The Queensland cohort of 28,979 patients experienced 1712 melanoma deaths and the SEER cohort of 57,402 patients included 6929 melanoma deaths. Survival rates were in favour of females across nearly all tumour stages, including thin invasive tumours in both cohorts after adjusting for demographic and clinical factors [odds ratio (OR) death female:male for stage I melanoma = 0.64 in Queensland and OR = 0.79 in the US, both P < 0.001]. The sex influence on survival interacted with age categories. In particular, the survival advantage was inconsistent in females with stage I melanoma aged under 60. Females with melanoma have a survival advantage over males including in stage I melanomas. However, this advantage is dependent on age at diagnosis, suggesting an underlying biological mechanism influenced by age that exists from the very early stages of the disease.
Publisher: Informa UK Limited
Date: 08-1996
Publisher: Wiley
Date: 25-02-2019
DOI: 10.1002/IJC.32204
Publisher: American Association for Cancer Research (AACR)
Date: 09-2019
DOI: 10.1158/1055-9965.EPI-19-0203
Abstract: China contributes to almost half of the esophageal cancer cases diagnosed globally each year. However, the prognosis information of this disease in this large population is scarce. Data on a population-based cohort consisting of residents of Shandong Province, China who were diagnosed with esophageal cancer during the period from 2005 to 2014 were analyzed. The cancer-specific survival rates were estimated using Kaplan–Meier analysis. Discrete-time multilevel mixed-effects survival models were used to investigate socioeconomic status (SES) disparities on esophageal cancer survival. The unadjusted 1-, 3-, and 5-year cause-specific survival rates were 59.6% [95% confidence interval (CI), 59.2%–59.9%], 31.9% (95% CI, 31.5%–32.3%), and 23.6% (95% CI, 23.1%–24.0%), respectively. Patients of blue-collar occupations had higher risk of esophageal cancer–related death than those of white-collar occupations in the first 2 years after diagnosis. Rural patients had higher risk of death than urban patients in the first 3 years after diagnosis. The risks of esophageal cancer–related death among patients living in low/middle/high SES index counties were not different in the first 2 years after diagnosis. However, patients living in high SES index counties had better long-term survival (3–5 years postdiagnosis) than those living in middle or low SES index counties. Socioeconomic inequalities in esophageal cancer survival exist in this Chinese population. Higher in idual- or area-level SES is associated with better short-term or long-term cancer survival. Elucidation of the relative roles of the SES factors on survival could guide interventions to reduce disparities in the prognosis of esophageal cancer.
Publisher: Wiley
Date: 04-07-2021
DOI: 10.1111/CEN.14545
Abstract: Smoking has been associated with a reduced risk of thyroid cancer, but whether the association varies between higher- and lower-risk cancers remains unclear. We aimed to assess the association between smoking and risk of thyroid cancer overall as well as by tumour BRAF mutational status as a marker of potentially higher-risk cancer. We recruited 1013 people diagnosed with thyroid cancer and 1057 population controls frequency-matched on age and sex. Multivariable logistic regression was used to assess the association overall and in analyses stratified by tumour characteristics. We used sensitivity analysis to assess the potential for selection bias. We found little evidence of an association with current smoking (odds ratio [OR] = 0.93 95% confidence interval [CI]: 0.69-1.26 current vs. never smoking), but a higher number of pack-years of smoking was associated with a lower risk of thyroid cancer (OR = 0.75 95% CI: 0.57-0.99 ≥20 pack-years vs. never). However, after correcting for potential selection bias, we observed a statistically significant inverse association between current smoking and risk of thyroid cancer (bias-corrected OR = 0.65 95% CI: 0.51-0.83). Those with BRAF-positive cancers were less likely to be current smokers than those with BRAF-negative cancers (prevalence ratio: 0.79 95% CI: 0.62-0.99). We found smoking was inversely related to thyroid cancer risk and, in particular, current smoking was associated with a reduced risk of potentially more aggressive BRAF-positive than the likely more indolent BRAF-negative papillary thyroid cancers.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.CANEP.2015.02.008
Abstract: Conditional survival estimates take into account the time that a patient has remained alive following diagnosis to provide a realistic perspective on the probability of longer term survival. Such estimates are scarce for childhood cancer, particularly by age at diagnosis or stage of cancer. De-identified population-based data were obtained from the Australian Paediatric Cancer Registry for children aged 0-14 years diagnosed with cancer between 1983 and 2010. Mortality status was followed up to the end of 2011. The hybrid period method was used to calculate relative survival estimates for those who were at risk during the period 2002-2011. Conditional survival stratified by diagnostic group or subgroup, age and stage at diagnosis was then obtained from the ratio of the relative survival estimates at different time points. A total of 13,537 children were eligible for inclusion. Five-year survival for all childhood cancers combined improved from 82% at diagnosis (95% confidence interval=81-83%) to 89% (88-90%) conditional on surviving one year, and 97% (97-98%) conditional on surviving five years after diagnosis. Conditional survival reached 95% within five years of diagnosis for nearly all types of cancer, regardless of a child's age or stage at diagnosis. Most children diagnosed with cancer who are alive five years after diagnosis can anticipate similar survival to children in the general population. This information may help alleviate some of the distress associated with childhood cancer, particularly for those with an initially poor prognosis.
Publisher: AMPCo
Date: 03-2012
DOI: 10.5694/MJA11.11194
Abstract: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage. Descriptive study of population-based data on all 150,059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997-2006. Hazard ratios for the categories of area-socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates. Five-year survival was lower for Indigenous people diagnosed with cancer (50.3% 95% CI, 47.8%-52.8%) compared with non-Indigenous people (61.9% 95% CI, 61.7%-62.2%). There was no evidence that this differential varied by remoteness (P = 0.780) or area-socioeconomic disadvantage (P = 0.845). However, it did vary by time after diagnosis. In a time-varying survival model stratified by age, sex and cancer type, the 50% excess mortality in the first year (adjusted HR, 1.50 95% CI, 1.38-1.63) reduced to near unity at 2 years after diagnosis (HR, 1.03 95% CI, 0.78-1.35). After a wide disparity in cancer survival in the first 2 years after diagnosis, Indigenous patients with cancer who survive these 2 years have a similar outlook to non-Indigenous patients. Access to services and socioeconomic factors are unlikely to be the main causes of the early lower Indigenous survival, as patterns were similar across remoteness and area-socioeconomic disadvantage. There is an urgent need to identify the factors leading to poor outcomes early after diagnosis among Indigenous people with cancer.
Publisher: Wiley
Date: 31-10-2014
DOI: 10.1002/IJC.28537
Abstract: Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy (BSO) is recommended in breast cancer susceptibility gene (BRCA)-positive women, whereas in women from the general population, hysterectomy plus BSO may increase the risk of overall mortality. The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population-base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (n = 21,067). We fitted flexible parametric breast cancer-specific and overall survival models with 95% confidence intervals (also known as Royston-Parmar models) to assess the impact of risk-reducing surgery (removal of uterus, one or both ovaries). We also stratified analyses by age 20-49 and 50-79 years, respectively. Overall, 1,426 women (7%) underwent risk-reducing surgery (13% of premenopausal women and 3% of postmenopausal women). No women who had risk-reducing surgery compared to 171 who did not have risk-reducing surgery developed a gynaecological cancer. Overall, 3,165 (15%) women died, including 2,195 (10%) from breast cancer. Hysterectomy plus BSO was associated with significantly reduced risk of death overall [adjusted hazard ration (HR), 0.69 95% confidence interval (CI), 0.53-0.89 p = 0.005]. Risk reduction was greater among premenopausal women, whose risk of death halved (HR, 0.45 95% CI, 0.25-0.79 p < 0.006). This was largely driven by reduction in breast cancer-specific mortality (HR, 0.43 95% CI, 0.24-0.79 p < 0.006). This population-based study found that risk-reducing surgery halved the mortality risk for premenopausal breast cancer patients. Replication of our results in independent cohorts and subsequently randomised trials are needed to confirm these findings.
Publisher: Wiley
Date: 21-03-2012
DOI: 10.1002/PBC.23115
Abstract: International studies examining the association between the incidence of childhood cancer and characteristics of the area in which the patient lives have generally reported inconsistent patterns. Area-based differentials in childhood cancer throughout Australia have not been previously published at a national level. Population-based information from the Australian Paediatric Cancer Registry was used to identify all children aged 0- to 14-years old diagnosed with invasive cancer or intracranial and intraspinal tumors of benign or uncertain behavior between 1996 and 2006. Age-standardized incidence rates per million children per year and the corresponding incidence rate ratios were calculated, categorized by remoteness of residence and an area-based index of socioeconomic disadvantage. Results were also stratified by the most common types of childhood cancer. There was a significant, decreasing gradient in the incidence of childhood cancer as remoteness of residence increased. Children living in remote or very remote areas were 21% less likely to be diagnosed with cancer compared to children in major cities, mainly due to differences in the incidence of leukemias and lymphomas. This differential was no longer significant when only non-Indigenous children were considered. No clear relationship was found between incidence and socioeconomic status (SES) in contrast to similar earlier studies. The findings by remoteness of residence are consistent with the lower incidence rates of cancer that are typically associated with Indigenous Australians. There is also a suggestion that the etiological factors associated with childhood leukemia and SES may have altered over time.
Publisher: Public Library of Science (PLoS)
Date: 26-08-2022
DOI: 10.1371/JOURNAL.PONE.0273244
Abstract: While Aboriginal and Torres Strait Islander peoples have poorer cancer survival than other Australians, absolute measures of survival disparities are lacking. This study quantified crude probabilities of deaths from cancer and other causes and estimated the number of avoidable deaths for Aboriginal and Torres Strait Islanders if these survival disparities were removed. Flexible parametric relative survival models were used to estimate reported measures for a population-based cohort of 709,239 Australians (12,830 Aboriginal and Torres Strait Islander peoples), 2005–2016. Among Aboriginal and Torres Strait Islander peoples, the 5-year crude probability of cancer death was 0.44, while it was 0.07 for other causes of death. These probabilities were 0.07 and 0.03 higher than among other Australians, respectively. Magnitude of these disparities varied by cancer type and ranged for cancer deaths from .05 for pancreatic, prostate and uterine cancers to 0.20 for cervical and head and neck cancers. Values for disparity in other causes of death were generally lower. Among an average cohort of Aboriginal and Torres Strait Islander peoples diagnosed per year over the most recent five-year diagnosis period (2012–2016, n = 1,269), approximately 133 deaths within 5 years of diagnosis were potentially avoidable if they had the same overall survival as other Australians, with 94 of these deaths due to cancer. The total number of avoided deaths over the entire study period (2005–2016) was 1,348, with 947 of these deaths due to cancer. Study findings suggest the need to reduce the prevalence of risk factors prevalence, increase screening participation, and improve early detection, diagnosis and treatment rates to achieve more equitable outcomes for a range of cancer types. Reported measures provide unique insights into the impact of a cancer diagnosis among Aboriginal and Torres Strait Islander peoples from a different perspective to standard relative survival measures.
Publisher: Wiley
Date: 28-11-2011
DOI: 10.1002/IJC.25706
Abstract: People living with lymphohematopoietic neoplasms (LHNs) are known to have increased risks of second cancer however, the incidence of second cancers after LHNs has not been studied extensively in Australia. The Australian Cancer Database was used to analyze site-specific risk of second primary cancer after LHNs in 127,707 patients diagnosed between 1983 and 2005. Standardized incidence ratios (SIRs) were calculated using population rates. Overall, patients with an LHN had nearly twice the risk of developing a second cancer compared to the Australian population. Among 40,321 patients with non-Hodgkin's lymphoma (NHL), there was over a fourfold significant increase in melanoma, Kaposi sarcoma, cancer of the lip, connective tissue and peripheral nerves, eye, thyroid, Hodgkin's disease (HD) and myeloid leukemia. Among 6,396 patients with HD, there was over a fourfold significant increase in melanoma, Kaposi sarcoma, cancer of the lip, oral cavity and pharynx, female breast, uterine cervix, testis, thyroid, NHL and myeloid leukemia. Among the 33,025 patients with lymphoid and myeloid leukemia, significant excess were seen for cancers of the lip, eye, connective tissue and peripheral nerves, NHL and HD. Among the 13,856 patients with plasma cell tumors, there was over fourfold significant increase for melanoma, cancer of the connective tissue and peripheral nerves and myeloid leukemia. Our findings provide evidence of an increased risk of cancer, particularly ultraviolet radiation- and immunosuppression-related cancers, after an LHN in Australia.
Publisher: S. Karger AG
Date: 2019
DOI: 10.1159/000500663
Abstract: The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM ( i n /i = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 ( i /i & #x3c 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 ( i /i & #x3c 0.05) and of 3% from 1999 to 2014 ( i /i & #x3c 0.01). These results may be used to inform CM awareness c aigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.
Publisher: Wiley
Date: 06-06-2018
DOI: 10.1111/ANS.14047
Abstract: Sentinel node biopsy (SNB) is now the standard of care for women with early-stage breast cancer. Despite lower morbidity than axillary lymph node dissection, widespread variation in SNB rates by non-clinical factors persists. We explored the factors associated with SNB usage and changes in those associations over time for recently diagnosed women. We report here on a linked population-based cancer registry and hospital inpatient admission data set for 5577 women aged at least 20 years diagnosed with a first primary invasive early-stage node-negative breast cancer from July 2008 to 2012 in Queensland, Australia, who underwent breast cancer-related surgery within 2 years of diagnosis. Multivariate logistic regression was used to model predictors of SNB separately for 5172 women with ≤30 mm tumours and 405 with 31 to ≤50 mm tumours. Overall, 3972 (77%) women with ≤30 mm tumours and 221 (55%) of those with larger tumours underwent SNB. Usage increased over time for both cohorts but was consistently lower among those with larger tumours. A more recent diagnosis, having breast-conserving surgery, living in more accessible areas and attending a private or high-volume hospital independently increased the odds of SNB for both cohorts. There was no evidence that the geographical disparity had reduced over the study period for either cohort. Geographical disparities to accessing SNB persist. Efforts to promote multidisciplinary care and facilitate education in healthcare changes through innovative solutions using emerging technologies as well as targeted research to identify the barriers to equitable access remain critical.
Publisher: American Medical Association (AMA)
Date: 11-2008
DOI: 10.1001/ARCHDERM.144.11.1468
Abstract: To assess physician, patient, and skin lesion characteristics that affect the number of benign skin lesions excised by primary care physicians for each skin cancer. Prospective study collecting clinical, patient, and histopathologic details of excisions or biopsies of skin lesions by random s les of primary care physicians. Southeast Queensland involving traditional family medicine physicians (n = 104 response rate, 53.9%) and family medicine physicians working in 27 primary care skin cancer clinics (n = 50 response rate, 75.0%). Of 28 755 skin examinations recorded during the study, 11 403 skin lesions were excised or biopsied 97.5% of the excised lesions had clinical and histologic diagnoses recorded. Number of lesions needed to excise or biopsy (NNE) for 1 melanoma (pigmented lesions only) and NNE for 1 nonmelanoma skin cancer (nonpigmented lesions only). The NNE for nonpigmented lesions (n = 8139) was 1.5 (95% confidence interval, 1.4-1.6) and for pigmented lesions (n = 2977) was 19.6 (16.2-22.9). The NNE estimates were up to 8 times lower if the physician thought the lesion was likely to be malignant and up to 2.5 times higher if there was strong patient pressure to excise. The NNE estimates varied by other physician-, patient-, and lesion-related variables. Clinical impressions of excised skin lesions were strongly associated with NNE estimates. By focusing on pigmented skin lesions and by addressing the physician- and patient-specific factors identified, the effectiveness of future training for primary care physicians in the clinical management of skin cancer could be improved.
Publisher: Cambridge University Press (CUP)
Date: 27-07-2009
Publisher: Frontiers Media SA
Date: 11-09-2018
Publisher: BMJ
Date: 04-2018
Publisher: Springer Science and Business Media LLC
Date: 02-10-2008
DOI: 10.1245/S10434-007-9584-4
Abstract: Australian women with early breast cancer should be given the choice between breast-conserving surgery (BCS) or mastectomy. This is the first Australian study to report on patterns of surgical care specifically for early breast cancer at a population level. Two population-based routine data collections were linked to obtain surgical treatment information for breast cancer cases diagnosed in 2004 in Queensland, from which we identified 1274 cases of early female breast cancer. Logistic regression was used to assess the likelihood of female breast cancer patients having mastectomy, BCS, and axillary node dissection, after adjusting for patient and hospital demographics, tumor size, and comorbidities. Three-quarters (77%) of women had BCS, 29% had a mastectomy, and 86% had dissection of the axillary lymph nodes. The likelihood of women having mastectomy was higher among women living in rural areas, those treated in public hospitals, and women who had comorbidities of anemia or heart failure. In contrast, BCS was more likely for women treated in private hospitals or hospitals with high surgical caseload. Heart failure decreased the likelihood of BCS. Having an axillary node dissection was more likely among younger women and those treated in high caseload hospitals. The observed differentials in surgical treatment for early breast cancer patients suggest that access issues may have contributed to the decision-making process. Understanding the reasons why women with early breast cancer choose a certain treatment strategy should be a focus of future research.
Publisher: Oxford University Press (OUP)
Date: 13-09-2012
DOI: 10.1111/J.1365-2133.2012.11064.X
Abstract: An examination of melanoma incidence according to anatomical region may be one method of monitoring the impact of public health initiatives. To examine melanoma incidence trends by body site, sex and age at diagnosis or body site and morphology in a population at high risk. Population-based data on invasive melanoma cases (n = 51473) diagnosed between 1982 and 2008 were extracted from the Queensland Cancer Registry. Age-standardized incidence rates were calculated using the direct method (2000 world standard population) and joinpoint regression models were used to fit trend lines. Significantly decreasing trends for melanomas on the trunk and upper limbs/shoulders were observed during recent years for both sexes under the age of 40 years and among males aged 40-59years. However, in the 60 and over age group, the incidence of melanoma is continuing to increase at all sites (apart from the trunk) for males and on the scalp/neck and upper limbs/shoulders for females. Rates of nodular melanoma are currently decreasing on the trunk and lower limbs. In contrast, superficial spreading melanoma is significantly increasing on the scalp/neck and lower limbs, along with substantial increases in lentigo maligna melanoma since the late 1990s at all sites apart from the lower limbs. In this large study we have observed significant decreases in rates of invasive melanoma in the younger age groups on less frequently exposed body sites. These results may provide some indirect evidence of the impact of long-running primary prevention c aigns.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2020
DOI: 10.1158/1055-9965.EPI-19-0693
Abstract: With the improvements in cancer diagnosis and treatment, more patients with cancer are surviving for longer periods than before. This study aims to quantify the proportion cured and median survival time for those who are not cured for major cancers in Australia. Australian population-based cohort of 2,164,172 cases, ages 15 to 89 years, whose first cancer diagnosis between 1982 and 2014 was one of 22 leading cancers, were followed up to December 2014. Flexible parametric cure models were used to estimate the proportion cured and median survival time for those uncured by age, sex, and spread of disease, and temporal trends in these measures. Cure estimates could be generated for 19 of the 22 cancer types. The unadjusted proportion cured ranged from 5.0% for pancreatic cancer to 90.0% for melanoma. Median survival time for those uncured ranged from 0.35 years for pancreatic cancer to 6.05 years for prostate cancer. Cancers were ided into four groups according to their proportion cured in the 1980s and the degree of improvement over 28 years. Esophageal, stomach, pancreatic, liver, gallbladder, lung, and brain cancer had lower proportion cured and smaller improvements over time. For cancers with poor survival in which little has changed over time either in prolonging life or achieving statistical cure, efforts should be focused on reducing the prevalence of known risk factors and earlier detection, thereby enabling more effective treatment. Cure models provide unique insights into whether survival improvements are due to prolonging life or through curing the disease.
Publisher: MDPI AG
Date: 14-02-2020
Abstract: This study aimed to identify whether cancer-related health behaviours including participation in cancer screening vary by geographic location in Australia. Data were obtained from the 2014–2015 Australian National Health Survey, a computer-assisted telephone interview that measured a range of health-related issues in a s le of randomly selected households. Chi-square tests and adjusted odds ratios from logistic regression models were computed to assess the association between residential location and cancer-related health behaviours including cancer screening participation, alcohol consumption, smoking, exercise, and fruit and vegetable intake, controlling for age, socio-economic status (SES), education, and place of birth. The findings show insufficient exercise, risky alcohol intake, meeting vegetable intake guidelines, and participation in cervical screening are more likely for those living in inner regional areas and in outer regional/remote areas compared with those living in major cities. Daily smoking and participation in prostate cancer screening were significantly higher for those living in outer regional/remote areas. While participation in cancer screening in Australia does not appear to be negatively impacted by regional or remote living, lifestyle behaviours associated with cancer incidence and mortality are poorer in regional and remote areas. Population-based interventions targeting health behaviour change may be an appropriate target for reducing geographical disparities in cancer outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2007
DOI: 10.1016/J.JURO.2007.03.024
Abstract: Spermatocytic seminoma is a rare subtype of testicular germ cell tumor which has been reported to occur in elderly men. We report the first population based estimate of incidence, temporal trends and age distribution of this tumor. All cases of primary testicular cancer identified by cancer registries in Australia between 1982 and 2002 were available for analysis. The International Classification of Diseases for Oncology code M-9063/3 was used to identify spermatocytic seminomas. Incidence trends were modeled using Poisson regression. There were 58 cases of spermatocytic seminoma out of 9,658 cases of primary malignant testicular neoplasms identified by the cancer registries. This tumor comprised 1.1% of all seminoma and the age standardized incidence rate was 0.4 per million (95% CI 0.3-0.6). A temporal increase in incidence was found but not one reaching statistically significance. Age at diagnosis ranged from 19 to 92 years with a mean of 53.5 (SD 16.7) and a median of 54 years. Spermatocytic seminoma should be considered in the differential diagnosis for testicular germ cell tumors presenting in young adults because this tumor occurs as often in men younger than 55 years as it does in older men. Although rare, the occurrence of this tumor is not as singular as the current literature suggests.
Publisher: American Medical Association (AMA)
Date: 07-2011
DOI: 10.1001/ARCHDERMATOL.2011.48
Abstract: To improve the proportion of men 50 years or older who conduct a thorough whole-body skin self-examination (SSE), because these men are at increased risk of being diagnosed as having thick melanomas and dying of melanoma. Randomized trial of a video-based intervention to increase whole-body SSE compared with brochures-only control. Men from an Australian population register. The study included 930 men 50 years or older. The men were randomly assigned to receive either written materials only (control) or written materials along with a DVD or video and 2 postcard reminders (intervention). Telephone interviews were conducted at baseline and at 7 and 13 months. The proportion of men who conducted a whole-body SSE with the help of 2 mirrors and/or a person to assist with difficult-to-see areas. Compared with baseline (10%), by 13 months both groups had increased their whole-body SSE behaviors similarly (36% intervention and 31% control) (P = .85). At 7 months, the intervention group was significantly more likely to examine at least 1 part of their back (P < .001) and to examine a greater number of body sites (P < .001). At 7 months, the proportion of men conducting any SSE increased by 28% in the intervention group compared with 13% in the control group (P < .001), but at 13 months, the prevalence of any self-examination (83% vs 80%) was again similar. While men 50 years or older are responsive to appropriately targeted intervention materials to increase their SSE behaviors, the addition of a video or DVD to written materials had only a transient advantage for optimal SSE practices. anzctr.org.au Identifier: 12608000384358.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.C.6695933.V1
Abstract: Abstract Spatial modeling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modeling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modeling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations. /
Publisher: Frontiers Media SA
Date: 08-04-2019
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.C.6695933.V2
Abstract: Abstract Spatial modeling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modeling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modeling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations. /
Publisher: Informa UK Limited
Date: 05-02-2014
DOI: 10.1080/19338244.2013.771247
Abstract: This study investigated the association between outdoor work and response to a behavioral skin cancer early detection intervention among men 50 years or older. Overall, 495 men currently working in outdoor, mixed, or indoor occupations were randomized to a video-based intervention or control group. At 7 months post intervention, indoor workers reported the lowest proportion of whole-body skin self-examination (wbSSE 20%). However, at 13 months mixed workers engaged more commonly in wbSSE (36%) compared with indoor (31%) and outdoor (32%) workers. In adjusted analysis, the uptake of early detection behaviors during the trial did not differ between men working in different settings. Outdoor workers compared with men in indoor or mixed work settings were similar in their response to an intervention encouraging uptake of secondary skin cancer prevention behaviors during this intervention trial.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.BREAST.2017.09.005
Abstract: Reducing geographical inequalities in breast cancer stage remains a key focus of public health policy. We explored whether patterns of advanced breast cancer by residential accessibility and disadvantage in Queensland, Australia, have changed over time. Population-based cancer registry study of 38,706 women aged at least 30 years diagnosed with a first primary invasive breast cancer of known stage between 1997 and 2014. Multilevel logistic regression was used to examine temporal changes in associations of area-level factors with odds of advanced disease after adjustment for in idual-level factors. Overall 19,401 (50%) women had advanced breast cancer. Women from the most disadvantaged areas had higher adjusted odds (OR = 1.23 [95%CI 1.13, 1.32]) of advanced disease than those from least disadvantaged areas, with no evidence this association had changed over time (interaction p = 0.197). Living in less accessible areas independently increased the adjusted odds (OR = 1.18 [1.09, 1.28]) of advanced disease, with some evidence that the geographical inequality had reduced over time (p = 0.045). Sensitivity analyses for un-staged cases showed that the original associations remained, regardless of assumptions made about the true stage distribution. Both geographical and residential socioeconomic inequalities in advanced stage diagnoses persist, potentially reflecting barriers in accessing diagnostic services. Given the role of screening mammography in early detection of breast cancer, the lack of population-based data on private screening limits our ability to determine overall participation rates by residential characteristics. Without such data, the efficacy of strategies to reduce inequalities in breast cancer stage will remain compromised.
Publisher: Elsevier BV
Date: 05-2018
Publisher: Wiley
Date: 02-2009
Abstract: This review outlines current international patterns in prostate cancer incidence and mortality rates and survival, including recent trends and a discussion of the possible impact of prostate-specific antigen (PSA) testing on the observed data. Internationally, prostate cancer is the second most common cancer diagnosed among men (behind lung cancer), and is the sixth most common cause of cancer death among men. Prostate cancer is particularly prevalent in developed countries such as the United States and the Scandinavian countries, with about a six-fold difference between high-incidence and low-incidence countries. Interpretation of trends in incidence and survival are complicated by the increasing impact of PSA testing, particularly in more developed countries. As Western influences become more pronounced in less developed countries, prostate cancer incidence rates in those countries are tending to increase, even though the prevalence of PSA testing is relatively low. Larger proportions of younger men are being diagnosed with prostate cancer and living longer following diagnosis of prostate cancer, which has many implications for health systems. Decreasing mortality rates are becoming widespread among more developed countries, although it is not clear whether this is due to earlier diagnosis (PSA testing), improved treatment, or some combination of these or other factors.
Publisher: Elsevier BV
Date: 09-2020
DOI: 10.1016/J.HPB.2019.11.015
Abstract: An association between higher hospital-volume and better "quality of surgery" and long-term survival has not been reported following pancreatic cancer surgery in low resection-volume regions such as in Australia. Using a population-level study, we compare "quality of surgery" and two-year survival following pancreaticoduodenectomy between Australian hospitals grouped by resection-volume. Data on all patients undergoing pancreaticoduodenectomy for adenocarcinoma in the Australian state of Queensland, between 2001 and 2015, were obtained from the Queensland Oncology Repository. Hospitals were grouped into high (≥6 resections annually) and low (<6) volume centres. Following adjustment for case-mix, "quality-of-treatment" indicators were compared between hospital groups using multivariate logistic regression and Poisson regression analysis and two-year cancer-specific and overall survival were compared using multivariate Cox proportional hazard models. Compared with high-volume centres, low-volume centres had worse two-year cancer-specific survival (Adjusted HR = 1.31 95% CI:1.03-1.68), higher 30-day mortality (Adjusted IRR = 3.81 95% CI: 1.36-10.62) and fewer patients received "high-quality surgery" (Adjusted OR = 0.55 95% CI: 0.33-0.90). Differences in 30-day mortality, or "quality-of-treatment" indicators did not entirely explain the observed survival difference between hospital-volume groups. In an Australian environment, a "high" hospital-volume was significantly associated with better quality surgery and two-year survival following pancreaticoduodenectomy.
Start Date: 06-2010
End Date: 12-2013
Amount: $80,007.00
Funder: Australian Research Council
View Funded ActivityStart Date: 08-2021
End Date: 07-2024
Amount: $588,955.00
Funder: Australian Research Council
View Funded Activity