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Cenin D.R.,Education and Research | St John D.J.B.,Cancer Prevention Center | St John D.J.B.,University of Melbourne | Ledger M.J.N.,Education and Research | And 3 more authors.
Medical Journal of Australia | Year: 2014

Objectives: To estimate the impact of various expansion scenarios of the National Bowel Cancer Screening Program (NBCSP) on the number of bowel cancer deaths prevented; and to investigate the impact of the expansion scenarios on colonoscopy demand.Design: MISCAN-Colon, a well established, validated computer simulation model for bowel cancer screening, was adjusted to reflect the Australian situation. In July 2013, we simulated the effects of screening over a 50-year period, starting in 2006. The model parameters included rates of participation in screening and follow-up, rates of identification of cancerous and precancerous lesions, bowel cancer incidence, mortality and the outcomes of the NBCSP. Five implementation scenarios, based on biennial screening using an immunochemical faecal occult blood test, were developed and modelled. A sensitivity analysis that increased screening participation to 60% was also conducted.Participants: Australian residents aged 50 to 74 years.Main outcome measures: Comparison of the impact of five implementation scenarios on the number of bowel cancer deaths prevented and demand for colonoscopy.Results: MISCAN-Colon calculated that in its current state, the NBCSP should prevent 35 169 bowel cancer deaths in the coming 40 years. Accelerating the expansion of the program to achieve biennial screening by 2020 would prevent more than 70 000 deaths. If complete implementation of biennial screening results in a corresponding increase in participation to 60%, the number of deaths prevented will increase across all scenarios.Conclusions: The findings strongly support the need for rapid implementation of the NBCSP. Compared with the current situation, achieving biennial screening by 2020 could result in 100% more bowel cancer deaths (about 35 000) being prevented in the coming 40 years. © 2014, Australasian Medical Publishing Co. Ltd. All rights reserved.


Fritschi L.,University of Western Australia | Erren T.C.,University of Cologne | Glass D.C.,Monash University | Girschik J.,University of Western Australia | And 11 more authors.
British Journal of Cancer | Year: 2013

Background:Research on the possible association between shiftwork and breast cancer is complicated because there are many different shiftwork factors, which might be involved including: light at night, phase shift, sleep disruption and changes in lifestyle factors while on shiftwork (diet, physical activity, alcohol intake and low sun exposure).Methods:We conducted a population-based case-control study in Western Australia from 2009 to 2011 with 1205 incident breast cancer cases and 1789 frequency age-matched controls. A self-administered questionnaire was used to collect demographic, reproductive, and lifestyle factors and lifetime occupational history and a telephone interview was used to obtain further details about the shiftwork factors listed above.Results:A small increase in risk was suggested for those ever doing the graveyard shift (work between midnight and 0500 hours) and breast cancer (odds ratio (OR)=1.16, 95% confidence interval (CI)=0.97-1.39). For phase shift, we found a 22% increase in breast cancer risk (OR=1.22, 95% CI=1.01-1.47) with a statistically significant dose-response relationship (P=0.04). For the other shiftwork factors, risks were marginally elevated and not statistically significant.Conclusion:We found some evidence that some of the factors involved in shiftwork may be associated with breast cancer but the ORs were low and there were inconsistencies in duration and dose-response relationships. © 2013 Cancer Research UK.


Thomson A.K.,Curtin University Australia | Heyworth J.S.,University of Western Australia | Girschik J.,University of Western Australia | Slevin T.,Cancer Council Western Australia | And 2 more authors.
BMC Research Notes | Year: 2014

Background: Attributions of causality are common for many diseases, including breast cancer. The risk of developing breast cancer can be reduced by modifications to lifestyle and behaviours to minimise exposure to specific risk factors, such as obesity. However, these modifications will only occur if women believe that certain behaviours/lifestyle factors have an impact on the development of breast cancer. Method. The Breast Cancer, Environment and Employment Study is a case-control study of breast cancer conducted in Western Australia between 2009 and 2011. As part of the study 1109 women with breast cancer and 1633 women without the disease completed a Risk Perception Questionnaire in which they were asked in an open-ended question for specific cause/s to the development of breast cancer in themselves or in others. The study identified specific causal beliefs, and assessed differences in the beliefs between women with and without breast cancer. Results: The most common attributions in women without breast cancer were to familial or inherited factors (77.6%), followed by lifestyle factors, such as poor diet and smoking (47.1%), and environmental factors, such as food additives (45.4%). The most common attributions in women with breast cancer were to mental or emotional factors (46.3%), especially stress, followed by lifestyle factors (38.6%) and physiological factors (37.5%), particularly relating to hormonal history. Conclusions: While the majority of participants in this study provided one or more causal attributions for breast cancer, many of the reported risk factors do not correspond to those generally accepted by the scientific community. These misperceptions could be having a significant impact on the success of prevention and early detection programs that seek to minimise the pain and suffering caused by this disease. In particular, women who have no family history of the disease may not work to minimise their exposure to the modifiable risk factors. © 2014 Thomson et al.; licensee BioMed Central Ltd.


Morley B.C.,Center for Behavioural Research in Cancer | Scully M.L.,Center for Behavioural Research in Cancer | Niven P.H.,Center for Behavioural Research in Cancer | Okely A.D.,University of Wollongong | And 3 more authors.
Medical Journal of Australia | Year: 2012

Objectives: To examine the prevalence of overweight and obesity in Australian secondary school students and identify factors associated with excess adiposity. Design, setting and participants: Cross-sectional survey of students aged 12-17 years (in school years 8-11) who completed the National Secondary Students' Diet and Activity survey in 2009-10, which included a web-based self-report questionnaire and height and weight measurements. Main outcome measures: Overweight and obesity based on international standard body mass index (BMI) cut-offs for children and adolescents. Results: Data were analysed for 12 188 students. Just under one in four students were either overweight (18%) or obese (5%). After adjusting for demographic and health-behaviour characteristics, males were more likely than females to be overweight or obese (OR, 1.23; 95% CI, 1.07-1.40; P=0.004), as were both low (OR, 1.67; 95% CI, 1.40-1.99; P < 0.001) and medium (OR, 1.33; 95% CI, 1.14-1.55; P< 0.001) socioeconomic position (SEP) students compared with high SEP students. Students engaging in low levels of physical activity (OR, 1.21; 95% CI, 1.08-1.36; P = 0.001), more time in small-screen recreation (OR, 1.18; 95% CI, 1.05-1.32; P = 0.005), and short sleep duration (OR, 1.22; 95% CI, 1.05-1.41; P= 0.008) also had higher odds of being overweight or obese. Conclusions: There is a need for interventions to reduce overweight and obesity during adolescence. Preventive measures should include a focus on facilitating physical activity and reducing sedentary behaviour, as well as promoting adequate sleep, particularly among young people from lower SEP neighbourhoods who appear to be most susceptible.


Volkov A.,Center for Behavioural Research in Cancer | Dobbinson S.,Center for Behavioural Research in Cancer | Wakefield M.,Center for Behavioural Research in Cancer | Slevin T.,Cancer Council Western Australia
Australian and New Zealand Journal of Public Health | Year: 2013

Aims: To examine the change in sun protective behaviours and sunburn of Australians over a seven-year period, in the context of sustained skin cancer prevention campaigns and programs. Methods: Weekly cross-sectional telephone interviews of Australians were conducted throughout summer in 2010/11 for comparison with 2003/04 and 2006/07. In 2010/11, n=1,367 adolescents (12-17 years) and n=5,412 adults (18-69 years) were interviewed about their sun-related attitudes, weekend sun protection and sunburn. Multivariate analyses adjusted for key demographics, temperature, cloud, wind and ultraviolet radiation (UVR) to assess change in outcomes over time. Results: There were consistent improvements in adolescents' and adults' attitudes, intentional tanning and incidence of sunburn over time. Behavioural changes were variable. Adults spent less time outdoors during peak UVR compared to past surveys, while adolescents were less likely to be outdoors compared with 2006/07. Sunscreen use and wearing of long sleeves increased among adults, but hat wearing decreased for both age groups, as did leg cover by adolescents since 2003/04. There has been a sustained decrease in weekend sunburn among adolescents and adults. Conclusions: The findings suggest improvements in skin cancer prevention attitudes of Australians over time. Australians' compliance with sun protection during summer has improved in some areas, but is still far from ideal. The sustained decrease in weekend sunburn among adolescents and adults is encouraging, but further improvements are required. © 2013 The Authors.

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