NSW Cancer Institute

Eveleigh, Australia

NSW Cancer Institute

Eveleigh, Australia
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Price T.,Queen Elizabeth Hospital | Townsend A.,Queen Elizabeth Hospital | Karapetis C.,Flinders Medical Center | Kotasek D.,Ashford Cancer Center | And 3 more authors.
Cancer Causes and Control | Year: 2010

Objective The aim was to explore incidence, mortality and case survivals for invasive neuroendocrine cancers in an Australian population and consider cancer control implications. Methods Directly age-standardised incidence and mortality rates were investigated from 1980 to 2006, plus disease-specific survivals. Results Annual incidence per 100,000 increased from 1.7 in 1980-1989 to 3.3 in 2000-2006. A corresponding mortality increase was not observed, although numbers of deaths were low, reducing statistical power. Increases in incidence affected both sexes and were more evident for female lung, large bowel (excluding appendix), and unknown primary site. Common sites were lung (25.9%), large bowel (23.3%) (40.9% were appendix), small intestine (20.6%), unknown primary (15.0%), pancreas (6.5%), and stomach (3.7%). Site distribution did not vary by sex (p = 0.260). Younger ages at diagnosis applied for lung (p = 0.002) and appendix (p<0.001) and older ages for small intestine (p<0.001) and unknown primary site (p<0.001). Five-year survival was 68.5% for all sites combined, with secular increases (p<0.001). After adjusting for age and diagnostic period, survivals were higher for appendix and lower for unknown primary site, pancreas, and colon (excluding appendix). Conclusions Incidence rates are increasing. Research is needed into possible aetiological factors for lung and largebowel sites, including tobacco smoking, and excess body weight and lack of exercise, respectively; and Crohn's disease as a possible precursor condition. © Springer Science+Business Media B.V. 2010.


Carrington C.,Princess Alexandra Hospital Cancer Control Team | Stone L.,Sunshine Coast Cancer Services | Koczwara B.,Flinders Medical Center | Searle C.,Austin Health | And 6 more authors.
Asia-Pacific Journal of Clinical Oncology | Year: 2010

The issue of medication safety is highly significant when anti-cancer therapy is used as a treatment modality due to the high potential for harm from these agents and the disease context in which they are being used.These guidelines provide recommendations on the safe prescribing, dispensing and administration of chemotherapy and related agents used in the treatment of cancer. The guidelines represent a multidisciplinary collaboration to standardise the complex process of providing chemotherapy for cancer and to enhance patient safety. These are consensus guidelines based on the best available evidence and expert opinion of professionals working in cancer care. The aim of these guidelines is to assist in the prevention of medication errors and to improve patient safety with respect to the treatment of cancer.This guidance is intended for a multi-disciplinary audience and will have most relevance for medical, nursing and pharmacy staff involved in the complex processes of delivering chemotherapy and associated treatment. The scope of the guidelines includes; all patients and age groups receiving chemotherapy and targeted therapy for the treatment of cancer and cancer therapy administered by any route in both the hospital and home setting. These guidelines should be seen as point of reference for practitioners providing cancer chemotherapy services. © 2010 Blackwell Publishing Asia Pty Ltd.


Kingsland M.,University of Newcastle | Kingsland M.,Hunter New England Population Health | Wolfenden L.,University of Newcastle | Wolfenden L.,NSW Cancer Institute | And 9 more authors.
BMC Public Health | Year: 2013

Background: Excessive alcohol consumption is responsible for considerable harm from chronic disease and injury. Within most developed countries, members of sporting clubs participate in at-risk alcohol consumption at levels above that of communities generally. There has been limited research investigating the predictors of at-risk alcohol consumption in sporting settings, particularly at the non-elite level. The purpose of this study was to examine the association between the alcohol management practices and characteristics of community football clubs and at-risk alcohol consumption by club members. Methods. A cross sectional survey of community football club management representatives and members was conducted. Logistic regression analysis (adjusting for clustering by club) was used to determine the association between the alcohol management practices (including alcohol management policy, alcohol-related sponsorship, availability of low- and non-alcoholic drinks, and alcohol-related promotions, awards and prizes) and characteristics (football code, size and location) of sporting clubs and at-risk alcohol consumption by club members. Results: Members of clubs that served alcohol to intoxicated people [OR: 2.23 (95% CI: 1.26-3.93)], conducted 'happy hour' promotions [OR: 2.84 (95% CI: 1.84-4.38)] or provided alcohol-only awards and prizes [OR: 1.80 (95% CI: 1.16-2.80)] were at significantly greater odds of consuming alcohol at risky levels than members of clubs that did not have such alcohol management practices. At-risk alcohol consumption was also more likely among members of clubs with less than 150 players compared with larger clubs [OR:1.45 (95% CI: 1.02-2.05)] and amongst members of particular football codes. Conclusions: The findings of this study suggest a need and opportunity for the implementation of alcohol harm reduction strategies targeting specific alcohol management practices at community football clubs. © 2013 Kingsland et al.; licensee BioMed Central Ltd.


Sawyer A.L.,Hunter New England Population Health | Wolfenden L.,Hunter New England Population Health | Wolfenden L.,University of Newcastle | Wolfenden L.,NSW Cancer Institute | And 9 more authors.
Health Promotion Journal of Australia | Year: 2012

Issue addressed: There is accumulating evidence supporting a link between alcohol industry sponsorship and alcohol-related problems in both community and elite-level sports. Little is known, however, about the current status of such sponsorship, particularly of community sport. This study aimed to assess associations between alcohol industry sponsorship and different community football clubs in Australia. Methods: The study involved 101 community football clubs across New South Wales, Australia. One representative from each club took part in a cross-sectional telephone survey designed to assess club (football code, number of players, socioeconomic and geographic descriptors) and alcohol industry sponsorship (money, equipment, free alcohol or discounted alcohol) characteristics. Chi-square analysis was used to test associations between club characteristics, and: I) any alcohol industry sponsorship; and ii) type of sponsorship. Results: Eighty-eight per cent of clubs reported receiving sponsorship from the alcohol industry, and most clubs (82%) were sponsored by a licensed premises. There were no significant associations between club characteristics and source of alcohol industry sponsorship. However, small clubs were found to be significantly more likely to receive free or discounted alcohol sponsorship than larger clubs (p=0.05). Conclusions: This exploratory study suggests a significant presence of alcohol industry sponsorship among community football clubs in Australia.


Rowland B.C.,Deakin University | Wolfenden L.,University of Newcastle | Wolfenden L.,NSW Cancer Institute | Dodds P.,Hunter New England Population Health | And 4 more authors.
Health Promotion International | Year: 2015

This study was aimed to assess, using vignettes, the impact of a hypothetical 'designated driver' (DD) initiative on level of intended alcohol consumption. A secondary aim was to assess whether using any form of transport where someone else drove was associated with level of intended consumption. A total of 390 individual sports club members from 72 clubs in New South Wales, Australia, completed a telephone survey. Individuals were randomized into one of two groups: one receiving a hypothetical vignette where the sports club members drank in a setting that provided a DD program; and the other receiving a vignette where the setting in which sports club members drank did not have a DD program. Individuals in both groups were asked to estimate the amount of alcohol they would be likely to consume and the time over which they would consume alcohol, and to indicate the likely means of traveling home afterwards. No difference in the amount of alcohol intended to be consumed between those in the DD and the non-DD group was identified. However, secondary analysis identified that, after controlling for group allocation, greater alcohol consumption was reported by individuals who used transport that relied on someone else to drive them home. DD programs implemented in community sports clubs may not affect intended alcohol consumption by club members. However, using someone else to drive home was associated with greater alcohol consumption. To mitigate against this risk, licensed premises that implement safe transport strategies should consider the use of additional strategies to moderate alcohol consumption that may be inadvertently encouraged. © The Author 2014.


Kingsland M.,University of Newcastle | Kingsland M.,Hunter New England Population Health | Wiggers J.,University of Newcastle | Wiggers J.,Hunter New England Population Health | And 2 more authors.
BMJ Open | Year: 2012

Introduction: Alcohol consumption is a primary cause of physical, psychological and social harm to both the user and others. At both the professional and non-professional level, sports players and fans report consuming alcohol at greater levels than people not involved in sports. Limited systematic reviews have been conducted assessing interventions targeting alcohol consumption behaviour and related harms in the sporting context. Methods and analysis: The review aims to determine if interventions implemented in the sport setting decrease alcohol consumption and related harms. Participants may include all persons regardless of age or other characteristics. Studies will be included which have implemented interventions within the sport setting and have either measured: alcohol consumption, excessive alcohol consumption or intoxication or alcohol-related injury or violence. Randomised controlled trials, staggered enrolment trials, stepped-wedged trials, quasi-randomised trials, quasi-experimental trials and natural experiments will be included. Studies without a parallel comparison group will be excluded. Data will be sourced from a range of electronic databases and sources of grey literature. Two authors will independently screen all titles and abstracts of papers identified through the search strategy. Two authors will independently examine the full text of all remaining papers to determine eligibility. Two authors will independently extract data from eligible studies and independently assess risk of bias by assessing the adequacy of study characteristics. Where studies are sufficiently homogeneous, trial results will be synthesised using a fixed-effects meta-analysis. Standardised mean differences will be used for continuous outcomes and RRs will be used for binary outcomes. Dissemination: The findings of this study will be disseminated widely through mechanisms including peer-reviewed publications and conference presentations.


Kingsland M.,University of Newcastle | Kingsland M.,Hunter New England Population Health | Wolfenden L.,University of Newcastle | Wolfenden L.,NSW Cancer Institute | And 7 more authors.
BMJ Open | Year: 2011

Introduction: Excessive alcohol consumption is responsible for considerable harm from chronic disease and injury. Within most developed countries, members of sporting clubs consume alcohol at levels above that of communities generally. Despite the potential benefits of interventions to address alcohol consumption in sporting clubs, there have been no randomised controlled trials to test the effectiveness of these interventions. The aim of this study is to examine the effectiveness of a comprehensive accreditation intervention with community football clubs (Rugby League, Rugby Union, soccer/association football and Australian Rules football) in reducing excessive alcohol consumption by club members. Methods and analysis: The study will be conducted in New South Wales, Australia, and employ a cluster randomised controlled trial design. Half of the football clubs recruited to the trial will be randomised to receive an intervention implemented over two and a half winter sporting seasons. The intervention is based on social ecology theory and is comprehensive in nature, containing multiple elements designed to decrease the supply of alcohol to intoxicated members, cease the provision of cheap and free alcohol, increase the availability and costattractiveness of non-alcoholic and low-alcoholic beverages, remove high alcohol drinks and cease drinking games. The intervention utilises a three-tiered accreditation framework designed to motivate intervention implementation. Football clubs in the control group will receive printed materials on topics unrelated to alcohol. Outcome data will be collected pre-and postintervention through cross-sectional telephone surveys of club members. The primary outcome measure will be alcohol consumption by club members at the club, assessed using a graduated frequency index and a seven day diary. Ethics and dissemination: The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2008-0432). Study findings will be disseminated widely through peer-reviewed publications and conference presentations.


Wilson L.A.,University of Sydney | Wilson L.A.,University of Western Sydney | Gerard Morgan G.,University of Sydney | Gerard Morgan G.,North Coast Public Health Unit | And 7 more authors.
Environmental Health: A Global Access Science Source | Year: 2013

Background: This study examined the association between unusually high temperature and daily mortality (1997-2007) and hospital admissions (1997-2010) in the Sydney Greater Metropolitan Region (GMR) to assist in the development of targeted health programs designed to minimise the public health impact of extreme heat. Methods. Sydney GMR was categorized into five climate zones. Heat-events were defined as severe or extreme. Using a time-stratified case-crossover design with a conditional logistic regression model we adjusted for influenza epidemics, public holidays, and climate zone. Odds ratios (OR) and 95% confidence intervals were estimated for associations between daily mortality and hospital admissions with heat-event days compared to non-heat event days for single and three day heat-events. Results: All-cause mortality overall had similar magnitude associations with single day and three day extreme and severe events as did all cardiovascular mortality. Respiratory mortality was associated with single day and three day severe events (95 thpercentile, lag0: OR = 1.14; 95%CI: 1.04 to 1.24). Diabetes mortality had similar magnitude associations with single day and three day severe events (95thpercentile, lag0: OR = 1.22; 95%CI: 1.03 to 1.46) but was not associated with extreme events. Hospital admissions for heat related injuries, dehydration, and other fluid disorders were associated with single day and three day extreme and severe events. Contrary to our findings for mortality, we found inconsistent and sometimes inverse associations for extreme and severe events with cardiovascular disease and respiratory disease hospital admissions. Controlling for air pollutants did not influence the mortality associations but reduced the magnitude of the associations with hospital admissions particularly for ozone and respiratory disease. Conclusions: Single and three day events of unusually high temperatures in Sydney are associated with similar magnitude increases in mortality and hospital admissions. The trend towards an inverse association between cardio-vascular admissions and heat-events and the strong positive association between cardio-vascular mortality and heat-events suggests these events may lead to a rapid deterioration in persons with existing cardio-vascular disease resulting in death. To reduce the adverse effects of high temperatures over multiple days, and less extreme but more frequent temperatures over single days, targeted public health messages are critical. © 2013 Wilson et al.; licensee BioMed Central Ltd.


Rawashdeh M.A.,University of Sydney | Bourne R.M.,University of Sydney | Ryan E.A.,University of Sydney | Lee W.B.,NSW Cancer Institute | And 4 more authors.
Academic Radiology | Year: 2013

Objective: To identify specific mammographic appearances that reduce the mammographic detection of breast cancer. Materials and Methods: This study received institutional board review approval and all readers gave informed consent. A set of 60 mammograms each consisting of craniocaudal and mediolateral oblique projections were presented to 129 mammogram Breastscreen readers. The images consisted of 20 positive cases with single and multicentric masses in 16 and 4 cases, respectively (resulting in a total of 24 cancers), and readers were asked to identify and locate the lesions. Each lesion was then ranked according to a detectability rating (ie, the number of observers who correctly located the lesion divided by the total number of observers), and this was correlated with breast density, lesion size, and various descriptors of lesion shape and texture. Results: Negative and positive correlations between lesion detection and density (r = -0.64, P = .007) and size (r = 0.65, P = .005), respectively, were demonstrated. In terms of lesion size and shape, there were significant correlations between the probability of detection and area (r = 0.43, P = .04), perimeter (r = 0.66, P = .0004), lesion elongation (r = 0.49, P = .02), and lesion nonspiculation (r = 0.78, P < .0001). Conclusions: The results of this study have identified specific lesion characteristics associated with shape that may contribute to reduced cancer detection. Mammographic sensitivity may be adversely affected without appropriate attention to spiculation. © 2013 AUR.


Rawashdeh M.,University of Sydney | Lee W.,NSW Cancer Institute | Pietrzyk M.,University of Sydney | Bourne R.,University of Sydney | And 3 more authors.
Proceedings of SPIE - The International Society for Optical Engineering | Year: 2013

Purpose: The current study aims to compare ROC with JAFROC methodologies to investigate how the choice of available analytical approaches in observer studies can impact upon study conclusions. Methods and materials: A total of 129 readers independently reviewed 60 mammographic cases, 20 of which were biopsy proven cases (abnormal) and 40 were normal. Each case consisted of the four standard cranio-caudal (CC) and medio-lateral oblique (MLO) projections. Readers were asked to interpret and locate any presence of cancer, and levels of confidence were scored on a scale of 1-5. Radiology workstations supporting 5MP diagnostic monitors and with full image manipulation tools were used to display all images. JAFROC and ROC methodologies were used and figures of merit and Az values respectively were correlated against key reader characteristics such as experience, qualifications, breast reading practices and physical characteristics using Spearman techniques. Results: Correlation analysis between reader characteristics and JAFROC analysis demonstrated that four key characteristics were linked to performance: years of qualification as a radiologist (p=0.05, r= 0.18), years reading mammograms (p=0.01, r=0.24), number of mammograms read per year (p=0.001, r=0.24), and hours reading mammogram per week (p=0.04, r= 0.19). The ROC method indicated that determinants of performance were confined to years reading mammograms (p=0.02, r = 0.2), and number of mammograms read per year (p=0.04, r=0.23). Conclusion: This work demonstrates the practical impact on study conclusions when different methodologies are used. The location sensitivity approach employed and statistical power with JAFROC, would suggest that the findings from this approach should be prioritized. © 2013 SPIE.

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