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Wright CM, Halkett G, Carey Smith R, Moorin R. Sarcoma epidemiology and cancer-related hospitalisation in Western Australia from 1982 to 2016: a descriptive study using linked administrative data. BMC Cancer 2020; 20:625. [PMID: 32631311 PMCID: PMC7336405 DOI: 10.1186/s12885-020-07103-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/23/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sarcomas are a heterogeneous group of malignancies arising from mesenchymal cells. Epidemiological studies on sarcoma from Australia are lacking, as previous studies have focused on a sarcoma type (e.g. soft tissue) or anatomical sites. METHODS Linked cancer registry, hospital morbidity and death registration data were available for Western Australia (WA) from 1982 to 2016. All new sarcoma cases among WA residents were included to estimate incidence, prevalence, relative survival and cancer-related hospitalisation, using the Information Network on Rare Cancers (RARECARENet) definitions. To provide a reference point, comparisons were made with female breast, colorectal, prostate and lung cancers. RESULTS For 2012-16, the combined sarcoma crude annual incidence was 7.3 per 100,000, with the majority of these soft tissue sarcoma (STS, incidence of 5.9 per 100,000). The age-standardised incidence and prevalence of STS increased over time, while bone sarcoma remained more stable. Five-year relative survival for the period 2012-16 for STS was 65% for STS (higher than lung cancer, but lower than prostate, female breast and colorectal cancers), while five-year relative survival was 71% for bone sarcoma. Cancer-related hospitalisations cost an estimated $(Australian) 29.1 million over the study period. CONCLUSIONS STS incidence has increased over time in WA, with an increasing proportion of people diagnosed aged ≥65 years. The analysis of health service use showed sarcoma had a lower mean episode of cancer-related hospitalisation compared to the reference cancers in 2016, but the mean cost per prevalent person was higher for sarcoma than for female breast, colorectal and prostate cancers.
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Affiliation(s)
- Cameron M Wright
- Health Economics and Data Analytics, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
- School of Medicine, College of Health & Medicine, University of Tasmania, Churchill Avenue, Hobart, Tasmania, 7005, Australia.
| | - Georgia Halkett
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, 6102, Australia
| | - Richard Carey Smith
- Department of Orthopaedic Surgery, Sir Charles Gardner Hospital, Hospital Ave, Nedlands, Western Australia, 6009, Australia
| | - Rachael Moorin
- Health Economics and Data Analytics, School of Public Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
- Centre for Health Services Research, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
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Wright CM, Nowak AK, Halkett G, Moorin RE. Incorporating competing risk theory into evaluations of changes in cancer survival: making the most of cause of death and routinely linked sociodemographic data. BMC Public Health 2020; 20:1002. [PMID: 32586298 PMCID: PMC7318745 DOI: 10.1186/s12889-020-09084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Relative survival is the most common method used for measuring survival from population-based registries. However, the relative survival concept of ‘survival as far as the cancer is concerned’ can be biased due to differing non-cancer risk of death in the population with cancer (competing risks). Furthermore, while relative survival can be stratified or standardised, for example by sex or age, adjustment for a broad range of sociodemographic variables potentially influencing survival is not possible. In this paper we propose Fine and Gray competing risks multivariable regression as a method that can assess the probability of death from cancer, incorporating competing risks and adjusting for sociodemographic confounders. Methods We used whole of population, person-level routinely linked Western Australian cancer registry and mortality data for individuals diagnosed from 1983 to 2011 for major cancer types combined, female breast, colorectal, prostate, lung and pancreatic cancers, and grade IV glioma. The probability of death from the index cancer (cancer death) was evaluated using Fine and Gray competing risks regression, adjusting for age, sex, Indigenous status, socio-economic status, accessibility to services, time sub-period and (for all cancers combined) cancer type. Results When comparing diagnoses in 2008–2011 to 1983–1987, we observed substantial decreases in the rate of cancer death for major cancer types combined (N = 192,641, − 31%), female breast (− 37%), prostate (− 76%) and colorectal cancers (− 37%). In contrast, improvements in pancreatic (− 15%) and lung cancers (− 9%), and grade IV glioma (− 24%) were less and the cumulative probability of cancer death for these cancer types remained high. Conclusion Considering the justifiable expectation for confounder adjustment in observational epidemiological studies, standard methods for tracking population-level changes in cancer survival are simplistic. This study demonstrates how competing risks and sociodemographic covariates can be incorporated using readily available software. While cancer has been focused on here, this technique has potential utility in survival analysis for other disease states.
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Affiliation(s)
- Cameron M Wright
- Health Economics and Data Analytics, Faculty of Health Sciences, School of Public Health, Curtin University, Kent St, Bentley, 6102, Western Australia. .,School of Medicine, College of Health & Medicine, University of Tasmania, Churchill Avenue, Hobart, Tasmania, 7005, Australia.
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, 6009, Western Australia.,School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Kent St, Bentley, 6102, Western Australia
| | - Georgia Halkett
- Midwifery and Paramedicine, Faculty of Health Sciences, School of Nursing, Curtin University, Kent St, Bentley, 6102, Western Australia
| | - Rachael E Moorin
- Health Economics and Data Analytics, Faculty of Health Sciences, School of Public Health, Curtin University, Kent St, Bentley, 6102, Western Australia.,Centre for Health Services Research, Faculty of Medicine, Dentistry and Health Sciences, School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia
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Rana RH, Alam K, Gow J, Ralph N. Predictors of health care use in Australian cancer patients. Cancer Manag Res 2019; 11:6941-6957. [PMID: 31440086 PMCID: PMC6664209 DOI: 10.2147/cmar.s193615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/07/2019] [Indexed: 12/24/2022] Open
Abstract
Objective The purpose of this study is to measure health care utilization in Australian cancer patients based on their demographic, geographic and socioeconomic backgrounds. Method A total of 13,609 participants (aged 15 and over) from 7,230 households were interviewed as part of Wave 13 of the national Household, Income and Labour Dynamics in Australia (HILDA) survey. Five hundred and seventeen participants indicated a current cancer diagnosis with 90% of those receiving active treatment at the time of interview. Independent sample t-tests, Pearson Chi-sq tests, Kruskal‒Wallis H test, binary logistic regression and a zero-inflated Poisson regression were used to examine inequality in health care use. Results Demographic and sociocultural factors such as advancing age, gender, low income, low education status, rurality, no private health insurance, increased psychological distress and less access to specialist care are associated with lower health care utilization among cancer patients. However, models of care such as general practitioner-led cancer care is preferable in younger individuals with cancer, while accessing specialist care is associated with lower rates of hospitalization and higher levels of psychological distress increases hospital length of stay. Conclusions The findings of lower health care utilization by those cancer patients with characteristics of disadvantage have implications for policy development and intervention design. Broadly, policies targeting structural social inequities are likely to increase health care utilization among the most affected/disadvantaged populations. Further investigation is needed to identify potential links between health care utilization and cancer outcomes as a step toward targeted interventions for improving outcomes in the adversely affected groups.
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Affiliation(s)
- Rezwanul Hasan Rana
- School of Commerce, University of Southern Queensland, Toowoomba, Australia.,Centre for Health, Informatics and Economic Research, University of Southern Queensland, Queensland, Australia
| | - Khorshed Alam
- School of Commerce, University of Southern Queensland, Toowoomba, Australia.,Centre for Health, Informatics and Economic Research, University of Southern Queensland, Queensland, Australia
| | - Jeff Gow
- School of Commerce, University of Southern Queensland, Toowoomba, Australia.,School of Accounting, Economics and Finance, University of Kwazulu-Natal, Durban, South Africa
| | - Nicholas Ralph
- Health Systems & Psycho-Oncology, Cancer Council Queensland, Queensland, Australia.,School of Nursing, University of Southern Queensland, Queensland, Australia.,St Vincent's Private Hospital , Queensland, Australia
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Liu B, Lao X, Feng Y, Liu J, Jiao M, Zhao M, Wang J, Zhang X, Liu J, Qi X, Liu H, Chen R, Wu Q, Hao Y. Cancer prevalence among the rural poverty-stricken population in Northeast China. Cancer Manag Res 2019; 11:5101-5112. [PMID: 31213921 PMCID: PMC6549405 DOI: 10.2147/cmar.s205867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/05/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose: The burden of cancer impacts many of the world’s top concerns, but little information is published about the characteristics of cancer prevalence in the poor population. Materials and methods: Data on cancer prevalence were obtained from the Health Poverty Alleviation Information System of Heilongjiang province. Prevalence was defined as all living cancer cases on October 1, 2018. Geographical area, cancer site, sex, age, educational level, and time since diagnosis were investigated. Results: There were 10,529 cancer cases among 624,869 poor rural people in Heilongjiang up to October 1, 2018, and 77% of them did not have labor ability. Females accounted for 53.4%. The top five common cancers were lung, breast, colorectal, stomach, and liver cancer. There were distinct regional, sex, and age distribution differences in cancers. The prevalence rate for overall cancers was 1,685.0 per 100,000 people, which was much higher than that of the national level. Cancer prevalence peaked at an earlier age group (65–69 year). The 5-year cancer prevalence was 80.1% of the total cases. Conclusion: Cancer imposes significant health and financial burdens in the rural poor. This study presents total and partial prevalence for the first time using actual dates from a large poor population in China, providing valuable information for tailored cancer prevention and control, quantifying the cancer burden and identifying priorities for poverty alleviation plans.
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Affiliation(s)
- Baohua Liu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China.,Harbin Center for Disease Control and Prevention, Harbin, Heilongjiang, People's Republic of China
| | - Xinxin Lao
- Educational Administration Section, General Hospital of Heilongjiang Farms & Land Reclamation Administration, Harbin, Heilongjiang, People's Republic of China
| | - Yang Feng
- Network Communication Section, Heilongjiang Third Hospital, Beian, Heilongjiang, People's Republic of China
| | - Jiazhuo Liu
- Second Project Section, Project Fund Supervision Service Center of Heilongjiang Health and Family Planning Commission, Harbin, Heilongjiang, People's Republic of China
| | - Mingli Jiao
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Miaomiao Zhao
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Jiahui Wang
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Xin Zhang
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Jingjing Liu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Xinye Qi
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Huan Liu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Ruohui Chen
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
| | - Yanhua Hao
- Department of Social Medicine, School of Public Health, Harbin Medical University, Heilongjiang, People's Republic of China
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Moynihan R, Barratt AL, Buchbinder R, Carter SM, Dakin T, Donovan J, Elshaug AG, Glasziou PP, Maher CG, McCaffery KJ, Scott IA. Australia is responding to the complex challenge of overdiagnosis. Med J Aust 2018; 209:332-334. [DOI: 10.5694/mja17.01138] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/09/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Ray Moynihan
- Centre for Research in Evidence‐Based Practice, Bond University, Gold Coast, QLD
| | | | | | | | | | - Jan Donovan
- Consumers Health Forum of Australia, Canberra, ACT
| | - Adam G Elshaug
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW
| | - Paul P Glasziou
- Centre for Research in Evidence‐Based Practice, Bond University, Gold Coast, QLD
| | | | | | - Ian A Scott
- Princess Alexandra Hospital, Brisbane, QLD
- University of Queensland, Brisbane, QLD
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Meehan E, Reid SM, Williams K, Freed GL, Sewell JR, Vidmar S, Donath S, Reddihough DS. Hospital admissions in children with cerebral palsy: a data linkage study. Dev Med Child Neurol 2017; 59:512-519. [PMID: 27900776 DOI: 10.1111/dmcn.13350] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2016] [Indexed: 01/06/2023]
Abstract
AIM The overall aim was to investigate the feasibility and utility of linking a cerebral palsy (CP) register to an administrative data set for health services research purposes. We sought to compare CP hospital admissions to general childhood population admissions, and identify factors associated with type and frequency of admissions in a CP cohort. METHOD The CP register for Victoria, Australia was linked to the state's hospital admissions database. Data pertaining to the admissions of a CP cohort (n=1748) that took place between 2007 and 2014 were extracted. Population data were also obtained. RESULTS Overall, 80% of the CP cohort (n=1401) had at least admission between 2007 and 2014, accounting for 11 012 admissions or 1.5% of all admissions in their age group. Compared to general population admissions, CP admissions were more costly and more likely to be elective (66% vs 57%; p<0.001), medical (71% vs 57%; p<0.001), and to take place in metropolitan hospitals (92% vs 78%; p<0.001). Increased CP severity and complexity were associated with having more admissions and a higher proportion of admissions attributable to respiratory illness. INTERPRETATION By linking with administrative data sets, CP registers may be useful for health services research and inform health service delivery.
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Affiliation(s)
- Elaine Meehan
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Susan M Reid
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Developmental Medicine, The Royal Children's Hospital, Melbourne, Vic., Australia
| | - Gary L Freed
- Health Systems and Workforce Unit, Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Jillian R Sewell
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Vic., Australia
| | - Suzanna Vidmar
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Clinical Epidemiology and Biostatistics Unit, Data Science, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Susan Donath
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Clinical Epidemiology and Biostatistics Unit, Data Science, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Dinah S Reddihough
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia.,Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Developmental Medicine, The Royal Children's Hospital, Melbourne, Vic., Australia
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Zheng R, Zeng H, Zhang S, Chen T, Chen W. National estimates of cancer prevalence in China, 2011. Cancer Lett 2015; 370:33-8. [PMID: 26458996 DOI: 10.1016/j.canlet.2015.10.003] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Little is known about the nationwide cancer prevalence in China. This paper aimed at assessing the 5-year cancer prevalence in China for 25 major cancers. MATERIALS AND METHODS Incidence data were estimated using data from 177 cancer registries and covering 175 million populations. Survival data were from 17 cancer registries diagnosed during 2003-2005 and followed up until 31 December 2010. Standardized protocols for data collection and validation were adopted. Cancer prevalence for 25 major sites was estimated from year-specific incidence rates and survival probabilities according to standardized formula. RESULTS The estimated 5-year prevalence for all cancers combined in 2011 in China was 7.49 million (3.68 million for men and 3.81 million for women). Cancer prevalence estimates for 5 years varied by cancer sites, ranging from 11,900 for testicular cancer to 1.02 million for women breast cancer. Those most prevalent five cancers (breast, colorectal, lung, stomach and esophageal cancers) covered 56.1% of cancer burden in China. The proportion for the 5-year prevalence was higher in urban areas compared to rural areas (666 per 100,000 versus 440 per 100,000), while cancer prevalence estimates were higher for women compared to men, with the men/women ratio of 5-year cancer prevalence reaching 0.96. CONCLUSIONS This paper provides the first systematic analysis on 5-year cancer prevalence for 25 major cancers in China in 2011, which may serve as a baseline for assessment of the overall effectiveness of cancer health care. The huge number of cancer survivors requires resource allocation to improve health care programs and primary prevention, especially in rural areas.
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Affiliation(s)
- Rongshou Zheng
- National Office for Cancer Prevention and Control, National Cancer Center, No. 17, Pan-Jia-Yuan South Lane, Chaoyang District, Beijing 100021, China
| | - Hongmei Zeng
- National Office for Cancer Prevention and Control, National Cancer Center, No. 17, Pan-Jia-Yuan South Lane, Chaoyang District, Beijing 100021, China
| | - Siwei Zhang
- National Office for Cancer Prevention and Control, National Cancer Center, No. 17, Pan-Jia-Yuan South Lane, Chaoyang District, Beijing 100021, China
| | - Tianhui Chen
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, ImNeuenheimer Feld 580 (TP3), D-69120 Heidelberg, Germany; Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou, Zhejiang, China
| | - Wanqing Chen
- National Office for Cancer Prevention and Control, National Cancer Center, No. 17, Pan-Jia-Yuan South Lane, Chaoyang District, Beijing 100021, China.
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