Academic literature on the topic 'Cancer in Australia'
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Journal articles on the topic "Cancer in Australia"
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Long, R., A. Woods, C. Biondi, J. Luzuriaga, C. Anderiesz, P. Jackson, C. Giles, and H. Zorbas. "Collection and Reporting of National Cancer Stage at Diagnosis Data in Australia (STaR Project)." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 67s. http://dx.doi.org/10.1200/jgo.18.61300.
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Background: Stage at diagnosis is an important prognostic factor for cancer, providing contextual information for interpreting population health indicators such as mortality from cancer and cancer survival. Australian population-based cancer registries (PBCRs) routinely collect information on cancer incidence and mortality. The need for high quality, comprehensive national data on stage at diagnosis to supplement these data are widely recognized in Australia. The collection and dissemination of quality national stage data will enhance the: • ability to better monitor cancer outcomes, inform cancer control policy; • understand variations across different populations; and • identify where further research and targeted strategies may be required to improve cancer outcomes. Linking data on cancer stage at diagnosis with other administrative cancer data will also allow for a better understanding of the relationship between stage at diagnosis, treatments received, patterns of cancer recurrence, and survival outcomes. Aim: To strengthen national data capacity by collecting and reporting cancer stage at diagnosis for Cancer Australia's Stage, Treatment and Recurrence (STaR) project. Methods: Working with state and territory population-based cancer registries (PBCRs) and the Australian Pediatric Cancer Registry, Cancer Australia supported the development and testing of Business Rules for the collection of national cancer stage at diagnosis for: • The top 5 incident cancers based on the Tumor, Node, and Metastasis (TNM) staging system. These rules were endorsed by the Australasian Association of Cancer Registries (AACR) as a national standard in May 2016; and • Childhood cancers, with a separate set of Business Rules for 16 childhood cancer types based on the Toronto Pediatric Cancer Stage Guidelines. These rules were supported by the AACR as a national standard. Results: Using the AACR-endorsed Business Rules, comprehensive national cancer stage at diagnosis data for the top 5 incident cancers (for 2011) have been collected in Australia for the first time. Over 90% of incidence cases were able to be assigned a value for registry-derived (RD) stage at diagnosis for melanoma (97%), prostate (97%), and female breast (94%) cancers. Lower staging completeness was found for colorectal cancers (88%), and for lung cancers (72%). Business Rules for the collection of stage at diagnosis data for pediatric cancers have also been developed; 93% of sample cases diagnosed in the period 2006-2010 were able to be staged, ranging from 84% for nonrhabdomyosarcoma to 100% for hepatoblastoma. Conclusion: The Business Rules enabled the uniform collection of cancer stage at diagnosis data for the first time in Australia. The collection of these data will allow for the linkage of stage at diagnosis to other sources of information, including patterns of treatments applied, and enable reporting of survival and recurrence outcomes by stage.
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Long, R., K. Cooper, A. Woods, C. Biondi, J. Luzuriaga, P. Jackson, C. Anderiesz, C. Giles, and H. Zorbas. "‘Bridging the Continuum' - Reporting Population-Level Trends Across the Continuum of Care: The Australian National Cancer Control Indicator (NCCI) Web Site." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 78s. http://dx.doi.org/10.1200/jgo.18.61200.
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Background: High-quality data can assist the development of policy and cancer strategies, stimulate lines of research, and inform the provision of care leading to better cancer outcomes. In November 2017 Cancer Australia launched the National Cancer Control Indicators (NCCI) Web site ( https://ncci.canceraustralia.gov.au ), Australia's first interactive Web site of cancer-specific, national population-based data across the continuum of care. The NCCI Web site presents a set of indicators for monitoring national cancer trends and benchmarking internationally across seven key aspects of cancer control; prevention, screening, diagnosis, treatment, psychosocial care, research and outcomes. Aim: By presenting a set of indicators using seven domains from the cancer care continuum, the NCCI Web site presents the most current Australian national data for a range of cancer control indicators in an accessible and interactive format. The primary aim of the NCCI Web site (hosted as part of the Cancer Australia Web site) is to monitor and report the most recent population-level trends to drive improvements across the cancer control continuum in Australia, and to facilitate international benchmarking of Australia's cancer control efforts. Methods: National data level on 33 individual measures across the seven cancer continuum domains was accessed from both government and nongovernment data custodians. Where applicable and available for measures, data were disaggregated and presented by age, sex, indigenous status, remoteness area of residence and socioeconomic status. Review of the data analysis was undertaken by 46 external reviewers including data custodians and subject matter experts. Results: Example summary data from several indicators across the NCCI Web site, including demographic disaggregation by age, sex, remoteness area of residence and socioeconomic status (where available) will be provided. e.g., • Smoking prevalence has decreased substantially over the past 30 years, and smoking rates among both adolescents and adults in Australia are among the lowest in the world. • Cancer mortality rates have been falling steadily since 1995, across most cancer types. Australia has lower mortality rates from cancer when compared with most other similar developed countries, about 6% lower than the estimated global average in 2012. National population-level data showing incidence by stage at diagnosis for the top five most common cancers has also been reported on the Web site - making Australia one of the few countries in the world where these data are available. Conclusion: The NCCI Web site is a flagship data Web site providing, for the first time, an evolving high-level national data resource to monitor Australian population-level trends in cancer control across the continuum. As one of the very few cross-continuum cancer reporting resources in the world, this is a valuable resource for use by those within the international cancer control community.
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Long, R., J. Luzuriaga, C. Biondi, A. Woods, P. Jackson, C. Anderiesz, C. Giles, and H. Zorbas. "Collection and Reporting of System-Wide Cancer Treatment Activity Data As Part of the Stage, Treatment and Recurrence (STaR) Project." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 74s. http://dx.doi.org/10.1200/jgo.18.61400.
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Background: The need for high quality, comprehensive national data on the treatments applied to cancers is widely recognized within the Australian cancer control community. The analysis and reporting of cancer treatment data will greatly enhance our ability to better understand cancer care activity and outcomes - and in particular the treatments being applied across population groups. Aim: To collect and report national data on cancer treatments, as part of Cancer Australia's Stage, Treatment and Recurrence (STaR) project. The linking of this data with national data on stage at diagnosis, survival and recurrence, will help inform policy and practice and ultimately improve cancer outcomes. Methods: Cancer Australia developed a dataset of selected surgical procedures for the treatment of the top five incidence cancers (prostate, breast, colorectal, lung, and melanoma). A dataset of key selected radiotherapy, and systemic therapies for the treatment of all cancer types was also developed. Data for reporting system-wide treatment activity were extracted from existing national health administrative datasets, including: the Pharmaceutical Benefits Scheme (PBS), the Medicare Benefits Schedule (MBS) and the National Hospital Morbidity Database (NHMD). The scope of the analysis was selected surgical procedures, radiotherapy procedures, or pharmaceutical agents administered with the general intent to change the outcome of the cancer and/or provide symptom relief/ palliative care. Results: The data reported provide a high-level national system-wide overview of cancer treatments applied, including: • More than 1 million radiotherapy services were provided for all cancers combined in Australia (as indicated by MBS reimbursement claims data) for the years 2013 to 2015 inclusive; • The number of people receiving systemic anticancer therapies in Australia for all cancers combined (as indicated by PBS reimbursement claims data) increased from 198,756 in 2012 to 247,939 in 2016; and • The number of hospital separations recorded in the NHMD (i.e., episodes of admitted patient care) for patients with a principal diagnosis of cancer undergoing surgery for the treatment of the top five high incidence cancers in Australia increased from 53,516 in 2010 to 57,651 in 2015. Conclusion: National cancer treatment data were successfully collected and reported. Australia is one of very few countries in the world to collect and report national system-wide treatment data with a specific focus on cancer. These data will be linked to cancer incidence, stage at diagnosis, survival and recurrence data to help inform for population-level reporting of cancer outcomes.
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Lacey, Karen, Penelope Schofield, Meinir Krishnasamy, Carrie Lethborg, Elizabeth Cashill, Eileen Thompson, Jill Butty, et al. "Universal truths: Learning from the experience of cancer patients in Australia and England." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 255. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.255.
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255 Background: Self-reported patient experience data is vital to the design of responsive and relevant health services. Annual Cancer Patient Experience Surveys in England (NHS-CPES) have been used to effectively guide and monitor improvements in patient experience. This study measured baseline cancer patient experience in member hospitals of the Victorian Comprehensive Cancer Centre in Australia, and benchmarked this with cancer patients in England. Methods: The NHS-CPES instrument and methodology was used. A paper-based questionnaire was mailed to 5,722 admitted patients aged >18 years with an eligible ICD-10 code. Australian results were compared to 71,793 patients in England from the 2011/12 NHS-CPES. Results: 37% (2,101) patients responded. Most patients rated their overall care as very good or excellent (91% Australia, 88% England). Having a named nurse specialist was a key predictor of experience. Patients with a specialist nurse were significantly more positive in 50 questions in Australia (77%) and 64 questions in England (98%) compared to patients without one. In both countries, patients with rarer cancers tended to be less positive than those with other cancer types. Australian patients with brain/central nervous system cancers and sarcomas gave the lowest score in 46 questions (71%). Patients with a disability or a long-term condition, and those from minority ethnic groups were also less positive. Relevant patient information was lacking; only 65% of patients in Australia and 77% in England were given understandable written information specific to their care, and a little over half received information about financial entitlements (58% Australia, 52% England). Conclusions: Cancer patient experience using the NHS-CPES has been successfully measured and compared across two different health systems. Findings in Australia are similar to those in England suggesting the same key issues affect all cancer patients. Important areas for quality improvement include the provision of tailored written patient information and the provision of named nurse specialists as part of the model of care. Acknowledgement: The authors thank Quality Health Limited for data analysis and the NHS for permitting use of the NHS-CPES.
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Abdullah, Mohammad M. H., Jaimee Hughes, and Sara Grafenauer. "Whole Grain Intakes Are Associated with Healthcare Cost Savings Following Reductions in Risk of Colorectal Cancer and Total Cancer Mortality in Australia: A Cost-of-Illness Model." Nutrients 13, no. 9 (August 27, 2021): 2982. http://dx.doi.org/10.3390/nu13092982.
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Whole grain consumption has been associated with the reduced risk of several chronic diseases with significant healthcare monetary burden, including cancer. Colorectal cancer (CRC) is one of the most common cancers globally, with the highest rates reported in Australia. Three servings of whole grains provide a 15% reduction in total cancer and 17% reduction in CRC risk; however, 70% of Australians fall short of this level of intake. The aim of this study was to assess the potential savings in healthcare costs associated with reductions in the relative risk of CRC and total cancer mortality following the whole grain Daily Target Intake (DTI) of 48 g in Australia. A three-step cost-of-illness analysis was conducted using input parameters from: (1) estimates of current and targeted whole grain intakes among proportions (5%, 15%, 50%, and 100%) of the Australian adult (≥20 years) population; (2) estimates of reductions in relative risk (with 95% confidence intervals) of CRC and total cancer mortality associated with specific whole grain intake from meta-analysis studies; and (3) estimates of annual healthcare costs of CRC and all cancers from disease expenditure national databases. A very pessimistic (5% of population) through to universal (100% of population) adoption of the recommended DTI in Australia were shown to potentially yield savings in annual healthcare costs equal to AUD 1.9 (95% CI 1.2–2.4) to AUD 37.2 (95% CI 24.1–48.1) million for CRC and AUD 20.3 (95% CI 12.2–27.0) to AUD 405.1 (95% CI 243.1–540.1) million for total cancers. As treatment costs for CRC and other cancers are increasing, and dietary measures exchanging whole grains for refined grains are not cost preclusive nor does the approach increase energy intake, there is an opportunity to facilitate cost-savings along with reductions in disease for Australia. These results suggest specific benefits of encouraging Australians to swap refined grains for whole grains, with greater overall adherence to suggestions in dietary guidelines.
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Hall, Alix, Sang Minh Nguyen, Lisa Mackenzie, Rob Sanson-Fisher, Ian Olver, Tran Van Thuan, and Tran Thanh Huong. "What Caused My Cancer? Cancer Patients’ Perceptions on What May Have Contributed to the Development of Their Cancer: A Cross-Sectional, Cross-Country Comparison Study." Cancer Control 26, no. 1 (January 1, 2019): 107327481986378. http://dx.doi.org/10.1177/1073274819863786.
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Accurate public perceptions on the risk factors associated with cancer are important in promoting primary, secondary, and tertiary prevention. Limited studies have explored this topic among patients with cancer in non-western, low-to-middle-income countries. A cross-sectional survey to compare Australian and Vietnamese cancer patients’ perceptions of what caused their cancer was undertaken. Adult, patients with cancer from both countries, receiving radiotherapy treatment completed a standardized survey, which included a 25-item module assessing their beliefs on the causes of their cancer. Items ranged from known evidence-based causes (eg, smoking, sun exposure) to non-evidence-based beliefs (eg, stress or anxiety, physical injury, or trauma). Country-specific logistic regression analyses were conducted to identify differences in the determinants of patients’ top perceived causes. A total of 585 patient surveys were completed (75% response rate; 285 from Australia, and 300 from Vietnam). Most patients were male (58%) and aged 60 years and older (55%). The most frequently reported risk factor overall and for the Australian sample was “getting older” (overall = 42%, Australia = 49%, and Vietnam = 35%). While the most frequently reported risk factor for the Vietnamese sample was “poor diet” (overall = 39%, Australia = 11%, and Vietnam = 64%). There were differences in the characteristics associated with the top causes of cancer identified by Australian and Vietnamese patients. Patients’ beliefs about what may have caused their cancer are complex and likely to be impacted by multiple factors, including the country from which they reside. Developing public awareness campaigns that are accurate and tailored to address the specific beliefs and possible misconceptions held by the target community are needed.
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Carey, R., R. Norman, D. Whiteman, A. Reid, R. Neale, P. Webb, and L. Fritschi. "The Future Excess Fraction of Cancer Attributable to High Body Mass Index in Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 194s. http://dx.doi.org/10.1200/jgo.18.78402.
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Background: High body mass index (BMI > 25 kg/m2) has been found to be associated with an increased risk of many cancers, including cancers of the colon and rectum, liver, and pancreas. Aim: This study aimed to estimate the future burden of cancer resulting from current levels of overweight and obesity in Australia. Methods: The future excess fraction method was used to estimate the future burden of cancer among the proportion of the Australian adult population who were overweight or obese in 2016. Calculations were conducted for 13 cancer types, including cancers of the colon, rectum, kidney, and liver. Results: The cohort of 18.7 million adult Australians in 2016 will develop ∼7.6 million cancers over their lifetime. Of these, ∼402,500 cancers (5.3%) will be attributable to current levels of overweight and obese. The majority of these will be postmenopausal breast cancers (n = 72,300), kidney cancers (n = 59,200), and colon cancers (n = 55,100). More than a quarter of future endometrial cancers (30.3%) and esophageal adenocarcinomas (35.8%) will be attributable to high body mass index. Conclusion: A significant proportion of future cancers will result from current levels of high body mass index. Our estimates are not directly comparable to past estimates of the burden from overweight and obesity because they describe different quantities - future cancers in currently exposed vs current cancers due to past exposures. The results of this study provide us with relevant up-to-date information about how many cancers in Australia could be prevented.
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Thoumi, Andrew, Gerald B. Fogarty, Elizabeth J. Paton, and Stephen Shumack. "Is the contribution of Australian research to the national 2019 clinical practice guidelines for keratinocyte cancer adequate? A simple analysis." International Journal of Radiology & Radiation Therapy 8, no. 4 (October 12, 2021): 144–54. http://dx.doi.org/10.15406/ijrrt.2021.08.00307.
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Introduction: The Australian 2002 National Health and Medical Research Council (NHMRC) treatment guidelines for non-melanoma skin cancer (NMSC) were updated in 2008. At this time, the lack of high-quality Australian research conducted between 2002 to 2008 was noted. The primary aim of the present study was to assess the improvement in the quantity and quality of Australian research in the 2019 keratinocyte cancer guidelines. Secondary aims included an assessment of the quantity and quality of Australian research in comparison to the guidelines provided by the other selected countries, and an evaluation of the improvements in the Australian contribution since 2008. Method: Surgical (Sx) and radiotherapy (RT) treatment sections were interrogated. The analysis was simple. Each reference was counted as one unit. The quantity assessment was carried out by categorizing the references according to their country of origin: Australia, United Kingdom (UK), United States (US) and European Union (EU) countries, which were grouped as one country (EU) for the purpose of this study. The number of references from each country were then added up. To assess for quality, all references were ranked according to the American Society of Plastic Surgeons (ASPS) rating scale. A quality ratio for each country was then calculated by dividing the total number of prospective trials (i.e., levels I and II) by the number of retrospective studies (level III and lower) from each country if the numbers were sufficient. To evaluate the Australian improvement since 2008, Australian references were first categorized according to their year of publication (2002 to 2017), and then allocated to one of four bins of class intervals representing time periods. Results: Twenty-five of the 133 Sx references in the 2019 guidelines were Australian, which was less than the US (58) and EU (37), but better than the UK (12). Quality ratios were: Australia 0.8, UK 1.4, US 0.31, and EU 0.48. Of the 238 RT references, Australia contributed 53, US 107, EU 62, and UK 16. Quality ratios were: Australia 0.06, UK 0.3, US 0.18, and EU 0.34. Australia’s contribution to the UK and US RT guidelines were evaluated. For the UK RT guidelines (11 references), Australia contributed 3, UK 1, US 2 and EU 5. For the US ASTRO guidelines (101 references), Australia contributed 20, UK 1, US 44 and EU 36. Quality ratios were Australia 0.11, US 0.19 and EU 0.2. For Australian research overtime (2002-2017), the quantity and quality of Sx papers are decreasing; whereas for RT, the quantity is increasing but the quality remains poor. Conclusion: The contribution of Australian research to Australia’s own keratinocyte cancer guidelines is not the highest and did not improve over the period of evaluation. The same can be stated for Australia’s research contribution to the UK and US RT guidelines. Australia needs to do more high-quality research.
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Coates, Alan S. "Cancer control in Australia." Medical Journal of Australia 169, no. 1 (July 1998): 8–9. http://dx.doi.org/10.5694/j.1326-5377.1998.tb141466.x.
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McPhate, Alan, and A. J. McMichael. "Breast cancer in Australia." Medical Journal of Australia 148, no. 8 (April 1988): 422. http://dx.doi.org/10.5694/j.1326-5377.1988.tb115978.x.
Full textDissertations / Theses on the topic "Cancer in Australia"
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Shahid, Shaouli. "Towards understanding disparities in cancer outcomes for Aboriginal Australians: exploring Aboriginal perceptions and experiences of cancer in Western Australia." Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/467.
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Cancer has become one of the major chronic diseases among Aboriginal and Torres Strait Islander people of Australia, and was declared a health priority in the National Aboriginal and Torres Strait Islander Health Strategy in 2001. Since then efforts have been instigated to improve the epidemiological information with regard to cancer among Aboriginal Australians in several jurisdictions. Specific issues related to cancer have been identified. Aboriginal Australians compared with non-Aboriginal people have higher occurrence of preventable cancers and are less likely to access cancer screening, are diagnosed at a more advanced stage, have poor continuity of care, lower compliance with treatment and lower five-year survival rates. Several risk factors for higher incidence of some cancers have also been noted. However, these do not adequately explain the reasons behind the delayed presentation, poor compliance and different treatment outcomes of cancer among Aboriginal Australians compared to the total population.To investigate and explore the variations in Aboriginal Australians’ beliefs, understanding and perceptions around cancer and their experiences with cancer services, an exploratory, in-depth qualitative study was undertaken in several locations of Western Australia (WA). This was done with a view to understanding Aboriginal decision-making processes in relation to accessing cancer care in WA. The study was approved by the Human Research Ethics Committee (HREC) of Curtin University, the Western Australian Aboriginal Health Information and Ethics Committee (WAAHIEC), the Royal Perth and Sir Charles Gairdner Hospitals, and by the local Aboriginal Community Controlled Health Services (ACCHS) in regions where the research was conducted.The study adopted a hermeneutic phenomenological research design and used qualitative methods. A hermeneutic phenomenological approach was chosen as this allowed understanding to emerge from the experiences of the participants through interpreting the situated meaning of humans in the world. The views of 30 Aboriginal participants – including patients, survivors and close family members who had lost someone to cancer in their families – were gathered through in-depth interviews. The fieldwork was conducted between March 2006 and September 2007. Interview data were tape-recorded, transcribed and analysed using NVivo7 Software. Thematic analysis was carried out from the information.The findings from the study suggest that many factors affect Aboriginal people’s willingness and ability to participate in cancer-related screening and treatment services. Late diagnoses were not only due to late presentations, as some delayed diagnoses occurred in patients who had regular contact with medical services. Participation in treatment is affected by beliefs and fatalistic attitudes towards cancer; limited understanding of the biomedical aspects of cancer and treatment processes; preference of Aboriginal people to use other approaches to healing such as traditional healers and bush medicine; unwillingness to be separated from family and country, and several infrastructural and logistical issues such as cost, transport and accommodation. It was found that fear of death, shame, beliefs such as cancer is contagious and other spiritual issues affected Aboriginal people’s decisions around accessing services.Moreover, miscommunication between Aboriginal patients and health care providers, lack of cultural security and culturally appropriate support services, lack of Aboriginal staff within the hospital to personally support Aboriginal patients, and the alienating environment of oncology treatment services were also mentioned as barriers. Factors important for effective patient-provider communication such as language, shared understanding, knowledge and use of medical terminology require particular attention. Lack of a reliable and on-going relationship with service providers also came up quite persistently. All of these issues were underpinned by the historical context which includes past discriminatory treatment and experiences of racism by Aboriginal people within mainstream medical institutions. These factors contribute to fear of the medical system, feelings of disempowerment, and mistrust towards the system which constrain Aboriginal participation in cancer treatment and other support services.The results of this study indicate that an understanding of the complex “layers” (from micro to macro) of factors and the interactions between them is required to elucidate Aboriginal people’s decision-making processes around engaging and participating in mainstream cancer services. This research identified gaps in knowledge and understanding and a lack of support services within Aboriginal communities.The findings from the research have been shared with relevant cancer-specific and Aboriginal Community Controlled Health Services with a vision to utilise the study outcomes for the benefit of Aboriginal individuals and communities. Aboriginal people were invited to be co-presenters and co-authors wherever the study findings were presented. An Indigenous Women’s Cancer Support Group (IWCSG) was established in Geraldton after the completion of fieldwork there. This support group has been working to raise awareness of cancer in local Aboriginal people.Some suggestions and recommendations to improve services and cancer outcomes for Aboriginal Australians came out of the study. These include: employment of Aboriginal staff in services and involvement of them in decision-making, maintenance of culturally sensitive, empathetic person-to-person contact, provision of infrastructural and institutional support to involve Aboriginal families within the treatment domain; acknowledgement of holistic concepts of health and well-being; and increase Aboriginal health literacy with regard to cancer.
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Brestovac, Brian. "Human papillomavirus and cervical cancer in Western Australia." University of Western Australia. School of Biomedical and Chemical Sciences, 2005. http://theses.library.uwa.edu.au/adt-WU2006.0037.
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Oliffe, John, and mikewood@deakin edu au. "Prostate cancer : Anglo-Australian heterosexual perspectives." Deakin University. School of Health and Social Development, 2003. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050712.095519.
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Prostate cancer is one of the most prominent diseases in mens health. It is inherently 'male', given the exclusivity of the prostate gland to mens bodies and its physiological connection to testosterone and male sexuality. The biomedical complexities of prostate cancer continue to be unravelled and researched and are often connected to identifying causes, the virtues of screening and treatment modalities. However, despite the biological male 'sex' link, most of the prostate cancer research is not connected with research on gender relations, men and masculinities. The net outcome is that mens lives and illness experiences are absent in much of the prostate cancer research. This PhD thesis Prostate cancer: Anglo-Australian heterosexual perspectives, is an ethnographic study of thirty-five Anglo-Australian men diagnosed with prostate cancer. Participants shared their experiences of living with prostate cancer in the context of health promotion, health services and in relation to their sexuality and intimate relationships. Through participant photographic novella and in-depth semi-structured interviews, rich cultural insights are provided. A social constructionist gender analysis is used in this research that shows how the social constructions of masculinity interconnect and occasionally collide with prostate cancer throughout the illness trajectory.
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Sadkowsky, Krystian Reginald. "An analysis into geographic regional differences in cancer survival in Australia during 1982-1997 /." [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16944.pdf.
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Macharper, Anthony G. "Survival from cancer and socio-economic status in South Australia /." Title page, table of contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmm149.pdf.
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Moore, Simon Reading. "Oral cancer in South Australia : a twenty year study 1977-1996." Title page, table of contents and precis only, 1999. http://web4.library.adelaide.edu.au/theses/09DM/09dmm824.pdf.
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Cheok, Frida. "Participation in mammographic screenings in South Australia /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phc51843.pdf.
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Platt, Violet. "The experiences of cancer survivors as they transition from chemotherapy treatment to life after cancer." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2012. https://ro.ecu.edu.au/theses/484.
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This study explored and described the experience of people with a diagnosis of cancer, as they transitioned from life as a chemotherapy patient to life after treatment as a cancer survivor. The purpose of this study was to ultimately improve the care of people as they transitioned into life after completion of chemotherapy treatment. There is minimal information related to this phase of the cancer trajectory, therefore this study was intentionally exploratory and descriptive. To achieve the proposed outcome a two-phased approach was undertaken. In Phase One a qualitative approach was followed using Grounded Theory to the descriptive level of data analysis. The study was undertaken in a large tertiary hospital in Western Australia. The sample comprised of 14 cancer survivors who had completed chemotherapy treatment in the previous four to twelve weeks. Data was collected via semi structured telephone interviews. Descriptors of issues and experiences that arose in the first six months following completion of chemotherapy were elicited. Data was subsequently transcribed, coded and organised into themes of congruent relevance. Cancer survivors were found to transition through two stages in the early weeks following completion of chemotherapy. When physical symptoms and emotional losses were all encompassing, the survivors displayed vulnerability due to the loss of the treatment environment and a range of challenging emotions. As the weeks passed and physical symptoms began to abate, the survivors began to display characteristics of resilience, self empowerment and information seeking strategies which both informed and protected the survivor. The domains that challenged the survivor throughout this transition period encompassed physical, social, psychological and spiritual issues. In Phase Two of the study, key findings from Phase One were utilised to inform the adaptation of an existing quality of life tool, Quality of life – Cancer Survivor, which was identified following an extensive literature review. The adapted tool, Quality of Life – Chemotherapy Cancer Survivor, was assessed for clarity, content validity and apparent internal consistency by an expert panel of six oncology nurses who were employed within the same tertiary hospital setting. Feedback from this process was used to further amend the original tool. The researcher intends to pilot test the revised tool with cancer survivors in preparation for a larger scale population based study following this Masters study. This study has provided an insight into the survivorship issues as people transition to life after chemotherapy and findings begin to fill a gap in understanding which has not previously be addressed in the available literature. Implications for future research and clinical practice including, gaps in survivor’s knowledge and transition process issues, are provided.
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Walker, Sandra, and n/a. "Prostate cancer support groups an evaluation." Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20060905.085536.
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The population of Australia is increasing in age, consequently the incidence of
cancer diagnoses is rising. This rise will have a dramatic impact on hospitals with
much of the disease burden extending to psychological support for cancer care. At
present few men diagnosed with cancer seek support. This study sought to explore
men's perceptions of support and prostate cancer support groups.
The benefits of support groups for men with prostate cancer have been well
documented in international studies. In Australia however, relatively few men
diagnosed with prostate cancer join such groups and few studies have examined the
factors that influence membership and attendance. This study investigated the
experiences of a sample of 181 Australian men diagnosed with prostate cancer, 80 of
whom were members of support groups and 107 who were not. The participants were
recruited from prostate cancer support groups and an outpatient department of a major
cancer hospital, in Melbourne, Australia. The two groups were compared on a range
of factors, including disease characteristics, illness perceptions and views of prostate
cancer support groups. Further, members of support groups rated a number of
objectives to determine the effectiveness of the groups.
The majority of members recommended prostate cancer support groups to
other men with prostate cancer (92%), however of the non-members of prostate
cancer support groups, almost half (48%) had never heard of them. Factors that
discriminated between support group members and non-members were emotional
perceptions of the illness, symptom reports and illness coherence, with support group
members reporting higher scores on these variables. Length of diagnosis and age
were also factors that discriminated between the groups with support group members younger and diagnosed longer than non-members. There were no differences between
the groups on personal control, both groups reported high perceptions of control over
the disease. Members reported more benefits and less costs associated with prostate
cancer support groups than non-members. Benefits included information, support,
sharing experiences, and supporting other men with the disease. Costs included
negative discussions, other men dying, and the distance required to travel to the
groups. Both members and non-members reported distance to travel to the groups as
a major barrier to attendance. The majority of members had heard of the groups
through friends and, for non-members who had heard of the groups, through hospital
staff. General practitioners were one of the least likely sources of information about
prostate cancer support groups reported by members.
Prostate cancer support group members reported high levels of satisfaction
with the groups on a range of objectives outlined by the Cancer Council of Victoria.
Making friends and accessing community assistance exceeded men's expectations of
attendance, however men reported a desire for more information and communication.
A need for more funding, advertising, and recognition of prostate cancer support
groups by medical staff was also reported.
Many men with prostate cancer are unaware of support groups, however a
number of benefits were noted by both members and non-members. Greater
recognition of prostate cancer support groups by medical staff may provide men with
prostate cancer an opportunity to access those benefits. Health service providers
should consider the important role prostate cancer support groups play in the recovery
of men from prostate cancer and consider ways of dispelling myths men may hold
regarding the notion of support.
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Sanjida, Saira. "A retrospective case-control study on the prescribing practices of antidepressants administered to cancer patients and non-cancer patients in Australia." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/94240/1/Saira_Sanjida_Thesis.pdf.
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Comorbidity of depression risks is common among cancer patients. The pharmacological treatment of depression is antidepressants. However, antidepressants may interact with anticancer drugs or cause adverse reactions. The prescription practice of antidepressants to cancer patients in Australia is not well documented. Our systematic review and meta-analysis identified that the overall prevalence rate of antidepressants was 15.6% varied widely by world-region and gender. A retrospective case-control study was undertaken to determine the recent prescription practice of antidepressants to cancer and non-cancer patients in Australia. Mirtazapine was the highly prescribed antidepressants to cases, whereas Desvenlafaxine was prescribed to controls. Considerable variation in the prescribing patterns of antidepressants was identified. Prospective studies are needed to ascertain whether patients are being treated optimally.
Books on the topic "Cancer in Australia"
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Kricker, Anne. Breast cancer in Australia. Sydney: Alpha Biomedical Communications, 1996.
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Cervical cancer in Australia. Canberra, ACT: Australian Institute of Health and Welfare, Dept. of Human Services and Health, 1995.
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Carr, Matthew. Battle scars: A solder's strategy for fighting cancer. Edgecliff, N.S.W: Jane Curry Publishing, 2011.
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Australia, BreastScreen. BreastScreen Australia monitoring report / the Australian Institute of Health Welfare and the Australian Government Department of Health and Aging for the BreastScreen Australia Program. Canberra: Australian Institute of Health and Welfare, c2003., 2003.
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Threlfall, Timothy J. Cancer incidence and mortality in Western Australia, 1996: A report of the Western Australian Cancer Registry. Perth, W.A: Health Statistics Branch, Health Information Centre, Health Dept. of Western Australia, 1998.
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Australian Institute of Health and Welfare. Breast cancer in Australia: An overview, 2009. Canberra: Australian Institute of Health and Welfare, 2009.
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McDermid, Ian. Cancer incidence projections Australia 2002 to 2011. Canberra: Australian Institute of Health and Welfare, 2005.
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Goodwin, Melissa. Cancer incidence projections: Australia, 2011 to 2020. Canberra: Australian Institute of Health and Welfare, 2012.
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Welfare, Australian Institute of Health and. Ovarian cancer in Australia: An overview, 2010. Canberra: Australian Institute of Health and Welfare, 2010.
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Welfare, Australian Institute of Health and. Breast cancer in Australia: An overview, 2009. Canberra: Australian Institute of Health and Welfare, 2009.
Find full textBook chapters on the topic "Cancer in Australia"
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Khoo, Liane, and Douglas Joshua. "Multiple Myeloma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 493–500. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_100.
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Boyer, Michael, and Kate Mahon. "Lung Carcinoma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 75–78. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_13.
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Smithers, Bernard Mark, Janine M. Thomas, and Bryan H. Burmeister. "Esophagus Carcinoma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 97–100. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_17.
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El-Khoury, Toufic, Michael Solomon, and Jane Young. "Anal Carcinoma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 215–18. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_39.
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Henderson, Michael A. "Cutaneous Melanoma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 265–68. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_51.
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Spillane, Andrew J., and Meagan E. Brennan. "Breast Carcinoma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 285–91. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_56.
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Boyer, Michael, and Kate Mahon. "Testicle Carcinoma Surveillance Counterpoint: Australia." In Patient Surveillance After Cancer Treatment, 449–52. Totowa, NJ: Humana Press, 2012. http://dx.doi.org/10.1007/978-1-60327-969-7_88.
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Macrae, Finlay, and Clara Gaff. "Genetic Counselling Across Culture and Health Systems: Australia." In Hereditary Colorectal Cancer, 503–34. Boston, MA: Springer US, 2010. http://dx.doi.org/10.1007/978-1-4419-6603-2_30.
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Narayan, Kailash, Sylvia van Dyk, and David Bernshaw. "Australia: Peter Maccullum Cancer Center, Melbourne." In Gynecologic Radiation Therapy, 167–72. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-540-68958-4_13.
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Broom, Alex. "Prostate Cancer and Masculinities in Australia." In Men, Masculinities and Health, 178–97. London: Macmillan Education UK, 2010. http://dx.doi.org/10.1007/978-1-137-08076-9_11.
Full textConference papers on the topic "Cancer in Australia"
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Adhitya, Anita, and Donald Benjamin. "13 Reexamining the cancer paradigm." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.119.
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Glasziou, Paul, Mark Jones, Thanya Pathirana, Alexandra Barratt, and Katy Bell. "16 The burden of cancer overdiagnosis in australia." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.30.
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Basnayake, T., P. Valery, P. Carson, and P. De Ieso. "Lung Cancer in the Northern Territory, Australia: A Comparison Between Indigenous and Non-Indigenous Australians." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3991.
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Takahashi, Hirokazu, Akiko Matsumoto, and Tomio Nakayama. "17 Cancer screening may cause overdiagnosis in japan." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.123.
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Lombard, Janine M., Nicholas Zdenkowski, Kathy Wells, Nicca Grant, Linda Reaby, John F. Forbes, and Jacquie Chirgwin. "Abstract P1-12-05: Aromatase inhibitor induced musculoskeletal syndrome (AIMSS) in Australian women with early breast cancer: An Australia and New Zealand Breast Cancer Trials Group (ANZBCTG) survey of members of the Breast Cancer Network Australia (BCNA)." In Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium; December 9-13, 2014; San Antonio, TX. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.sabcs14-p1-12-05.
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Smith, Jenna, Rachael Dodd, Jolyn Hersch, Erin Cvejic, Kirsten McCaffery, and Jesse Jansen. "15 The effect of different communication strategies about stopping cancer screening on inyention to screen and cancer anxiety: a randomised online study in older adults." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.29.
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Clark, Stephen D., Alison T. Brenner, Daniel S. Reuland, and Michael P. Pignone. "92 Effect of a lung cancer screening decision aid on understanding of overdiagnosis." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.105.
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Grannis, Frederic. "72 Special project #1: the tobacco industry, alvan feinstein and lung cancer overdiagnosis." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.84.
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Asselin, Genevieve, Sylvain L’Espérance, Alice Nourissat, and Marc Rhainds. "73 Is magnetic resonance imaging in prostate cancer a possible avenue for reducing overdiagnosis?" In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.85.
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Farber, Rachel, Alexandra Barratt, Nehmat Houssami, Kevin McGeechan, and Katy Bell. "81 Has the transition to digital mammography in breast cancer screening resulted in real benefits?" In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.93.
Full textReports on the topic "Cancer in Australia"
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Lichtenberg, Frank. Are Increasing 5-Year Survival Rates Evidence of Success Against Cancer? A reexamination using data from the U.S. and Australia. Cambridge, MA: National Bureau of Economic Research, June 2010. http://dx.doi.org/10.3386/w16051.
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson, and Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, June 2022. http://dx.doi.org/10.57022/sneg4189.
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Background Australia is a multi-cultural society with increasing rates of people from culturally and linguistically diverse (CALD) backgrounds. On average, CALD groups have higher rates of tobacco use, lower participation in cancer screening programs, and poorer health outcomes than the general Australian population. Lower cancer screening and smoking cessation rates are due to differing cultural norms, health-related attitudes, and beliefs, and language barriers. Interventions can help address these potential barriers and increase tobacco cessation and cancer screening rates among CALD groups. Cancer Council NSW (CCNSW) aims to reduce the impact of cancer and improve cancer outcomes for priority populations including CALD communities. In line with this objective, CCNSW commissioned this rapid review of interventions implemented in Australia and comparable countries. Review questions This review aimed to address the following specific questions: Question 1 (Q1): What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Question 2 (Q2): What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? This review focused on Chinese-, Vietnamese- and Arabic-speaking people as they are the largest CALD groups in Australia and have high rates of tobacco use and poor screening adherence in NSW. Summary of methods An extensive search of peer-reviewed and grey literature published between January 2013-March 2022 identified 19 eligible studies for inclusion in the Q1 review and 49 studies for the Q2 review. The National Health and Medical Research Council (NHMRC) Levels of Evidence and Joanna Briggs Institute’s (JBI) Critical Appraisal Tools were used to assess the robustness and quality of the included studies, respectively. Key findings Findings are reported by components of an intervention overall and for each CALD group. By understanding the effectiveness of individual components, results will demonstrate key building blocks of an effective intervention. Question 1: What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Thirteen of the 19 studies were Level IV (L4) evidence, four were Level III (L3), one was Level II (L2), none were L1 (highest level of evidence) and one study’s evidence level was unable to be determined. The quality of included studies varied. Fifteen tobacco cessation intervention components were included, with most interventions involving at least three components (range 2-6). Written information (14 studies), and education sessions (10 studies) were the most common components included in an intervention. Eight of the 15 intervention components explored had promising evidence for use with Chinese-speaking participants (written information, education sessions, visual information, counselling, involving a family member or friend, nicotine replacement therapy, branded merchandise, and mobile messaging). Another two components (media campaign and telephone follow-up) had evidence aggregated across CALD groups (i.e., results for Chinese-speaking participants were combined with other CALD group(s)). No intervention component was deemed of sufficient evidence for use with Vietnamese-speaking participants and four intervention components had aggregated evidence (written information, education sessions, counselling, nicotine replacement therapy). Counselling was the only intervention component to have promising evidence for use with Arabic-speaking participants and one had mixed evidence (written information). Question 2: What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? Two of the 49 studies were Level I (L1) evidence, 13 L2, seven L3, 25 L4 and two studies’ level of evidence was unable to be determined. Eighteen intervention components were assessed with most interventions involving 3-4 components (range 1-6). Education sessions (32 studies), written information (23 studies) and patient navigation (10 studies) were the most common components. Seven of the 18 cancer screening intervention components had promising evidence to support their use with Vietnamese-speaking participants (education sessions, written information, patient navigation, visual information, peer/community health worker, counselling, and peer experience). The component, opportunity to be screened (e.g. mailed or handed a bowel screening test), had aggregated evidence regarding its use with Vietnamese-speaking participants. Seven intervention components (education session, written information, visual information, peer/community health worker, opportunity to be screened, counselling, and branded merchandise) also had promising evidence to support their use with Chinese-speaking participants whilst two components had mixed (patient navigation) or aggregated (media campaign) evidence. One intervention component for use with Arabic-speaking participants had promising evidence to support its use (opportunity to be screened) and eight intervention components had mixed or aggregated support (education sessions, written information, patient navigation, visual information, peer/community health worker, peer experience, media campaign, and anatomical models). Gaps in the evidence There were four noteworthy gaps in the evidence: 1. No systematic review was captured for Q1, and only two studies were randomised controlled trials. Much of the evidence is therefore based on lower level study designs, with risk of bias. 2. Many studies provided inadequate detail regarding their intervention design which impacts both the quality appraisal and how mixed finding results can be interpreted. 3. Several intervention components were found to have supportive evidence available only at the aggregate level. Further research is warranted to determine the interventions effectiveness with the individual CALD participant group only. 4. The evidence regarding the effectiveness of certain intervention components were either unknown (no studies) or insufficient (only one study) across CALD groups. This was the predominately the case for Arabic-speaking participants for both Q1 and Q2, and for Vietnamese-speaking participants for Q1. Further research is therefore warranted. Applicability Most of the intervention components included in this review are applicable for use in the Australian context, and NSW specifically. However, intervention components assessed as having insufficient, mixed, or no evidence require further research. Cancer screening and tobacco cessation interventions targeting Chinese-speaking participants were more common and therefore showed more evidence of effectiveness for the intervention components explored. There was support for cancer screening intervention components targeting Vietnamese-speaking participants but not for tobacco cessation interventions. There were few interventions implemented for Arabic-speaking participants that addressed tobacco cessation and screening adherence. Much of the evidence for Vietnamese and Arabic-speaking participants was further limited by studies co-recruiting multiple CALD groups and reporting aggregate results. Conclusion There is sound evidence for use of a range of intervention components to address tobacco cessation and cancer screening adherence among Chinese-speaking populations, and cancer screening adherence among Vietnamese-speaking populations. Evidence is lacking regarding the effectiveness of tobacco cessation interventions with Vietnamese- and Arabic-speaking participants, and cancer screening interventions for Arabic-speaking participants. More research is required to determine whether components considered effective for use in one CALD group are applicable to other CALD populations.
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Liu, Edgar, Malgorzata Lagisz, Evelyne de Leeuw, and Hyungmo Yang. Place-based Health Interventions in NSW - A rapid review of evidence. SPHERE HUE Collaboratory, November 2022. http://dx.doi.org/10.52708/pbhi-el.
Full textAbstract:
This report describes a rapid review exercise on the place-based intervention approaches to improving the health and wellbeing outcomes of residents in the Australian state of New South Wales (NSW). The aim of this exercise is to inform the Cancer Institute NSW on their future policy and program developments in cancer prevention and screening. Specifically, it seeks to answer the following research questions: 1. What place-based interventions for health promotion and risk prevention and screening currently exist in NSW? 2. How effective have these interventions been in achieving their stated objectives?
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, August 2022. http://dx.doi.org/10.57022/pxwj3682.
Full textAbstract:
Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.