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Chilko N, Dean S, Matheson LM, Grills R, Davidson AJ, Kearns P, Campbell D, Rogers MJ, Collins IM. Prostate cancer survival in South West Victoria. Aust J Rural Health 2022; 30:676-682. [PMID: 35605157 DOI: 10.1111/ajr.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/17/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore reasons for survival disparities for patients with prostate cancer in the Barwon South West area of Victoria. DESIGN, SETTING AND PARTICIPANTS We have described incidence, diagnostics, treatment pathways, and survival for four regions of the Barwon South Western Victoria. Analysis included all newly diagnosed prostate cancer patients from 2009 to 2015 in the Evaluation of Cancer Outcomes Barwon South West Registry. Regions included 1: Queenscliffe 2: Geelong, Colac Otway and Corangamite 3: Moyne, Warrnambool and Southern Grampians and 4: Glenelg. Across the four regions, variables were compared using a chi square statistic or analysis of variance and survival data was assessed with the Kaplan-Meier curves. MAIN OUTCOME MEASURES Incidence, treatment pathways and survival for prostate cancer patients. RESULTS A total of 1776 patients were diagnosed with prostate cancer from 2009 to 2015 in the Barwon South West area. In regions 1-4, there were 298 (1.04%), 1085 (0.92%), 273 (0.97%) and 120 (1.2%) cases, respectively. There was no significant difference in Gleason score and treatment. The 5-year survival rate was 85%, 76%, 71% and 80%, respectively, as compared with the national average of 95%. PSA scores >20 ng/ml at diagnosis, as a surrogate for high-risk disease, occurred in 23%, 29%, 22% and 21%, respectively (p < 0.01). The proportions presenting with stage IV disease were 17%, 26%, 21% and 6%, respectively (p = 0.10). CONCLUSION Men diagnosed with prostate cancer in South West Victoria have a considerably lower 5-year survival compared with the national average with later disease at presentation in some areas.
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Affiliation(s)
- Natalie Chilko
- Barwon Health, Geelong, Victoria, Australia.,Albury Wodonga Regional Cancer Centre, East Albury, New South Wales, Australia
| | - Samantha Dean
- Southwest Healthcare, Warrnambool, Victoria, Australia
| | - Leigh M Matheson
- Barwon South Western Regional Integrated Cancer Service, Geelong, Victoria, Australia
| | - Richard Grills
- Department of Surgery, Deakin University, Geelong, Victoria, Australia.,Department of Urological Surgery, Barwon Health, Geelong, Victoria, Australia
| | | | | | - David Campbell
- Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia
| | - Margaret J Rogers
- Barwon South Western Regional Integrated Cancer Service, Geelong, Victoria, Australia
| | - Ian M Collins
- Southwest Healthcare, Warrnambool, Victoria, Australia.,Department of Surgery, Deakin University, Geelong, Victoria, Australia
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2
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Muthusamy A, Long D, Underhill CR. Improving recruitment to clinical trials for regional and rural cancer patients through a regionally based clinical trials network. Med J Aust 2021; 214:453-454.e1. [PMID: 33990964 DOI: 10.5694/mja2.51078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Donna Long
- Regional Trials Network Victoria, Albury, NSW
| | - Craig R Underhill
- Border Medical Oncology, Albury, NSW.,Rural Clinical School, UNSW, Albury, NSW
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3
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Matheson LM, Pitson G, Yap CH, Singh M, Collins I, Campbell P, Patrick A, Rogers MJ. Measuring the quality of cancer care in the Barwon South Western region, Victoria, Australia. Int J Qual Health Care 2021; 33:5983668. [PMID: 33196785 DOI: 10.1093/intqhc/mzaa145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The implementation of clinical quality indicators for monitoring cancer care in regional, rural and remote areas. DESIGN Retrospective data from a population-based Clinical Quality Registry for lung, colorectal and breast cancers. SETTING All major health services in the Barwon South Western region, Victoria, Australia. PARTICIPANTS All patients who were diagnosed with cancer and who presented to a health service. INTERVENTION(S) Clinical subgroups to review variations. MAIN OUTCOME MEASURES(S) Clinical quality indicators for lung, colorectal and breast cancers. RESULTS Clinical indicators included the following: discussion at multidisciplinary meetings, the timeliness of care provided and the type of care for different stages of the disease and survival outcomes. Many of the derived clinical indicator targets were reached. However, variations led to an improvement in the tumour stage being recorded in the medical record; an improved awareness of the need for adjuvant chemotherapy for colorectal cancer; a reduction in time to treatment for lung cancer and a reduced time to surgery for breast cancer, and the 30-day mortality post-treatment for all of the tumour streams was highlighted. CONCLUSIONS Clinical quality indicators allow for valuable insights into patterns of care. These indicators are easily reproduced and may be of use to other cancer centres and health services.
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Affiliation(s)
- L M Matheson
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - G Pitson
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - C H Yap
- Cardiothoracic Surgery, University Hospital Geelong, Geelong, VIC 3220, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - M Singh
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - I Collins
- Dept of Oncology, South West Healthcare, Warrnambool, VIC 3280, Australia and.,School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - P Campbell
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia.,School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - A Patrick
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - M J Rogers
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
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Kim ML, Matheson L, Garrard B, Francis M, Broad A, Malone J, Eastman P, Rogers M, Yap C. Use of clinical quality indicators to improve lung cancer care in a regional/rural network of health services. Aust J Rural Health 2019; 27:183-187. [DOI: 10.1111/ajr.12493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 10/04/2018] [Accepted: 11/15/2018] [Indexed: 01/22/2023] Open
Affiliation(s)
- Michelle Lynne Kim
- Department of Cardiothoracic Surgery Barwon Health Geelong VictoriaAustralia
| | - Leigh Matheson
- Barwon South Western Integrated Cancer Services Geelong Victoria Australia
| | - Brooke Garrard
- Barwon South Western Integrated Cancer Services Geelong Victoria Australia
| | - Michael Francis
- Barwon Health Andrew Love Cancer Centre Geelong Victoria Australia
| | - Adam Broad
- Barwon Health Andrew Love Cancer Centre Geelong Victoria Australia
| | - James Malone
- Barwon Health Andrew Love Cancer Centre Geelong Victoria Australia
| | - Peter Eastman
- Barwon Health Andrew Love Cancer Centre Geelong Victoria Australia
- Department of Palliative Care Barwon Health Geelong Victoria Australia
| | - Margaret Rogers
- Barwon South Western Integrated Cancer Services Geelong Victoria Australia
- Deakin University School of Medicine Waurn Ponds Victoria Australia
| | - Cheng‐Hon Yap
- Department of Cardiothoracic Surgery Barwon Health Geelong VictoriaAustralia
- Barwon Health Andrew Love Cancer Centre Geelong Victoria Australia
- Deakin University School of Medicine Waurn Ponds Victoria Australia
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Collins IM, Lum C, Versace VL. Influence of socioeconomic factors and distance to radiotherapy on breast-conserving surgery rates for early breast cancer in regional Australia; implications of change. Asia Pac J Clin Oncol 2017; 14:e224-e230. [PMID: 29159936 DOI: 10.1111/ajco.12828] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
Abstract
AIMS Breast conserving surgery rates are affected by many factors including distance to radiotherapy and tumor-related features. Numerous studies have found women who must travel further for radiotherapy are more likely to choose mastectomy and avoid radiotherapy. We examined relationships between socioeconomic group, distance to radiotherapy services and mastectomy rates across a range of rural and metropolitan settings. METHODS We used a dataset extracted from the Evaluation of Cancer Outcomes Barwon South Western Registry, which captured data on new breast cancer diagnoses in the southwest region of Victoria, Australia. Using logistic regression, we modeled treatment choice of women with early breast cancer (mastectomy vs breast conserving surgery) using explanatory variables that included distance to radiotherapy, and area-level socioeconomic data from the Australian Bureau of Statistics, while controlling for clinical factors. RESULTS Mastectomy was associated with tumor size, nodal burden and younger age at surgery. Distance to a radiotherapy center was also strongly associated with increased rates of mastectomy for women who traveled 100-200 km for radiotherapy (odds ratio = 1.663; P = 0.03) compared to the reference group who were within 100 km of radiotherapy. No socioeconomic differences were seen between the two groups. CONCLUSION A strong association between distance to radiotherapy and the type of surgery for early breast cancer was found. Improving access to radiotherapy therefore has the potential to improve breast cancer outcomes for women in regional Australia.
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Affiliation(s)
- Ian M Collins
- School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Caroline Lum
- Border Medical Oncology, Deakin University, Deakin Rural Health, Warrnambool, Victoria, Australia
| | - Vincent L Versace
- School of Medicine, Deakin University, Deakin Rural Health, Warrnambool, Victoria, Australia
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Rogers MJ, Matheson L, Garrard B, Maher B, Cowdery S, Luo W, Reed M, Riches S, Pitson G, Ashley DM. Comparison of outcomes for cancer patients discussed and not discussed at a multidisciplinary meeting. Public Health 2017; 149:74-80. [PMID: 28575751 DOI: 10.1016/j.puhe.2017.04.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/15/2017] [Accepted: 04/24/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Comparison of outcomes for cancer patients discussed and not discussed at a multidisciplinary meeting (MDM). STUDY DESIGN Retrospective analysis of the association of MDM discussion with survival. METHODS All newly diagnosed cancer patients from 2009 to 2012, presenting to a large regional cancer service in South West Victoria, Australia (620 colorectal, 657 breast, 593 lung and 511 haematological) were recorded and followed up to 5 years after diagnosis. Treatment patterns and survival of patients whose treatment was discussed at an MDM compared to those who were not, were explored. RESULTS The proportion of patients presented to an MDM within 60 days after diagnosis was 56% (n = 366) for breast cancer, 59% (n = 363) for colorectal cancer, 27% (n = 137) for haematological malignancies and 60% (n = 355) for lung cancer. Seventy-three percent (n = 886) of patients discussed at an MDM had their tumour stage recorded in their medical records while only 52% (n = 604) of patients not discussed had their tumour stage recorded (P < 0.01). We found for haematological and lung cancer patients that those presented to an MDM prior to treatment had a significant reduction in mortality (lung cancer hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.50-0.76, P < 0.01) (haematological cancer HR 0.58, 95% CI 0.35-0.96, P = 0.03) compared to patients whose cases were not discussed at an MDM after adjusting for the potential cofounders of age, stage, comorbidities and treatment. This was not the case for colorectal and breast cancer patients where there was no significant difference. CONCLUSION MDM discussion has been recommended as best practice in the management of cancer patients, however, from a public health perspective this creates potential issues around access and resources. It is likely that MDM presentation patterns and outcomes across tumour streams are linked in complex ways. We believe that our data would demonstrate that these patterns differ across tumour streams and that more detailed work is required to better allocate relatively scarce and potentially costly MDM resources to tumour streams and patient groups that may get the most benefit.
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Affiliation(s)
- M J Rogers
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
| | - L Matheson
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
| | - B Garrard
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
| | - B Maher
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
| | - S Cowdery
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia.
| | - W Luo
- Pattern Recognition and Data Analytics, Deakin University, Geelong, Victoria, Australia.
| | - M Reed
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
| | - S Riches
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
| | - G Pitson
- Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.
| | - D M Ashley
- Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia.
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Rogers MJ, Matheson LM, Garrard B, Mukaro V, Riches S, Sheridan M, Ashley D, Pitson G. Cancer diagnosed in the Emergency Department of a Regional Health Service. Aust J Rural Health 2016; 24:409-414. [PMID: 26833693 DOI: 10.1111/ajr.12280] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Patients diagnosed with cancer in the Emergency Department (ED) have more advanced disease at diagnosis and poorer outcomes. High rates of initial presentation to ED suggest potential problems with access to care. The aim of this project was to interpret findings in regional/rural Victoria and explore implications for practice. DESIGN Cross-sectional study linking two independent data sets. SETTING Regional city of Geelong and surrounding rural areas in south-west Victoria. PARTICIPANTS All newly diagnosed cancer patients in 2009. MAIN OUTCOME MEASURES Number of cancer patients diagnosed in the ED. RESULTS One in five newly diagnosed cancer patients present to ED 6 months prior to cancer diagnosis. One in 10 is diagnosed as a result of their ED visit. Patients presenting to ED were older, more often men and from disadvantaged areas. Symptoms on presentation included chest complaints, bowel obstruction, abdominal pain, anaemia and generalised weakness. Cancer diagnosed in the ED is associated with advanced stage and shorter survival. CONCLUSION Reasons for presentation to ED would be multifactorial and include complex cases with coexisting symptoms making diagnosis difficult. The general public appear to have a low level of awareness of alternative primary care services or difficulty accessing such information. Some of the changes towards reducing the number of patients presenting to ED will include patient education.
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Affiliation(s)
- Margaret J Rogers
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Leigh M Matheson
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia
| | - Brooke Garrard
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia
| | - Violet Mukaro
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia.,Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia
| | - Sue Riches
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia
| | - Michael Sheridan
- Emergency Department, Barwon Health, Geelong, Victoria, Australia
| | - David Ashley
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Geelong, Victoria, Australia.,Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia
| | - Graham Pitson
- Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.,Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia
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Wong SF, Matheson L, Morrissy K, Pitson G, Ashley DM, Khasraw M, Lorgelly PK, Henry MJ. Retrospective analysis of cancer survival across South-Western Victoria in Australia. Aust J Rural Health 2015; 24:79-84. [DOI: 10.1111/ajr.12203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Shu Fen Wong
- Department of Medicine; Barwon Health; Deakin University; Geelong Victoria Australia
- Andrew Love Cancer Centre; Barwon Health; Geelong Victoria Australia
| | - Leigh Matheson
- Barwon South Western Regional Integrated Cancer Services; Geelong Victoria Australia
| | - Kate Morrissy
- Barwon South Western Regional Integrated Cancer Services; Geelong Victoria Australia
| | - Graham Pitson
- Andrew Love Cancer Centre; Barwon Health; Geelong Victoria Australia
- Barwon South Western Regional Integrated Cancer Services; Geelong Victoria Australia
| | - David M. Ashley
- Department of Medicine; Barwon Health; Deakin University; Geelong Victoria Australia
- Andrew Love Cancer Centre; Barwon Health; Geelong Victoria Australia
- Barwon South Western Regional Integrated Cancer Services; Geelong Victoria Australia
| | - Mustafa Khasraw
- Andrew Love Cancer Centre; Barwon Health; Geelong Victoria Australia
| | - Paula K. Lorgelly
- Centre of Health Economics; Monash University; Melbourne Victoria Australia
| | - Margaret J. Henry
- Barwon South Western Regional Integrated Cancer Services; Geelong Victoria Australia
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