Publications by authors named "Canfell K"

The coronavirus disease 2019 pandemic substantially impacted the delivery of cancer services and programs. Here we reviewed and synthesized the global scale and impact of pandemic-related delays and disruptions on cancer services, including diagnosis, diagnostic procedures, screening, treatment and supportive and palliative care. Based on data from 245 articles in 46 countries, we observed declines in the number of cancer screening participation (39.

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Australia's National Lung Cancer Screening Program will commence in July 2025, targeted at individuals aged 50-70 years with a 30 pack-year smoking history (equivalent to 20 cigarettes per day for 30 years), who either currently smoke or have quit within the past 10 years. We forecasted the number of screening-eligible individuals over the first 5 years of the program using data from the 2019 National Drug Strategy Household Survey and the 2022 Australian Bureau of Statistics population projections. Multiple imputation integrated with predictive modelling of future or unmeasured smoking characteristics was used to address missing data and, simultaneously, to project individuals' smoking histories to 2030.

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Background: Despite HPV vaccines' availability for over a decade, coverage across the US varies. While some states have tried to increase HPV vaccination coverage, most model-based analyses focus on national impacts. We evaluated hypothetical changes in HPV vaccination coverage at the national and state levels for California, New York, and Texas using a mathematical model.

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While HC2 and GP5+/6+ PCR-EIA were pivotal in test validation of new HPV assays, they represent the first generation of comparator tests based upon technologies that are not in widespread use anymore. In the current guideline, criteria for second-generation comparator tests are presented that include more detailed resolution of HPV genotypes. Second-generation comparator tests should preferentially target only the 12 genotypes classified as carcinogenic (IARC-group I), and show consistent non-inferior sensitivity for CIN2+ and CIN3+ and specificity for ≤CIN1 compared to one of the first-generations comparators, in at least three validation studies using benchmarks of 0.

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Objective: The coronavirus pandemic impacted health-seeking behaviour and access to primary care in Australia. We investigated factors associated with intention-to-attend and attendance of cervical screening during the pandemic, mainly in Victoria, Australia.

Methods: We used questionnaire and attendance data (Aug 2020-Nov 2022) from Compass-PLUS, a sub-study of the Compass randomized-controlled trial of Human Papillomavirus-based vs cytology-based screening.

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Article Synopsis
  • The study evaluates strategies for colorectal cancer (CRC) surveillance in individuals with familial CRC risk, comparing different methods of colonoscopy and fecal testing.
  • The optimal strategy identified is a combination of 10-yearly colonoscopy and 2-yearly FIT from ages 40 to 80, which enhances life quality and reduces costs.
  • This approach not only prevents more CRC deaths but also significantly decreases the number of colonoscopies required compared to current guidelines.
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Objective: Australia's National Bowel Cancer Screening Program (NBCSP) offers two-yearly screening to 50-74-year-olds for the prevention and early detection of colorectal cancer (CRC). Internationally, detailed reporting of participation across multiple screening rounds - also known as longitudinal adherence - is becoming more common, but remains limited in Australia. We described the longitudinal screening adherence of individuals by age and sex invited to the NBCSP at least once, and quantified longitudinal adherence among individuals who received four NBCSP invitations.

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Objective: Improvement in cancer survival over recent decades has not been accompanied by a narrowing of socioeconomic disparities. This study aimed to quantify the loss of life expectancy (LOLE) resulting from a cancer diagnosis and examine disparities in LOLE based on area-level socioeconomic status (SES).

Methods: Data were collected for all people between 50 and 89 years of age who were diagnosed with cancer, registered in the NSW Cancer Registry between 2001 and 2019, and underwent mortality follow-up evaluations until December 2020.

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  • Australia has seen rising rates of multiple myeloma (MM) incidence and mortality, prompting research into survival trends across different treatment eras from 1985 to 2015.
  • A study of over 11,500 individuals showed a marked improvement in 5-year relative survival rates, increasing from 31.0% in 1985-1995 to 56.1% in 2008-2015, especially among those diagnosed under 70 years old.
  • Despite advancements in treatment leading to better overall survival, older patients (70+) still face poorer outcomes, highlighting the need for ongoing research and targeted therapies for this age group.
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Article Synopsis
  • - The study analyzes changes in multiple myeloma incidence and mortality rates in Australia from 1982-2018 and makes projections for 2019-2043 using population-based statistical models.
  • - Results show that the incidence of multiple myeloma increased by 1.9% annually from 2006-2018, while the mortality rate decreased by 0.4% annually from 1990-2018.
  • - Projections indicate a 14.9% increase in incidence and a 27.5% decrease in mortality rates by 2043, with a significant rise in the number of people living with multiple myeloma expected to reach 27,093, up from 10,288
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Background: Despite HPV vaccines' availability for over a decade, coverage across the US varies. While some states have tried to increase HPV vaccination coverage, most model-based analyses focus on national impacts. We evaluated hypothetical changes in HPV vaccination coverage at the national and state levels for California, New York, and Texas using a mathematical model.

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Article Synopsis
  • The study aimed to investigate self-reported out-of-pocket health care expenses among Australians aged 45 and older, focusing on differences based on cancer status and various socio-demographic factors.
  • It involved a cross-sectional design, utilizing data from the 45 and Up Study participants in New South Wales who completed a follow-up questionnaire in 2020, linked to cancer registry data.
  • Results showed that 42.7% of respondents reported out-of-pocket expenses over $1000 in the previous year, with higher rates among those diagnosed with cancer, particularly in the last two years, and those with higher socioeconomic status or private health insurance.
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Article Synopsis
  • This study evaluates how preferences for genetic and genomic risk-tailored chronic disease screening affect public acceptance and participation in these programs.
  • A systematic review found 12 studies, primarily focusing on cancer screening and preferences for rare genetic variants, identifying 26 program attributes that influence decisions, with survival rates and test accuracy being the most critical factors.
  • The conclusion suggests that effective communication about potential benefits and test reliability can significantly enhance the willingness of individuals to engage in these screening programs.
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The U.S.-affiliated Pacific Islands (USAPI) have higher cervical cancer incidence and mortality rates and lower screening coverage compared with the United States.

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During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19.

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Aim: Large-scale studies investigating health-related quality of life (HRQL) in cancer survivors are limited. This study aims to investigate HRQL and its relation to optimism and social support among Australian women following a cancer diagnosis.

Methods: Data were from the Australian Longitudinal Study on Women's Health, a large cohort study (n = 14,715; born 1946-51), with 1428 incident cancer cases ascertained 1996-2017 via linkage to the Australian Cancer Database.

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Background: Weighting can improve study estimate representativeness. We examined the impact of weighting on associations between participants' characteristics and cancer, cardiovascular and all-cause mortality in the Australian 45 and Up Study cohort.

Methods: Raking weighted cohort data to the 2006 Australian population for seven sociodemographic characteristics.

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COVID-19 disrupted cancer control worldwide, impacting preventative screening, diagnoses, and treatment services. This modelling study estimates the impact of disruptions on colorectal cancer cases and deaths in Canada and Australia, informed by data on screening, diagnosis, and treatment procedures. Modelling was used to estimate short- and long-term effects on colorectal cancer incidence and mortality, including ongoing impact of patient backlogs.

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Background And Aims: Systematic reviews of the relationship between alcohol consumption and all-cause mortality have reported different relative risk (RR) curves, possibly due to the choice of reference group. Results have varied from 'J-shaped' curves, where low-volume consumption is associated with reduced risk, to monotonically increased risk with increasing consumption. We summarised the evidence on alcohol consumption and all-cause mortality exclusively from systematic reviews using lifetime abstainers or low-volume/occasional drinkers as the reference group.

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Article Synopsis
  • The study projects premature mortality rates in Australia until 2044, revealing a significant decrease in age-standardized rates but an increase in total premature deaths due to an aging population.
  • It found a 44.4% decrease in rates from 1990-1994 to 2015-2019, with predictions of a 12.7% further decline by 2044, yet total deaths are expected to rise from 272,815 to 334,894.
  • Cancer is forecasted to remain the leading cause of premature deaths, emphasizing the need for targeted public health strategies in Australia.
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Background: The burden of cancer can be altered by screening. The field of cancer screening is constantly evolving; from the initiation of program for new cancer types as well as exploring innovative screening strategies (e.g.

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  • This study evaluates the cost-effectiveness of combined genomic screening for high-risk conditions in young adults in Australia, comparing it to existing clinical testing methods.
  • The intervention could prevent significant morbidity and mortality, estimating around 31,094 quality-adjusted life years (QALYs) gained by identifying and managing risks for various cancers and coronary heart disease.
  • While the upfront cost of implementing the screening for 50% of the population is AU$832 million, the potential health benefits suggest that this approach could be a valuable investment for the public healthcare system.
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To support a strategy to eliminate cervical cancer as a public health problem, the World Health Organisation (WHO) reviewed its guidelines for screening and treatment of cervical pre-cancerous lesions in 2021. Women living with HIV have 6-times the risk of cervical cancer compared to women in the general population, and we harnessed a model platform ('Policy1-Cervix-HIV') to evaluate the benefits and harms of a range of screening strategies for women living with HIV in Tanzania, a country with endemic HIV. Assuming 70% coverage, we found that 3-yearly primary HPV screening without triage would reduce age-standardised cervical cancer mortality rates by 72%, with a number needed to treat (NNT) of 38.

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In 2020, the World Health Organization (WHO) launched a strategy to eliminate cervical cancer as a public health problem. To support the strategy, the WHO published updated cervical screening guidelines in 2021. To inform this update, we used an established modeling platform, Policy1-Cervix, to evaluate the impact of seven primary screening scenarios across 78 low- and lower-middle-income countries (LMICs) for the general population of women.

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