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CCV Seminar Series

Date(s): 6 Jun 2017
Time: 12 pm - 1:00 pm
Location: 615 St Kilda Road, Melbourne (Meeting Room 312 & 313)

Rebecca Bergin, Senior Research Officer, Cancer Council Victoria

How does time to treatment and symptoms compare for rural and urban colorectal cancer patients in Victoria?

Aim: Investigate colorectal cancer time intervals (patient, primary care, diagnostic, treatment and total intervals) and symptoms by area of residence. Methods: Cross-sectional survey assessing symptoms, presentation routes and dates to treatment from patients, GPs and specialists for Module 4 of the International Cancer Benchmarking Project. The Victorian Cancer Registry contacted patients aged over 40, 5-7 months post-diagnosis. GPs and specialists were sent a survey with patients' consent. Quantile regression for count data examined differences by area of residence for time intervals at the median, 75th and 90th percentiles, adjusting for age, gender, insurance and socio-economic status.
Results: 433 patients (48% rural), 289 GPs and 144 specialists returned surveys (consent rate: 41%, 75%, 35% respectively). Common symptoms in the 78% symptomatic cases were blood in stool (39%), change in bowel habit (34%), stomach pain (30%) and weight loss (16%). Significantly more rural than urban patients noted fatigue (39% vs 28%, p=.03). Rural symptomatic cases showed a longer total interval at all percentiles (median 23 days; 75th 53 days; 90th 38 days), and 90th percentile of the diagnostic interval (48 days). Combining data for symptomatic and screen-detected cases, the total interval was significantly longer for rural than urban cases in the 75th and 90th (30 days; 60 days), and 90th percentile of the diagnostic interval (47 days).
Conclusions: Rural and urban patients reported similar symptoms. Adjusting for important confounders, rural residence was associated with longer total and diagnostic interval quantiles.

Rebecca Bergin, Senior Research Officer, Cancer Council Victoria

Levers and challenges to national cancer policy development and implementation: key informant perspectives

Aim: To investigate levers and challenges for cancer health service policy or program development and implementation: in Australia, Canada, New Zealand, Scotland and Denmark.
Methods: Semi-structured interviews were conducted with key informants (KI) identified through author contacts and snowballing. KIs were sent a transcript of the interview for additional comments or corrections. A realist thematic analysis was performed to explore the interaction of context, mechanisms and outcomes.
Results: Thirteen KIs participated in interviews (average: 41mins). KI roles included program managers, clinical leaders, advocacy experts and senior researchers. Factors leveraging cancer policy change included advocacy from organisations, consumers and the media; strong leadership; clear program aims and adaptability. Research evidence was essential in identifying the problem, lack of progress or opportunity for improvement. Evidence used included benchmarking, modelling and use of research networks. Stakeholder engagement was also essential, but could be particularly challenging when introducing clinicians to new evidence. Contextual factors also played a role, including complexity in health systems, political change or policy priorities, and global or local financial or resource constraints. KIs also identified that initiatives had long development timelines, and perceived that access to decision-makers was easier in smaller countries.
Conclusions: A range of program levers, challenges and contextual factors influence cancer care policy development and implementation.

Tahlia Williams, Research Officer, Cancer Council Victoria

Secondary school students' response to the ban on the secondary supply of alcohol in Victoria

Aim: To examine changes in Victorian students' sources for alcohol and perceived ease of accessing alcohol from different sources subsequent to the introduction of secondary supply legislation.
Methods: Cross-sectional survey of 12-to-17-year-old Victorian students conducted in 2011 (n=4413) and 2014 (n=4576). Students completed anonymous, self-report surveys. Questions assessed use of alcohol, perceived ease of access from different sources, how the student's last alcoholic drink was accessed and access to alcohol without parent/guardian permission.
Results: Of ever drinkers, the proportion obtaining their last drink from someone other than a parent decreased from 13% before, to 9% after, the ban on secondary supply (p<0.05). Conversely, the proportion who obtained their alcohol from a parent/guardian increased (41% in 2011 to 51% in 2014; p<0.01). Perceived ease of access from a stranger also decreased from 45% before, to 37% after the ban (p<0.01). Of students who obtained alcohol from someone other than a parent and who were categorised as a risky drinker (five or more drinks on at least one occasion in the past week), 64% in 2011 compared to 59% in 2014 reported they did not have parent/guardian permission however this difference was not significant (p=0.20).
Conclusions: Students most commonly obtained alcoholic drinks from their parents/guardians, and the proportion doing so increased after the ban. Further research is needed to explore the relationship between secondary supply and drinking behaviour.


Updated: 30 May, 2017