A comprehensive evaluation of bladder cancer epidemiology and outcomes in Australia

OBJECTIVE: To review bladder cancer statistics and management in Australia and identify gaps for future work here. METHODS: Evidence was reviewed from GLOBOCAN 2008v2.0, Pubmed, and conference presentations. We also use data from reports from Cancer Council Australia, State Cancer Councils, and Australian Institute of Health and Welfare. RESULTS: The incidence and mortality rates of bladder cancer in Australia closely parallel those of other developed countries. Bladder cancer was the 8th most common cause of cancer in men, and the 17th most common cause of cancer in women. Bladder cancer was the 13th most common cause of cancer death in men, and the 17th most common cause of cancer death in women. We briefly review the evidence regarding causality, including nutritional, occupational, and environmental factors. We compare Australian incidence and mortality rates internationally, by state/territory, by socioeconomic strata, and by geographical regions. Importantly, we review evidence on the quality of bladder cancer management in Australia. CONCLUSIONS: The geographical, regional, and socioeconomic differences in Australian bladder cancer statistics may be associated with different patterns of diagnosis and treatment. IMPLICATIONS: The quality of bladder cancer surveillance and cystectomies in Australia requires improvement to conform to global standards and to improve decreasing survival rate

Positive lifestyle changes following urological cancer diagnoses – an Australian interview based study

© 2015, © Emerald Group Publishing Limited. Purpose – The purpose of this paper is to examine ethnic Australian urological cancer patients and the positive life changes that those patients report after cancer diagnosis. Design/methodology/approach – A sample of 50 Australian urological cancer patients of ethnic origin were chosen to participate in this study. One-on-one semi structured interviews were conducted with the patients. Findings – Cancer diagnosis often serves as an impetus for making positive lifestyle changes. Most (98 per cent) of this study’s participants reported that they made positive lifestyle changes following a diagnosis of cancer. Those positive lifestyle changes include: greater appreciation of health and life (100 per cent); improved diet (94 per cent); closer relationships with family and friends (90 per cent); more frequent visits to the doctor for check-ups (74 per cent); increased physical activity (48 per cent); starting a new hobby (36 per cent); greater knowledge about their health in general (32 per cent) and increased spirituality (22 per cent). Research limitations/implications – The limitation of this study is the small sample of patients with ethnic diversity specific to western Sydney. Larger multicentre studies across Australia are required to confirm the findings. Additionally, this study focused on positive life changes, because 98 per cent of the participants reported positive lifestyle changes after diagnosis. However, there are related negative health behaviour changes, which this study has not addressed in depth. Furthermore, a comparison between positive life changes of ethnic Australian patients’ against the experience of post cancer diagnosis of non-ethnic Australian patients could investigate this issue further and possibly provide further insight. Originality/value – The majority (98 per cent) of the participants report positive lifestyle changes following urological cancer diagnoses. The patient population of predominantly elderly (84 per cent), males (90 per cent) differs from the current literate which states that positive lifestyle changes (posttraumatic growth) are mainly found to be significantly correlated to being female, younger and non-white and greater event severity

EAES recommendations for the management of gastroesophageal reflux disease

BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most frequent benign disorders of the upper gastrointestinal tract. Management of GERD has always been controversial since modern medical therapy is very effective, but laparoscopic fundoplication is one of the few procedures that were quickly adapted to the minimal access technique. The purpose of this project was to analyze the current knowledge on GERD in regard to its pathophysiology, diagnostic assessment, medical therapy, and surgical therapy, and special circumstances such as GERD in children, Barrett's esophagus, and enteroesophageal and duodenogastroesophageal reflux. METHODS: The European Association of Endoscopic Surgery (EAES) has tasked a group of experts, based on their clinical and scientific expertise in the field of GERD, to establish current guidelines in a consensus development conference. The expert panel was constituted in May 2012 and met in September 2012 and January 2013, followed by a Delphi process. Critical appraisal of the literature was accomplished. All articles were reviewed and classified according to the hierarchy of level of evidence and summarized in statements and recommendations, which were presented to the scientific community during the EAES yearly conference in a plenary session in Vienna 2013. A second Delphi process followed discussion in the plenary session. RESULTS: Recommendations for pathophysiologic and epidemiologic considerations, symptom evaluation, diagnostic workup, medical therapy, and surgical therapy are presented. Diagnostic evaluation and adequate selection of patients are the most important features for success of the current management of GERD. Laparoscopic fundoplication is the most important therapeutic technique for the success of surgical therapy of GERD. CONCLUSIONS: Since the background of GERD is multifactorial, the management of this disease requires a complex approach in diagnostic workup as well as for medical and surgical treatment. Laparoscopic fundoplication in well-selected patients is a successful therapeutic option