School of Population Health
Current research topic: Cancer epidemiology
Please find below a sample of current projects:
Comparison of different patient pathways to the diagnosis of melanomas in Waikato, New Zealand
Co-investigators: Dr Sally Ioannides (Eyers), Professor Mark Elwood, A/Prof Amanda Oakley, A/Prof Marius Rademaker
The incidence, prevalence and mortality rates of melanoma in New Zealand are amongst the highest in the world. New technology used in the diagnosis of melanoma and monitoring of suspicious skin lesions, such as dermoscopy and short-term sequential digital dermoscopy (“mole mapping”), have been shown to detect thinner lesions than regular diagnostic techniques and to improve diagnostic efficiency.
Focusing on the Waikato population, this study will compare different melanoma diagnostic pathways including the MoleMap screening process, the public referral Virtual Lesion Clinic (VLC), and other referrals.
The study will also assess the clinical outcomes of a cohort of patients screened by MoleMap in Waikato in 2010-1012 with a recommendation for biopsy. The results of this study will give an indication of the impact and efficacy of these different pathways, and will help to build evidence regarding the effectiveness of melanoma screening and diagnostic programmes.
Management of suspected cancer in primary care ICBP module 3 New Zealand web survey
Co-investigators: Dr Sally Ioannides (Eyers), Professor Mark Elwood, Professor Ross Lawrenson, Dr Tana Fishman
Cancer is the leading cause of death in New Zealand and the incidence is growing, largely due to the increasing and ageing population. Delays in cancer diagnosis and management can occur at any point on the patient pathway, impacting on both survival and inequities. The potential to improve cancer outcomes by improving management in primary care is being investigated in Module 3 of an international study, coordinated from the UK: the International Cancer Benchmarking Partnership (ICBP).
This study will be New Zealand’s first involvement with the ICBP project. The aim of this project is to explore the causes of diagnostic delays in cancer in primary care, and potential solutions, through the examination of systems for the management of suspected cancer in general practice including the behaviour, beliefs and attitudes of GPs when investigating symptoms of suspected cancer in New Zealand.
A national study of GPs will allow comparisons between different types of practice and of community. The study will explore potential barriers to primary care access as well as access to cancer investigations and specialist review, and will address GP knowledge and attitudes regarding the management of suspected cancer.
The Effect of Obesity on Aromotase Inhibitor Efficacy in Breast Cancer Treatment
Co-investigators: Dr Sally Eyers, Professor Mark Elwood, Dr Paula Barlow, Dr David Porter
Obesity is now defined as a global pandemic with over 1 billion adults classed as overweight and an additional 475 million defined as obese.
Obesity is associated with an increased risk and poorer prognosis in several types of cancer, including endometrial, colon and postmenopausal breast cancer. Adjuvant hormone therapy is a mainstay of treatment for receptor-positive breast cancer. Recent research has suggested that Aromatase Inhibitors (AIs), a type of hormonal therapy, may be less effective in obese women, possibly due to the greater amount of aromatase, which resides in peripheral fatty tissue. It has been speculated that obese women may require higher doses of AIs to achieve therapeutic levels of oestrogen suppression, however AIs are currently given as a standard dose irrespective of body weight or body surface area.
There are currently no systematic reviews on the effect of obesity on AI efficacy in breast cancer treatment, and there have been no specific therapy recommendations made for obese breast cancer sufferers.
This systematic review will look at prospective clinical trials and observational studies with an observed outcome relating to treatment efficacy, including mortality and risk of recurrence.