Low Birth-weight in NSW, 1987: a Population-based Study

Summary: The New South Wales perinatal data collection was used to examine the association between low birth-weight and some of its potential risk factors. The study population comprised all recorded singleton births to residents of NSW in 1987. Low birth-weight infants were categorized as either small for gestational age (SGA) or preterm (less than 37 weeks). Risk factors were analyzed separately for these categories. The risk factors examined were primarily demographic or reproductive history variables. Univariate analysis and multivariate logistic regression were used to evaluate the risk factors. The factors associated with SGA birth were mainly demographic (maternal age, parity, marital status, socioeconomic status, and ethnic group) while those associated with preterm birth had more reproductive history variables (maternal age, parity, marital status, prior spontaneous abortion, prior induced abortion, prior stillbirth or neonatal death, sex of infant). A first antenatal visit after 12 weeks had a statistically significant but small effect on both SGA and preterm birth.     

Recent Negative Cytology Prior to Histologically Confirmed Carcinoma in Situ of the Cervix

Summary: Women with histologically confirmed carcinoma in situ of the cervix were studied within the records of the Victorian Cervical Cytology Registry. The prevalence of histologically confirmed carcinoma in situ during 1992 was 2.67 per 1,000 women screened. Thirty per cent (401 of 1,327) of the women with carcinoma in situ had negative cervical cytology reported during the 2 years prior to the diagnosis of carcinoma in situ and at least 49% (648 of 1,327) had negative cytology during the preceding 5 years. Adenocarcinoma in situ comprised 3.4% of all cases; these women were significantly older and more likely to have had a recent negative smear report than women with squamous carcinoma in situ. Fifty-five per cent of the women with squamous carcinoma in situ had HPV reported on the biopsy compared with only 27% of the women with adenocarcinoma in situ. Ten per cent of the women with carcinoma in situ had a past history of cytological or histological abnormality; this proportion did not vary by type of carcinoma in situ. This relatively high proportion of negative cytology in close proximity to a diagnosis of carcinoma in situ is to be expected if there is active treatment of lesser lesions and frequent screening of members of the community.     

Underutilization of radiotherapy for lung cancer in New South Wales,Australia

BACKGROUND:

Lung cancer is the leading cause of cancer death in most developed countries. Radiotherapy is important in its treatment, with an estimated optimal utilization rate between 45% and 68% at initial diagnosis. The objective of this study was to describe radiotherapy practice for lung cancer in New South Wales (NSW), Australia.

METHODS:

Patients with lung cancer were identified prospectively from the NSW Central Cancer Registry (CCR) from November 1, 2001 to December 31, 2002. Questionnaires were mailed to diagnosing and treating clinicians to obtain detailed information on diagnosis, staging, referrals, and treatment. The authors describe referral for and receipt of radiotherapy treatment.

RESULTS:

Of 1812 patients with lung cancer patients who were identified, 943 patients (52%) were referred for radiotherapy, 846 patients (47%) received a radiotherapy questionnaire, and 727 patients (40%) received radiotherapy. Compared with optimal radiotherapy, there was less curative radiotherapy to the primary site (20% actual vs 50% optimal), and there was more palliative radiotherapy to metastatic sites (36% actual vs 11% optimal). The greatest shortfall in radiotherapy use was observed in patients who had limited stage small cell lung cancer (46% actual vs 94% optimal). The use of combined‐modality treatment for stage III nonsmall cell lung cancer and for limited stage small cell lung cancer was uncommon.

CONCLUSIONS:

There is underutilization of radiotherapy for lung cancer in NSW, especially in small cell lung cancer. The use of combined‐modality treatment for potentially curable lung cancers is suboptimal. These issues have to be addressed to improve survival and quality of life for patients with lung cancer. Cancer 2010. © 2009 American Cancer Society.