Western Australian Institute for Medical Research (WAIMR)


http://www.waimr.uwa.edu.au

Cancer Epidemiology

The Epidemiology Unit studies the causes and patterns of cancer in human populations. We are involved in a broad range of studies covering most aspects of cancer epidemiology.

A particular interest is occupational causes of cancer. We study people in particular occupations (particularly heavy industries) and follow them to see if they are at increased risk of cancer. Other types of studies involve comparing the work histories of people with and without cancer. If a particular work exposure causes cancer, we expect to see more people in that job who have cancer than who don't have cancer. Currently we have studies running on prostate cancer, colorectal cancer, non-Hodgkin lymphoma and childhood leukaemia and brain cancer. In order to improve the methods used in these types of studies we are developing new tools for assessing work histories using cutting-edge computer technologies.

In addition, we use large databases to investigate the treatment and outcomes of people with cancer. For example, we look at whether treatment follows recommended guidelines, whether rural people with cancer are getting the same access to treatment as city dwellers, and how inequities could be improved. We also look at links between cancer and other diseases. These associations often suggest new areas of investigation for exploring causes or prevention of cancer.

Senior Research Staff

Lin Fritschi A/Professor Lin Fritschi

Head, Cancer Epidemiology

Research: occupational causes of cancer; exposure assessment in epidemiological studies

Research Details

WA Bowel Health Study (WABOHS) - funded by NHMRC

Bowel cancer is the second most commonly diagnosed cancer in Australians, after non-melanocytic skin cancer. About 10% of bowel cancers can be linked to a family history or genetics. The remaining 90% are thought to be linked to environmental and lifestyle factors, although it is not clear what factors are most involved. Many research studies have inconsistent findings, which we believe is because there are actually different causes of cancers in the different sides (left versus right) of the large bowel.

The goal of the WA Bowel Health Study (WABOHS) is to identify the environmental and lifestyle factors that may contribute specifically to the development of bowel cancer in different areas of the large bowel. We are also interested in the interactions between these lifestyle factors and low-risk genes that may lead to cancer in different areas of the large bowel.

This study will help clarify the role of a range of risk factors in bowel cancer. Hence it will help us develop a way of reducing this cancer in the community.

Prostate Health Study - funded by Healthway and the BUPA Foundation

During 2001/02 over 1000 men participated in a case control study in which we sought to examine a range of biological, environmental and lifestyle risk factors for prostate cancer and Benign Prostatic Hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate which can block the bladder outlet causing urinary tract symptoms. Having a father or brother with prostate cancer and having a diet high in foods such as white bread, red meat, chips and sugar were both found to be significant risk factors for developing prostate cancer. There was also some evidence to suggest that Vietnam veterans were at an increased risk, however the small number of veterans participating in this study limited the conclusions which could be made. Surprisingly, our study found that men who were significantly overweight were less likely to develop the disease. This result may reflect the difficultly in detecting early prostate cancer in men who are overweight compared with thinner men. Other lifestyle and environmental exposures such as regular participation in physical activity, testosterone levels, occupational exposure to toxic metals, pesticides and diesel exhaust were not found to be related to prostate cancer.

In this study only age was found to be a significant risk factor for having surgically treated BPH. The conclusion that has been drawn from this study and previous work is that BPH may be a natural part of ageing for men, similar to menopause in women.

Collaborators and staff: Justine Leavy, Gina Ambrosini, Deborah Glass, Anna Timperio, Jafar Tabrizi, Jennifer Girschik

Other case-control studies

We are involved with a number of other case-control studies in Australia. For many of these, there is a primary interest in occupational exposures. The cancers being studied include: non-Hodgkin lymphoma, pancreatic cancer, childhood leukaemia, and childhood brain cancer.

OccIDEAS - funded by NHMRC

Occupational exposures to different chemical, biological and physical agents amongst workers are very common. Other than a few carcinogens, we know very little about the thousands of harmful agents present at workplaces. OccIDEAS is occupational intelligent database assessment software, which offers a modern solution to the traditional assessment processes performed by occupational experts. The massive data which results from hundreds of agent exposure in many jobs traditionally is managed manually. This is a very lengthy, rigid and inflexible system and can lead to inconsistencies in the assessments and consequently unreliable results.

What OccIDEAS provide is a web based software application designed for multiple users at different levels in the assessment process, with incorporated automatic assessment functionalities. It is a comprehensive and very flexible system, which provide extensive range of functionalities and can be tailored easily according to the user's needs. It has been designed for multiple users from the study manager through the interviewer to the expert assessor to manage all facets of the exposure assessment workflow, including: selection and retrieving of appropriate questions; interviewer interface; questionnaire data storage; extraction of questionnaire data; questionnaire data viewing interface; exposure assessment interface; and exposure data storage. All users can easily access the information they need in the comfort of a contemporary software application. The ultimate aim of this project is to develop a collaborative virtual international community of occupational researchers where all data can be accessed and processed in an accessible, cheaper, user friendly way which is portable across studies. It brings a novel approach to occupational agent exposure assessment, combining computer technology with sophisticated algorithms designed to learn from experience.

Collaborators and staff: Troy Sadkowsky, Amitava Datta, Agnes Gyalai-Korpos, Jennifer Girschik

2006 Publications

  1. Lawler SP, Kvaskoff M, DiSipio T, Whiteman D, Eakin E, Aitken J, Fritschi L. 2006. Solaria use in Queensland, Australia. Aust N Z J Public Health. 30(5):479-82. [NCBI PubMed Entry] [IF 0.976]
  2. Eakin E, Youlden D, Baade P, Lawler S, Reeves M, Heyworth J, Fritschi L. 2006. Health status of long-term cancer survivors: Results from an Australian population-based sample. Cancer Epidemiology Biomarkers and Prevention 15:1969-76. [NCBI PubMed Entry] [IF 4.460]
  3. DiSipio T, Rogers C, Newman B, Whiteman D, Eakin E, Fritschi L, Aitken J. 2006. The Queensland Cancer Risk Study: behavioural risk factor results. Aust N Z J Public Health. 30:375-82. [NCBI PubMed Entry] [IF 0.976]
  4. Williams H, Fritschi L, Katris P, Beauchamp C. 2006. Evaluating the usefulness of self-reported risk factors in a skin cancer screening program. Melanoma Research 16:341-345. [NCBI PubMed Entry] [IF 1.534]
  5. Alfonso HS, Fritschi L, de Klerk NH, Ambrosini GL, Beilby J, Olsen N, William Musk A. 2006. Plasma vitamin concentrations and incidence of mesothelioma and lung cancer in individuals exposed to crocidolite at Wittenoom, Western Australia. Eur J Cancer Prev. 15:290-294. [NCBI PubMed Entry] [IF 1.764]
  6. Mitchell KJ, Fritschi L, Reid A, McEvoy SP, Ingram DM, Jamrozik K, Clayforth C, Byrne MJ. 2006. Rural-urban differences in the presentation, management and survival of breast cancer in Western Australia. Breast 15:769-776. [NCBI PubMed Entry] [IF 1.705]
  7. Vajdic CM, Grulich AE, Kaldor JM, Fritschi L, Benke G, Hughes AM, Kricker A, Turner JJ, Milliken S, Armstrong BK. 2006. Specific infections, infection-related behaviour, and risk of non-Hodgkin lymphoma in adults. Cancer Epidemiology Biomarkers and Prevention 15:1102-1108. [NCBI PubMed Entry] [IF 4.460]
  8. Fritschi L, Driscoll TR. 2006. Cancer due to occupation in Australia. Australia and New Zealand Journal of Public Health 30(3):213-219. [NCBI PubMed Entry] [IF 0.976]
  9. Segarajasingam DS, Ang EBH, Fritschi L, Foster NM, Mendelson RM, Forbes GM. 2006. Seasonal variation of participation in colorectal neoplasia screening by colonoscopy or CT colonography (Letter). Australian and New Zealand Journal of Public Health 30:287-288. [NCBI PubMed Entry]< [IF 0.976]
  10. Forbes G and the Multicentre Australian Colorectal-neoplasia Screening (MACS) Group. 2006. A comparison of colorectal neoplasia screening tests - a multicentre community based study of the impact of consumer choice. Medical Journal of Australia 184:546-550. [NCBI PubMed Entry] [IF 2.127]
  11. Fritschi L, Dye SA, Katris P. 2006. Validity of melanoma diagnosis in a community based screening program. American Journal of Epidemiology 164(4):385-90. [NCBI PubMed Entry] [IF 5.068]
  12. Fritschi L, Day LM, Shirangi A, Robertson ID, Lucas M, Vizard AL. 2006. Injury in Australian veterinarians. Occupational Medicine 56:199-203. [NCBI PubMed Entry] [IF 1.127]
  13. Leavy J, Fritschi L, Ambrosini G. 2006. Vietnam military service history and prostate cancer. BMC Public Health 6:75. [NCBI PubMed Entry] [IF 1.658]
  14. Baade P, Fritschi L, Eakin E. 2006. Non-cancer causes of death in people with cancer. Cancer Causes and Control 17(3):287-297. [NCBI PubMed Entry] [IF 3.195]
  15. Wilson P, Sexton W, Singh A, Smith M, Durham S, Cowie A, Fritschi L. 2006. Family experiences of tissue donation in Australia. Progress in Transplantation 16:52-56. [NCBI PubMed Entry]
  16. Williams HA, Fritschi L, Reid A, Beauchamp C, Katris P. 2006. Who attends skin cancer screening in Western Australia? Results from the Lions Cancer Institute Skin Cancer Screening Program Australia and New Zealand. Journal of Public Health 30:75-80. [NCBI PubMed Entry] [IF 0.976]

2007 Publications

  1. Eakin EG, Youlden DR, Baade PD, Lawler SP, Reeves MM, Heyworth JS, Fritschi L. 2007. Health behaviors of cancer survivors: Data from an Australian population-based survey. Cancer Causes & Control 18(8):881-94. [NCBI PubMed Entry]
  2. Fritschi L, Divitini M, Talbot-Smith A, Knuiman M. 2007. Left-handedness and risk of breast cancer. British Journal of Cancer 97(5):686-7. [NCBI PubMed Entry]
  3. Karipidis KK, Benke G, Sim M, Kauppinen T, Kricker A, Hughes AM, Grulich AE, Vajdic CM, Kaldor J, Armstrong BK, Fritschi L. 2007. Occupational exposure to ionizing and non-ionizing radiation and risk of non-Hodgkin lymphoma. International Archives of Occupational and Environmental Health 80(8):663-70. [NCBI PubMed Entry] [IF 1.482]
  4. Fritschi L, Tabrizi J, Leavy J, Ambrosini G, Timperio A. 2007. Risk factors for surgically treated benign prostatic hyperplasia in Western Australia. Public Health 121(10):781-9. [NCBI PubMed Entry] [IF 0.986]
  5. Clayforth C, Fritschi L, Byrne MJ, McEvoy S, Ingram D, Sterrett J, Harvey JM, Joseph D, Jamrozik K. 2007. Five-year survival from breast cancer in Western Australia over a decade. The Breast 16(4):375-81. [NCBI PubMed Entry] [IF 1.705]
  6. Morris M, Platell C, Fritschi L, Iacopetta B. 2007. Failure to complete adjuvant chemotherapy is associated with adverse survival in stage III colon cancer patients. British Journal of Cancer 96(5):701-7. [NCBI PubMed Entry] [IF 4.115]
  7. Carrière P, Baade P, Fritschi L. 2007. Population-based incidence and age distribution of spermatocytic seminoma. The Journal of Urology 178(1):125-8. [NCBI PubMed Entry] [IF 3.592]
  8. Vajdic CM, Fritschi L, Grulich AE, Kaldor JM, Benke G, Hughes AM, Kricker A, Turner JJ, Miliken S, Goumas C, Armstrong BK. 2007. Atopy, exposure to pesticides and risk of non-Hodgkin lymphoma. International Journal of Cancer 120(10):2271-4. [NCBI PubMed Entry] [IF 4.700]
  9. Mina K, Fritschi L, Knuiman M. 2007. A valid semiquantitative food frequency questionnaire to measure fish consumption. European Journal of Clinical Nutrition 61(8):1023-31. [NCBI PubMed Entry] [IF 2.163]
  10. Lynch BM, Baade P, Fritschi L, Leggett B, Owen N, Newman B, Aitken JF. 2007. Modes of presentation and pathways to diagnosis of colorectal cancer in Queensland. Medical Journal of Australia 186(6):288-91. [NCBI PubMed Entry] [IF 2.127]
  11. Fritschi L, Glass DC, Tabrizi J, Leavy JE, Ambrosini GL. 2007. Occupational risk factors for prostate cancer and benign prostatic hyperplasia: A case-control study in Western Australia. Occupational and Environmental Medicine 64(1):60-5. [NCBI PubMed Entry] [IF 2.255]
  12. Shirangi, A, Fritschi L, Holman CD. 2007. Prevalence of occupational exposures and protective practices in Australian female veterinarians. Australian Veterinary Journal 85(1-2):32-8. [NCBI PubMed Entry] [IF 0.587]
  13. Karipidis KK, Benke G, Sim M, Fritschi L, Yost M, Armstrong BK, Hughes AM, Vajdic CM, Grulich AE, Milliken S, Kaldor J, Kricker A. 2007. Occupational exposure to power frequency magnetic fields and risk of non-Hodgkin lymphoma. Occupational and Environmental Medicine 64(1):25-9. [NCBI PubMed Entry] [IF 2.255]
  14. Reid A, Berry G, de Klerk N, Hansen J, Heyworth J, Ambrosini G, Fritschi L, Olsen N, Merler E, Musk AW. 2007. Age and sex differences in malignant mesothelioma after residential exposure to blue asbestos (crocidolite). Chest 131(2):376-82. [NCBI PubMed Entry] [IF 4.008]
  15. Baade P, Fritschi L, Freedman DM. 2007. Mortality due to amyotrophic lateral sclerosis and Parkinson's disease among melanoma patients in Australia. Neuroepidemiology 28(1):16-20. [NCBI PubMed Entry] [IF 2.602]