Marianne Weber

A comparison of Δ9-THC and anandamide induced c-fos expression in the rat forebrain

Abstract Rats were injected with the cannabinoid receptor agonists Δ9-THC (5 mg/kg) or anandamide (20 mg/kg) and assessed for changes in body temperature and locomotor activity. Their brains were then examined for the expression of the immediate early gene c-fos. Similar reductions in body temperature and locomotor activity were seen with Δ9-THC and anandamide although there was evidence, in line with previous reports, to suggest a shorter duration of action of anandamide. Δ9-THC and anandamide caused equally high levels of c-fos expression in the paraventricular nucleus of the hypothalamus and the lateral septum. Both drugs also increased c-fos expression in the central nucleus of the amygdala although the effect was greater with Δ9-THC. Only Δ9-THC caused significant increases in c-fos expression in the nucleus accumbens and caudate-putamen. These differences may be linked to differential activation of cannabinoid receptor subtypes or to differences in efficacy in activating second messenger systems linked to cannabinoid receptors. These findings complement evidence of qualitative differences in the actions of anandamide and Δ9-THC emerging from tests of drug discrimination, cross-tolerance, conditioned place preference and anxiety.

Population characteristics related to colorectal cancer testing in New South Wales, Australia: results from the 45 and Up Study cohort

Objective To compare the characteristics of people who utilize colorectal cancer screening tests with those who do not. Setting Self-reported questionnaire data from 15,900 women and 14,953 men aged 50 or over who had never had colorectal cancer were taken from the 45 and Up Study cohort in Australia in 2006. Methods A cross-sectional analysis of colorectal cancer test behaviour within the last five years by faecal occult blood test (FOBT), or by any test (FOBT, sigmoidoscopy or colonoscopy) was performed. Results A total of 36.2% of participants reported colorectal cancer testing and 17.9% reported having a FOBT. Both FOBT and any testing were reduced significantly in groups with the following attributes compared with the remaining population; ages 50–59 and 80+; female; no family history of colorectal cancer; lower education; lower income; not speaking English at home; lack of private health insurance; not being retired; not living with a partner and not having other screening tests. Compared with other participants, test uptake was particularly low among current smokers (relative risk 0.76, 95% CI 0.71–0.80), sedentary participants (0.71, 95% CI 0.66–0.77), those without fruit (0.77, 95% CI 0.71–0.84) or vegetables (0.79, 95% CI 0.69–0.90) in their daily diet and those with a disability (0.91, 95% CI 0.85–0.97). Compared with participants from major cities, outer regional area participants were significantly more likely to report a FOBT (1.31, 95% CI 1.23–1.39) however participants in remote areas were significantly less likely to have had any colorectal cancer test (0.75, 95% CI 0.67–0.85). Conclusion Subgroups of the Australian population may require targeted intervention to ensure equity in colorectal cancer screening.

Cancer screening among migrants in an Australian cohort; cross-sectional analyses from the 45 and Up Study

BackgroundLimited evidence suggests that people from non-English speaking backgrounds in Australia have lower than average rates of participation in cancer screening programs. The objective of this study was to examine the distribution of bowel, breast and prostate cancer test use by place of birth and years since migration in a large population-based cohort study in Australia.MethodsIn 2006, screening status, country of birth and other demographic and health related factors were ascertained by self-completed questionnaire among 31,401 (16,126 women and 15,275 men) participants aged 50 or over from the 45 and Up Study in New South Wales.Results35% of women and 39% of men reported having a bowel cancer test and 57% of men reported having a prostate specific antigen (PSA) test, in the previous 5 years. 72% of women reported having screening mammography in the previous 2 years. Compared to Australian-born women, women from East Asia, Southeast Asia, Continental Western Europe, and North Africa/Middle East had significantly lower rates of bowel testing, with odds ratios (OR; 95%CI) ranging from 0.5 (0.4–0.7) to 0.7 (0.6–0.9); migrants from East Asia (0.5, 0.3–0.7) and North Africa/Middle East (0.5, 0.3–0.9) had significantly lower rates of mammography. Compared to Australian-born men, bowel cancer testing was significantly lower among men from all regions of Asia (OR, 95%CI ranging from 0.4, 0.3–0.6 to 0.6, 0.5–0.9) and Continental Europe (OR, 95%CI ranging from 0.4, 0.3–0.7 to 0.7, 0.6–0.9). Only men from East Asia had significantly lower PSA testing rates than Australian-born men (0.4, 0.3–0.6). As the number of years lived in Australia increased, cancer test use among migrants approached Australian-born rates.ConclusionCertain migrant groups within the population may require targeted intervention to improve their uptake of cancer screening, particularly screening for bowel cancer.

Risk factors for erectile dysfunction in a cohort of 108 477 Australian men

Objectives: To quantify relationships between erectile dysfunction (ED), ageing and health and lifestyle factors for men aged 45 years and older.

Smoking cessation after cancer.

Freddy Sitas, Cancer Council New South Wales, Wooloomooloo; University of Sydney, Camperdown; and University of New South Wales, Kensington, New South Wales, Australia Marianne F. Weber, Cancer Council New South Wales, Wooloomooloo; and University of Sydney, Camperdown, New South Wales, Australia Sam Egger, Sarsha Yap, and May Chiew, Cancer Council New South Wales, Wooloomooloo, New South Wales, Australia Dianne O’Connell, Cancer Council New South Wales, Wooloomooloo; University of Sydney, Camperdown; University of New South Wales, Kensington; and University of Newcastle, Callaghan, New South Wales, Australia

Relationship between Lifestyle and Health Factors and Severe Lower Urinary Tract Symptoms (LUTS) in 106,435 Middle-Aged and Older Australian Men: Population-Based Study

Background Despite growing interest in prevention of lower urinary tract symptoms (LUTS) through better understanding of modifiable risk factors, large-scale population-based evidence is limited. Objective To describe risk factors associated with severe LUTS in the 45 and Up Study, a large cohort study. Design, Setting, and Participants A cross-sectional analysis of questionnaire data from 106,435 men aged ≥45 years, living in New South Wales, Australia. Outcome Measures and Statistical Analysis LUTS were measured by a modified version of the International Prostate Symptom Score (m-IPSS). The strength of association between severe LUTS and socio-demographic, lifestyle and health-related factors was estimated, using logistic regression to calculate odds ratios, adjusted for a range of confounding factors. Results Overall, 18.3% reported moderate, and 3.6% severe, LUTS. Severe LUTS were more common among men reporting previous prostate cancer (7.6%), total prostatectomy (4.9%) or having part of the prostate removed (8.2%). After excluding men with prostate cancer or prostate surgery, the prevalence of moderate-severe LUTS in the cohort (n = 95,089) ranged from 10.6% to 35.4% for ages 45–49 to ≥80; the age-related increase was steeper for storage than voiding symptoms. The adjusted odds of severe LUTS decreased with increasing education (tertiary qualification versus no school certificate, odds ratio (OR = 0.78 (0.68–0.89))) and increasing physical activity (high versus low, OR = 0.83 (0.76–0.91)). Odds were elevated among current smokers versus never-smokers (OR = 1.64 (1.43–1.88)), obese versus healthy-weight men (OR = 1.27 (1.14–1.41)) and for comorbid conditions (e.g., heart disease versus no heart disease, OR = 1.36 (1.24–1.49)), and particularly for severe versus no physical functional limitation (OR = 5.17 (4.51–5.93)). Conclusions LUTS was associated with a number of factors, including modifiable risk factors, suggesting potential targets for prevention.

Sociodemographic and health-related predictors of self-reported mammogram, faecal occult blood test and prostate specific antigen test use in a large Australian study

BackgroundWhile several studies have examined factors that influence the use of breast screening mammography, faecal occult blood tests (FOBT) for bowel cancer screening and prostate specific antigen (PSA) tests for prostate disease in Australia, research directly comparing the use of these tests is sparse. We examined sociodemographic and health-related factors associated with the use of these tests in the previous two years either alone or in combination.MethodsCross-sectional analysis of self-reported questionnaire data from 96,711 women and 82,648 men aged 50 or over in The 45 and Up Study in NSW (2006–2010).Results5.9% of men had a FOBT alone, 44.9% had a PSA test alone, 18.7% had both tests, and 30.6% had neither test. 3.2% of women had a FOBT alone, 56.0% had a mammogram alone, 16.2% had both and 24.7% had neither test. Among men, age and socioeconomic factors were largely associated with having both FOBT and PSA tests. PSA testing alone was largely associated with age, family history of prostate cancer, health insurance status and visiting a doctor. Among women, age, use of hormone replacement therapy (HRT), health insurance status, family history of breast cancer, being retired and not having a disability were associated with both FOBT and mammograms. Mammography use alone was largely associated with age, use of HRT and family history of breast cancer. FOBT use alone among men was associated with high income, living in regional areas and being fully-retired and among women, being fully-retired or sick/disabled.ConclusionsThese results add to the literature on sociodemographic discrepancies related to cancer screening uptake and highlight the fact that many people are being screened for one cancer when they could be screened for two.

Identifying high risk individuals for targeted lung cancer screening: Independent validation of the PLCOm2012 risk prediction tool

Lung cancer screening with computerised tomography holds promise, but optimising the balance of benefits and harms via selection of a high risk population is critical. PLCOm2012 is a logistic regression model based on U.S. data, incorporating sociodemographic and health factors, which predicts 6‐year lung cancer risk among ever‐smokers, and thus may better predict those who might benefit from screening than criteria based solely on age and smoking history. We aimed to validate the performance of PLCOm2012 in predicting lung cancer outcomes in a cohort of Australian smokers. Predicted risk of lung cancer was calculated using PLCOm2012 applied to baseline data from 95,882 ever‐smokers aged ≥45 years in the 45 and Up Study (2006–2009). Predictions were compared to lung cancer outcomes captured to June 2014 via linkage to population‐wide health databases; a total of 1,035 subsequent lung cancer diagnoses were identified. PLCOm2012 had good discrimination (area under the receiver‐operating‐characteristic‐curve; AUC 0.80, 95%CI 0.78–0.81) and excellent calibration (mean and 90th percentiles of absolute risk difference between observed and predicted outcomes: 0.006 and 0.016, respectively). Sensitivity (69.4%, 95%CI, 65.6–73.0%) of the PLCOm2012 criteria in the 55–74 year age group for predicting lung cancers was greater than that using criteria based on ≥30 pack‐years smoking and ≤15 years quit (57.3%, 53.3‐61.3%; p < 0.0001), but specificity was lower (72.0%, 71.7–72.4% versus 75.2%, 74.8–75.6%, respectively; p < 0.0001). Targeting high risk people for lung cancer screening using PLCOm2012 might improve the balance of benefits versus harms, and cost‐effectiveness of lung cancer screening.

Cancer incidence and mortality in people aged less than 75 years: changes in Australia over the period 1987-2007.

BACKGROUND Australia has one of the highest rates of cancer incidence worldwide and, despite improving survival, cancer continues to be a major public health problem. Our aim was to provide simple summary measures of changes in cancer mortality and incidence in Australia so that progress and areas for improvement in cancer control can be identified. METHODS We used national data on cancer deaths and newly registered cancer cases and compared expected and observed numbers of deaths and cases diagnosed in 2007. The expected numbers were obtained by applying 1987 age-sex specific rates (average of 1986-1988) directly to the 2007 population. The observed numbers of deaths and incident cases were calculated for 2007 (average of 2006-2008). We limited the analyses to people aged less than 75 years. RESULTS There was a 28% fall in cancer mortality (7827 fewer deaths in 2007 vs. 1987) and a 21% increase in new cancer diagnoses (13,012 more diagnosed cases in 2007). The greatest reductions in deaths were for cancers of the lung in males (-2259), bowel (-1797), breast (-773) and stomach (-577). Other notable falls were for cancers of the prostate (-295), cervix (-242) and non-Hodgkin lymphoma (-240). Only small or no changes occurred in mortality for cancers of the lung (female only), pancreas, brain and related, oesophagus and thyroid, with an increase in liver cancer (267). Cancer types that showed the greatest increase in incident cases were cancers of the prostate (10,245), breast (2736), other cancers (1353), melanoma (1138) and thyroid (1107), while falls were seen for cancers of the lung (-1705), bladder (-1110) and unknown primary (-904). CONCLUSIONS The reduction in mortality indicates that prevention strategies, improvements in cancer treatment, and screening programmes have made significant contributions to cancer control in Australia since 1987. The rise in incidence is partly due to diagnoses being brought forward by technological improvements and increased coverage of screening and early diagnostic testing.

Smoking in migrants in New South Wales, Australia: report on data from over 100,000 participants in the 45 and Up Study

INTRODUCTION AND AIMS Approximately 25% of the Australian population was born abroad, yet there has been very little tobacco control aimed at culturally and linguistically diverse communities and limited data exist on smoking among Australian migrants. The aim of this study was to compare smoking characteristics of Australian migrants (in terms of place of birth and age migrated) to those of Australian-born residents. DESIGN AND METHODS A cross-sectional analysis of self-reported questionnaire data from 53 207 women and 48 777 men aged 45 years or over in The 45 and Up Study in Australia (2006-2008) was performed. RESULTS 52.6% (95% confidence intervals 52.1-53.0) of men and 35.5% (35.1-35.9) of women reported ever being a regular smoker and 7.6% (7.4-7.8) and 7.3% (7.1-7.5) reported current smoking, respectively. Compared with Australian-born men, a higher proportion of men born in Europe, North Africa and the Middle East were current smokers, with odds ratios adjusted for age, income, education and place of residence (OR; 95% confidence intervals) ranging from 1.30 (1.16-1.45) to 1.96 (1.49-2.58). Compared with Australian-born women, a lower proportion of women from East (0.21; 0.12-0.36) and Southeast Asia (0.38; 0.26-0.54) were current smokers and a higher proportion of women from New Zealand (1.45; 1.17-1.79) and the UK/Ireland (1.25; 1.12-1.40) were current smokers. Among women born in Asia, the risk of smoking increased significantly the younger they migrated to Australia. Duration smoked and amount smoked per day were primarily lower among migrants than Australian-born. CONCLUSIONS Smoking prevalence varies substantially across cultural subgroups. Understanding smoking dynamics across diverse cultural groups will assist in better targeting of tobacco control programs.