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Spatial modelling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the PRISMA guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modelling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modelling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations.

Background: This study quantified differences in remaining life expectancy (RLE) among Aboriginal and Torres Strait Islander and other Australian patients with cancer. We assessed how much of this disparity was due to differences in cancer and noncancer mortality and calculated the population gain in life years for Aboriginal and Torres Strait Islanders cancer diagnoses if the cancer survival disparities were removed. Methods: Flexible parametric relative survival models were used to estimate RLE by Aboriginal and Torres Strait Islander status for a population-based cohort of 709,239 persons (12,830 Aboriginal and Torres Strait Islanders), 2005 to 2016. Results: For all cancers combined, the average disparity in RLE was 8.0 years between Aboriginal and Torres Strait Islanders (12.0 years) and other Australians (20.0 years). The magnitude of this disparity varied by cancer type, being >10 years for cervical cancer versus Conclusions: A cancer diagnosis exacerbates the existing disparities in RLE among Aboriginal and Torres Strait Islanders. Addressing them will require consideration of both cancer-related factors and those contributing to noncancer mortality. Impact: Reported survival-based measures provided additional insights into the overall impact of cancer over a lifetime horizon among Aboriginal and Torres Strait Islander peoples.

Our study measures the impact of diagnosing cancers early before they metastasise on reducing the burden of cancer death. A cohort of 716 501 people aged 15 to 89 years diagnosed with a solid cancer in New South Wales, Australia, during 1985 to 2014 were followed-up to December 2015. Crude probabilities of cancer death by stage at diagnosis were calculated for all solid cancers combined and five individual cancers using flexible parametric relative survival models. These probabilities were used to estimate the number of avoided cancer deaths within 10 years of diagnosis in three 10-year diagnostic periods if all cases with known distant stage were instead diagnosed at an earlier stage. Cancers are known to be diagnosed at distant stage composed ~16% of all solid cancers diagnosed during 2005 to 2014. Assuming all these cases were instead diagnosed at regional stage, an annual average of 2064 cancer deaths would have been potentially avoided within 10 years of diagnosis. This equated to ~21% of modelled observed deaths. Alternatively, if half of all known distant cases diagnosed during 2005 to 2014 were diagnosed as regional and half as localised, the average number of deaths avoided per year would increase to 2677 (~28%). Estimates varied by diagnostic period, sex and cancer type, reflecting both the different stage distributions for the cancer types, and the respective survival differences between cancer stages. While prevention is the most effective pillar of cancer control, these findings quantify the potential benefits of diagnosing all cancer types when they are less advanced to reduce the burden of cancer mortality.

Of the various less-than-comfortable narrative strands of the status quo that the COVID-19 pandemic has succeeded in showing up in stark relief—our rather troubling (if somewhat half-hearted) complacence about the systemic blind-spots that continue to colour the prevailing culture of a clearly inequitable higher education policy-framework—easily features among the most worrying, and thus, among those precise pulse-points that carry tremendous potential to help build the post-pandemic reset better, stronger and palpably fairer.1 In this piece, the authors endeavour to elaborate upon this and supplement the same with a brief analysis of India’s year-old National Education Policy, 20202—and how this nation (India) of more than 1.3 billion,3 supposedly poised on the cusp of a massive self-reinvention—is attempting to embark upon this journey.

Rare cancers collectively account for around a quarter of cancer diagnoses and deaths. However, epidemiological studies are sparse. We describe spatial and geographical patterns in incidence and survival of rare cancers across Australia using a population-based cancer registry cohort of rare cancer cases diagnosed among Australians aged at least 15 years, 2007 to 2016. Rare cancers were defined using site- and histology-based categories from the European RARECARE study, as individual cancer types having crude annual incidence rates of less than 6/100 000. Incidence and survival patterns were modelled with generalised linear and Bayesian spatial Leroux models. Spatial heterogeneity was tested using the maximised excess events test. Rare cancers (n = 268 070) collectively comprised 22% of all invasive cancer diagnoses and accounted for 27% of all cancer-related deaths in Australia, 2007 to 2016 with an overall 5-year relative survival of around 53%. Males and those living in more remote or more disadvantaged areas had higher incidence but lower survival. There was substantial evidence for spatial variation in both incidence and survival for rare cancers between small geographical areas across Australia, with similar patterns so that those areas with higher incidence tended to have lower survival. Rare cancers are a substantial health burden in Australia. Our study has highlighted the need to better understand the higher burden of these cancers in rural and disadvantaged regions where the logistical challenges in their diagnosis, treatment and support are magnified.

We develop a general formalism to study the reflection of radio waves, generated by ultra high energy cosmic ray events, from the Antarctic ice surface. Our formalism is based on plane wave decomposition of spherical waves and is applicable to the observations made by the ANITA detector. We find that our numerical result shows good agreement with the calibration data obtained by the High-Altitude Calibration (HiCal) experiment. ce features such as the local sastrugi. We incorporate these roughness models to investigate whether the non-uniform surface roughness of Antarctica can explain these anomalous events.

Objective Despite Australia’s National Cervical Screening Program, Indigenous women have a disproportionately high burden of cervical cancer. We describe temporal and area-level patterns in prevalence of histologically conformed high-grade cervical abnormalities (hHGA) among cytologically screened women by Indigenous status. Methods This was a population-based study of 2,132,925 women, aged 20–69, who underwent cervical screening between 2008 and 2017, in Queensland, Australia. Of these, 47,136 were identified as Indigenous from linked hospital records. Overall patterns in hHGA prevalence by Indigenous status were quantified using prevalence rate ratios (PrRR) from negative binomial models. Bayesian spatial models were used to obtain smoothed prevalence estimates of hHGA across 528 small areas compared to the state average. Results are presented as maps and graphs showing the associated uncertainty of the estimates. Results Overall, screened Indigenous women had significantly higher hHGA prevalence than non-Indigenous women. However, the magnitude of the difference reduced over time ( p Conclusions While the temporal reduction in Indigenous: non-Indigenous differential in hHGA prevalence is encouraging, further research into the key drivers of the continuing higher risk among Indigenous women is warranted.

Background: This study quantifies the number of potentially “avoided”cancer deaths due to differences in 10-year relative survival between three time periods, reflecting temporal improvements in cancer diagnostic and/or treatment practices in Australia. Methods: National population-based cohort of 2,307,565 Australians ages 15 to 89 years, diagnosed with a primary invasive cancer from 1985 to 2014 with mortality follow-up to December 31, 2015. Excess mortality rates and crude probabilities of cancer deaths were estimated using flexible parametric relative survival models. Crude probabilities were then used to calculate “avoided cancer deaths” (reduced number of cancer deaths within 10 years of diagnosis due to survival changes since 1985–1994) for all cancers and 13 leading cancer types. Results: For each cancer type, excess mortality (in the cancer cohort vs. the expected population mortality) was significantly lower for more recently diagnosed persons. For all cancers combined, the number of “avoided cancer deaths” (vs. 1985–1994) was 4,877 (1995–2004) and 11,385 (2005–2014) among males. Prostate (1995–2004: 2,144; 2005–2014: 5,099) and female breast cancer (1,127 and 2,048) had the highest number of such deaths, whereas Conclusions: Screening and early detection likely contributed to the high number of “avoided cancer deaths” for prostate and female breast cancer, whereas early detection remains difficult for lung and pancreatic cancers, highlighting the need for improved preventive and screening measures. Impact: Absolute measures such as “avoided cancer deaths” can provide a more tangible estimate of the improvements in cancer survival than standard net survival measures.

Background: With the improvements in cancer diagnosis and treatment, more patients with cancer are surviving for longer periods than before. This study aims to quantify the proportion cured and median survival time for those who are not cured for major cancers in Australia. Methods: Australian population-based cohort of 2,164,172 cases, ages 15 to 89 years, whose first cancer diagnosis between 1982 and 2014 was one of 22 leading cancers, were followed up to December 2014. Flexible parametric cure models were used to estimate the proportion cured and median survival time for those uncured by age, sex, and spread of disease, and temporal trends in these measures. Results: Cure estimates could be generated for 19 of the 22 cancer types. The unadjusted proportion cured ranged from 5.0% for pancreatic cancer to 90.0% for melanoma. Median survival time for those uncured ranged from 0.35 years for pancreatic cancer to 6.05 years for prostate cancer. Cancers were divided into four groups according to their proportion cured in the 1980s and the degree of improvement over 28 years. Esophageal, stomach, pancreatic, liver, gallbladder, lung, and brain cancer had lower proportion cured and smaller improvements over time. Conclusions: For cancers with poor survival in which little has changed over time either in prolonging life or achieving statistical cure, efforts should be focused on reducing the prevalence of known risk factors and earlier detection, thereby enabling more effective treatment. Impact: Cure models provide unique insights into whether survival improvements are due to prolonging life or through curing the disease.

Astrophysical neutrinos are excellent probes of astroparticle physics and high-energy physics. With energies far beyond solar, supernovae, atmospheric, and accelerator neutrinos, high-energy and ultra-high-energy neutrinos probe fundamental physics from the TeV scale to the EeV scale and beyond. They are sensitive to physics both within and beyond the Standard Model through their production mechanisms and in their propagation over cosmological distances. They carry unique information about their extreme non-thermal sources by giving insight into regions that are opaque to electromagnetic radiation. This white paper describes the opportunities astrophysical neutrino observations offer for astrophysics and high-energy physics, today and in coming years. Astrophysical neutrinos are excellent probes of astroparticle physics and high-energy physics. With energies far beyond solar, supernovae, atmospheric, and accelerator neutrinos, high-energy and ultra-high-energy neutrinos probe fundamental physics from the TeV scale to the EeV scale and beyond. They are sensitive to physics both within and beyond the Standard Model through their production mechanisms and in their propagation over cosmological distances. They carry unique information about their extreme non-thermal sources by giving insight into regions that are opaque to electromagnetic radiation. This white paper describes the opportunities astrophysical neutrino observations offer for astrophysics and high-energy physics, today and in coming years.

The Radio Neutrino Observatory Greenland (RNO-G) is scheduled for deployment in the summerof 2021. It will target the detection of astrophysical and cosmogenic neutrinos above 10 PeV. With 35 autonomous stations, it will be the largest implementation of a radio neutrino detector to date.The stations combine best-practice instrumentation from all previous radio neutrino arrays, such as a deep phased-array trigger and surface antennas. These proceedings describe the experimentalconsiderations that have driven the design of RNO-G and the current progress in deployment, aswell as discuss the projected sensitivity of the instrument. RNO-G will provide a unique view ofthe Northern Sky and will also inform the design of the radio component of IceCube-Gen2.

Background While relative survival is commonly used to describe cancer prognosis, its interpretation remains confusing. Alternative measures provide additional insights into the survival experience of Australian cancer patients. Methods Population-based cohort of over 2 million Australians diagnosed with 19 types of primary invasive cancer from 1982 to 2014 with mortality follow-up to 31 December 2015. Flexible parametric survival models were used to estimate loss of life expectancy, avoidable cancer deaths, crude survival, probability of cure and survival of uncured population for cancers diagnosed in Australia. Results There has been an overall decrease in the loss of life expectancy caused by a cancer diagnosis. Australians diagnosed in 2014 will gain an extra 432,588 life years due to the improvement in relative survival since 1982. Similarly, 29% (females) and 40% (males) of expected cancer deaths among the 2005-2014 cohort will be avoided compared to the 1985-1994 cohort. While the 10- year crude probability of cancer deaths decreased over time, patterns varied by cancer type. The crude probability of competing deaths increased with age. Between 1982 and 2009, the cure proportion increased significantly for all cancers. Conclusion Alternative measures of survival may help communicate the reducing impact that a cancer diagnosis has on average life expectancy. Key messages The growing number of Australian cancer survivors can pose emerging challenges to these patients, their caregivers, medical professionals and health-care systems in accessing or providing evidence-based survivorship and psychosocial care after a cancer diagnosis.

We investigate the use of parabolic equation (PE) methods for solving radio-wave propagation in polar ice. PE methods provide an approximate solution to Maxwell's equations, in contrast to full-field solutions such as finite-difference-time-domain (FDTD) methods, yet provide a more complete model of propagation than simple geometric ray-tracing (RT) methods that are the current state of the art for simulating in-ice radio detection of neutrino-induced cascades. PEs are more computationally efficient than FDTD methods, and more flexible than RT methods, allowing for the inclusion of diffractive effects and modeling of propagation in regions that cannot be modeled with geometric methods. We present a new PE approximation suited to the in-ice case. We conclude that current ray-tracing methods may be too simplistic in their treatment of ice properties, and their continued use could overestimate experimental sensitivity for in-ice neutrino detection experiments. We discuss the implications for current in-ice Askaryan-type detectors and for the upcoming Radar Echo Telescope, two families of experiments for which these results are most relevant. We suggest that PE methods be investigated further for in-ice radio applications., SCOPUS: ar.j, info:eu-repo/semantics/published

This article presents the design of the Radio Neutrino Observatory Greenland (RNO-G) and discusses its scientific prospects. Using an array of radio sensors, RNO-G seeks to measure neutrinos above 10 PeV by exploiting the Askaryan effect in neutrino-induced cascades in ice. We discuss the experimental considerations that drive the design of RNO-G, present first measurements of the hardware that is to be deployed and discuss the projected sensitivity of the instrument. RNO-G will be the first production-scale radio detector for in-ice neutrino signals., Comment: 51 pages, 27 figures, version updated to include corrected figure of effective areas

Supplemental material, sj-pdf-1-msc-10.1177_0969141320984199 for Temporal and area-level variation in prevalence of high-grade histologically confirmed cervical abnormalities among Indigenous and non-Indigenous women, Queensland, Australia, 2008–2017 by Paramita Dasgupta, Joanne F Aitken, John Condon, Gail Garvey, Lisa J Whop, Claire DeBats and Peter D Baade in Journal of Medical Screening

Supplemental material, sj-pdf-2-msc-10.1177_0969141320984199 for Temporal and area-level variation in prevalence of high-grade histologically confirmed cervical abnormalities among Indigenous and non-Indigenous women, Queensland, Australia, 2008–2017 by Paramita Dasgupta, Joanne F Aitken, John Condon, Gail Garvey, Lisa J Whop, Claire DeBats and Peter D Baade in Journal of Medical Screening

The Radar Echo Telescope for Cosmic Rays (RET-CR) is a pathfinder experiment for the Radar Echo Telescope for Neutrinos (RET-N), a next-generation in-ice detection experiment for ultra high energy neutrinos. RET-CR will serve as the testbed for the radar echo method to probe high-energy particle cascades in nature, whereby a transmitted radio signal is reflected from the ionization left in its wake. This method, recently validated at SLAC experiment T576, shows promising preliminary sensitivity to neutrino-induced cascades above the energy range of optical detectors like IceCube. RET-CR intends to use an in-nature test beam: the dense, in-ice cascade produced when the air shower of an ultra high energy cosmic ray impacts a high-elevation ice sheet. This in-ice cascade, orders of magnitude more dense than the in-air shower that preceded it, is similar in profile and density to the expected cascade from a neutrino-induced cascade deep in the ice. RET-CR will be triggered using surface scintillator technology and will be used to develop, test, and deploy the hardware, firmware, and software needed for the eventual RET-N. We present the strategy, status, and design sensitivity of RET-CR, and discuss its application to eventual neutrino detection.

The SLAC T-576 beam test experiment showed the feasibility of the radar detection technique to probe high-energy particle cascades in dense media. Corresponding particle-level simulations indicate that the radar method has very promising sensitivity to probe the $>$PeV cosmic neutrino flux. As such, it is crucial to demonstrate the in-situ feasibility of the radar echo method, which is the main goal of the current RET-CR experiment. Although the final goal of the Radar Echo Telescope is to detect cosmic neutrinos, we seek a proof of principle using cosmic-ray air showers penetrating the (high-altitude) Antarctic ice sheet. When an UHECR particle cascade propagates into a high-elevation ice sheet, it produces a dense in-ice cascade of charged particles which can reflect incoming radio waves. Using a surface cosmic-ray detector, the energy and direction of the UHECR can be reconstructed, and as such this constitutes a nearly ideal in-situ test beam to provide the proof of principle for the radar echo technique. RET-CR will consist of a transmitter array, receiver antennas and a surface scintillator plate array. Here we present the simulation efforts for RET-CR performed to optimise the surface array layout and triggering system, which affords an estimate of the expected event rate.

The Radar Echo Telescope for Cosmic Rays (RET-CR) is a recently initiated experiment designed to detect the englacial cascade of a cosmic-ray initiated air shower via in-ice radar, toward the goal of a full-scale, next-generation experiment to detect ultra high energy neutrinos in polar ice. For cosmic rays with a primary energy greater than 10 PeV, roughly 10% of an air-shower's energy reaches the surface of a high elevation ice-sheet ($\gtrsim$2 km) concentrated into a radius of roughly 10 cm. This penetrating shower core creates an in-ice cascade many orders of magnitude more dense than the preceding in-air cascade. This dense cascade can be detected via the radar echo technique, where transmitted radio is reflected from the ionization deposit left in the wake of the cascade. RET-CR will test the radar echo method in nature, with the in-ice cascade of a cosmic-ray initiated air-shower serving as a test beam. We present the projected event rate and sensitivity based upon a three part simulation using CORSIKA, GEANT4, and RadioScatter. RET-CR expects $\sim$1 radar echo event per day.

Television and radio serial dramas have been used as an effective entertainment-education (EE) strategy to address complex health and social issues around the world. In this article, we analyse India’s experience with the EE television serial, Main Kuch Bhi Kar Sakti HoonSeason 3 (I, A Woman, Can Achieve Anything, hereafter MKBKSH-3), broadcasted in 2019. Produced by Population Foundation of India, MKBKSH-3purposely employed principles of narrative persuasion to tackle open defecation, promote contraceptive use, and advocate for gender equality in a deeply entrenched patriarchal system. As part of a larger programme evaluation, we conducted data collection using two complementary methods: (1) field experiments in Uttar Pradesh’s Kanpur Dehat district with repeated measures among viewers and non-viewers; and (2) viewer surveys through the popular interactive voice response system with callers from across 28 states and union territories. Wherever possible, we kept questions consistent to help triangulate research findings. Our results indicate a significant increase in toilet ownership and decrease in open defecation among MKBKSH-3viewers. Further, MKBKSH-3’scharacters and storylines helped raise awareness of injectable contraceptives, and viewers—both male and female—displayed an increased likelihood of moving toward adopting contraceptives that were promoted. These empirical findings add to the growing literature on the value of entertainment-education serial dramas as enabling media for social and behaviour change.

The balloon-borne ANITA [1] experiment is designed to detect ultra-high energy neutrinos via radio emissions produced by in-ice showers. Although initially purposed for interactions within the Antarctic ice sheet, ANITA also demonstrated the ability to self-trigger on radio emissions from ultra-high energy charged cosmic rays [2] (CR) interacting in the Earth's atmosphere. For showers produced above the Antarctic ice sheet, reflection of the down-coming radio signals at the Antarctic surface should result in a polarity inversion prior to subsequent observation at the ∼35–40 km altitude ANITA gondola. Based on data taken during the ANITA-1 and ANITA-3 flights, ANITA published two anomalous instances of upcoming cosmic-rays with measured polarity opposite the remaining sample of ∼50 UHECR signals [3, 4]. The steep observed upwards incidence angles (25–30 degrees relative to the horizontal) require non-Standard Model physics if these events are due to in-ice neutrino interactions, as the Standard Model cross-section would otherwise prohibit neutrinos from penetrating the long required chord of Earth. Shoemaker et al. [5] posit that glaciological effects may explain the steep observed anomalous events. We herein consider the scenarios offered by Shoemaker et al. and find them to be disfavored by extant ANITA and HiCal experimental data. We note that the recent report of four additional near-horizon anomalous ANITA-4 events [6], at >3σ significance, are incompatible with their model, which requires significant signal transmission into the ice.

Background: Understanding the burden of competing (non-breast cancer) mortality is important for the growing number of breast cancer survivors. We quantity these patterns, and the impact of two leading non-cancer causes of death, within ten years of breast cancer diagnosis. Methods: Population based cancer registry study of 23,809 women aged 50–79 diagnosed with first primary breast cancer in Queensland, Australia, 1997 to 2012 with additional data linkage to identify individual non-cancer mortality causes. Flexible parametric competing-risks models were used to estimate the crude and adjusted probabilities of death. Results: While overall mortality increased with age at diagnosis, this effect was strongest for non-cancer (such as cardiovascular and cerebrovascular disease) mortality. Women diagnosed with advanced breast cancer had a higher crude probability of breast cancer death (23.1% versus 4.5% for localised) but similar probability of competing mortality (11.6% versus 11.3%). Within each category of spread of disease, the probability of breast-cancer deaths remained relatively constant with age, while the probability of competing deaths increased. The 10-year probability of dying from breast cancer was 3.7%, 4.2% and 5.6% among women with localised disease aged 50 to 59, 60–69 and 70–79 respectively, but 3.1%, 7.8% and 22.9% for competing mortality. Increasing age, advanced disease and being unpartnered were independently associated with increased risk of breast cancer and competing deaths. Conclusions: Promotion of improved health behaviors after a cancer diagnosis and development of individualized strategies for clinical management should be prioritized as part of optimal care for breast cancer survivors.

Indigenous women continue to experience a disproportionately higher burden of cervical cancer than non‐Indigenous women in Australia. The National Indigenous Cervical Screening Project used probabilistic record linkage to combine population‐based administrative databases and identify Indigenous women on Pap Smear Registers. This study aimed to quantify the spatial variation by local government areas (LGAs) for Indigenous and non‐Indigenous women in Queensland in cervical screening participation rates and related outcomes. Empirical Bayes local geostatistical smoothing was performed to reduce the likelihood of spurious variation between small areas. The cohort included 1,091,260 women (2 per cent Indigenous) aged 20 to 69 with 2,393,708 Pap smears between 2006 and 2011. Indigenous women had smoothed LGA‐specific 5‐year participation rates (interquartile range (IQR) 38.9–53.3 per 100 eligible women) consistently lower than non‐Indigenous women (IQR 80.7–85.3). The non‐overlapping confidence intervals of these rates suggest that the Indigenous differential was significant. Compared with Indigenous women, non‐Indigenous women had consistently lower and more stable prevalence rates of histologically confirmed high grade abnormalities (IQR 8.0–10.1 versus 15.0–21.3 per 1,000 screened women). Although the LGA‐specific rates also suggest that a higher proportion of non‐Indigenous women were followed‐up within two months of an abnormal screening result, the wide confidence intervals for these estimates limit our ability to draw definitive conclusions about spatial patterns for this outcome. These findings highlight the importance of continued monitoring and ongoing efforts to identify drivers of these patterns and develop effective strategies to improve participation and potentially reduce the cervical cancer burden among Indigenous women.

Background Coal mine dust lung disease comprises a group of occupational lung diseases including coal workers pneumoconiosis. In many countries, there is a lack of robust prevalence estimates for these diseases. Our objective was to perform a systematic review and meta-analysis of published contemporary estimates on prevalence, mortality, and survival for coal mine dust lung disease worldwide. Methods Systematic searches of PubMed, EMBASE and Web of Science databases for English language peer-reviewed articles published from 1/1/2000 to 30/03/2021 that presented quantitative estimates of prevalence, mortality, or survival for coal mine dust lung disease. Review was conducted per PRISMA guidelines. Articles were screened independently by two authors. Studies were critically assessed using Joanna Briggs Institute tools. Pooled prevalence estimates were obtained using random effects meta-analysis models. Heterogeneity was measured using the I2 statistics and publication bias using Egger’s tests. Results Overall 40 studies were included, (31 prevalence, 8 mortality, 1 survival). Of the prevalence estimates, fifteen (12 from the United States) were retained for the meta-analysis. The overall pooled prevalence estimate for coal workers pneumoconiosis among underground miners was 3.7% (95% CI 3.0–4.5%) with high heterogeneity between studies. The pooled estimate of coal workers pneumoconiosis prevalence in the United States was higher in the 2000s than in the 1990s, consistent with published reports of increasing prevalence following decades of declining trends. Sub-group analyses also indicated higher prevalence among underground miners, and in Central Appalachia. The mortality studies were suggestive of reduced pneumoconiosis mortality rates over time, relative to the general population. Conclusion The ongoing prevalence of occupational lung diseases among contemporary coal miners highlights the importance of respiratory surveillance and preventive efforts through effective dust control measures. Limited prevalence studies from countries other than the United States limits our understanding of the current disease burden in other coal-producing countries.

Background Sentinel node biopsy (SNB) is now the standard of care for women with early-stage breast cancer. Despite lower morbidity than axillary lymph node dissection, widespread variation in SNB rates by non-clinical factors persists. We explored the factors associated with SNB usage and changes in those associations over time for recently diagnosed women. Methods We report here on a linked population-based cancer registry and hospital inpatient admission data set for 5577 women aged at least 20 years diagnosed with a first primary invasive early-stage node-negative breast cancer from July 2008 to 2012 in Queensland, Australia, who underwent breast cancer-related surgery within 2 years of diagnosis. Multivariate logistic regression was used to model predictors of SNB separately for 5172 women with ≤30 mm tumours and 405 with 31 to ≤50 mm tumours. Results Overall, 3972 (77%) women with ≤30 mm tumours and 221 (55%) of those with larger tumours underwent SNB. Usage increased over time for both cohorts but was consistently lower among those with larger tumours. A more recent diagnosis, having breast-conserving surgery, living in more accessible areas and attending a private or high-volume hospital independently increased the odds of SNB for both cohorts. There was no evidence that the geographical disparity had reduced over the study period for either cohort. Conclusion Geographical disparities to accessing SNB persist. Efforts to promote multidisciplinary care and facilitate education in healthcare changes through innovative solutions using emerging technologies as well as targeted research to identify the barriers to equitable access remain critical.

Background While net probabilities of death in the relative survival framework ignore competing causes of death, crude probabilities allow estimation of the real risk of cancer deaths. This study quantifies temporal trends in net and crude probabilities of death. Methods Australian population-based cohort of 2,015,903 people aged 15-89 years, diagnosed with a single primary invasive cancer from 1984 to 2013 with mortality follow-up to 31 December 2014. Survival was analyzed with the cohort method. Flexible parametric relative survival models were used to estimate both probability measures by diagnosis year for all cancers and selected leading sites. Results For each site, excess mortality rates reduced over time, especially for prostate cancer. While both the 10-year net and crude probability of cancer deaths decreased over time, specific patterns varied. For example, the crude probability of lung cancer deaths for males aged 50 years decreased from 0.90 (1984) to 0.79 (2013); whereas the corresponding probabilities for kidney cancer were 0.64 and 0.18 respectively. Patterns for crude probabilities of competing deaths were relatively constant. Although for younger patients, both net and crude measures were similar, crude probability of competing deaths increased with age, hence for older ages net and crude measures were different except for lung and pancreas cancers. Conclusions The observed reductions in probabilities of death over three decades for Australian cancer patients are encouraging. However, this study also highlights the ongoing mortality burden following a cancer diagnosis, and the need for continuing efforts to improve cancer prevention, diagnosis and treatment.

BACKGROUND: Breast reconstruction (BR) following mastectomy for breast cancer has been shown to improve quality of life and body image; however, there is significant geographic variation in BR rates. We explored factors associated with BR following mastectomy. METHODS: This is a population-based data linkage study consisting of cancer registry records linked to hospital inpatient episodes for 4104 women aged 20 years and over-diagnosed with a first primary invasive localized stage breast cancer between 1997 and 2012 in Queensland, Australia, who underwent a mastectomy. Multivariate logistic regression was used to model predictors of BR. RESULTS: Overall, 481 women (11.7%) underwent reconstruction. Proportions increased over time and were higher for younger women. Younger age, more recent diagnosis, living in high or very high accessibility areas or less disadvantaged areas, smaller tumours and attending a private or high-volume hospital independently increased the odds of reconstruction. The geographical disparity reduced significantly over time. CONCLUSION: Geographical barriers to accessing BR have reduced; however, continued monitoring and further research to inform strategies to further reduce subgroup disparities remain a priority.

Objective The survival benefits of having a partner for all cancers combined is well recognized, however its prognostic importance for individual cancer types, including competing mortality causes, is less clear. This study was undertaken to quantify the impact of partner status on survival due to cancer-specific and competing mortality causes. Methods Data were obtained from the population-based Queensland Cancer Registry on 176,050 incident cases of ten leading cancers diagnosed in Queensland (Australia) from 1996 to 2012. Flexible parametric competing-risks models were used to estimate cause-specific hazards and cumulative probabilities of death, adjusting for age, stage (breast, colorectal and melanoma only) and stratifying by sex. Results Both unpartnered males and females had higher total cumulative probability of death than their partnered counterparts for each site. For example, the survival disadvantage for unpartnered males ranged from 3% to 30% with higher mortality burden from both the primary cancer and competing mortality causes. The cause-specific age-adjusted hazard ratios were also consistent with patients without a partner having increased mortality risk although the specific effect varied by site, sex and cause of death. For all combined sites, unpartnered males had a 46%, 18% and 44% higher risk of cancer-specific, other cancer and non-cancer mortality respectively with similar patterns for females. The higher mortality risk persisted after adjustment for stage. Conclusions It is important to better understand the mechanisms by which having a partner is beneficial following a cancer diagnosis, so that this can inform improvements in cancer management for all people with cancer.

The aim of this systematic review was to examine variations in psychosocial outcomes by residential location and Indigenous status in women diagnosed with breast cancer (BC) in Australia. Systematic searches were undertaken using multiple databases covering articles between 1 January 1990 and 1 March 2015 focusing on adult women with BC in an Australian setting and measuring quality of life (QOL), psychological distress or psychosocial support. Thirteen quantitative and three qualitative articles were included. Two quantitative and one qualitative article were rated high quality, seven moderate and the remaining were low quality. No studies examining inequalities by Indigenous status were identified. Non-metropolitan women were more likely to record lower QOL relating to breast cancer-specific concerns and reported a lack of information and resources specific to their needs. Continuity of support, ongoing care and access to specialist and allied health professionals were major concerns for non-metropolitan women. Non-metropolitan women identified unmet needs in relation to travel, fear of cancer recurrence and lack of psychosocial support. Overall, there was a lack of evidence relating to variations in psychosocial outcomes for women with BC according to residential status or Indigenous status. While the review identified some specific concerns for non-metropolitan women with BC, it was limited by the lack of good quality studies using standardised measures. Copyright © 2016 John Wiley & Sons, Ltd.

Aims This study quantifies geographic inequities in loss of life expectancy (LOLE) by area-level socioeconomic status (SES) and accessibility to treatment. Methods Analysis was conducted using a population-based cancer-registry cohort (n = 371,570) of Queensland (Australia) residents aged 50−89 years, diagnosed between 1997–2016. Flexible parametric survival models were used to estimate LOLE by area-level SES and accessibility for all invasive cancers and the five leading cancers. The gain in life years that could be achieved if all cancer patients experienced the same relative survival as those in the least disadvantaged-high accessibility category was estimated for the 2016 cohort. Results For all invasive cancers, men living in the most disadvantaged areas lost 34 % of life expectancy due to their cancer diagnosis, while those from the least disadvantaged areas lost 25 %. The corresponding percentages for women were 33 % and 23 %. Accessibility had a lower impact on LOLE than SES, with patients from low accessibility areas losing 0–4 % more life expectancy than those from high accessibility areas. For cancer patients diagnosed in 2016 (n = 24,423), an estimated 101,387 life years will be lost. This would be reduced by 19 % if all patients experienced the same relative survival as those from the least disadvantaged-high accessibility areas. Conclusion The impact of a cancer diagnosis on remaining life expectancy varies by geographical area. Establishing reasons why area disadvantage impacts on life expectancy is crucial to inform subsequent interventions that could increase the life expectancy of cancer patients from more disadvantaged areas.

BACKGROUND: Cervical cancer incidence and mortality have declined in Australia since the implementation of a national cervical screening program in 1991, however, disparities in both measures between Indigenous and non-Indigenous women remain. We describe spatial and temporal changes in Pap test participation rates by Indigenous status for Queensland (Australia). Analyses were done in the context of renewed screening program in December 2017. METHODS: Population-based study 2,132,925 Queensland female residents, aged 20-69 years who underwent cervical screening from 2008 to December 2017; 47,136 were identified as Indigenous through linkage to hospital records. Bayesian spatial models were used to generate smoothed estimates of participation across 528 small areas during 2008-2012 and 2013-2017 compared to the overall state average (2008-2017). Results are presented as thematic maps and graphs showing the associated uncertainty of the estimates. RESULTS: Overall screening participation decreased over time for both Indigenous and non-Indigenous women. Strong spatial patterns were evident in five-year participation for both groups. Indigenous women had significantly lower participation than the Queensland average for ≥ 88 % of areas during both reporting periods whereas corresponding estimates were lower than average for

Background : Loss of life expectancy (LOLE) provides valuable insights into the impact of cancer. We evaluated the temporal trends in LOLE for Australian cancer patients and the gain in life years for recently diagnosed patients due to survival improvements. Methods : Analysis was conducted using an Australian population-based cohort (n = 1,865,154) aged 50–89 years, who were primarily diagnosed with one of 19 leading cancers between 1982–2015. Flexible parametric survival models were used to estimate LOLE and the proportion of life lost (POLL) by year, age group, sex, and, for New South Wales only, spread of disease. The total years of LOLE and gain in life years due to survival improvements were estimated for those diagnosed in 2014. Results : For 19 cancers combined, LOLE and POLL were significantly lower for more recent diagnoses. Cancer-specific temporal trends were consistent by age, sex, and spread of disease (where relevant) although the magnitude varied. Prostate, kidney, or non-Hodgkin lymphoma experienced the largest decreases in POLL over time. For the 2014 diagnoses, an estimation of 403,094 life years lost will be caused by the 19 cancers. With the increase in cancer survival over time, the 2014 cohort will gain an extra 432,588 life years (52 %) compared to that experienced by the 1982 cohort. Conclusion : While reduced impact of a cancer diagnosis on LOLE over time is encouraging, the growing number of cancer survivors in Australia is likely to pose complex challenges for cancer patients, their care givers, and health-care systems.

Objectives To systematically assess the evidence for variations in outcomes at each step along the breast cancer continuum of care for Australian women by residential location. Design Systematic review. Methods Systematic searches of peer-reviewed articles in English published from 1 January 1990 to 24 November 2017 using PubMed, EMBASE, CINAHL and Informit databases. Inclusion criteria were: population was adult female patients with breast cancer; Australian setting; outcome measure was survival, patient or tumour characteristics, screening rates or frequencies, clinical management, patterns of initial care or post-treatment follow-up with analysis by residential location or studies involving non-metropolitan women only. Included studies were critically appraised using a modified Newcastle–Ottawa Scale. Results Seventy-four quantitative studies met the inclusion criteria. Around 59% were considered high quality, 34% moderate and 7% low. No eligible studies examining treatment choices or post-treatment follow-up were identified. Non-metropolitan women consistently had poorer survival, with most of this differential being attributed to more advanced disease at diagnosis, treatment-related factors and socioeconomic disadvantage. Compared with metropolitan women, non-metropolitan women were more likely to live in disadvantaged areas and had differing clinical management and patterns of care. However, findings regarding geographical variations in tumour characteristics or diagnostic outcomes were inconsistent. Conclusions A general pattern of poorer survival and variations in clinical management for Australian female patients with breast cancer from non-metropolitan areas was evident. However, the wide variability in data sources, measures, study quality, time periods and geographical classification made direct comparisons across studies challenging. The review highlighted the need to promote standardisation of geographical classifications and increased comparability of data systems. It also identified key gaps in the existing literature including a lack of studies on advanced breast cancer, geographical variations in treatment choices from the perspective of patients and post-treatment follow-up.

The balloon-borne HiCal radio-frequency (RF) transmitter, in concert with the ANITA radio-frequency receiver array, is designed to measure the Antarctic surface reflectivity in the RF wavelength regime. The amplitude of surface-reflected transmissions from HiCal, registered as triggered events by ANITA, can be compared with the direct transmissions preceding them by O(10) microseconds, to infer the surface power reflection coefficient $\cal{R}$. The first HiCal mission (HiCal-1, Jan. 2015) yielded a sample of 100 such pairs, resulting in estimates of $\cal{R}$ at highly-glancing angles (i.e., zenith angles approaching $90^\circ$), with measured reflectivity for those events which exceeded extant calculations. The HiCal-2 experiment, flying from Dec., 2016-Jan., 2017, provided an improvement by nearly two orders of magnitude in our event statistics, allowing a considerably more precise mapping of the reflectivity over a wider range of incidence angles. We find general agreement between the HiCal-2 reflectivity results and those obtained with the earlier HiCal-1 mission, as well as estimates from Solar reflections in the radio-frequency regime. In parallel, our calculations of expected reflectivity have matured; herein, we use a plane-wave expansion to estimate the reflectivity R from both a flat, smooth surface (and, in so doing, recover the Fresnel reflectivity equations) and also a curved surface. Multiplying our flat-smooth reflectivity by improved Earth curvature and surface roughness corrections now provides significantly better agreement between theory and the HiCal 2a/2b measurements., Comment: submitted to Astropart. Phys