Cancer survival in New South Wales, Australia: socioeconomic disparities remain despite overall improvements

Background\ud \ud Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time.\ud Methods\ud \ud We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each ‘at risk’ period (1996–2000 and 2004–2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time.\ud Results\ud \ud Although survival increased over time for most individual cancers, Poisson-regression models indicated that socioeconomic disparities continued to exist in the recent period. Significant socioeconomic disparities were observed for stomach, colorectal, liver, lung, breast and prostate cancer in 1996–2000 and remained so for 2004–2008, while significant disparities emerged for cervical and uterus cancer in 2004–2008 (although the interaction between period and socioeconomic status was not significant). About 13.4 % of deaths attributable to a diagnosis of cancer could have been postponed if this socioeconomic disparity was eliminated.\ud Conclusion\ud \ud While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities

Long-term Survival Outcomes for Men Who Provided Ejaculate Specimens for Prostate Cancer Research: Implications for Patient Management

Background: Determining whether men diagnosed with early prostate cancer (PCa) will live long enough to benefit from interventions with curative intent is difficult. Although validated instruments for predicting patient survival are available, these do not have clinical utility so are not used routinely in practice. Objective: To test the hypothesis that volunteers who provided ejaculate specimens had a high survival rate at 10 and 15 yr and beyond. Design, setting, and participants: A total of 290 patients investigated because of high serum prostate-specific antigen donated ejaculate specimens for research between January 1992 and May 2003. The median age at the time of ejaculation was 63.5 yr. 153 of the donors were diagnosed with PCa and followed up to December 31, 2013. Outcome measurements and statistical analysis: Survival outcomes were compared with those for the whole population, as indicated by life expectancy tables up to 20 yr. Results and limitations: Men in the PCa group had life expectancies comparable with values listed in life expectancy tables for the whole population. Overall, PCa-specific and relative survival were significantly better for men in the non-PCa and PCa groups in comparison with men diagnosed with PCa in Queensland during the same period. Relative survival for those aged 20-49, 50-64, and ≥65 yr was >100% for ejaculate donors and 81.5%, 82.7%, and 65.2%, respectively, for the Queensland Cancer Registry reference at 10 yr. These findings for this highly selected patient cohort support the hypothesis that an ability to provide an ejaculate specimen is associated with a high likelihood of surviving 10-20 yr after donation, whether or not PCa was detected. Conclusion: Life expectancy tables may serve as a quick and simple life expectancy indicator for biopsy patients who donate ejaculate. Patient summary: Life expectancy tables indicated survival of up to 20 yr for men who provided ejaculate specimens for prostate cancer research. Life expectancy tables indicated survival of up to 20 yr for men who provided ejaculate specimens for prostate cancer research

Distribution of subsequent primary invasive melanomas following a first primary invasive OR in situ Melanoma Queensland, Australia, 1982-2010

IMPORTANCE: Melanoma survivors are known to have a highly elevated risk of subsequent primary melanomas. OBJECTIVE: To determine the relative risk of subsequent primary invasive melanomas following a first primary invasive or in situ melanoma, with a focus on body site. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort studywas conducted using population-based administrative data for melanoma diagnoses collected by the Queensland Cancer Registry, Queensland, Australia. Deidentified records of all cases of melanoma among Queensland residents during the period 1982-2005 were obtained and reviewed to December 31, 2010. There were 39 668 eligible cases of first primary invasive melanoma and 22 845 cases of first primary in situ melanoma. MAIN OUTCOMES AND MEASURES: Standardized incidence ratios (SIRs), a proxy measure for relative risk, were calculated by dividing the observed number of subsequent primary invasive melanomas by the product of the strata-specific incidence rates that occurred in the general population and the cumulative time at risk for the cohort. Synchronous subsequent melanomas (diagnosed within 60 days of the first primary melanoma) were excluded. Differences between SIRs were assessed using multivariate negative binomial regression adjusted for sex, age group, time to second diagnosis, and body site and expressed in terms of adjusted SIR ratios with corresponding 95%CIs. RESULTS: There were 5358 subsequent primary invasive melanomas diagnosed, resulting in SIRs of 5.42 (95%CI, 5.23-5.61) and 4.59 (4.37-4.82) for persons with a first primary invasive or in situ melanoma, respectively. The SIRs remained elevated throughout the follow-up period. In general, subsequent primary invasive melanomas were more likely to occur at the same body site as the initial invasive or in situ melanoma. The largest relative risk was for females with a first primary invasive melanoma on the head followed by a subsequent primary invasive melanoma also on the head (SIR, 13.32; 95%CI, 10.28-16.98). CONCLUSIONS AND RELEVANCE: Melanoma survivors require ongoing surveillance, with particular attention required for the body site of the initial lesion. Clinical practice guidelines have recognized the importance of monitoring for people with invasive melanoma; the results of the present study highlight the need for similar levels of supervision for those with a diagnosis of in situ melanoma

Pre-Maximum Spectropolarimetry of the Type Ia SN 2004dt

We report observations of SN 2004dt obtained with the Very Large Telescope of the European Southern Observatory on August 13.30, 2004 when the supernova was more than a week before optical maximum. SN 2004dt showed strong lines of \ion{O}{1}, \ion{Mg}{2}, \ion{Si}{2}, and \ion{Ca}{2} with typical velocities of absorption minimum around 17,000 \kms. The line profiles show material moving at velocities as high as 25,000 \kms in these lines. The observations also reveal absorption lines from \ion{S}{2} and \ion{Si}{3} with a velocity of only 11,000 \kms. The highest velocity in the \ion{S}{2} features can be traced no higher than 15,000 \kms, much lower than those of O, Mg, Si, and Ca. SN 2004dt has a polarization spectrum unlike any previously observed. The variation of the polarization across some \ion{Si}{2} lines approaches 2%, making SN 2004dt the most highly polarized SN Ia ever observed. In contrast, the strong line of O I at 777.4 nm shows little or no polarization signature. The degree of polarization points to a richly-structured partially burned silicon layer with substantial departure from spherical symmetry. A geometry that would account for the observations is one in which the distribution of oxygen is essentially spherically symmetric, but with bubbles of intermediate-mass elements with significant opacity within the oxygen substrate.Comment: Submitted to Ap

Analysis of the Flux and Polarization Spectra of the Type Ia Supernova SN 2001el: Exploring the Geometry of the High-velocity Ejecta

SN 2001el is the first normal Type Ia supernova to show a strong, intrinsic polarization signal. In addition, during the epochs prior to maximum light, the CaII IR triplet absorption is seen distinctly and separately at both normal photospheric velocities and at very high velocities. The high-velocity triplet absorption is highly polarized, with a different polarization angle than the rest of the spectrum. The unique observation allows us to construct a relatively detailed picture of the layered geometrical structure of the supernova ejecta: in our interpretation, the ejecta layers near the photosphere (v \approx 10,000 km/s) obey a near axial symmetry, while a detached, high-velocity structure (v \approx 18,000-25,000 km/s) with high CaII line opacity deviates from the photospheric axisymmetry. By partially obscuring the underlying photosphere, the high-velocity structure causes a more incomplete cancellation of the polarization of the photospheric light, and so gives rise to the polarization peak and rotated polarization angle of the high-velocity IR triplet feature. In an effort to constrain the ejecta geometry, we develop a technique for calculating 3-D synthetic polarization spectra and use it to generate polarization profiles for several parameterized configurations. In particular, we examine the case where the inner ejecta layers are ellipsoidal and the outer, high-velocity structure is one of four possibilities: a spherical shell, an ellipsoidal shell, a clumped shell, or a toroid. The synthetic spectra rule out the spherical shell model, disfavor a toroid, and find a best fit with the clumped shell. We show further that different geometries can be more clearly discriminated if observations are obtained from several different lines of sight.Comment: 14 pages (emulateapj5) plus 18 figures, accepted by The Astrophysical Journa

The Early Asymmetries of Supernova 2008D / XRF 080109

Spectropolarimetry of the Type Ib SN 2008D, associated with the XRF 080109, at two separate epochs, are presented. The epochs of these observations correspond to V-band light curve maximum and 15 days after light curve maximum (or 21 and 36 days after the XRF). We find SN 2008D to be significantly polarized, although the largest contribution is due to the interstellar polarization component of Q_ISP=0+/-0.1% and U_ISP=-1.2+/-0.1%. At the two epochs, the spectropolarimetry of SN 2008D is classified as being D1+L(HeI)+L(Ca II). The intrinsic polarization of continuum wavelength regions is <0.4%, at both epochs, implying an asymmetry of the photosphere of <10%. Similar to other Type Ibc SNe, such as 2005bf, 2006aj and 2007gr, we observed significant polarization corresponding to the spectral features of Ca II, He I, Mg I, Fe II and, possibly, O I 7774, about a close-to-spherically-symmetric photosphere. We introduce a new plot showing the chemically distinct line forming regions in the ejecta and comment on the apparent ubiquity of highly polarized high-velocity Ca II features in Type Ibc SNe. The polarization angle of Ca II IR triplet was significantly different, at both epochs, to those of the other species, suggesting high-velocity Ca II forms in a separate part of the ejecta. The apparent structure in the outer layers of SN 2008D has implications for the interpretation of the early-time X-ray emission associated with shock break-out. (abridged)Comment: ApJ Subm., 45 pages, 13 figure

Cancer survival for Aboriginal and Torres Strait Islander Australians: a national study of survival rates and excess mortality

BackgroundNational cancer survival statistics are available for the total Australian population but not Indigenous Australians, although their cancer mortality rates are known to be higher than those of other Australians. We aimed to validate analysis methods and report cancer survival rates for Indigenous Australians as the basis for regular national reporting.MethodsWe used national cancer registrations data to calculate all-cancer and site-specific relative survival for Indigenous Australians (compared with non-Indigenous Australians) diagnosed in 2001-2005. Because of limited availability of Indigenous life tables, we validated and used cause-specific survival (rather than relative survival) for proportional hazards regression to analyze time trends and regional variation in all-cancer survival between 1991 and 2005.ResultsSurvival was lower for Indigenous than non-Indigenous Australians for all cancers combined and for many cancer sites. The excess mortality of Indigenous people with cancer was restricted to the first three years after diagnosis, and greatest in the first year. Survival was lower for rural and remote than urban residents; this disparity was much greater for Indigenous people. Survival improved between 1991 and 2005 for non-Indigenous people (mortality decreased by 28%), but to a much lesser extent for Indigenous people (11%) and only for those in remote areas; cancer survival did not improve for urban Indigenous residents.ConclusionsCancer survival is lower for Indigenous than other Australians, for all cancers combined and many individual cancer sites, although more accurate recording of Indigenous status by cancer registers is required before the extent of this disadvantage can be known with certainty. Cancer care for Indigenous Australians needs to be considerably improved; cancer diagnosis, treatment, and support services need to be redesigned specifically to be accessible and acceptable to Indigenous people

Star Clusters in the Nearby Late-Type Galaxy NGC 1311

Ultraviolet, optical and near infrared images of the nearby (D ~ 5.5 Mpc) SBm galaxy NGC 1311, obtained with the Hubble Space Telescope, reveal a small population of 13 candidate star clusters. We identify candidate star clusters based on a combination of their luminosity, extent and spectral energy distribution. The masses of the cluster candidates range from ~1000 up to ~100000 Solar masses, and show a strong positive trend of larger mass with increasing with cluster age. Such a trend follows from the fading and dissolution of old, low-mass clusters, and the lack of any young super star clusters of the sort often formed in strong starbursts. The cluster age distribution is consistent with a bursting mode of cluster formation, with active episodes of age ~10 Myr, ~100 Myr and ~1 Gyr. The ranges of age and mass we probe are consistent with those of the star clusters found in quiescent Local Group dwarf galaxies.Comment: 21 pages, 11 figures, accepted by A

Spectropolarimetry of the Type IIb Supernova 2001ig

We present spectropolarimetric observations of the Type IIb SN 2001ig in NGC 7424; conducted with the ESO VLT FORS1 on 2001 Dec 16, 2002 Jan 3 and 2002 Aug 16 or 13, 31 and 256 days post-explosion. These observations are at three different stages of the SN evolution: (1) The hydrogen-rich photospheric phase, (2) the Type II to Type Ib transitional phase and (3) the nebular phase. At each of these stages, the observations show remarkably different polarization properties as a function of wavelength. We show that the degree of interstellar polarization is 0.17%. The low intrinsic polarization (~0.2%) at the first epoch is consistent with an almost spherical (<10% deviation from spherical symmetry) hydrogen dominated ejecta. Similar to SN 1987A and to Type IIP SNe, a sharp increase in the degree of the polarization (~1%) is observed when the outer hydrogen layer becomes optically thin by day 31; only at this epoch is the polarization well described by a ``dominant axis.'' The polarization angle of the data shows a rotation through ~40 degrees between the first and second epochs, indicating that the asymmetries of the first epoch were not directly coupled with those observed at the second epoch. For the most polarized lines, we observe wavelength-dependent loop structures in addition to the dominant axis on the Q-U plane. We show that the polarization properties of Type IIb SNe are roughly similar to one another, but with significant differences arising due to line blending effects especially with the high velocities observed for SN 2001ig. This suggests that the geometry of SN 2001ig is related to SN 1993J and that these events may have arisen from a similar binary progenitor system.Comment: 42 pages, 12 figures (figs. 11 and 12 are both composed of four subpanels, figs. 6,7,8,11 and 12 are in color, fig. 1 is low res and a high res version is available at http://www.as.utexas.edu/~jrm/), ApJ Accepte