A Randomised Controlled Trial Of A Decision Aid For Prenatal Screening And Diagnosis
Funder
National Health and Medical Research Council
Funding Amount
$269,625.00
Summary
Prenatal screening is becoming increasingly available to pregnant women in many countries, including Australia, to test for Down syndrome and other chromosomal disorders as well as neural tube defects. Almost half the pregnant women in Victoria are now undergoing prenatal screening. Inherent in all screening tests is the possibility of false positive or false negative results. More than 5% of all women undergoing prenatal screening are likely to receive false positive results and must decide whe ....Prenatal screening is becoming increasingly available to pregnant women in many countries, including Australia, to test for Down syndrome and other chromosomal disorders as well as neural tube defects. Almost half the pregnant women in Victoria are now undergoing prenatal screening. Inherent in all screening tests is the possibility of false positive or false negative results. More than 5% of all women undergoing prenatal screening are likely to receive false positive results and must decide whether to put the pregnancy at risk of miscarriage, or a possible pregnancy termination, as a result of the necessary follow-up invasive diagnostic test. Many women do not realise they may have to face this decision. Others are not aware that their baby may be born with undiagnosed problems even if they have the screening test. One aspect of care that is likely to have a crucial influence on women's experience of screening is how much they are informed about a test prior to undergoing it. Most women visit a GP early in the first trimester of pregnancy. This visit provides an opportunity for information provision about prenatal screening. Decision aids have been developed as adjuncts to practitioners' counselling to prepare patients for decision-making. In this project we will be developing a decision aid for women considering their prenatal screening options. A randomised controlled trial will compare the efficacy of a general educational pamphlet to that of a tailored decision aid in preparing women for decision-making about prenatal screening. A total of 500 women who are less than 11 weeks pregnant and are attending one of 50 GPs will be included. Self-report questionnaires will be used to assess women immediately after use of the educational materials and then again at 24 weeks of pregnancy. The impact of the educational materials on informed choice, decisional conflict, anxiety, depression and uptake of prenatal screening tests will be compared.Read moreRead less
Serum Mesothelin-related Protein As An Early Marker Of Mesothelioma
Funder
National Health and Medical Research Council
Funding Amount
$354,750.00
Summary
The deadly asbestos-induced cancer mesothelioma is continuing to kill tens of thousands of individuals per year and its incidence is increasing. It is expected to cost communities hundreds of billions of dollars in compensation. This disease is usually already quite advanced by the time a patients presents to a doctor with symptoms so we have been working on methods of early detection. This project studies a new, exciting method of diagnosis using blood levels of a molecule called 'SMRP'. Late l ....The deadly asbestos-induced cancer mesothelioma is continuing to kill tens of thousands of individuals per year and its incidence is increasing. It is expected to cost communities hundreds of billions of dollars in compensation. This disease is usually already quite advanced by the time a patients presents to a doctor with symptoms so we have been working on methods of early detection. This project studies a new, exciting method of diagnosis using blood levels of a molecule called 'SMRP'. Late last year we published a paper in the prestigious journal Lancet showing that SMRP was a good test to help diagnose mesothelioma and this became a lead news item around the world because of widespread concern about this disease. In those studies we found strong clues that this test was very sensitive and could detect mesothelioma a year or so before a patient develops symptoms. In this grant we will evaluate whether this test could be useful for screening asbestos-exposed individuals for early detection of this cancer. We will also study ways of improving the test using laboratory methods. This would provide a foundation for studies aimed at determining if early treatment could improve patient survival.Read moreRead less
Diagnostic Markers For Malignant Mesothelioma And Other Respiratory Diseases
Funder
National Health and Medical Research Council
Funding Amount
$467,315.00
Summary
The deadly asbestos-induced cancer mesothelioma is continuing to kill tens of thousands of individuals per year. We have been working on improving the tests available to detect this cancer and to follow the course of the disease with the aim of reducing patients' anxiety and health-care costs.
Sensitive Serum Markers For Improved Diagnosis, Monitoring And Screening For Early Detection Of Mesothelioma
Funder
National Health and Medical Research Council
Funding Amount
$410,880.00
Summary
The deadly asbestos-induced cancer mesothelioma is continuing to kill tens of thousands of individuals per year and its incidence is increasing. Mesothelioma is predicted to cost communities hundreds of billions of dollars in compensation. This disease is unusually difficult to diagnose and tends to be already quite advanced by the time patients present to the doctor with symptoms. Unfortunately, treatment options for the majority of patients are limited and most die within a year of diagnosis. ....The deadly asbestos-induced cancer mesothelioma is continuing to kill tens of thousands of individuals per year and its incidence is increasing. Mesothelioma is predicted to cost communities hundreds of billions of dollars in compensation. This disease is unusually difficult to diagnose and tends to be already quite advanced by the time patients present to the doctor with symptoms. Unfortunately, treatment options for the majority of patients are limited and most die within a year of diagnosis. In different forms of cancer, levels of certain proteins in the blood can be measured and have been shown to indicate the presence of tumour and in some cases the extent of tumour. These proteins are collectively known as tumour markers. Tumour markers for ovarian, prostate, breast and other cancers are used by doctors to help with the diagnosis of specific cancers, to monitor the patients response to treatment and to give a valuable early warning of remission or relapse. There is no tumour marker currently used for patients with mesothelioma. We have shown in early studies published in the prestigious journal The Lancet that soluble mesothelin related protein (SMRP) is actually elevated in more than 75% of mesothelioma patients and in less than 2% of patients with other cancer and non-cancer lung diseases. In this current project we plan to extend our studies looking at blood levels of SMRP to see if they will help in the care of patients with mesothelioma. So far we have done most of the work in a particular group of patients, but it is vital that the work be extended to other groups with different types and durations of exposure to asbestos and to different areas of the country. As part of that we need to test how stable the molecule is in blood samples, because if it is not very stable it wont be a very pratical test. We also plan to look at some other markers that have been clinically useful in other forms of cancer and we will try to identify new, novel mesothelioma specific markers. This work has the potential to impact on patient care in many centres of the world.Read moreRead less
Clinical Utility Of A Novel Serum Marker, Serum Mesothelin Family Protein (SMF) In Mesothelioma Patients
Funder
National Health and Medical Research Council
Funding Amount
$323,250.00
Summary
Asbestos fibres can cause a number of cancers, one of the most aggressive and untreatable being mesothelioma. Unfortunately mesothelioma is largely resistant to the main forms of therapy: surgery, chemotherapy and radiation treatment. The average survival from diagnosis is only 8.5 months. It is sometimes difficult to diagnose mesothelioma and additional tests would be useful. Also, a simple screening test may be able to detect the earlier stages of this disease, and allow for early treatment, w ....Asbestos fibres can cause a number of cancers, one of the most aggressive and untreatable being mesothelioma. Unfortunately mesothelioma is largely resistant to the main forms of therapy: surgery, chemotherapy and radiation treatment. The average survival from diagnosis is only 8.5 months. It is sometimes difficult to diagnose mesothelioma and additional tests would be useful. Also, a simple screening test may be able to detect the earlier stages of this disease, and allow for early treatment, would be of widespread value to the community. Markers of cancer can be detected in the blood for a number of cancers e.g. prostate, colon, liver and ovary. No reliable serum marker for the presence of mesothelioma has been described and this study describes work aimed at further evaluating a novel marker that we have been researching in collaboration with a group from Seattle, USA. Mesothelin is a protein made in mesothelial tissue such as mesothelioma. When an individual develops mesothelioma the levels increase in the blood. Also, a proportion of individuals increased levels of this molecule can be detected prior to presentation. This means that it may become a useful screening tool in asbestos-exposed individuals and might be a clinical indicator of the need for further testing and, if early disease is found, early treatments. Given that early treatment of cancer is more effective than late treatment in most clinical situations, this is likely to improve the prognosis for this disease. For this marker to be clinically useful, a careful correlation between its level in the blood and the exact amount of tumour that is present (based on precised computerised tomography x-ray measurements of the tumour) are important. The findings of this study may have widespread implications for patients with mesothelioma and individuals at risk of developing mesothelioma after exposure to asbestos.Read moreRead less
Developing A Scalable, Woman-centred Model For Cervical Cancer Screening In Vulnerable Women In India
Funder
National Health and Medical Research Council
Funding Amount
$1,330,369.00
Summary
Cervical cancer is a devastating but preventable disease and 1 in 5 cases of cervical cancer in the world occur in India. We will work with women, communities, and health services in two States of India (Tamil Nadu and Mizoram) to design a woman friendly approach to prevent cervical cancer. This project brings together international and Indian experts to overcome current barriers to cervical screening by using a newer, more effective way of screening to reach underserved women and save lives.