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G G Giles

Publications and source records attributed to G G Giles.

90 records · Page 5Linked to original sources
PubMed1993

Endometrial cancer: trends in incidence and survival: a preventable disease?

Endometrial cancer is the commonest gynaecological cancer. Its relative increase in incidence over recent decades has been generally associated with a reduction in mortality. Evidence is presented to show a considerable variation in incidence worldwide; Australia, like England and Wales, has a comparatively low incidence. The incidence is highest in parts of the United States where it has shown an annual fall of nearly 3% between 1973 and 1987. The influence of hysterectomy, oral contraception and hormone replacement therapy at the menopause are discussed relative to incidence and prevention of the disease. Obesity and its prevention are also shown to have an influence on incidence and its ethnic variation worldwide. Despite a minor improvement in survival in FIGO published figures, the recent COSA-UK-NZ 'high risk' trial highlights the importance to the patient of closely monitored clinical trials.

Adolescent↗
PubMed1992

Visualizing age-period-cohort trend surfaces: a synoptic approach.

Mortality data from 1950 to 1986 in Australia have been used to exemplify a method of displaying trends by age and cohort in populations over time. The visual summary or synoptic method illustrated here is similar to a topographic map with age and calendar time as its ordinates. This method is complementary to conventional analyses of age-period-cohort data which lack a summary graphic view other than that provided by the trend in age-standardized rates or a three dimensional perspective plot. Mortality from ischaemic heart disease (IHD), lung cancer and motor vehicle accidents are used as examples of the method and illustrate its utility when dealing with different forms of mortality trend e.g. cross-sectional cohort, and mixed trends.

Age Factors↗
PubMed1992

Investigation, follow-up and recurrence after resection of colorectal cancer.

A study was undertaken to determine the patterns of management in the 2 years following resection of colorectal cancer by Victorian surgeons. Patients were identified by the Victorian Cancer Register as having colorectal cancer diagnosed between July 1 and December 31 1987. The surgeon of each of the 947 eligible patients who underwent surgery was sent a questionnaire seeking information about the pre-operative investigation, type of surgery and subsequent line of referral. Only 16% of colonic cancers and 39% of rectal cancers were biopsied pre-operatively and colonoscopy was undertaken in one-half and one-third respectively. Of the 737 responses, 555 patients were considered to have had curative surgery, and details of their follow-up during the four 6-month periods following surgery was analysed; this includes the effect of tumour stage and surgeon activity on the use and frequency of each test. Most patients had a clinical examination in each of the 6 month periods, but almost half did not have a colonoscopy and two-thirds did not have the serum CEA level measured at all. Only one in eight had a chest X-ray and fewer had the liver scanned during this 2 year period. Eighty-two patients (20% of those satisfactorily followed) suffered a recurrence during this period. Twenty-six were asymptomatic at the time of recurrence and were diagnosed by a routine test and of these, eight were diagnosed by tests used infrequently. Sixteen (20%) were considered surgically curable.

Aftercare↗
PubMed1991

Where people die in Victoria.

OBJECTIVE: To describe where deaths occur in Victoria and to determine to what extent the probability of dying in certain institutions is associated with cause of death and sociodemographic variables. DESIGN: Descriptive study of death certificates and multivariate analysis of 7697 deaths that occurred in a three-month period in 1988. SETTING: The State of Victoria. MAIN OUTCOME MEASURES: Cause of death, age, sex, marital status, and socioeconomic status. RESULTS: Most deaths occurred in public hospitals (48%) followed by private homes (21%), nursing homes (14%) and private hospitals (9%). Only 2% of all deaths (90% from cancer) occurred in hospices. Women were more likely to die in a nursing home than were men (21% v. 8%) and less likely to die at home (17% v. 24%). The proportion of deaths increased with age in nursing homes and declined in private homes. Significant predictors of death in a public hospital were age and socioeconomic status; the probability diminished with increasing age and was lower for those in the upper third for socioeconomic status. Predictors for dying in a private home were age and marital status; the probability diminished with age and in the absence of a spouse. CONCLUSIONS: Death as a hospice inpatient is comparatively rare in Victoria and the impact of hospice outpatient or domiciliary care on dying at home has yet to be established. Should death at home become a preferred option, the presence and ability of a spouse or other caregiver will be a significant factor.

Age Factors↗
PubMed1991

The lung cancer epidemic in Australia, 1910 to 1989.

Deaths that occurred in Australia between 1985 and 1989 that were ascribed to cancers of the respiratory tract and intrathoracic organs were obtained to update Australian lung cancer mortality trends. The age-standardised mortality rate from lung cancer in males decreased significantly from 49/100,000 in 1980-1984 to 46.4/100,000 in 1985-1989 (-5.5%). Lung cancer mortality in females increased significantly to 12.3/100,000 in 1985-1989 from an average of 10.7/100,000 in 1980-1984 (+15%). We conclude that lung cancer mortality in males is declining and although mortality in females continues to increase, there is evidence that the rate of increase has started to slow. The decline in male mortality has been anticipated from their trends in smoking cessation. The slowing increase in women cannot be ascribed to similar patterns of cessation. It is considered more likely to be due to decreasing trends in tar consumption linked to the tar content of preferred brands.

Adult↗
PubMed1990

Management of primary, operable breast cancer in Victoria.

The study aimed to describe the surgical treatment in cases of primary, operable breast cancer in Victoria. All patients who were entered in a population-based cancer registry and who met the entry criteria over a six-month period were identified. In respect of each patient, the treating surgeon completed a questionnaire about patient characteristics, investigations, tumour description, surgery, radiotherapy and chemotherapy. For 716 eligible cases, 635 (89%) questionnaires were returned by 200 treating surgeons; this gave a mean rate of 6.3 breast-cancer patients per surgeon per year. Most (61%) surgeons treated one to four breast-cancer patients per year and only 4% of surgeons treated more than 20 breast-cancer patients each. Little systematic difference was found in the treatment approach that was adopted by the surgeons with heavy or light case-loads of patients with breast cancer. Twenty-two per cent of patients underwent breast-conserving operations. Virtually all the remainder underwent mastectomy, most commonly modified radical mastectomy.

Adult↗
PubMed1990

Incorporation of twins in the regressive logistic model for pedigree disease data.

Segregation and twin disease concordance analyses have assumed a theoretical underlying liability following a multivariate normal distribution. For reasons of computation, of incorporation of measured explanatory variables, and of testing of fit and assumptions, newer analytical methods are being developed. The regressive logistic model (RLM) relies on expressing the pedigree likelihood as a product of conditional probabilities, one for each individual. In addition to logistic regression modelling of measured epidemiological variables on disease prevalence, there is modelling of vertical transmission, of transmission of unmeasured genotypes and of sibship environment. This paper discusses methods for the analysis of binary traits in twins and in pedigrees. Some extensions to the RLM for pedigrees which include twins are proposed. These enable exploration of twin concordance in the context of the twins' common parenthood, the sibship similarities within the family, and the twins' similarity in age, sex, genes and environment.

Asthma↗
PubMed1988

Cancer in migrants to Australia: extending the descriptive epidemiological data.

Australia experienced a large influx of European migrants during the period 1950-1975. The descriptive epidemiological data on cancer rates within the major migrant groups, reviewed here, provide strong evidence of environmental and behavioral influences on the etiology of various cancers. The opportunity to extend the conventional type of data analysis, to include an examination of the effect of duration of residence upon cancer risk, provides further insight into cancer etiology. The possibilities of further exploring the descriptive data are also discussed, and both the desirability and the timeliness of mounting analytical studies of the Southern European migrants to Australia are emphasized.

Australia↗
PubMed1988

Incidence of non-melanocytic skin cancer treated in Australia.

In 1985, as part of a national random household omnibus survey by a market research company, 30,976 Australians (mostly of European origin) were asked whether they had ever been treated by a doctor for skin cancer. The treating doctor or hospital was then approached for confirmation of the diagnosis of all those people who claimed to have been so treated within the past 12 months. Demographic data were also collected, permitting analysis by age, sex, country of birth, current residence, and skin reaction to strong sunlight. Melanomas accounted for less than 5% of the tumours treated. The world standardised incidence of melanoma was 19/100,000 population. The standardised incidence of treated non-melanocytic skin cancer in Australia was estimated to be 823/100,000. The standardised rates for basal cell carcinoma and squamous cell carcinoma were 657 and 166/100,000 respectively, yielding a standardised rate ratio of about 4:1. Standardised rates based on medically confirmed cases only were 555, 443, and 112/100,000 for all non-melanocytic skin cancers, basal cell carcinomas, and squamous cell carcinomas respectively. Significant differences and trends in incidence were noted with respect to age and sex. Rates in men were higher than those in women but significantly so only after the age of 60. People born in Australia had a rate of 936/100,000 compared with 402/100,000 in British migrants. Rates for non-melanocytic skin cancer showed a gradient with respect to latitude within Australia. The rate in people residing north of 29 degrees S was 1242/100,000 compared with a rate of 489/100,000 in those living south of 37 degrees S. A person's skin reaction to strong sunlight was a good indicator of the risk of skin cancer, tanning ability being inversely related to its incidence. The rate in those who always burnt and never tanned when exposed to strong sunlight was 1764/100,000 compared with a rate of 616/100,000 in those who always tanned and never burnt. These findings have important implications for public education programmes in relation to exposure to sunlight in Australia.

Adolescent↗
PubMed1984

The Bridgewater family project: urban isolation and health.

The establishment of a health centre linked to the University of Tasmania in a new housing estate in an outer suburb of Hobart presented a unique opportunity to study the health and illness of the community. A representative group of 200 families was interviewed personally about their family structure, health, illness and lifestyles. The sample of families selected corresponded well to the total population when compared with information from census data. This paper describes the objectives of the Bridgewater family project and the preliminary results that have identified separate groups of patients for closer study. Single-parent families made up 23% of the sample; only 9% of the single mothers were working. One-quarter of the men were unemployed and 14% admitted that they had been in trouble with the police. One-third of the fathers and 22% of the mothers smoked more than 25 cigarettes per day. One-third of the men drank more than 100 g of alcohol per day (the proportion of women was much smaller). These groups of patients are considered to be at risk to their health. As part of the larger study, the medical records of those who attended the local health centre were concurrently analysed to assess the morbidity of the family members and this information will be the subject of a further report.

Adolescent↗
PubMed1984

Respiratory symptoms in Tasmanian adolescents: a follow up of the 1961 birth cohort.

The 1961 birth cohort of Tasmanians (n = 8410) was initially surveyed in 1968 and was followed up in 1974 for the history and presence of respiratory symptoms and signs. The study was designed to describe and compare the natural histories of wheeze and productive cough. In 1981 a 10% stratified random sample of the original cohort was again followed up and this sample's responses were compared across the three surveys. Wheezing was found to be more persistent than productive cough. Wheezers were twice as likely as coughers to persist with their symptoms to the age of 20. These persistent wheezers represented 3.6% of the cohort available for follow-up in 1974 (n = 7132). Wheezing was also invariably associated with decreased spirometric performance, particularly FEV at 0.5 s and FEF 25-75. The new wheezers first detected in 1974 had had significantly decreased spirometry measurements in 1968 compared to those of their coughing or symptom-free peers. An early history of cough was associated with triple the incidence of wheeze in previously asymptomatic children. Hayfever and eczema were associated with persistence of wheeze. A child with either of these diagnoses was four times as likely to persist in wheezing to the age of twenty than a wheezer without atopic complaint. No significant associations could be demonstrated between wheezing and smoking.

Adolescent↗
PubMed1984

Myeloproliferative and lymphoproliferative disorders in Tasmania, 1972-80: patterns in space and time.

During the period 1972-80, 866 patients with myeloproliferative (MP) and lymphoproliferative (LP) disorders were diagnosed in Tasmania. The residential histories of these cases were compared with those of population-based controls. No space-time clustering was demonstrated by individuals of any single diagnosis or group of diagnoses, nor were any regional differences in incidence detected. However, urban-rural differences were observed. Rural exposures were important especially in early childhood and at specific intervals before onset for certain diagnoses. Farm residence in early life yielded heightened relative risks, especially for sufferers from chronic lymphocytic leukemia and acute nonlymphoblastic leukemia. Regional analysis demonstrated elevated risks of residence in orcharding and dairying regions and in an urban-industrial municipality. High risks were associated with latent periods before diagnosis. The findings suggest environmental agents, acting prenatally or in early life, as well as in adult life, as important risk factors in the later development of MP and LP disorders.

Adult↗
PubMed1984

Myeloproliferative and lymphoproliferative disorders in Tasmania, 1972-80: occupational and familial aspects.

All cases in a population-based series of myeloproliferative and lymphoproliferative (LP) disorders diagnosed in usual residents of Tasmania between 1972 and 1980 were asked for occupational histories and the occurrence of similar diseases in their close relatives. Occupational risks were observed for males who had farmed, mined, or worked in foundries and for women who had farmed or had been hairdressers. For individual diagnoses, the risk to farmers was seen to vary with age at diagnosis, sex, and region. With regard to familial risks, the LP and MP groups seemed to breed true, relatives being affected with a disorder from the other group not more often than would be expected by chance. The risks were of two kinds: Those to siblings and that between parent and child, particularly between mother and son. Occupational risks for the familial cases were limited to farming particularly in males diagnosed at 65 years of age or older. Females possessed elevated risks for the LP group only, and their highest relative risk was for those diagnosed before age 65. This evidence suggests that familial clustering of these disorders partly may be due to common environmental exposures in males from rural kindreds.

Adult↗