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1.
Asian Pac J Cancer Prev ; 25(1): 3-7, 2024 Jan 01.
Article in English | MEDLINE | ID: mdl-38285763

ABSTRACT

BACKGROUND: Care for families affected by Familial Breast and Ovarian Cancer (FBOC) is challenging as a broad range of professions and specialties are involved. The aim was to review management and outcomes for a cohort of women at high risk for familial breast and ovarian cancer. METHODS: Ten-year retrospective follow-up study of individuals in Southern New Zealand  assessed by Genetic Health Service New Zealand to be high risk for FBOC and without a personal cancer diagnosis at time of consultation. RESULTS: Twenty women were identified; twelve underwent genetic testing, and a pathogenic BRCA variant was identified in eleven. Eight women had no testing, as no index case was available. Guidelines had been fully adhered to in 55% of women, regardless of BRCA status. Six did not undergo appropriate breast surveillance. To date, seven of the 11 patients who tested positive for a pathogenic BRCA variant (64%) had risk-reducing surgeries. Two women were diagnosed with breast cancer on surveillance imaging; none were diagnosed with ovarian cancer. Four women were lost to follow-up, one of whom subsequently presented with a symptomatic breast cancer. CONCLUSIONS: To our knowledge, this is the first study providing long-term data for FBOC in New Zealand. Overall, guidelines were followed satisfactorily, but some women did not receive appropriate surveillance or referrals. An integrated interdisciplinary long-term care provision model in New Zealand might help to address gaps in FBOC surveillance and management.


Subject(s)
Breast Neoplasms , Ovarian Neoplasms , Female , Humans , Follow-Up Studies , Retrospective Studies , New Zealand/epidemiology , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Breast Neoplasms/genetics , Genetic Testing/methods , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/epidemiology , Ovarian Neoplasms/genetics , Genetic Predisposition to Disease
2.
Acta Diabetol ; 54(1): 63-71, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27650535

ABSTRACT

AIMS: Insulin pumps have been publically funded in New Zealand since 2012 for patients who meet certain clinical criteria; however, the patterns of utilization have not been described. We undertook a nationwide study to estimate the annual proportions of patients with type 1 diabetes mellitus who used a pump between 2012 and 2014, overall, and according to sex, age, ethnicity, socioeconomic position, and region. METHODS: We used data from the New Zealand Virtual Diabetes Register and routinely collected national demographic, health, and pharmaceutical dispensing data from the Ministry of Health to identify patients with type 1 diabetes and to calculate the overall, and subgroup, proportions using pumps. RESULTS: Between 2012 and 2014, funded pump use among patients with type 1 diabetes (n = 13,727) increased from 1.8 to 9.3 % overall; however, there were differences in uptake according to demographic characteristics and region. In 2014, proportionate pump use was significantly higher in females versus males (adjusted odds ratio (OR) 2.0 [95 % confidence interval 1.8-2.3]), in those aged <20 years, and in some regions. Maori (indigenous people), Pacific, and Asian patients were significantly less likely to use pumps than New Zealand Europeans (ORs 0.30 [0.23-0.41], 0.26 [0.14-0.46], 0.22 [0.14-0.35], respectively), as were those in the most versus the least deprived socioeconomic decile (OR 0.36 [0.25-0.52]). CONCLUSIONS: It is essential to explore the factors driving differential insulin pump uptake, in both New Zealand and elsewhere, if all patients are to have equal opportunity to benefit from intensive diabetes management.


Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/epidemiology , Insulin Infusion Systems/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asian People , Child , Child, Preschool , Demography , Ethnicity , Female , Geography , Humans , Hypoglycemic Agents/administration & dosage , Hypoglycemic Agents/therapeutic use , Infant , Infant, Newborn , Insulin/administration & dosage , Insulin/therapeutic use , Male , Middle Aged , New Zealand/epidemiology , Registries , Sex Factors , Socioeconomic Factors , White People , Young Adult
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