Search

Objective The main aim of this study was to explore any association between colorectal cancer (CRC) and rotating shift work in nurses and midwives. The secondary aim of this study was to identify risk factors for CRC in nurses and midwives who are rotating shift workers. Design Cross-sectional study. Setting Electronic survey of participants from Australia, New Zealand and the United Kingdom. Subjects A sample of 8,199 male and female nurses and midwives from Australia, New Zealand and the United Kingdom invited through their registration papers or newsletter advertisement. Main outcome measure Prevalence of CRC in participants who have worked rotating shifts for 1-14 years or ≥15 years compared to participants who have never worked rotating shifts. In addition, risk factors for CRC in the rotating shift work population were analysed in a multivariate logistic regression model in order to obtain odds ratio of CRC. Results No statistically significant difference was found in the prevalence of CRC between those who have never worked rotating shift work, worked 1-14 years and worked 15 or more years. Among rotating shift workers, diabetes was associated with a 123-fold (95% CI 39-392; p<0.001) increased odds of CRC, while Inflammatory Bowel Disease (IBD) was associated with a 190-fold (95%CI 68-526; p<0.001) increased odds of CRC. Screening colonoscopy or sigmoidoscopy for CRC was associated with a 10-fold (95% CI 3-35; p<0.001) increased odds of being diagnosed with CRC. Conclusion No significant association was found between rotating shift work and colorectal cancer in nurses and midwives. In nurses and midwives who are rotating shift workers, diabetes, IBD and CRC screening significantly increased the odds of CRC. [ABSTRACT FROM AUTHOR]

This paper presents the first full micro costing of a commonly used cancer genetic counselling and testing protocol used in the UK. Costs were estimated for the Cardiff clinic of the Cancer Genetics Service in Wales by issuing a questionnaire to all staff, conducting an audit of clinic rooms and equipment and obtaining gross unit costs from the finance department. A total of 22 distinct event pathways were identified for patients at risk of developing breast, ovarian, breast and ovarian or colorectal cancer. The mean cost per patient were pound sterling 97- pound sterling 151 for patients at moderate risk, pound sterling 975- pound sterling 3072 for patients at high risk of developing colorectal cancer and pound sterling 675- pound sterling 2909 for patients at high risk of developing breast or ovarian cancer. The most expensive element of cancer genetic services was labour. Labour costs were dependent upon the amount of labour, staff grade, number of counsellors used and the proportion of staff time devoted to indirect patient contact. With the growing demand for cancer genetic services and the growing number of national and regional cancer genetic centers, there is a need for the different protocols being used to be thoroughly evaluated in terms of costs and outcomes. [ABSTRACT FROM AUTHOR]