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Objective: To examine the screening–treatment–mortality pathway among women with invasive breast cancer in 2006–2014 using linked data. Methods: BreastScreen histories of South Australian women diagnosed with breast cancer (n = 8453) were investigated. Treatments recorded within 12 months from diagnosis were obtained from linked registry and administrative data. Associations of screening history with treatment were investigated using logistic regression and with cancer mortality outcomes using competing risk analyses, adjusting for socio‐demographic, cancer and comorbidity characteristics. Results and conclusion: For screening ages of 50–69 years, 70% had participated in BreastScreen SA ≤ 5 years and 53% ≤ 2 years of diagnosis. Five‐year disease‐specific survival post‐diagnosis was 90%. Compared with those not screened ≤5 years, women screened ≤2 years had higher odds, adjusted for socio‐demographic, cancer and comorbidity characteristics, and diagnostic period, of breast‐conserving surgery (aOR 2.5, 95% CI 1.9–3.2) and radiotherapy (aOR 1.2, 95% CI 1.1–1.3). These women had a lower unadjusted risk of post‐diagnostic cancer mortality (SHR 0.33, 95% CI 0.27–0.41), partly mediated by stage (aSHR 0.65, 95% CI 0.51–0.81), and less breast surgery (aSHR 0.78, 95% CI 0.62–0.99). Screening ≤2 years and conserving surgery appeared to have a greater than additive association with lower post‐diagnostic mortality (interaction term SHR 0.42, 95% CI 0.23–0.78). The screening–treatment–mortality pathway was investigated using linked data. [ABSTRACT FROM AUTHOR]

In this paper, the evolution of the ethics committees for health research, their history, membership, and function in China and Australia is described. Investigators in each country compared the history and governance of their ethical systems based on the published evidence rather than personal opinions. Similarly, examples of challenges were selected from the literature. In both countries, the aim was to maximize the social benefits of research and minimize the risk imposed on the participants. Common challenges include maintaining independence, funding and delivering timely ethical reviews of the research projects. These challenges can be difficult where research ethics committees rely on voluntary contributions and lack a strong resource base. They must adapt to the increasingly rapid pace of research as well as the technological sophistication. Population health research can challenge the conventional views of consent and privacy. The principles of the sound ethical review are common in both countries; governance arrangements and operational procedures, however, can differ, reflecting the cultural values and norms of their host countries and in respect of legal environments. By studying the evolution and function of ethics committees in the two countries, we established the differences in the governance and health systems, while similar ethical objectives helped sustain collaborative research. [ABSTRACT FROM AUTHOR]

Key resources for evaluating PGx effect on drug exposure-response The Clinical Pharmacogenetics Implementation Consortium (CPIC) is a network of PGx experts who curate PGx data identified in the primary literature and develop guidelines on how to translate PGx test results into actionable prescribing decisions [[14]]. Drug interactions/phenoconversion Potential metabolic drug interactions within supportive care drug combinations and between the supportive care drugs and cytotoxics must be considered. Concomitant use of these medications can convert genotypic normal metabolizers into phenotypic poor metabolizers, which could have drastic effects on drugs metabolized by CYP2D6, including opioids, but also anticancer therapies like tamoxifen, thus resulting in poorer patient outcomes. Clinical problem Precision drug dosing is important for both anticancer and supportive care drugs because of interindividual variability in drug exposure [[3]]. [Extracted from the article]