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Background: Medicare-subsidised Team Care Arrangements (TCAs) support Australian general practitioners to implement shared care between collaborating health professionals for patients with chronic medical conditions and complex needs. We assessed the prevalence of TCAs, factors associated with TCA uptake and visits to TCA-subsidised allied health practitioners, for adults newly diagnosed with cancer in New South Wales, Australia. Methods: We carried out a retrospective individual patient data linkage study with 13 951 45 and Up Study participants diagnosed with incident cancer during 2006–16. We used a proportional hazards model to estimate the factors associated with receipt of a TCA after cancer diagnosis. Results: In total, 6630 patients had a TCA plan initiated (47.5%). A TCA was more likely for patients aged ≥65 years, those with higher service utilisation 4–15 months prior to cancer diagnosis, a higher number of comorbidities, lower self-rated overall health status, living in areas of greater socio-economic disadvantage, lower educational attainment and those with no private health insurance. A total of 4084 (61.6%) patients with a TCA had at least one TCA-subsidised allied health visit within 24 months of the TCA. Conclusions: TCAs appear to be well targeted at cancer patients with chronic health conditions and lower socioeconomic status. Nevertheless, not all patients with a TCA subsequently attended a TCA-subsidised allied healthcare professional. This suggests either a misunderstanding of the plan, the receipt of allied health via other public schemes, a low prioritisation of the plan compared to other health care, or suboptimal availability of these services. Medicare-subsidised Team Care Arrangements (TCAs), designed to coordinate care for people with long-term chronic or terminal conditions requiring treatment from a multidisciplinary team, have not been evaluated for adults newly diagnosed with cancer. Of those, 47.5% have a TCA initiated, but not all take up community-based TCA-subsidised allied health care. Prior poor health and lower socioeconomic status made TCAs more likely. TCAs appear well aligned with need. Apparent incomplete uptake of TCA-subsidised allied health services suggests suboptimal utilisation of this plan. Investigation of the healthcare trajectories of specific patient subgroups may help identify barriers. [ABSTRACT FROM AUTHOR]

Colon cancer is the second most frequently diagnosed cancer in women in Norway, where incidence rates of colon cancer increased 3‐fold between 1955 and 2014, for unknown reasons. We aimed to assess the burden of colon cancer attributable to modifiable risk factors in Norwegian women using the data from the Norwegian Women and Cancer (NOWAC) study. Self‐reported information from 35 525 women from the NOWAC study were available. These included the following exposures: smoking status, alcohol consumption, body mass index, physical activity, intake of calcium, fibers, and red and processed meat. Colon cancer cases were identified from the Cancer Registry of Norway. A parametric piecewise constant hazards model was used to estimate the strength of exposure‐cancer associations. Population attributable fractions with 95% confidence intervals (CIs) were calculated considering competing risk of death. The fraction of incident colon cancer attributable to ever smoking was 18.7% (95% CI 4.7%‐30.6%), low physical activity 10.8% (95% CI −0.7% to 21.0%), alcohol consumption 14.5% (95% CI −2.8% to 28.9%), and low intake of calcium 10.0% (95% CI −7.8% to 24.8%). A small proportion of colon cancer cases was attributable to combined intake of red and processed meat over 500 g/week, overweight/obesity, and low intake of fibers. Jointly, these seven risk factors could explain 46.0% (95% CI 23.0%‐62.4%) of the colon cancer incidence burden. Between 23% and 62% of the colon cancer burden among women in Norway was attributable to modifiable risk factors, indicating an important preventive potential of a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Thyroid cancer incidence and the prevalence of overweight and obesity are increasing, but the future thyroid cancer burden attributable to contemporary levels of overweight and obesity has not been evaluated before. We quantified this burden in Australia, and assessed whether the overweight/obesity‐attributable burden differed by sex or other population subgroupings. We estimated the strength of the associations of overweight and obesity with thyroid cancer with adjusted proportional hazards models using pooled data from seven Australian cohorts (N = 367 058) with 431 thyroid cancer cases ascertained from linked national cancer registry data during a maximum 22‐year follow‐up. We combined these estimates with nationally representative 2017 to 2018 estimates of overweight and obesity prevalence to estimate population attributable fractions (PAFs) of future thyroid cancers attributable to overweight and obesity, accounting for competing risk of death, and compared PAFs for population subgroups. Contemporary levels of overweight and obesity explain 18.6% (95% confidence interval [CI] = 5.2%‐30.2%), and obesity alone 13.7% (95% CI: 5.2%‐21.4%), of the future thyroid cancer burden. The obesity‐attributable thyroid cancer burden is 21.4% (95% CI: 2.8%‐36.5%) for men and 10.1% (95% CI: 0.8%‐18.6%) for women. Were the currently obese overweight instead, 9.9% (95% CI: 1.0%‐18.1%) of thyroid cancers could be avoided. The relative overweight/obesity‐attributable burden is higher for those consuming on average more than two alcoholic drinks per day (63.4%) and for those who are not married/co‐habiting (33.2%). In conclusion, avoiding excess weight, especially obesity, should be a priority for thyroid cancer prevention. Further studies, with findings stratified by tumour size, may reveal the potential role of overdiagnosis in our results. What's new? As the incidence of thyroid cancer has increased, questions have arisen regarding possible associations with increasing incidence of overweight and obesity. Here, the authors projected the future burden of thyroid cancer in Australia with regard to incidence of overweight and obesity. Analyses show that current levels of overweight and obesity in Australia explain about 19% of future thyroid cancers, with 14% of cancers attributed to obesity alone. Moreover, if currently obese individuals were instead overweight, nearly 10% of thyroid cancers could be avoided. The findings suggest that many thyroid cancers could be prevented through improved weight management. [ABSTRACT FROM AUTHOR]

The trends in incidence of lung cancer in never smokers are unclear as well as the significance of risk factors. We studied time trends in the incidence and risk factors of lung cancer in never smokers in Finland in a large, pooled cohort. We pooled data from seven Finnish health cohorts from the period between 1972 and 2015 with 106 193 never smokers. The harmonised risk factors included education, alcohol consumption, physical activity, height and BMI. We retrieved incident lung cancers from the nation‐wide Finnish Cancer Registry. We estimated average annual percent change (AAPC) and the effects of risk factors on cause‐specific hazard ratios (HRs) of lung cancer using Poisson regression. We detected 47 lung cancers in never smoking men (n = 31 859) and 155 in never smoking women (n = 74 334). The AAPC of lung cancer incidence was −3.30% (95% confidence interval [CI]: −5.68% to −0.88%, P =.009) in never smoking men and 0.00% (95% CI: −1.57% to 1.60%, P =.996) in never smoking women. Of the five studied risk factors only greater height in women had a statistically significant increased risk of lung cancer (multivariate HR = 1.84, 95%CI: 1.08 to 3.12). It is plausible that tobacco control measures focused on working places have reduced passive smoking among men more than among women, which could explain the declining trend in lung cancer incidence in never smoker men but not in never smoker women. As tobacco control measures have not been targeted to domestic environments, it is likely that women's exposure to passive smoking has continued longer. What's New The incidence trends and risk factors of lung cancer in never smokers remain unclear. In a harmonised population‐based cohort of 106,193 never smokers, here the authors found a decreasing trend of lung cancer incidence in men and no trend in women. Among several possible risk factors including education, alcohol consumption, physical activity, height, and body mass index, the results confirmed the association between greater height and lung cancer risk in women. As tobacco control measures have only targeted working and not domestic environments, it is plausible that women's exposure to passive smoking has continued for a longer time than men's exposure. [ABSTRACT FROM AUTHOR]