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: Objective: This study investigated variations in healthcare expenditure for colorectal cancer (CRC) patients in South Australia by socioeconomic position (SEP) and remoteness area. Methods: Benefits incidence analysis (BIA) was used to examine healthcare expenditure and utilisation in relation to CRC patients by SEP and remoteness areas. Utilisation data was obtained for patients diagnosed with CRC in 2003?2013 from a dataset linked to a population?based cancer registry, Medicare Benefits Scheme (MBS), Pharmaceutical Benefits Scheme (PBS), hospital and death data. Concentration indices estimated the distribution of health expenditure on MBS, MBS palliative care, PBS and general practitioners. Costs of claims data and length of stay in hospital were used as indicators of healthcare utilisation. Results: The results indicated that MBS palliative healthcare services utilisation favoured the more advantaged groups for both SEP and remoteness area (Concentration index (CI)= 0.1681, t?value=54.42 (SEP) and CI=0.1546, t?value=41.64). MBS expenditure was also favourable to the more advantaged groups (CI: 0.0785 and 0.0493).PBS and MBS general practitioner expenditure were equal (?0.0093 to 0.0250). Conclusion: Overall MBS and PBS healthcare expenditure for CRC patients was close to equality, however utilisation of MBS?funded palliative healthcare services was less concentrated in low SEP and more remote areas. Implications for public health: Whether the differences in palliative healthcare utilisation supplied by private providers are offset by other services requires investigation to determine if there is a need for initiatives to improve equality and give greater support to those who choose to die at home., Colorectal cancer (CRC) is the third most common cancer globally, with Australia having one of the highest incidence rates.[sup.1] Differences exist across populations in incidence and survival from CRC both [...]

Background: Effective bowel cancer screening is freely available in Australia, however, there are inequities in utilisation amongst non-English speakers at home. This study estimates the health impacts and cost-effectiveness of recruitment interventions targeted at Arabic and Mandarin speaking populations in Victoria, Australia to increase bowel cancer screening participation. Methods: A Markov microsimulation model simulated the development of bowel cancer, considering National Bowel Cancer Screening Program participation rates. Culturally specific recruitment interventions e.g., community education and tailored paid media for 50–74-year-olds were compared to usual practice. A cost-utility analysis was conducted over a 50-year time horizon from a healthcare perspective, to estimate the cost per quality-adjusted life year (QALY) based on plausible effectiveness levels. Costs are in 2019 Australian dollars. Results: Intervention costs were $6.90 per person for the Arabic speaking group and $3.10 for Mandarin speakers. The estimated cost/QALY was $2,781 (95% uncertainty interval [UI]: $2,144─$3,277) when screening increased by 0.2% in the Arabic group, and an estimated 5–6 additional adenoma and cancer cases were detected. In the Mandarin group, the estimated cost/QALY was $1,024/QALY (95%UI: $749─$1,272) when screening increased by 1.1%, and an estimated 18–23 additional adenoma and cancer cases were detected. Conclusions: Culturally specific recruitment interventions to increase bowel cancer screening are inexpensive and likely to be cost-effective. Improvements in capturing language spoken at home by the National program would facilitate more precise estimates of the effectiveness and cost-effectiveness of these interventions. [ABSTRACT FROM AUTHOR]

The Hippo signaling pathway is functionally conserved in Drosophila melanogaster and mammals, and its proposed function is to control tissue homeostasis by regulating cell proliferation and apoptosis. The core components are composed of a kinase cascade that culminates with the phosphorylation and inhibition of Yes-associated protein 1 (YAP1). Phospho-YAP1 is retained in the cytoplasm. In the absence of Hippo signaling, YAP1 translocates to the nucleus, associates with co-activators TEAD1-4, and functions as a transcriptional factor promoting the expression of key target genes. Components of the Hippo pathway are mutated in human cancers, and deregulation of this pathway plays a role in tumorigenesis. Loss of the NF2 tumor suppressor gene is the most common genetic alteration in meningiomas, and the NF2 gene product, Merlin, acts upstream of the Hippo pathway. Here, we show that primary meningioma tumors have high nuclear expression of YAP1. In meningioma cells, Merlin expression is associated with phosphorylation of YAP1. Using an siRNA transient knockdown of YAP1 in NF2-mutant meningioma cells, we show that suppression of YAP1 impaired cell proliferation and migration. Conversely, YAP1 overexpression led to a strong augment of cell proliferation and anchorage-independent growth and restriction of cisplatin-induced apoptosis. In addition, expression of YAP1 in nontransformed arachnoidal cells led to the development of tumors in nude mice. Together, these findings suggest that in meningiomas, deregulation of the Hippo pathway is largely observed in primary tumors and that YAP1 functions as an oncogene promoting meningioma tumorigenesis.

Author(s): Anita Lal, Ana Maria Mantilla-Herrera, Lennert Veerman, Kathryn Backholer, Gary Sacks, Marjory Moodie, Mohammad Siahpush, Rob Carter, Anna Peeters In supporting information file S4 Table, some table row headers [...]

Dental caries is the most prevalent oral disease across the life course. This study modeled the population health and economic impact of a 20% sugar sweetened beverages tax (SSB) for preventing dental caries compared to no intervention (societal and healthcare perspective). A cost-effectiveness analysis according to quintiles of area-level socioeconomic disadvantage was performed for the 2020 Australian population (0-100 years old) using a closed cohort Markov model. A qualitative assessment of implementation considerations (e.g., acceptability, equity, sustainability) was undertaken. Health outcomes were modeled as decayed teeth prevented and disability-adjusted life years (DALYs) averted. The 10-year and lifetime scenarios were modeled with probabilistic sensitivity analysis (Monte Carlo simulation, 2000 cycles). The 10-year scenario from a societal perspective yielded cost-savings of AUD$63.5M, healthcare cost-savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted. The lifetime scenario resulted in societal cost savings of AUD$176.6M, healthcare cost-savings of AUD$122.5M, 1,309,211 decayed teeth averted and 254.9 DALYs averted. Modeling indicated 71.5% and 74.5% cost-effectiveness for the 10-year and lifetime scenarios, respectively. A three-fold health benefit for the least advantaged was found compared to the most advantaged. A 20% SSB tax in Australia is cost-effective and promotes health equity. [ABSTRACT FROM AUTHOR]