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06 Mar 2019
Opinion Piece

Building parity into performance

March 2019

This month began with a visit to the annual Lorne Cancer Conference.  Congratulations to all who have shared in the 30-year history of the meeting, and to the organising committee for yet another successful event.  It was great to see strong representation from throughout the alliance and to share conversations and learnings across the cancer spectrum.

There is always some pride in showcasing Lorne’s natural beauty to international visitors and, emerging from sessions from time-to-time to blink into the sunlight really affirmed that we are a nation of coast-dwellers.

Australia is unique in this regard with around 85 per cent of us living within 50km of the sea. We are also among the most urbanised countries in the world, with 70 per cent of people calling a capital city home. This mix of metro, regional and rural populations presents opportunity and challenge. According to World Health Organisation (WHO) comparisons in the last decade, Australian residents have better cancer survival than people living in most other countries and other regions.

Australia performs well in international reporting

The International Agency for Research on Cancer (IARC) mortality-to-incidence (MIR) ratio data as reported in Cancer in Australia 2017 provides the surest sign that Australia and New Zealand punch well above our weight in the Oceania region with a MIR of 0.3. By comparison, the MIR for the world sits at 0.6, putting us at the forefront of a group of countries with higher cancer survival than the world average.  

There is tremendous opportunity in having such a strong baseline, but one of the ongoing challenges for Victoria and our region is parity. Safeguarded by a robust economy and consistent funding, the responsibility is ours to ensure that disparities are continually identified and addressed. We need to look at where we are doing well but more importantly where the gaps are.

Lung, colorectal and gynecological cancer incidence and mortality are still comparatively high, particularly in socially-disadvantaged communities and where care is not as close to home as it is for city-dwellers.  While we are justifiably proud of progress made in recent years, Pacific neighbours are not faring nearly so well and we need to ensure that distance from the epicentre does not equate to diminished effect.   For example, according to IARC Globocan 2018 figures, more than half of all cancers identified among people living in Papua New Guinea result in death.  Within our own country, in the five years from 2010-2014, the age-standardised mortality rate was highest in the NT and lowest in the ACT. 

Investigator-initiated trials program will have major impact

So where are our efforts best placed? Right now, investigator-initiated trials (IIT) are the number one unmet need for Victoria’s cancer research community. IIT trials are established and managed by non-pharmaceutical researchers, who also retain responsibility for legal and regulatory requirements.  In a supported workforce initiative announced this month, our Investigator-initiated Trial Program will increase access to more than 6,000 patients across Victoria, Australia and overseas. Patients with blood; colorectal; lung or breast cancers and some advanced-stage cancers, will gain access to pivotal clinical trials through this program. The four projects encompass oncological disciplines not often associated with clinical trials: radiotherapy, palliative care, surgery and anesthetics.

Master of Cancer Science program underway

Many years of planning, hard work and dedication came to fruition when we formally launched the new Master of Cancer Sciences program delivered through the University of Melbourne last month. Much work was undertaken in the early planning and development of this program by Professors Michael Henderson, Sandy Heriot and Michael Jefford from Peter MacCallum Cancer Centre. I’d particularly like to acknowledge my fellow course convenor Dr David Kok, as well as Michelle Barrett and Sathana Dushyanthen from our own Education Development team and the Melbourne School of Professional and Continuing Education Graduate Online team headed by Amgad Louka for their leadership in getting this highly innovative course up and running.

Speaking at the launch, the Parliamentary Secretary for Health Anthony Carbines said, “This program will build the sort of world-class workforce that renews hope and helps save lives. This degree will equip the workforce with cutting-edge tools to bring the best of cancer care to Victoria, as well as taking this state’s research findings to the world.”

It was a hugely gratifying evening, made more special by the opportunity to welcome some of the first students. 

It was also an opportunity to thank the subject coordinators Dr Joep Vissers, Assoc Prof Andrew Weickhardt, Assoc Prof Brigid Lynch, Dr Lucinda Morris, Dr Julia Lai-Kwon and Dr Kirsten Fairfax; along with the significant number of people who helped formulate the vision and the hundreds more who are contributing their expertise.

As we embark on another fulfilling and busy year, please ensure the major VCCC Research Conference is in your diary Monday 16 and Tuesday 17 September 2019. 

Professor Grant McArthur
Executive Director