The 45 and Up Study is the biggest cohort study ever undertaken in Australia.
The study has gathered demographic, health and lifestyle information from 266,000 individuals, aged 45 and over, across NSW. All participants have also now been invited to complete the first of its 5 year follow-up questionnaires and the data will be available this year.
The study is managed by The Sax Institute with Cancer Council NSW as the major partner.
Other partners are: the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; beyondblue; NSW Government Family & Community Services – Carers, Ageing and Disability Inclusion; and the Australian Red Cross Blood Service..
Researchers at Cancer Council NSW have used the 45 and Up Study data for various projects, including:
- Investigating issues in men’s health, such as lower urinary tract symptoms or erectile dysfunction
- Investigating the effects of tobacco use on health and mortality
- Investigating the extent of cancer screening in NSW and the effects of screening on cancer incidence
- Describing how multiple lifestyle risk factors for cancer (diet, exercise, body weight, alcohol and smoking) combine to affect a person’s risk of cancer
45 and Up Study Publications from Cancer Council NSW
Tobacco and Mortality
In 2015, Dr Marianne Weber, Mr Sam Egger and A/Prof Freddy Sitas were co-authors on a publication lead by Prof Emily Banks at the Australian National University which quantified the number of deaths in the 45 and Up Study associated with smoking. This study provides the first large-scale, direct evidence on smoking and mortality in Australia and shows that up to 1.8 million of our 2.7 million smokers will die from their habit if they continue to smoke. That is, up to 2 in every 3 smokers will die from the habit.
Colorectal cancer incidence and screening
In 2014, Dr Marianne Weber was a co-author on a publication lead by Dr Annika Steffen at the University of South Australia which demonstrated that colorectal cancer incidence was lower among participants with a history of colorectal cancer screening, compared with participants who were never screened and the benefit lasted for at least 4 years after screening.
Cancer Screening Among Immigrants in Regional Areas of NSW
In 2014, Dr Marianne Weber, Ms May Chiew, Ms Clare Kahn, and A/Prof Freddy Sitas from our Cancer Research Division, were co-authors on a publication which examined uptake of faecal occult blood testing (FOBT) as well as PSA testing and mammography in men and women respectively during the previous two years. The research also looked at the difference in cancer screening between our immigrant and Australian-born populations in rural and urban areas. The results revealed that just 22 per cent of male and 18 per cent of female immigrants living in rural regions had undergone FOBT, compared with 26 per cent and 20 per cent of Australian-born men and women living in rural areas. Similar disparities were also seen amongst immigrants living in urban dwellings; with just 16 per cent of male and 13 per cent of female immigrants taking up FOBT screening, compared with 22 per cent and 18 per cent of Australian-born men and women.
Lower Urinary Tract Symptoms (LUTS)
In 2014 A/Prof David Smith and Dr Marianne Weber from our Cancer Research Division, were co-authors on one of the largest studies in the world to document associations between LUTS and socio-demographic, lifestyle and other health issues. It is also one of the few to report severe LUTS. In addition to low socioeconomic status and serious chronic disease, it identifies several modifiable risk factors that are associated with severe LUTS, including smoking, lack of physical activity and obesity. These factors, if modified, may reduce the risk of LUTS, as well as a number of other chronic diseases, including cancer, in men. If men want to reduce their risk of urinary problems into older age they can take some simple measures, such as, quitting smoking, losing some weight and getting regular exercise.
In 2013, Dr Marianne Weber, Prof David Smith, Prof Dianne O’Connell and A/Prof Freddy Sitas, from our Cancer Research Division, were co-authors on a publication which looked at men in the 45 and Up Study and their experiences with erectile dysfunction. The report showed that almost two thirds of the men surveyed suffered some degree of erectile dysfunction and for men aged 75 years and over, almost all of them reported either moderate or severe erectile dysfunction. The study showed that factors such as smoking, diet, and alcohol can increase the risk of erectile dysfunction, whereas men who exercised had a lower risk. This information provides health practitioners in NSW with useful information about erectile dysfunction in their local communities. From here, we can better monitor and report on the side effects of many of the treatments for prostate cancer, such as those studied in the Prostate Cancer Care and Outcomes Study.
From the findings of this publication, Cancer Council NSW created an infographic poster and pamphlet for GPs, to help keep men informed about the effects of their lifestyle choices.
A/Prof David Smith gave a presentation on this issue in 2013, you can view it below.
Cancer Screening and Socioeconomic Issues
In 2013, Dr Marianne Weber, A/Prof David Smith, A/Prof Freddy Sitas and Prof Dianne O’Connell, from our Cancer Research Division, were authors on a paper that looked at the socio-demographics characteristics of those being screened for breast cancer, prostate cancer and bowel cancer. This publication highlights that people often get screened for one cancer (i.e., breast and prostate) when they could be screened for two (i.e. many people are not screened for bowel cancer).
Lower Urinary Tract Symptoms (LUTS) and Country of Birth
In 2013, Dr Marianne Weber and A/Prof David Smith, from our Cancer Research Division, were co-authors on a paper that studied the rates of LUTS in men born overseas, and compared these to men born in Australia. This publication outlines findings that indicate region of birth plays may be related to the development of LUTS.
Treatment pathways for colorectal cancer
In 2013, Mr David Goldsbury and Prof Dianne O’Connell, from our Cancer Research Division, were authors on a paper that investigated whether patients saw their GP between having a colonoscopy and surgery. Doing so would mean the GP is involved in the treatment process, which can be beneficial for patients seeing multiple specialists for treatments. This study showed that there may be room for improvement in this area of the Australian health care system.
Smoking and Social Interaction
In 2012, Dr Marianne Weber, Ms May Chiew, Mr Sam Egger and A/Prof Freddy Sitas, from our Cancer Research Division, were authors on a paper that measured the social interactions of current smokers, past smokers and people who had never been smokers. This study showed that smokers were not only worse off economically, but also were likely to be more socially isolated. This report highlights the importance of comprehensive social support services for people wanting to quit..
Smoking in Migrant Populations
In 2012, Dr Marianne Weber, Mr Sam Egger,and A/Prof Freddy Sitas, from our Cancer Research Division, were authors on a paper that looked at the distribution of smokers by where they were born. The study showed that after accounting for socio-economic status, men born in Europe, North Africa and the Middle East were more likely to smoke than men born in Australia and women born in Asia were less likely to smoke that Australian-born women.
Cancer Screening in Migrant Populations
In 2009, Dr Marianne Weber, A/Prof David Smith, Prof Dianne O’Connell and A/Prof Freddy Sitas, from our Cancer Research Division, were co-authors on a paper that compared the use of cancer screening tests of immigrants with those of Australian born participants. Results showed that, in general, immigrants did not access cancer screening tests at the same rates as Australian born participants, however, as the number of years lived in Australia increased, the use of screening tests by immigrants approached that of Australian born participants.
Colorectal Cancer Screening
In 2008, Dr Marianne Weber and A/Prof Freddy Sitas, from our Cancer Research Division, were co-authors on a paper that investigated the characteristics of participants that utilized bowel cancer screening tests. Bowel cancer screening uptake was low among those with lower education, lower income, a lack of private health insurance. Compared with other participants, test uptake was particularly low among current smokers, inactive participants, those without fruit or vegetables in their daily diet and those with a disability.
You can read this publication here: http://msc.sagepub.com/content/15/3/137.full.pdf+html
Click here to read the newsletter about some recent projects at Cancer Council which have used 45 and Up Study data.
For more information on the sub-studies being conducted at Cancer Council NSW, please contact:
For more information on the 45 and Up Study please contact the study directly at https://www.saxinstitute.org.au/our-work/45-up-study/