Cancer care receives high praise from patients in Northern NSW Local Health District

People receiving cancer treatment across Northern NSW Local Health District (NNSWLHD) have provided overwhelmingly positive feedback for the care they received in the latest Bureau of Health Information’s (BHI) Outpatient Cancer Clinics Survey. More than 8,000 patients from across the state provided feedback with almost all (99 per cent) rating their overall care as ‘very good’ or ‘good’. This result has been consistently high since 2019 for NSW and is an improvement from last year.

Key feedback received from people accessing cancer care in Northern NSW Local Health District include:

• 99 per cent of patients rated their overall care as ‘very good’ or ‘good’

• 99 per cent of patients rated the health professionals who treated them as ‘very good’ or

‘good’

• 95 per cent said they ‘defnitely’ received safe, high quality care from the clinic

• 97 per cent agreed that the health professionals were kind and caring

• 95 per cent agreed that reception staff were polite and welcoming

Overall, NNSWLHD results showed signifcant improvements across three measures compared to the 2023 survey, while individual clinic sites Grafton, Lismore and Tweed all recorded between 3 and 9 measures that were signifcantly improved compared to 2023.

NNSWLHD Chief Executive Tracey Maisey said it’s encouraging to hear such positive feedback, with the District’s cancer teams committed to providing supportive care to people living with cancer.

“Our teams are focussed on providing a caring and compassionate experience for patients and their loved ones attending our cancer clinics,” Ms Maisey said.

“It’s wonderful to know that patients are feeling supported during their care, and that they are treated with the dignity and kindness they deserve.

“With the new Integrated Cancer Care Service now at the Tweed Valley Hospital, we look forward to continuing to provide excellent care in the new setting, and delivering expanded services such as radiotherapy closer to home for more patients.”

Professor Tracey O’Brien AM, NSW Chief Cancer Offcer and CEO, Cancer Institute NSW thanked cancer patients for taking the time to provide feedback on their care.

“Every 10 minutes someone in NSW is diagnosed with cancer, with one person dying from the disease every half an hour. Our cancer services are among the best in the country and it’s imperative our health system delivers world-class cancer care, in a safe and supportive environment,” Professor O’Brien said.

“I’d like to thank the expert and passionate health professionals working in our state’s cancer services, for supporting people and communities at an extraordinarily challenging time of their lives.

“These survey results highlight our commitment to delivering person-centred care with compassion, respect and dignity. We will continue to work closely with local health districts, cancer centres and clinicians across NSW to ensure that people with cancer have the support they need to navigate the healthcare system.”

The NSW Government invests around $180 million each year, through the Cancer Institute NSW, to improve cancer care in NSW and lessen the impact of cancer for people across the state.

The results of the Bureau of Health Information Outpatient Cancer Clinics Survey 2024 are available at: https://www.bhi.nsw. gov.au/.

Excess Body Fat Substantially Increases Risk of Postmenopausal Breast Cancer, Study Finds

New research from Spain, published in the Journal of Epidemiology & Community Health, suggests that nearly 40% of postmenopausal hormone-positive breast cancer cases could be linked to excess body fat. This fgure is signifcantly higher than the current estimate of one in 10 cases attributed to excess weight, based on body mass index (BMI).

The fndings indicate that the true impact of obesity on breast cancer risk has likely been underestimated.

The researchers argue that BMI, commonly used to assess obesity, is not an accurate indicator of body fat, particularly in older women. BMI does not account for factors such as age, sex, or ethnicity, making it less reliable in this demographic. To address this limitation, the study compared BMI with the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), a validated measure of body fat that takes both age and sex into account.

The study included 1,033 postmenopausal white women with breast cancer and 1,143 women without the disease, matched for age, sex, and geographic region. All participants were part of the MCC-Spain study, which investigates environmental and genetic factors related to various cancers, including bowel, breast, stomach, and prostate cancers, as well as chronic lymphocytic leukemia.

Participants provided detailed information on sociodemographics, lifestyle, personal and family medical history, and reproductive history. Dietary habits were assessed using a validated 140-item Food Frequency Questionnaire, and alcohol consumption between the ages of 30 and 40 was gathered through a selfadministered survey.

The study classifed body fat according to the CUN-BAE into four categories: below 35%, 35%-39.9%, 40%-44.9%, and 45% or above. BMI was categorized into: less than 25 kg/m², 25-29.9, 30-34.9, and 35 and above. The average BMI was just over 26 in the control group and slightly above 27 in women with breast cancer, while average CUN-BAE values were close to 40% for both groups.

Among the comparison group, 45% of women had a BMI below 25, compared with 37% of women with breast cancer. A BMI of 30 or above, indicating obesity, was observed in 20% of the control group and just over 24% of those with breast cancer. In terms of CUN-BAE, 20.5% of the control group had body fat below 35%, compared with 16% of those with breast cancer. Conversely, 46% of the control group had a CUN-BAE of 40% or higher, compared with 53% of the breast cancer group.

Crucially, a CUNBAE of 45% or higher was associated with more than double the risk of developing postmenopausal breast cancer, compared to those with a CUN-BAE below 35%. No similar trend was observed using BMI, leading researchers to estimate that 23% of breast cancer cases could be attributed to excess body fat when using BMI, but this fgure rose to 38% when using CUN-BAE. For hormone-positive cancers specifcally, the estimated proportion of cases attributable to excess body fat was 20% using BMI and 42% using CUN-BAE. While the researchers acknowledge that this case-control study cannot establish causality, and that the CUN-BAE formula was derived from a sample of sedentary individuals, they emphasize the signifcance of their fndings. The number of breast cancer cases that were not hormonepositive was small, limiting the study’s scope for non-hormonerelated cases.

Nonetheless, the researchers conclude:

“Our study indicates that excess body fat is a signifcant risk factor for hormone receptorpositive breast cancer in postmenopausal women. The population impact may be underestimated when relying solely on BMI, and more accurate measures of body fat, such as CUN-BAE, should be used when estimating the cancer burden attributable to obesity in postmenopausal breast cancer.”

These fndings are essential for informing public health strategies aimed at preventing breast cancer, as more accurate measures of body fat can help identify individuals at higher risk and guide more effective prevention efforts.