South Australian Social and Behavioural Cancer Research Symposium 2026

Background: Multimorbidity (co-occurrence of two or more long-term conditions) impacts all stages of cancer care, increases prognosis uncertainty and care complexity, and is associated with adverse outcomes. This study aimed to understand Australian stakeholder experiences and recommendations for a model of care to manage multimorbidity in people with a history of cancer. This study explored stakeholder experiences and recommendations for managing multimorbidity in people with a history of cancer.

Methods: Adult consumers with a history of cancer and multimorbidity or relevant caregiving experience (n = 30), and healthcare professionals (n = 26) participated in qualitative semi-structured focus groups or interviews. Reflexive thematic analysis was used to identify key themes and inform a prototype clinical pathway. 

Results: Participants reported challenges including fragmented care due to siloed systems, poor communication, ineffective digital tools, difficulty navigating care, inadequate psychological screening, and limited follow-up in tertiary and primary care. They suggested a clinical pathway for multimorbidity in cancer should include a ‘go-to’ healthcare professional/team providing whole-person care from diagnosis throughout survivorship. It must address pre-existing and emerging conditions, including psychological morbidity, with ongoing assessment, screening, and sustained connection to non-cancer specialists. Ongoing care should include guidance on late effects and consumer advice on symptoms and go-to contacts. Resources needed include specialist nursing coordination, psycho-oncology support, improved primary care access, tailored digital health tools, and chronic disease management plan adjustments. 

Conclusion: Multimorbidity management in cancer requires integrated survivorship care, interdisciplinary collaboration, and sustained navigation. Further implementation-focused research, policy reform, and resourcing are essential.

Background: Health Navigator (HN) interventions are designed to address patients’ health-related social needs (e.g. financial insecurity). Evidence suggests HN interventions may improve the wellbeing of populations living with cancer. However, research in hospital settings is limited. 

Aim: To explore the feasibility and acceptability of a hospital-based HN intervention to address the social needs of a disadvantaged population living with cancer.

Methods: Participants were ≥18 years and presented to the Northern Adelaide Cancer Centre. Participants who reported social needs and requested assistance were linked to the HN. The HN assisted participants to co-develop a referral plan to appropriate services, and provided advocacy over a six-month follow-up period. Participants who did not request assistance were not referred to the HN. Primary outcomes were intervention feasibility and acceptability. Feasibility was defined using process measures, e.g. intervention uptake and completion. Acceptability was explored using focus groups (n=11 participants, n=2 caregivers and n=2 oncologists) and thematic analysis. Secondary outcomes included pre/post intervention changes in social needs and other patient-reported measures (e.g. Coping with Cancer Ability). 

Results: All participants who reported social needs requested assistance from the HN (100%, n=55/55). The prevalence of all needs reduced following intervention, with the greatest reductions reported in support needs (↓62%). Participants, carers and clinicians reported the intervention to be highly acceptable, but cited service availability as a key limitation. 

Conclusions: Participants and clinicians report the intervention is acceptable and reduced social needs. Larger scale implementation studies are required to determine intervention feasibility in the context of limited service provision.

Objective: While there is a growing acknowledgement of the importance of healthcare providers (HCPs) building knowledge and providing equitable care within cancer broadly, there is little knowledge within gynaecological cancer care specifically for LGBTQ+ populations, particularly within Australia. The aim of this study was to understand the level of knowledge, attitudes, and inclusivity practices within healthcare settings when treating LGBTQ+ populations within gynaecological cancer care.

Methods: This study was a mixed methods design and recruited Australian health care professionals treating LGBTQ+ populations within gynaecological cancer care. Twenty-one surveys were completed related to domains of knowledge, inclusivity, and attitudes regarding LGBTQ+ peoples, with 11 participants completing short answer responses resulting in one theme and one subtheme.

Results: HCPs reported and demonstrated high levels of knowledge, positive attitudes, and inclusive practices for LGBTQ+ peoples within various healthcare professions. However, concerns around using offensive language, needing more specific training, particularly regarding changes to self-identity in trans men and impacts of hormone therapy on cancer treatments, are needed as well as resources for carers. 

Conclusion: HCPs are seeking more education and institutional assistance in order to support LGBTQ+ populations within gynaecological cancer care. Systemic training, policy reform, and resources are essential to enable HCPs to provide equitable, knowledgeable, and affirming care to best support all LGBTQ+ peoples in all aspects of gynaecological cancer care.

Background: Survival rates for childhood cancers have improved, significant psychosocial burden persists during diagnosis, treatment and into survivorship. There is limited understanding of how children’s psychosocial needs evolve throughout the cancer care continuum. This meta-ethnographic review synthesised qualitative evidence on the psychosocial needs and experiences of paediatric cancer patients’ (0-19 years) and developed an explanatory model describing how needs change over time. 

Methods: A meta-ethnography was conducted following Noblit and Hare and has been reported according to eMERGe guidelines. A systematic search (January 2009- June 2025) identified 32 eligible qualitative studies. Qualitative data were categorised into first‐order (i.e., participant verbatim) and second-order constructs (i.e., authors interpretations) and then compared to generate higher-level (third-order) interpretations. 

Results: Psychosocial needs and experiences were categorised into six domains: 1) family, 2) peer relationships, 3) psychosocial care, 4) emotions, 5) control, and 6) information. Different psychosocial needs, expressed through newly generated theory, became more prominent at different points in the cancer continuum, from children being emotionally protected by caregivers at diagnosis, to children seeking to participate in their daily care during treatment, to regaining ownership and autonomy in their lives throughout survivorship. Key challenges included relationship loss at diagnosis, procedural anxiety, loss of autonomy during treatment, and lack of co-ordination support in survivorship, marked by fragmented psychosocial support and unmet informational needs. 

Conclusion: Study findings identify the period immediately after diagnosis as a critical window for early psychosocial pre and/or rehabilitation to support the need for coordinated developmentally attuned psychosocial pathways across paediatric oncology services.

People with multiple myeloma (MM) and smouldering myeloma (SMM) experience high rates of psychological distress and low quality of life, yet resources to promote mental health and wellbeing remain limited. This gap is exacerbated by the limited number of resources co-designed with individuals with lived experience. Hence, in partnership with lived experience experts and national advocacy organisation, Myeloma Australia, we aimed to adapt an existing, evidence-based mental health program to meet the nuanced and often psychological unmet needs of this vulnerable patient population.  

Twenty people aged 38-72 with MM (n=16) or SMM (n=4), and Myeloma Australia nurses (n=4), formed the lived experience panel and completed the Be Well Plan – a 5-week, group-based, online mental health and wellbeing program delivered by a trained facilitator. Empowerment, mental wellbeing, anxiety and depression were assessed before and after the intervention. The Double-Diamond co-design methodology was used to identify and implement adaptations regarding, content, structure and delivery.  

The unadapted Be Well Plan demonstrated encouraging feasibility and acceptability, with significant and substantial improvements in mental wellbeing (ηp²= .243) and empowerment (ηp²= .246). No significant changes were reported in anxiety and depression, providing a clear rationale for adaptations and contextualisation for MM and SMM. Qualitative thematic analysis of post-program feedback highlighted key areas for adaptation including the need for slower pacing, simplification of content and myeloma-specific examples; all of which informed program refinements within the Intervention Mapping framework, resulting in a new program – the myWELL Plan.

Rigorous and intentional inclusion of people with lived experience enabled the development of a more tailored mental health program, contextualised for the complex and highly nuanced needs of people with MM and SM. The myWELL Plan is now operational and ready for evaluation in a national RCT.

Introduction: This presentation outlines a process and outcomes for co-designing alcohol policy for breast cancer prevention with women (community members) based on options deliberated with the media, NGOs, health promotion agency representatives, advocacy groups and service providers. It also provides details about a research translation partnership with the Cancer Council SA to action the recommendations from the deliberative dialogues.

Method: We undertook deliberative dialogues (July 2023-July 2024) using Experience-Based Co-Design to investigate women’s ‘asks’ for systems-level changes that might increase knowledge about alcohol-breast cancer risk, and support alcohol reduction, and then devise policy options with stakeholders. We recruited 15 Australian women (aged 40-65 years self-reported light/medium/heavy drinking, different social classes with no breast cancer history) who remained engaged through 5 focus groups and informed the content for deliberation and development of policy with stakeholders (n=3 groups of 10-12 stakeholders; 2 hours/dialogue group).

Findings: Our process identified areas for policy responsive to structures that contribute to misinformation/misperceptions about alcohol-breast cancer risk (i.e. regulating commercial practices). It indicated areas for improving women’s trust in risk messaging, involving them in priority-setting for improving transparency in policy development. Deliberative dialogues with stakeholders supported guidelines for communication about alcohol-breast cancer risk that spotlight determinants (not individual behaviours).

Discussion: Co-design led by lived experience experts has high potential to inform suitable service delivery, community practice and communication delivered through the media, focused on reducing preventable alcohol-related breast cancers. Our process for co-designing policy aligns with the National Preventive Health Strategy and the SA Cancer Plan.

Background & Aim: Sun-protective hats are one of five key endorsed sun safety behaviours. South Australian government secondary schools have limited guidance and no mandatory hat policy. This study aims to pilot a hat-wearing intervention for Year 7 and 8 students in two schools, using student leadership to develop a self-guided toolkit promoting sun protection behaviours.

Methods: The hat-wearing intervention will be implemented in Terms 1 and 4, 2026. This abstract reports baseline survey data from Year 7-10 students, parents/guardians and teachers, alongside peer-leadership group involvement. Surveys will be repeated post-intervention with focus groups (Term 4, 2026). 

Results: To date, 241 people (45% students, 41% parents/guardians, 14% teachers) completed the baseline survey. While most students agreed they should be mindful of skin cancer (86%) and endorsed sun protection (69%), only 38% regularly practiced it, with hat-wearing being the least reported sun protection behaviour used when outside for 15 minutes or more in spring/summer (14%). Overall, 64% believed student hat-wearing should increase, however only 44% of students agreed. Key barriers for hat-wearing reported by students were forgetting hats (90%) and discomfort (74%). Initial peer-leadership sessions (n=10 students) highlighted peer-to-peer education, media/poster distribution, accessible hat storage, incentives (e.g. house points), and personalised school hats as strategies to support engagement. 

Conclusion: Students recognise skin cancer risks and sun safety but less frequently practice protective behaviours. Peer-led initiatives, supported by ongoing engagement, will guide interventions and toolkit development to overcome barriers and support sun protection implementation in secondary schools.

Purpose: This scoping review examines the available evidence on cancer-related discrimination.

Methods: Cancer-related discrimination was defined as direct and recurring experiences of enacted stigma, behaviours, or unfair treatment based on an individual's cancer history, current diagnosis, or perceived risk. A systematic search of PubMed, EMBASE, Web of Science, the Cochrane CENTRAL, and PsycINFO identified peer-reviewed original research published before December 13, 2024. Two independent reviewers screened studies, and data were narratively synthesised using the Health Stigma and Discrimination Framework (i.e., discrimination drivers and system-level facilitators; discrimination experiences; impacts).

Results: A total of 156 studies met the inclusion criteria, comprising 70 cross-sectional studies, six systematic reviews, 62 qualitative papers, 13 mixed-methods studies, two scoping reviews, one longitudinal study, and two experimental studies. Reported experiences of cancer-related discrimination were categorised into the following contexts: 1) familial and social; 2) hiring and workplace; and 3) insurance and welfare; and 4) healthcare. Discrimination drivers included misconceptions that cancer is contagious, employer concerns about productivity and costs, rigid welfare policies, and diminished empathy for perceived ‘self-inflicted’ cancers. Experiences ranged from social ostracization and bullying, to workplace dismissals, job rejections, and barriers to insurance or financial support. In healthcare contexts, provider blame, judgment and strained patient-clinician interactions were reported. Impacts of discrimination included self-isolation, concealment of diagnosis, internalised stigma, psychological distress, financial burdens, and delayed treatment-seeking. 

Conclusion: Cancer-related discrimination may arise from cultural, institutional, and structural mechanisms, with significant impacts on quality of life and health. Policy and institutional reforms along with public education are needed to address these challenges.

Background: Racism imposes a hinderance towards achieving equity in healthcare by pervasing on an individual, community, societal and institutional level. Diversity in clinical research is essential to achieve favourable outcomes and mitigate inequities in disease impact and burden. Methodologies are described and proposed by scholars to achieve this equity in research grounded in decolonising frameworks and indigenist knowledges. Cancer is the highest contributing cause to mortality in the world with an inequitably higher impact on First Nations Peoples. Research specific to First Nations Peoples, following principles of Indigenous research, is critical to warrant advocacy and delivery of measures with relevant translatable outcomes and benefits. 

Aim: The following paper presents a case study of a longitudinal cohort project assessing oral human papillomavirus-associated oral cancer in First Nations peoples of South Australia. 

Methodologies: It discusses different decolonising methodologies and its application and relevance in a clinical research project. 

Results: It proposes 8 principles to abide by whilst striving for equity in research and diffusing the power differential. 

Conclusion: Health equity mandates establishing guidelines which addresses systemic barriers, rigid structures and increased burden of disease to create opportunities for each participant to be as healthy as possible. The HPV-OPC project is one of the most successful longitudinal cohort studies in the world with a focus on oral HPV infections and oral cancers among a First Nations community. Steps have been taken from the early planning stages to the final delivery of outcomes ensuring benefit to community, sustainable approaches, cultural safety, community leadership, anti-racism and effective screening of oral cancers. These eight guidelines can be adapted into clinical research projects with First Nations Peoples to achieve equitable outcomes.

Background: Colorectal cancer (CRC) remains a major public health concern in Australia. Despite the availability of a biennial faecal immunochemical test (FIT) through the national screening program, participation rates vary markedly across geographic areas. Previous research has often overlooked spatial heterogeneity in health indicators, limiting the effectiveness of place-based interventions. This study examined area-level health and behavioural factors associated with CRC screening participation across Australia.

Methods: We analysed national data from 404 local government areas (LGAs), including indicators such as current smoking, excessive alcohol consumption, adequate fruit intake, obesity, and other health determinants. Aggregated CRC screening participation rates were sourced from the Public Health Information Development Unit (December 2024 release). Spatial autocorrelation (Global Moran’s I) assessed clustering, while multiscale geographically weighted regression identified spatially varying associations between screening participation and health and behavioural indicators. The golden gradient-based optimisation algorithm determined variable-specific bandwidths. 

Results: CRC screening participation exhibited significant spatial clustering across LGAs (Global Moran’s I = 0.4954; p = 0.01). Indicators such as psychological distress, physical inactivity and speaking only English at home had global associations with CRC screening. In contrast, obesity, current smoking, excessive alcohol consumption, adequate fruit intake, comorbidity, private health insurance, and poor self-rated health showed localised effects. Adequate fruit intake and comorbidity were consistently positively associated with participation, while poor self-rated health, current smoking, excessive alcohol consumption and obesity were generally linked to lower participation. 

Conclusions: Incorporating spatially varying health and behavioural indicators into public health planning can support targeted interventions and improve CRC screening participation.

Background and Aims: Colorectal cancer (CRC) screening using the faecal immunochemical test (FIT) reduces CRC incidence and mortality. However, effectiveness is limited due to suboptimal participation rates, with barriers including faecal aversion and lack of test familiarity. A user-friendly approach is needed to increase participation. WaterFIT uses a rapid antigen test (RAT) cassette to analyse toilet bowl water after a bowel motion. The aim was to determine the diagnostic performance of WaterFIT for advanced neoplasia (CRC and advanced pre-cancerous lesions) compared to FIT.

Methods: Individuals scheduled for colonoscopy were invited to complete both WaterFIT and FIT before their procedure. FITs were returned by post for laboratory haemoglobin (Hb) analysis, while the WaterFIT result developed on the RAT cassette, with a photo submitted online. Colonoscopy outcomes were assessed. Diagnostic accuracy measures for advanced neoplasia were calculated for WaterFIT and FIT at comparable positivity thresholds (≥2 µg Hb/g faeces).

Results: 105 patients completed WaterFIT, FIT and colonoscopy, with 35.2% (n=37/105) positivity with WaterFIT and 36.2% (n=38/105) positivity with FIT. Advanced neoplasia was diagnosed in 8.6% of individuals (including 1 CRC). The sensitivity of WaterFIT for advanced neoplasia was 88.9% (n=8/9) compared to 55.6% (n=5/9) for FIT. The CRC was detected by both tests. The negative predictive value was 98.5% for WaterFIT and 94.0% for FIT. There were no significant differences between the performance of WaterFIT and FIT (p>0.05).

Conclusions and Significance/Impact: WaterFIT has equivalent diagnostic accuracy to FIT in detecting advanced neoplasia and hence has potential to reduce CRC incidence and mortality.

Background: Lung cancer screening (LCS) presents unique opportunities to support a high-risk population with smoking cessation information and support. 

Aim: To inform appropriate health promotion resources, this study explored perceptions of smoking cessation messaging characteristics. 

Methods: Think-aloud interviews were conducted with participants meeting Australia’s National LCS Program eligibility criteria (including >30 pack-year smoking history), immediately prior to Program commencement. Participants verbally narrated responses to exemplars of international, LCS-specific, smoking cessation information, selected following a systematic audit of existing resources. Codebook thematic analysis was used to interpret transcripts and structure reporting against key Extended Parallel Process Model constructs (Acceptability, Threat, Efficacy, and Fear). 

Results: Participants (N=34; 71% smoking daily) were broadly supportive of cessation information disseminated in LCS but recommended concise resources with locally-relevant language and design. Personalisation and directness in messaging were suggested to convey susceptibility to and severity of potential smoking-related harms, but with non-judgemental tone empathetic to individual’s long smoking histories. To strengthen beliefs about response/self-efficacy, participants emphasised that resources should incorporate age-targeted risk information and encourage quit attempts with the support of realistic behavioural strategies and available services. Supportive information that encouraged self-reflection, rather than telling people ‘what to do’, had the potential to counter potential self-exemption and message rejection. 

Conclusion: Findings highlight the importance of direct, empathetic, and efficacy-enhancing cessation messaging in LCS. Existing resources require extensive modification to achieve relevance. Co-designed resources have the potential to support cessation and screening uptake, and minimise stigma, particularly when tailored to the preferences of individuals eligible for LCS.

Objectives/purpose: People with intellectual disability experience persistent barriers to accessing and receiving appropriate cancer care, leading to poorer cancer-related outcomes than the general population. This scoping review aimed to identify and examine peer-reviewed research exploring the cancer survivorship experiences of people with intellectual disability from their perspectives following their own cancer diagnosis.

Procedures: A scoping review was conducted in September 2024 following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A comprehensive search identified 1,239 studies, of which eight met the eligibility criteria and were included in the final review.

Sample and setting: Of the eight studies included, all were conducted in the UK between 2007 and 2016. Across these studies, a total of 20 participants with intellectual disability were represented, including 12 women and eight men, with a mean age of 53.6 years (range: 34–76). All studies used qualitative methods.

Results: Three themes were constructed in the synthesis: (1) Include me, (2) My real feelings, and (3) Having the right help. These themes highlight the emotional, communication, and support needs as voiced by people with intellectual disability during cancer survivorship. However, experiences, needs and preferences outside the UK remain unexplored.

Conclusion and clinical implications: This is the first review to summarise research on the cancer survivorship experiences of people with intellectual disability from their own perspectives. A larger, international evidence base is urgently needed to inform equitable cancer care systems and address the needs of people with intellectual disability.

Objectives/purpose: Finding My Way – Advanced (FMW-A) is a co-designed 6-module self-guided online CBT program for women with metastatic breast cancer (MBC). This study evaluated program engagement and efficacy in improving quality of life (QOL) and distress.

Methods: A national multisite randomised controlled trial recruited eligible women with MBC (aged 18+ years, life expectancy of 6+ months, internet access, and sufficient English). Participants were recruited via direct clinician approach (61.8%) across 10 sites, or self-referral (38.2%). Participants were randomised to intervention (FMW-A) or control (Breast Cancer Network Australia’s ‘My Journey’ online). Measures of QOL (primary outcome), general distress (DASS21), cancer-specific distress (PSS-SR),  fear of progression (FoPQ), and unmet needs (SCNS) were assessed at baseline, post-intervention, and 3- and 6-month follow-up.

Results: 280 women consented (54.8% consent rate; 139 intervention, 141 control). Participants (Age M±SD=58.4±11.6), were diagnosed an average of 2.9 years prior (39% with de novo MBC), and exhibited significant baseline burden: many exceeded clinical thresholds for impaired mental-QOL (48%) and physical-QOL (55%); cancer-related distress (43.3%), fear of progression (51%), and depression, anxiety and/or stress (37.7%). Program engagement was moderate (Mean=3.03 modules accessed; 4.75 logins; 30/112 pages accessed). Full intention-to-treat analyses found FMW-A did not demonstrate superior benefits over My Journey for any outcome, however significant within-group improvements in Fear of Progression, Unmet Needs and select QOL domains were found for both programs.

Conclusion: Despite experiencing QOL and distress burden, participants showed only modest program engagement. Both FMW-A and My Journey are effective in improving Fear of Progression and Unmet Needs.

Background: Physical activity is an effective strategy in reducing the detrimental effects of cancer and treatment and improving survivors’ health and wellbeing. Unfortunately, physical activity levels often decline during chemotherapy. Infusion appointments present an opportunity to provide supportive care. Virtual Reality (VR) exercise during chemotherapy infusion offers a novel way to encourage physical activity and enhance the treatment experience. This approach has not been previously studied.

Aim: The aim of this body of work was to explore the preferences and perceptions of VR exercise during infusion and its potential clinical utility among 1) adults diagnosed with cancer who had experienced chemotherapy as part of their cancer management, and 2) infusion suite nurses.

Methods: Study 1 involved people diagnosed with cancer (n=8) who had completed chemotherapy. Study 2 included people diagnosed with cancer undergoing chemotherapy (n=5) and infusion nurses (n=3). Participants trialled seated VR pedal exercise and provided feedback via focus groups or interviews on therapeutic potential, preferences (e.g., virtual environment), equipment setup, and barriers. Transcripts data were analysed using qualitative content analysis.

Results: Participants reported enjoyment and potential therapeutic benefits such as distraction and reduced anxiety. Preferred VR features included hyper-real animation and natural environments. Nurses highlighted risks to cannulas from arm movement, chair safety, and the need for portable equipment.

Conclusion: To our knowledge this is the first body of work to explore VR exercise during infusion.  These insights will inform the development of tailored VR exercise experiences for use during chemotherapy infusion.

Background: There is strong epidemiological evidence that obesity is linked to an increased risk of multiple cancers, including colorectal, kidney, pancreatic, liver, thyroid, multiple myeloma, and several female reproductive cancers. Recent emerging global evidence suggests that obesity-related cancer rates are increasing among younger adult populations. However, there is currently limited research examining the prevalence and trends of obesity-related cancer (ORC) among young South Australian adults.

Aim: To examine 40-year trends in obesity-related cancer incidence among South Australians aged 20–49 years.

Methods: Data were drawn from the South Australian Cancer Registry (SACR). Population-based cancer incidence data (SACR, 1982–2021) were analysed for 12 previously identified obesity-related cancer types. Trends were evaluated for all obesity-related cancers combined and for site-specific obesity-related cancer types for 5-year periods using age-specific rates per 100,000 population and linear regression for trend significance.

Results:
• All obesity-related cancers combined increased significantly from 43.0 to 79.1 per 100,000 between 1982–86 and 2017–21 (p<0.0001). 
• Strong upward trends were observed for colorectal, kidney, pancreatic, thyroid, uterine corpus, breast cancer, multiple myeloma, and liver cancers, with the steepest increases in thyroid (from 3.1 to 10.0 per 100,000) and colorectal cancer (from 8.7 to 15.9). 
• Females exhibited consistently higher ORC rates than males, driven by breast, uterine, thyroid and ovarian cancers.

Conclusion: Over the past 40 years, obesity-related cancers have increased significantly, almost doubling during this observation period among South Australians under 50. These data mirror international trends linking early-life obesity with early-onset cancer risk. The sustained upward trajectory warrants future public health efforts to target cancer prevention among young South Australians.

Implications for Prevention: These findings reinforce the need for primordial prevention achieved through legislative and policy actions addressing obesogenic food and physical activity environments, and mass-media campaigns emphasising the risks of obesity in young adults.

Background: Cancer remains a leading cause of disease burden in Australia, with many cases linked to preventable lifestyle factors. Improving public understanding of modifiable cancer risks supports informed decision-making and protective behaviours. Tracking changes in these perceptions over time helps identify knowledge gaps and priority groups for targeted prevention efforts.

Aim: This study examined South Australians’ perceptions of modifiable cancer risk factors from 2018–2022 and identified groups with lower awareness.

Methods: Data were obtained from the telephone-based South Australian Population Health Survey Module System (n=3,002 in 2022), sampling residents aged 15+. Participants rated the perceived importance of factors (smoking, alcohol, diet, sun exposure, immunisation) in cancer risk on a 5-point scale. Trend and regression analyses explored changes over time and sociodemographic predictors.

Results: Risk perceptions remained relatively stable across 2018-2022, with some minor downward trends. Perceptions of cancer risk from smoking and sun exposure were consistently high, while perceptions for drinking alcohol and being unimmunised against viral infections were lowest. For alcohol, lower perceived cancer risk was significantly associated with older age, male sex, lower education, and higher drinking frequency (p<.05). For being unimmunised, lower perceived risk was associated with younger age and speaking English as a primary language (p<.001).

Conclusion: Significant gaps persist in the South Australian public's understanding of key cancer risk factors, particularly concerning alcohol consumption and lack of immunisation. Despite established scientific evidence, these factors are not perceived as high-risk by a substantial portion of the population, which may undermine preventative health efforts.

Aim: Cancer places substantial financial burden on people with cancer (PWC) and their caregivers, a pressure likely intensified by the current cost-of-living crisis. This study examines the prevalence and experiences of cancer-related financial strain among South Australians, reporting survey results from a mixed-method study.

Methods: An online panel recruited 312 South Australians affected by cancer in the past five years (n=105 PWC; n=207 caregivers). Participants reported current and pre-diagnosis financial circumstances retrospectively, including cost-related sacrifices, awareness of treatment expenses, and use of support resources.

Results: A third of PWC (34%) reported marked financial strain post-diagnosis, increasing from 26% pre-diagnosis. Almost half of PWC (46%) reported feeling unprepared for the financial burden of cancer, and 38% indicated limited-to-no discussions of direct costs with healthcare providers pre-treatment. Forty percent received increased financial support from others post-diagnosis; notably, 15% reported not receiving any financial help, despite requiring it. For PWC, financial strain was most commonly reported to substantially impact physical (51%) and mental wellbeing (46%) domains. Among PWC experiencing greater financial strain, reduced spending on leisure activities (58%), food (44%), and transport (42%) was most often reported. Early discussions with healthcare providers emerged as the most identified way to reduce financial strain (53% PWC, 35% caregivers), followed by pre-treatment access to financial planners/counsellors (38% PWC, 27% caregivers). 

Conclusion: Financial strain is a common and significant consequence of cancer for patients and caregivers, affecting wellbeing and practical daily living. Early cost discussions with healthcare providers and financial planning support may help mitigate this burden.

Background/Aim: Weight stigma is prevalent in health care. Despite this, few studies have explored weight stigma in relation to cancer care. This study provides preliminary data on the frequency and types of weight stigma experienced by people with cancer in Australia. 

Methods: People who had a cancer diagnosis in the past 10 years (n=150) completed an online survey to assess weight stigmatising experiences in cancer care. Experiences of weight stigma were assessed using an adapted version of the Stigmatising Situations in Healthcare measure. Descriptive, and multivariate analyses were conducted.

Results: Over half (n=79, 53%) of respondents reported experiencing weight stigma during their cancer care, including negative character judgements, accessibility issues, discrimination, unsolicited diet advice, and diagnostic overshadowing. The proportion of participants reporting at least one stigmatising experience ranged from 32% with a healthy BMI, to 70% among those whose weight was categorised as obese. Higher BMI, internalised weight bias, and healthcare avoidance were each independently associated with increased reports of weight stigma during cancer care. Participants who reported avoiding or delaying healthcare were more likely to report experiences of stigma. Higher ratings of physician empathy were associated with fewer reported experiences of weight stigma.

Conclusions: As the first Australian quantitative investigation of experiences of weight stigma during cancer care, preliminary results reveal people with cancer may face a range of weight stigmatising experiences during their cancer care. Experiences of weight stigma increased with higher internalised weight bias and avoidance and/or delaying of health care utilisation.

Background: Cancer-related cognitive impairment (CRCI) is commonly reported among people who have had cancer, interfering with everyday functioning. This reflects an issue in CRCI research where subjective reports of cognitive difficulties are often not reflected in neuropsychological test performance, leaving people feeling dismissed. The Oxford Digital Multiple Errands Test (OxMET) offers a novel approach to measuring cognition in contexts that reflect real-world demands but has not yet been studied in a cancer population.

Aim: The pilot study explored the use of a culturally adapted Australian version of the OxMET (OxMET-AU) to measure cognition in people who have had cancer. 

Methods: 20 adults with a history of non-metastatic cancer completed neuropsychological tests, subjective reports from the Functional Assessment of Cancer Therapy-Cognition (FACT-Cog), and the OxMET-AU. We hypothesised that OxMET-AU performance would positively correlate with FACT-Cog and neuropsychological test scores, that neuropsychological test scores would positively correlate with FACT-Cog scores, and that OxMET-AU performance would show stronger correlations with FACT-Cog scores than neuropsychological test scores. 

Results: Findings indicated that OxMET-AU performance aligned more closely with neuropsychological test scores than subjective FACT-Cog complaints, which reflected difficulties not captured by either measure. However, participants found the OxMET-AU acceptable and feasible. 

Conclusion: The discrepancy between OxMET-AU performance and subjective complaints may reflect differences in the constructs they measure, as well as statistical power limitations. Overall, the findings may support the value of a multimethod approach to measuring CRCI and suggest the OxMET-AU warrants further research in larger, diverse samples, to clarify these relationships.

Background: Prostate cancer is associated with persistent unmet supportive care needs, particularly in psychological wellbeing, sexual health, continence management, and access to reliable information. Digital health interventions offer opportunities to address these gaps and improve patient engagement; however, preferences for digital supportive care among people with prostate cancer have not been comprehensively synthesised. 

Aim: To identify and synthesise evidence on the preferences of people with prostate cancer regarding the design and delivery of digital supportive care.

Methods: A systematic search of six databases was conducted, with screening procedures following PRISMA guidelines. Four reviewers independently extracted data, and methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). A narrative and thematic synthesis approach was used to integrate findings across study designs.

Results: Of 5,184 records screened, studies were included. Data analysis is ongoing; however, preliminary findings of preferences for digital supportive care clustered across four domains: delivery mode, content, engagement, and barriers/enablers. Participants valued flexible, multi-modal digital formats including web-based platforms, mobile apps, telehealth, and telephone support. Older adults showed particular preference for telephone-based care. High-priority content included personalised education, decision support, symptom self-management (continence, fatigue, sexual health), structured exercise guidance, and psychosocial support. Engagement was enhanced by intuitive interfaces, tailored content, and clinician endorsement. Digital literacy challenges and emotional burden were key barriers. Supportive onboarding and clear guidance facilitated uptake.

Conclusion: People with prostate cancer show preference for flexible, personalised digital supportive care. Addressing barriers of digital literacy and emotional burden are essential to improve engagement and outcomes.

Background: Skin cancer is a major public health issue in South Australia, with higher incidence in rural and regional areas and limited access to specialist care. General Practitioners (GPs) play a critical role in prevention, early detection, and timely diagnosis – yet limited access to dermatoscopes and training can limit capability.

Aim: To improve skin cancer early detection in South Australia by increasing GP access to dermatoscopes and practical dermoscopy training, particularly in rural and regional areas. 

Methods: Since 2021, the Cancer Council SA Dermoscopy Grant Program has provided dermatoscopes and training to eligible GPs across South Australia. Applicants were required to complete practical dermoscopy training with the Australasian College of Dermatologists, funded by Preventive Health SA, and an RACGP module on skin cancer prevention. Priority was given to rural or regional practitioners and those without existing dermatoscope access. Post-award evaluation assessed frequency of dermatoscope use, changes in diagnostic confidence, and impacts on clinical practice.

Results: Across six rounds, 235 dermatoscopes were distributed statewide, with almost half awarded to regional GPs. Evaluation findings show most recipients now use their dermatoscope daily or weekly for skin checks, excisions, and referrals. GPs reported increased diagnostic confidence, earlier identification of suspicious lesions, and improved patient care, reflecting the integration of routine dermoscopy into general practice.

Conclusion: Equipping GPs with dermatoscopes and targeted training enhances diagnostic accuracy, supports earlier detection, and improves care for high-risk, underserved populations. Continued investment and opportunities for follow-up training may further increase the long-term impact of dermoscopy in primary care.

Aim: Greenhill Lodge provides supportive accommodation for regional people with cancer (PWC) and their caregivers. This study conducted a broad, preliminary exploration of guests’ food, movement, sleep, and social experiences and needs during their stays.

Methods: An accommodation exit survey recruited 131 participants (n=105 PWC; n=26 caregivers) over 10 months. Participants completed a retrospective survey on lifestyle areas during their stay. Telephone interviews were conducted with 11 participants (n=10 PWC; n=1 caregiver) for deeper insights.

Results: Participants were on average 64 years old (SD=10), predominantly female (55% PWC; 77% caregivers). Breast (23%) and prostate (22%) cancers were most common, with 75% of PWC undergoing treatment. Average stay was 12-15 nights. Few participants reported barriers to accessing food (<5%). Guests mainly sourced food from the on-site restaurant/café (79-81%) or prepared meals using in-room/shared kitchens (69-81%). About half reported reduced physical activity during stays (46-47%). Most PWC believed exercise was safe and beneficial (>70%), with interest in personalised programs (70%), yoga (47%) and walking groups (47%). Most reported sleep quality was similar to home, with room comfort supporting good sleep; however, 23-26% experienced poorer sleep, largely from environmental and treatment-related factors. Interest in social opportunities was high, especially for event outings (70%-77%). Interviews highlighted positive community atmosphere, particularly supported by staff. People experiencing social disconnect often relied on externally initiated connections, and linkage with existing services.

Conclusion: Guests reported high overall satisfaction. Structured exercise, social opportunities, and alternate signposting to existing services may further support guests during stays.

Purpose: To examine factors associated with mental illness (MI) in people with and without cancer, and the associations between cancer, MI and health literacy (HL).

Methods: This cross-sectional study was conducted using data from the Australian National Health Survey 2017-2018 and HL Survey. All participants aged ≥25 years were categorised into four groups based on self-reported cancer and MI. Multivariable logistic regressions were performed to examine characteristics associated with MI, with stratification by cancer status. General linear models were used to assess the association between nine individual HL domain scores and cancer and MI.

Results: About 30% of people with cancer (n=690/2276) and 27% of those without cancer (n=3483/12920) reported having a MI. Several characteristics were associated with higher odds of MI in both cancer and non-cancer groups: female gender, younger age, obesity, currently smoking, residing in a major city, lower socioeconomic status, having more comorbidities and being physically less active. For most of these characteristics, the associated risk was higher in people with cancer. MI was negatively associated with seven individual HL domain scores, whilst having cancer was negatively associated with only one domain. 

Conclusion: Risk factors for MI appeared to be similar in persons with and without cancer, but the associated relative risks are higher in those with cancer. HL is negatively associated with both MI and cancer, with stronger associations for MI. Improving HL in those with MI and cancer has the potential to improve modifiable risk factors and outcomes of this population.

Background: Cancer-related cognitive impairment (CRCI) is a common, distressing, and often persistent consequence of cancer and its treatment. Traditional assessments, such as neuropsychological testing, often fail to capture the everyday cognitive difficulties reported by people with a history of cancer. Psychophysiological measures can detect subtle variations in cognitive processing that may not be reflected in behavioural performance.

Aims: This systematic review synthesises studies using psychophysiological measures to assess cognitive processing during active task performance in individuals during and after cancer.

Methods: Searches of four databases were conducted and manual reference checking and snowballing were used to identify additional studies. Inclusion criteria were studies published between January 2000 and July 2025 that used one or more common psychophysiological measures to assess cognitive processing during cognitive tasks in people with a cancer diagnosis. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. Findings were synthesised narratively.

Results: Sixty-six studies met inclusion criteria. Functional MRI and electroencephalography were the most frequently used psychophysiological methods. Many studies reported findings that diverged from behavioural outcomes, demonstrating the sensitivity of psychophysiological measures in detecting cognitive changes in the absence of performance deficits. The review also highlighted underexplored methods that may offer additional insights into cognitive changes associated with cancer.

Conclusions: Expanding the use of psychophysiological approaches could improve understanding of CRCI and guide the development of effective prevention, management, and rehabilitation strategies. Such advancements have potential to enhance supportive care and quality of life for individuals affected by CRCI.

Background: Individuals at elevated risk for colorectal cancer (CRC) such as those with a prior history of CRC or polypectomy, genetic predisposition or a significant family history of CRC, undergo regular colonoscopy. The invasiveness of the colonoscopy procedure, along with regular healthcare system encounters, affect health related quality of life (HRQoL). However, there are no studies that have assessed HRQoL in this population in the Australian setting.

Aims: The study aimed to assess HRQoL and predictors.       
Methods: This was a cross-sectional analysis of HRQoL data from a survey in the Southern Co-Operative Program for the Prevention of Colorectal Cancer (SCOOP), South Australia. HRQoL was assessed using the EQ-5D-5L (0-1) and EQ-VAS (0-100), with higher values indicating better HRQoL. EQ-5D-5L utility scores were obtained using an Australian general population algorithm. Multivariable regression analysis was used to identify the predictors.

Results: 1916 individuals responded to the survey and were included in the analysis. The mean age was 65.4 (SD=10.19), and 51.6% were female. The mean EQ-5D-5L utility score was 0.81 (SD=0.20) and EQ-VAS score was 77.47 (SD=16.01). Lower HRQoL was associated with being female, separated marital status, unemployed, lower household income, higher body mass index, smoking, family history of CRC, and previous history of adenoma.

Conclusion: Participants reported good HRQoL which were comparable to the general Australian population values of 0.86 (SD= 0.19), and 73.2 (SD=21.7) for the utility score and VAS, respectively. Addressing modifiable predictors is important to improve HRQoL.

Australians who experience incarceration are at risk of profound health inequity. They often experience ongoing social exclusion and marginalisation that impede engagement with primary and preventive healthcare. Compounding this is excess exposure to carcinogens that are introduced due to disproportionate risky health behaviours in the context of entrenched social and structural disadvantage. It follows that justice-involved Australians are likely at increased risk of cancer incidence and mortality, co-morbidities, and encounter barriers to treatment access. However, there is a lack of Australian evidence about cancer-related outcomes among this population to inform appropriate and accessible health and support services.

This study aims to document cancer incidence, prevalence and mortality among South Australians who experience incarceration. We will use data linkage to establish a retrospective cohort, using SA-NT DataLink to combine data from SA Correctional Services, SA Cancer Registry, and the SA Death Register. This project seeks to generate critical insights to inform policy changes and improve cancer diagnosis, treatment, and survival rates for justice-involved people. Among the cohort, focus will also be placed on cancer-related health outcomes of Aboriginal and Torres Strait Islander individuals, who are over-represented in the prison population and may face additional health inequities. Overall findings are expected to contribute to better service provision and policy development, not only in South Australia but across other Australian jurisdictions, with the potential to improve quality of life for people at the intersection of cancer and incarceration.

The supportive care needs of people living with the incurable cancer - multiple myeloma - and its precursor - smouldering myeloma - are unique and evolving reflecting the adoption of new life-prolonging therapies, which have drastically extended survivorship. We aimed to understand the modern needs of this unique population, identify the gaps in supportive care and barriers to accessing psychological support, with the goal of using this information to better understand how supportive care frameworks can be best optimised to enhance the quality of life of people with myeloma.  Qualitative thematic analysis of semi-structured interviews identified key themes, which then informed a subsequent national survey. A comprehensive panel of validated measures were used to assess quality of life (MYPOS), mental wellbeing (SWEMWBS, PTGI), psychological distress (GAD-7 and PHQ-9), service usage, and satisfaction with service quality, aligned to the Supportive Care Framework for Cancer Care.  Interviews with twenty-five people with myeloma (n =21) and smouldering myeloma (n=4) identified communication breakdowns, inconsistent information and navigating services were common themes, with many participants describing loneliness, uncertainty and feeling responsible for coordinating their own care. Survey data, obtained from 192 respondents (myeloma n=159, smouldering n=33), reinforced these findings. Participants were predominantly aged 60-75 (70%), female (71%), from a Caucasian/European descent (97%) and living in metropolitan Australia (67%). Respondents met the criteria for clinically significant anxiety (17%) and depression (20%), with 33% reporting infrequent conversations about their prognosis, despite 68% reporting it was very or extremely important. Key barriers to person-centred support included pressures on healthcare professionals, fragmented systems, and insufficient navigation assistance.  Supportive care for people with multiple myeloma and smouldering myeloma remains inconsistent and poorly integrated into routine medical practice possibly due to the dominant focus on treatment efficacy and survival. Hence, strategies that assist patients navigate care pathways and access existing supports in a timely manner are required. Equally important is educating clinicians to recognise when patients are ready to discuss prognosis and palliative support, ensuring these conversations occur sensitively and strengthen person-centred care.

Recent theoretical and empirical advancements in well-being science can have meaningful implications for supportive cancer care when considering existential issues faced by people with incurable or life-limiting cancer diagnoses. We propose the possibility that certain elements of flourishing, such as meaning and purpose, deep personal relationships, and virtue, can be uniquely realised when life is ending. Using exploratory data from a study focussed on identifying the unmet needs of patients living with the blood cancer multiple myeloma, we thematically analysed interviews with patients and clinicians to explore the possibility of flourishing at the end of life. Smouldering myeloma and multiple myeloma patients (n=25) reported personal growth following their diagnosis through acceptance, meaning-making, and connection. At the same time, they reported a sense of loneliness and a desire to discuss prognosis and death in addition to focusing on treatment. On the contrary, clinicians (n=10) were hesitant to discuss death, balancing hope in treatments with preparation for dying. We argue that the hesitation to discuss death thwarts the opportunity to flourish during supportive care, and that existing solutions such as dignity therapy, meaning-centred psychotherapy, and multidisciplinary support could close this gap without diminishing hope in treatments.