Discuss about the Evidence of Gene Environment Interactions.
One of the leading causes of premature mortality in Australia is breast cancer (Australian Institute of Health and Welfare, 2015). According to Kami?ska, Ciszewski, ?opacka-Szatan, Miot?a and Staros?awska (2015), breast cancer is the most commonly detected neoplastic disease among the women population who are around their menopause. It is also regarded as one of the leading cause of reduction in women’s capability to participate normally in everyday life. The following assignment aims to analyse the impact and the outcome of the breast cancer under the light if community profile assessment of local government area (LGA), Victoria Daly. The assignment begins with describing the aetiology and epidemiology of breast cancer along with its incidence and prevalence rate in Victoria Daly, Australia. The assignment will then provide a detailed community profile analysis of Victoria Daly as per the statistics of Census of Australian Bureau of Statistics (2016) and comparing that profile statistics with the occurrence and severity of breast cancer. Towards the end, the report plans to discuss the community based nursing interventions that wil be helpful in treating breast cancer
According to the Cancer Council Australia (2017), the most commonly diagnosed cancer among the Australian women population is breast cancer and it accounts for about 60% of all the cases. Abnormal growth of the breast cells mostly the milk producing ducts or the glandular tissue leads to the generation of breast cancer. According to Nelson et al. (2012), disruption in the hormonal equilibrium, unhealthy lifestyle factors and environmental factors generally increases the risk of the development of breast cancer. However, it is still not clear why few group of population is more susceptible towards the generation of breast cancer in comparison to the other group of population. According to Nelson et al. (2012), hereditary pre-disposition along with the surrounding environment increases the susceptibility of developing breast cancer.Nelson et al. (2012) opined that a previous family reports of breast cancer, certain gene mutation (BRCA1 and BRCA2). According to Easton et al. (2015), the change in the coding sequence of BRCA1 and BRACA2 lead to the degeneration of certain hereditary syndromes known as HBC-SS (Hereditary Breast Cancer Site Specific) or HBOC (Hereditary Breast Ovarian Cancer). These two syndromes gradually manifest in the form of breast cancer.
The important lifestyle factors which are highlight by Ligibel et al. (2012) as the main cause behind the development of breast cancer include obesity, consumption of alcohol and smoking. According to the epidemiological studies published by Brooks and Zakhari (2013), moderate to high intake of alcohol increases the risk of developing breast cancer among the women. Apart from these there are other physiological factors that increases the susceptibility of developing breast cancer and this includes beginning of period at an early age of life (>12 years), beginning of menopause at an older age, post-menopausal hormone therapy and conceiving at later stages of lifeLigibel et al. (2012).
According to the Breast Cancer Network Australia (2017), the current statistics in Australian Breast Cancer reveals that in 2015, 15,600 women along with 145 men are detected with breast cancer in Australia with the majority section is in Victoria, Daly LGA. Approximately 43 women are diagnosed with breast cancer each day. The majority of the women who are diagnosed with breast cancer belong to the age group of 50 to 60 years. Moreover, breast cancer is the main form of cancer experienced by the Aboriginal and Torres Strait Islander (ATSI) women. However, ATSI women are probably less diagnosed with breast cancer in comparison to the non-ATSI women. Breast Cancer Network of Australia (2017) has further opined that the last five years survival rate for the women who are diagnosed with breast cancer is increasing at a steady rate. According to the survey conducted by AustralianBauru Of Statistics (2011) during the year 2008, there were 159,325 women who are alive and has been diagnosed with breast cancer for the past 27 years. It has also been estimated that 3,040 women and at least 25 men will lose their life for breast cancer by the end of 2018 in Victoria and in other parts of Australia (Australian Institute of Health and Welfare, 2014).
The Victoria Daly Region is a local government area of the Northern Territory of Australia. According to Australian Bureau of Statistics (ABS) Census of Population and Housing (2016), the total number of people residing in Victoria Daly Region is 2810 of then 1445 are men and 1369 are women. Thus there are no sharp difference between the ratio of men and women residing in this LA. Among this population, 345 people lies within the age group of 45 to 54 years and this number decreases sharply with age with total number of 129 people among the age group of 65 to 74 years and 59 people among the age group of 75 to 84 years. Thus the average life span of the majority of the population residing in Victoria Daly (LGA) is up to 54 to 64 years. Furthermore even if the age bracket increases, the parity between the different gender (male and female) exists. Such that the within the age bracket of 65 to 74 years, there are 65 females and 65 males. The rest half of the population is occupied by the Aboriginal and/or the Torres Strait Islander people. Moreover, the majority of the population are the citizen of Australia. However, at least 1365 people speak other language but only 955 people speak in English (ABS, 2016). The median age of person is 27 years with an average household size is 3.3. Thus the families residing in Victoria Daly is mostly nuclear (ABS, 2016). According to the Census report published by ABS (2016), the main earning member of the families are men and their principal occupation is agriculture, forestry and fishing and the age group which practise in population ranges from 15 to 54 years of age, with the highest concentration between the age bracket of 25 to 34 years. Other modes of occupation which are practised in Victoria Daly but not that popular include construction, retail trade, administrative and supportive service, public administration and safety and education-training. Among 223 people of the labour force status that have children in their families, only 10% of them work for full time where both male and female are employed. However, 14% of them approximately have single bread earner in their family and nearly41% are not working on a full time basis and falls under the low financial bracket. Only 21% of the working population (either both or employed) have a monthly income of $4000 or more (ABS, 2016).Only 561 people have their own motor vehicles and this includes both one wheeler, two wheelers, three wheelers and four or more wheelers. About them, nearly 50 to 45 % have one wheeler vehicles and 35 % have no vehicles at all. Moreover, the internet access is also poor among the population of Victoria Daly (LGA) this is highlighted further in the census of 2016 by ABS. According to ABS, only 301 people have internet access to their home and this percentage is minimal in comparison to the total number of population residing in Victoria Daly (LGA). In relation of poor access to internet, ABS has further highlighted in their 2016 census that the majority of the people residing in the LGA, Victoria Daly are socio-economically disadvantaged. According to Victoria Daly Regional Office (2017) lack of proper exposure, education, incomes and high percentage of aboriginal people are the reason behind the high percentage of socio-economic disadvantaged population.
The impact of breast cancer as a fatal public health problem in Victoria LGA can be examined based on the strength and weaknesses highlighted by ABS Census 2016 in Victoria Daly LGA profile. The census of Victoria Daly indicates that the as the age bracket increases, the number of population decreases. This indicates that the population is immune compromised and thus failing to withstand the impact of chronic and severe disease. According to the reports published by Karimi, Jessri, Houshiar-Rad, Mirzaei and Rashidkhani (2014), people who have a poor dietary pattern or have nutrient deficient diet are especially immuno-compromised and the condition is more severe among the women and this immune-compromised state makes them more susceptible towards developing breast cancer. Moreover, upon screening the community profile of Victoria Daly (LGA) it is clear that the greater percentage of population (25%) are below 34 years of age and this indicates that the percentage of the aged population will tend to increase within the next 10 years and thereby increasing the risk of the population towards developing breast cancer. According to DeSantis, Ma, Bryan and Jemal (2014), the risk of developing breast cancer increases with the age of the women. Kobayashiet al. (2012) highlighted that the use of the oral contraceptive, hormone replacement therapy and menopause increases the risk of breast cancer among the aged women. According to the forecast of ABS (2016), after 10 years there will be increase in the number of retired government employees (by 70%). This signifies that impact of breast cancer of Victoria (Daly LGA) will also increase with years as highlighted by the prevalence of diabetes among elderly women (Kobayashi et al. 2012). ABS Census (2016) have identified that 37% of the population in Victoria (Daly LGA) engage in less physical activity and mainly lead a sedentary as due to unemployment. According to Lahart, Metsios, Nevill and Carmichael (2015), lack of regular physical activity increase both the risk and recurrence of breast cancer. According to Victoria Daly Regional Office (2017), consumption of healthy food is significantly less among the population of Victoria LGA. Assi et al. (2013) have opined diet poor diet or low nutritional content in diet increases the risk of developing breast cancer. Moreover, poor diet along with lack of physical activity promotes obesity and this in turn increases the risk of developing breast cancer (Assi et al. 2013).
Health literary in Victoria Daly (LGA) is also very low; moreover, the majority of the population do not have access to internet in their home. According to Attai, Cowher, Al-Hamadani, Schoger, Staley & Landercasper (2015) social media sites serve as an effective tool for the treatment of breast cancer patients thus, lack of internet exposure decreases the awareness of breast cancer. Moreover, Australian Breast Cancer Council (2017) have highlighted that breast cancer is the major threat among the Australian women population. Therefore, mother living with the disease puts the daughter at a higher risk of developing breast cancer (Easton et al. 2015). In addition, Victoria Daly (LGA) have significantly high population rate of Aboriginal and Torres Strait Islander population. According to Morrell, You and Baker (2012), indigenous Australians have very limited socio-economic advantage and in majority of time experience health inequality and thus their breast cancer cases remain undiagnosed, leading to the increase in mortality along with increasing genetic predisposition.
Apart from the weakness, community profile of Victoria Daly (LGA) has sudden strengths of fighting against breast cancer and this includes higher proportion of labour force, affordable rents and affordable foods and daily amenity services. All these cumulate into increase in the economic advantage towards effective screening and treatment of breast cancer in the early stage. Moreover, Victoria Daly Regional Council (2017) is also observing audit risk committee meeting in order to identify the health and socio-economic threats of Victoria Daly (LGA).
There are three types of nursing healthcare preventive interventions which are important for the optimal management of the fatal diseases and are mostly procured by the community nurse and these are primary, secondary and tertiary interventions (Smith, Soubhi, Fortin, Hudon & O’Dowd, 2012). Primary preventive interventions are directly aimed towards promoting healthy via increasing protective factors of individuals along with inhibiting the rise of the fatal disease among the vulnerable population like Victoria Daly LGA (Starfield, 2012). Primary preventive interventions can be achieved via setting both long terms and short term strategies and the role of the community nurse will be to minimize the environmental risk factors that have the potential to increase the threat of the disease. In case of breast cancer, the community nurse will mostly be concerned via generating awareness in the domain of physical activity, reduction in the consumption of alcohol and tobacco, managing over-weight and diet. According to Nickels et al. (2013) reducing the environmental risk factors reduces the rate of developing cancer. Community nurse will also engage in community based educational program thereby helping to generate awareness about the disease(Murphy & Girot, 2013). Moreover, it will also be the duty of the community nurse to deliver care and the awareness program in a culturally competent manner in treats the indigenous population optimally(Murphy & Girot, 2013).
Secondary preventive interventions aim at reducing the impact of breast cancer via promoting early detection and screening of breast cancer while encouraging proper self-management strategies if the symptoms of breast cancer are being detected. According to Euhus, Di Carlo and Khouri (2015), screening is important for elimination of the disease while minimising the effect along with increasing the survival rate. The breast cancer population screening of Australia is generally directed towards the women population who falls under the age group of 50 to 74 years. It generally deals with two-yearly screening mammograms programs. Other types of screening which are popular for early detection of cancer in Australia include unselective screening, selective screening. Unselective screening is mass screening and selected screening is targeted screening done on the basis of the occupational exposures (Freimanis & Yacobozzi, 2014). Encouragement of self-management strategies in breast cancer mostly deals with procuring person centred care to the patients suffering from breast cancer from community nurse (Pulvirenti, McMillan &Lawn, 2014).
Tertiary prevention is the final mode of preventive intervention that works within the multidisciplinary primary healthcare framework that aims of decreasing the impact of breast cancer via managing complex breast cancer related complications like poor quality of life, reduction in self-esteem or other depressive symptoms which are mainly associated with palliative disease like cancer(Hulbert?Williams, Neal, Morrison, Hood & Wilkinson, 2012). Increase in the quality of life can be achieved via assisting the patients in performing daily activities or via providing care to reduce the association complications arising out of cancer like neurological disorders, muscle weakness, nutritional imbalance (Hulbert?Williams et al., 2012).
Conclusion
Thus from the above discussion it can be concluded that poor socio-economic issue, poor education, low rate of income, poor lifestyle choices, lack of amenities, high percentage of ageing population, unemployment are principal cause behind the severe impact of breast cancer among the population of Victoria Daly LGA with a special mention to the female population. However, proper procurement of primary secondary and tertiary interventions by the community health nurse will help to reduce the chronicity of the disease along with providing better disease outcome. Moreover, the community profile of Vitoria Daly LGA also highlights certain strengths like high percentage of labour workforce and easy availability of daily amenities at low price, these strengths should further be used in order to effective control and treatment of the disease.
References
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