with SSRIs. Am J Psychiatry 2007; 164:
1198–205.
16 Kim HJ, Fay MP, Feuer EJ, Midthune
DN. Permutation tests for joinpoint
regression with applications to cancer
rates. Stat Med 2000; 19: 335–51.
17 Wagner AK, Soumerai SB, Zhang F,
Ross-Degnan D. Segmented regression
analysis of interrupted time series
studies in medication use research.
J Clin Pharm Ther 2002; 27: 299–
309.
18 Pearson SA, Soumerai S, Mah C, Zhang
F, Simoni-Wastila L, Salzman C et al.
Racial disparities in access after
regulatory surveillance of
benzodiazepines. Arch Intern Med 2006;
166: 572–9.
19 Lu CY, Soumerai SB, Ross-Degnan D,
Zhang F, Adams AS. Unintended
impacts of a Medicaid prior
authorization policy on access to
medications for bipolar illness. Med Care
2010; 48: 4–9.
20 Breen CL, Degenhardt LJ, Bruno RB,
Roxburgh AD, Jenkinson R. The effects
of restricting publicly subsidised
temazepam capsules on benzodiazepine
use among injecting drug users in
Australia. Med J Aust 2004; 181: 300–4.
21 Tuma RS. Trastuzumab trials steal show
at ASCO meeting. J Natl Cancer Inst
2005; 97: 870–1.
22 Procter M, Suter TM, de Azambuja E,
Dafni U, van Dooren V, Muehlbauer S
et al. Longer-term assessment of
trastuzumab-related cardiac adverse
events in the Herceptin Adjuvant
(HERA) trial. J Clin Oncol 2010; 28:
3422–8.
23 Russell SD, Blackwell KL, Lawrence J,
Pippen JE Jr, Roe MT, Wood F et al.
Independent adjudication of
symptomatic heart failure with the use
of doxorubicin and cyclophosphamide
followed by trastuzumab adjuvant
therapy: a combined review of cardiac
data from the National Surgical
Adjuvant Breast and Bowel Project B-31
and the North Central Cancer Treatment
Group N9831 clinical trials. J Clin Oncol
2010; 28: 3416–21.
24 Ewer MS, Vooletich MT, Durand JB,
Woods ML, Davis JR, Valero V et al.
Reversibility of trastuzumab-related
cardiotoxicity: new insights based on
clinical course and response to medical
treatment. J Clin Oncol 2005; 23:
7820–6.
25 Jones AL, Barlow M, Barrett-Lee PJ,
Canney PA, Gilmour IM, Robb SD et al.
Management of cardiac health in
trastuzumab-treated patients with breast
cancer: updated United Kingdom
National Cancer Research Institute
recommendations for monitoring. Br J
Cancer 2009; 100: 684–92.
26 Olver IN, Haines IE. What changes are
needed to the current direction and
interpretation of clinical cancer research
to meet the needs of the 21st century?
Med J Aust 2009; 190: 74–7.
Myelodysplastic syndrome in New Zealand and Australia
E. J. Rodger and I. M. Morison
Department of Pathology, University of Otago, Dunedin, New Zealand
Key words
myelodysplastic syndrome, epidemiology,
haematology, New Zealand, Australia.
Correspondence
Ian Morison, Department of Pathology,
Dunedin School of Medicine, University of
Otago, PO Box 913, Dunedin 9054, New
Zealand.
Email: ian.morison@otago.ac.nz
Received 9 October 2011; accepted 14
September 2011.
doi:10.1111/j.1445-5994.2011.02619.x
Abstract
Background: Myelodysplastic syndrome (MDS), a haematological disorder of the
elderly, has been formally classified as a neoplastic disease for 10 years.
Aims: Our aim was to collate national cancer registry incidence data to describe the
epidemiology of MDS in New Zealand.
Methods: The New Zealand Cancer Registry has now reported five complete years of
incidence data, the last three of which were used for analysis. For the years 2005–2007,
age–sex specific and age-standardised MDS incidence rates from New Zealand were
compared with those from Australia. Age-standardised incidence rates were calculated
by the direct standardisation method and standardised rate ratios were compared at the
5, 1 and 0.1% levels.
Results: Diagnoses of MDS represented 1.3% of total cancer registrations in New
Zealand and 1.0% in Australia. In both New Zealand and Australia, 86–87% of MDS
cases were diagnosed in individuals 60 years of age, the incidence increased signifi-
cantly with age, and males had a significantly higher age-standardised incidence rate (P
< 0.001) than females. The incidence rate for New Zealand males was significantly
higher (P < 0.001) than Australian males. In both New Zealand males and females, the
age-standardised incidence rate of MDS was significantly higher (P < 0.05) than most
other haematological neoplasms.
Conclusions: In New Zealand and Australia, MDS is a common haematological neo-
plasm. The marked difference between male and female incidence rates, especially with
advancing age, may provide insights into the causes of this disease.
Cardiac testing in trastuzumab patients
© 2011 The Authors
Internal Medicine Journal © 2011 Royal Australasian College of Physicians 1235