The document summarizes the Cancer Lifestyle and Evaluation of Risk (CLEAR) study conducted by Cancer Council NSW to research cancer risk factors. It discusses that the CLEAR study has collected lifestyle and health information from over 8,000 cancer patients and 2,000 non-cancer controls. Cancer Council NSW scientists plan to use the CLEAR study data to research risk factors for cancer in six main areas: alcohol consumption, smoking, body mass index and physical activity, infectious agents, hormones, sun exposure and sleep patterns. The CLEAR study saves researchers time by collecting this foundational data on lifestyle factors and biomarkers that can now be analyzed to study cancer risks.

1. Research Report
Issue 25 • February 2014
FEATURED:
Cancer Risk Factors
2 Alcohol, Smoking,
BMI and Physical
Activity
Cancer Risk Factors
3 Infectious Agents,
Hormones, Sun
Exposure and Sleep
Our Insights
4 Ways to reduce
the risk of erectile
dysfunction
Help Us
4 Register to join
one of our
research studies
Our information can
save scientists a great
deal of time
Use our CLEAR Study to research
risk factors for cancer
The interaction between our lifestyle and genetic makeup
are the two key ingredients in understanding the causes of
Alcohol, tobacco, BMI/physical activity, infectious
cancer. Large numbers of people need to be studied in order
agents, hormones, sun exposure/sleep patterns
to research this interaction, and the Cancer Lifestyle and
Evaluation of Risk study (CLEAR) has been designed to do just
that. We have collected information from about 8,000 people with any cancer type and 2,000 ‘controls’—people without
cancer—so we can make valid comparisons.
You might imagine that having collected the CLEAR Study information the results from its analysis would be immediate,
fairly obvious, and applicable there and then. But it’s not. Managing the CLEAR Study is like continually compiling a
comprehensive encyclopaedia. If it sits on the shelf it is simply a repository of knowledge. The data only comes alive when
you come up with an idea and then cross-question the data, in order to prove or disprove it, or to lead to new areas to
research. CLEAR Study saves researchers a great deal of time having undertaken the foundation work of data collection.
We need two things to happen to make it all worthwhile: more information in the form of new participants, and creative
cancer researchers who want to interrogate the CLEAR Study data and blood samples.
Epidemiologists at CCNSW plan to start working on risk factors for cancer in six main areas: alcohol, tobacco, BMI and
physical activity, infectious agents, hormones, sun exposure and sleep patterns. We hope that collaborations will be
formed with other research institutes, and that laboratory scientists and doctors will join us to examine our questions from
their own specialised perspective, so that knowledge from one field can inform another.
If you have been diagnosed with cancer in the past 18 months, we encourage you to join the study.
Call 1800 500 894 or complete the consent form and questionnaire on line at clearstudy.org.au.
Cancer Council is now formally
associated with the University
of Sydney as an independent
research institute.
We look forward to continuing our long and rewarding association with
the University, to productive collaborations and to welcoming many more
students to supervision at Cancer Council.
Cancer Council 13 11 20
cancercouncil.com.au

2. CLEAR Study: Six areas that our scientists plan
to research for cancer risk factors
The CLEAR Study resource has blood samples and information in response to questions
asked in each of these categories
Alcohol
Because of its links with bowel and breast cancer and the cancers of the
upper digestive tract, alcohol has been nominated as a class 1 carcinogen
by the International Agency for Cancer Research. We intend to investigate
which cancers appear to be linked with alcohol in Australia, whether the
risk changes for people of different ethnic backgrounds, and if there are
more risks if the person is a smoker or is overweight?
CLEAR questions ask about the number of alcoholic
drinks participants had in a week, and on how many
days they typically drank alcohol.
Smoking
It is known there is a strong association between smoking
and lung and other related cancers, but there may be links
with cancers previously thought to be unaffected by smoking.
We plan to investigate the contemporary risks of smoking on
cancer in Australia, especially in regard to prostate, bowel and
breast cancer.
CLEAR questions about smoking ask whether
people have ever smoked, and if so, when, for
how long and how much.
Body Mass Index/Physical Activity
Not only are people who are obese and don’t exercise at a greater risk of
heart disease and stroke but they are also at a greater risk of getting certain
cancers. It’s suspected there are links between obesity and breast cancer,
but we need to know more about the importance of physical activity and
BMI at different stages of life; whether the results are the same for men
and women, for immigrants and people born in Australia, and if it makes a
difference if a high BMI is pre- or post-menopausal?
There are numerous questions in CLEAR about height
and weight, weight gain, time spent exercising or sitting
and time spent resting.
For more information, visit clearstudy.org.au or email clearstudyenquiries@nswcc.org.au
Cancer Council 13 11 20
cancercouncil.com.au

3. Infectious Agents
Human papillomavirus (HPV) infection is usually the cause of cervical
cancer, and it has recently been found that there are links with a number
of other cancer types. While the number of cancers in Australia caused
by infectious agents is very small (about 3%), they still cause unnecessary
suffering and death.
CLEAR has questions that enquire about sexual activity,
intra-venous drug use, tattoos and body piercings, as
well as organ transplants and blood transfusions, as
these activities can be the source of infections. CLEAR
blood samples will be tested for evidence of infections.
Hormones
CCNSW is looking at the link between various hormonal factors and
breast cancer, particularly with regard to the use of menopausal hormone
therapy and breast cancer. In addition, CLEAR data has been included in
a worldwide collaboration examining the links between breast cancer and
hormones.
Questions for women in the CLEAR Study ask about
the number of children, mother’s age when her
children were born, contraceptive use, when periods
started and use of HRT. We also ask about family
history of breast and ovarian cancers, hysterectomy,
mammograms and PAP smears.
Questions for men relate to when they started shaving,
when their voices broke and balding patterns.
Sun exposure and sleep patterns
We know there is a link between sun exposure and skin cancers, but
we need to collect information about the consequences of UV exposure
and other cancers. There is also debate about the consequences of
Vitamin D deficiency and cancer risk.
There may be a connection between irregular sleep patterns, such as
those experienced by shift workers, and some cancer types.
CLEAR asks where people have lived so UV exposure
from their environment using satellite data can be
calculated. We also ask about time spent outdoors,
skin colour and tanning, sunburn experiences and
exposure to indoor UV from solarium use.
For more information, visit clearstudy.org.au or email clearstudyenquiries@nswcc.org.au
Cancer Council NSW Research Report
Issue 25 • February 2014

4. Actively reduce
the risk of erectile
dysfunction
Recent research by Cancer
Council NSW reveals almost two
thirds of men aged 45 and above
have suffered from impotence.
Overweight men, men on lower incomes, inactive
men and smokers are all more likely to have
erectile dysfunction.
There are simple steps that can potentially reduce
a man’s risk of erectile dysfunction:
• Stopping smoking,
• Increasing physical activity,
• Maintaining a healthy weight
These are the most important factors in reducing
the risk, and will have longer lasting health
benefits too, including a lower risk of cancer and
heart disease.
Current heavy smokers are 86% more likely to
have erection problems than non-smokers and
obese men have double the risk compared to
men in the healthy weight range.
Data from the 45 and Up Study shows that 61%
of men surveyed have been affected by erectile
dysfunction, with the odds of a man experiencing
erectile dysfunction increasing by 11.3% each
year over the age of 45.
Raise the topic of erectile dysfunction with your GP
Associate Professor David Smith from Cancer Council NSW said, “Erectile
dysfunction is extremely common among Australian men and problems
increase as men age, with almost all men 75 years and over reporting
moderate to severe erection problems”.
Cancer Council is enlisting the support of GP’s to have “the difficult
conversation” with men who are at risk. Men who are experiencing ED
should see their GP to find out if there are any underlying health problems.
Simple steps can then be discussed to help prevent further loss of function,
and to prevent potential disease.”
Watch out for the ED poster at your GP’s clinic.
For more information, visit: cancercouncil.com.au
Register to
join a research
study today!
Return completed form to:
Reply Paid 79819
Potts Point, NSW 1335
Cancer Council and other academic bodies conduct
research studies to do with cancer. These studies may
be questionnaire based surveys, focus groups and
interviews or other types of research. Study participants
will not necessarily be cancer patients.
Title*
Register your interest to be included on our database.
Your story or the story of someone you know will help us
find the answers.
Address*
Yes, include me on the database. (If yes, we will
write to ask you some additional questions relating
to your health to allow us to match you to research
studies that suit you.)
Tick this box if you have been diagnosed with
cancer in the past 18 months. (If yes, you may be
eligible for the CLEAR Study and we will send you
further information.)
You can also register at cancercouncil.com.au/joinastudy
First Name*
Last Name*
Town*
Postcode*
Email
Phone
Mobile
* Mandatory
At Cancer Council we recognise the importance of your privacy and the safeguarding of your personal information. If you have concerns about the privacy of this information, you may provide it securely online at cancercouncil.com.au/joinastudy. Please be
assured that in collecting this information, it will be used for research purposes only, and will be handled in accordance with our Privacy Management Plan (www.cancercouncil.com.au) which addresses our compliance with all legislative requirements.
CAN 2030 02/14
Help
us beat
cancer