The aim of this study was to provide a current assessment of Australian secondary students' self-reported dietary, physical activity and sedentary behaviour. This study also examined the relationship between television viewing and students' dietary behaviour. Data are from a cross-sectional survey of 18 486 secondary students in 2005 from all Australian states except Western Australia. Participants reported their usual daily consumption (number of serves) of vegetables and fruit; their weekly consumption of unhealthy/non-core foods including fast food meals, snack foods and high-energy drinks; their engagement in moderate-vigorous physical activity over the previous week; and hours spent using electronic media for entertainment and doing homework on school days. The study found that 20% of students were meeting the daily requirement of four serves of vegetables, whereas 39% were eating the recommended three daily serves of fruit. Consumption of unhealthy/non-core foods was high, with 46% of students having fast food meals at least twice a week, 51% eating snack foods four or more times per week and 44% having high-energy drinks four or more times per week. Fourteen per cent of students engaged in recommended levels of physical activity and 29% engaged in recommended levels of sedentary behaviour. Age and gender differences occurred for most measures, and there were some socio-economic status differences. Heavier television use was associated with lower consumption of fruit and higher consumption of unhealthy/non-core foods. On the basis of the results of this study, it appears that a significant proportion of Australian secondary students fall short of current, national dietary and physical activity recommendations for teenagers. Continual monitoring of these behaviours is essential to help inform research and policy and identify where future efforts should be directed.

Uncertainty remains about the impact of bilateral breast cancer. Characteristics and outcomes of unilateral and bilateral breast cancer were compared within an Australian multi-institutional cohort. Demographic, tumour and treatment characteristics were compared among unilateral (n = 2336) and bilateral cases (52 synchronous, 35 metachronous) using descriptive analyses. Disease-specific outcomes were investigated using Cox regression modelling to adjust for prognostic and treatment factors. Factors associated with increased risk of bilateral breast cancer included lobular histology (p = 0.046), family history (p = 0.025) and metropolitan residence (p = 0.006). Mastectomy was more common for bilateral cases (p = 0.001) while radiotherapy was less common (p = 0.015). Index metachronous cases were less likely to receive hormonal therapy (p = 0.001). Five-year survivals for metachronous, synchronous and unilateral cases were 79%, 88% and 94%, respectively. Poorer outcomes remained after adjusting for prognostic factors [HR = 2.26, 1.21-4.21]. Our results confirm international findings indicating worse outcomes from bilateral compared with unilateral breast cancer.

Issue addressed This study investigated trends in sun protection policy and practice of Australian primary schools between 1998 and 2005 and the impact of the National SunSmart Schools Program. Methods Between September and November 2005, primary schools from all states and territories in Australia were surveyed on their sun protection policy and practice. Data were compared to 1998 and 2001 data and analysed using descriptive statistics and chi‐square tests. Results There has been an increase in the proportion of schools with written sun protection policy to 80%, although some aspects of policy were less likely to be included in 2005 than in 2001. Trends in sun protection practice were varied with a significant increase in hat wearing (to 85%) and a significant decrease in sunscreen use. SunSmart schools were found to have a higher level of policy (95% CF 65%, p<0.001) and practice than non‐SunSmart schools. Including specific aspects of sun protection in written policy were linked significantly to the corresponding practice for all aspects of sun protection except shade adequacy. Conclusions These findings highlight the need to continue encouraging the development of comprehensive written sun protection policies in primary schools and advocate for continued support for primary school sun protection activities. So what? The development of primary schools' written sun protection policy has the potential to greatly reduce childhood ultraviolet radiation exposure in Australia and so reduce the risk of skin cancer later in life.