Skin cancer is common in North America. Incidence rate trends are potentially important in the assessment of the effects of measures to increase sun awareness in the population as well as measures to reduce sun damage.
To determine the incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and cutaneous malignant melanoma (CMM) in a geographically defined Canadian population over a 40-year period.
Data were obtained from the BC Cancer Registry for the calendar years 1973, 1983, 1993, and 2003.
Age-standardized incidence rates increased significantly from 1973 to 2003 for BCC, SCC, and CMM.
The ethnic makeup of British Columbia has changed over time, and a novel method of accounting for the effect of this on skin cancer rates is presented.
The incidence rate for skin cancers continued to rise in British Columbia, but there appears to have been a decline in the incidence of CMM and BCC in the youngest cohorts.
In Canada, it is estimated that in 1992 115,000 new cases of cancer will be diagnosed. This total excludes 47,200 estimated new cases of non-melanoma skin cancer. The number of new cases is increasing by about 3,000 per year due partly to the aging population, improved registration, earlier detection of cancer and real increases in the incidence of some types of cancer. It is estimated that there will be 58,300 cancer deaths in 1992. By 1992, prostate cancer will have overtaken lung cancer as the leading cancer among men in the four western provinces while lung cancer is expected to exceed breast cancer as the leading cause of cancer deaths among women in some provinces, notably British Columbia. In British Columbia, the relative survival rates for most cancers improved between the periods 1970 to 1974 and 1980 to 1984. However, stomach, lung and pancreatic cancers, which have low survival rates, showed little improvement. This article is based on 1992 estimates of cancer incidence and mortality, cancer trends in Canada and relative cancer survival rates in British Columbia, found in Canadian Cancer Statistics 1992. This publication was prepared at Statistics Canada through a collaborative effort involving the Canadian Cancer Society, Health and Welfare Canada and the provincial/territorial cancer registries.
The objective of this study was to evaluate the impact of the 2005 British Columbia Ministry of Health Smoking Cessation Mass Media Campaign on short-term smoking behavior.
National cross-sectional data are used with a quasi-experimental approach to test the impact of the campaign.
Findings indicate that prevalence and average number of cigarettes smoked per day deviated upward from trend for the rest of Canada (P = .08; P = .01) but not for British Columbia. They also indicate that British Columbia smokers in lower risk groups reduced their average daily consumption of cigarettes over and above the 1999-2004 trend (-2.23; P = .10), whereas smokers in the rest of Canada did not, and that British Columbia smokers in high-risk groups did not increase their average daily consumption of cigarettes over and above the 1999-2004 trend, whereas smokers in the rest of Canada did (2.97; P = .01).
The overall poorer performance of high-risk groups is attributed to high exposure to cigarette smoking, which reduces a smoker's chances of successful cessation. In particular, high-risk groups are by definition more likely to be exposed to smoking by peers, but are also less likely to work in workplaces with smoking bans, which are shown to have a substantial impact on prevalence. Results suggest that for mass media campaigns to be more effective with high-risk groups, they need to be combined with other incentives, and that more prolonged interventions should be considered.
While injuries are a leading health concern for Aboriginal populations, injury rates and types vary substantially across bands. The uniqueness of Aboriginal communities highlights the importance of collecting community-level injury surveillance data to assist with identifying local injury patterns, setting priorities for action and evaluating programs. Secwepemc First Nations communities in British Columbia, Canada, implemented the Injury Surveillance Project using the Aboriginal Community-Centered Injury Surveillance System. This paper presents findings from a community-based participatory process evaluation of the Injury Surveillance Project. Qualitative data collection methods were informed by OCAP (Ownership, Control, Access, and Possession) principles and included focus groups, interviews and document review. Results focused on lessons learned through the planning, implementation and management of the Injury Surveillance Project identifying lessons related to: project leadership and staff, training, project funding, initial project outcomes, and community readiness. Key findings included the central importance of a community-based and paced approach guided by OCAP principles, the key role of leadership and project champions, and the strongly collaborative relationships between the project communities. Findings may assist with successful implementation of community-based health surveillance in other settings and with other health issues and illustrate another path to self-determination for Aboriginal communities. The evaluation methods represent an example of a collaborative community-driven approach guided by OCAP principles necessary for work with Aboriginal communities.
Cites: Am J Clin Nutr. 1999 Apr;69(4 Suppl):755S-759S10195598
Cites: Annu Rev Public Health. 2006;27:323-4016533120
Cites: Am J Public Health. 2008 Jan;98(1):22-718048800
Rural cancer survivors (RCS) potentially have unique medical and supportive care experiences when they return to their communities posttreatment because of the availability and accessibility of health services. However, there is a limited understanding of cancer survivorship in rural communities.
The purpose of this study is to describe RCS experiences accessing medical and supportive care postcancer treatment.
Interviews and focus groups were conducted with 52 RCS residing in northern British Columbia, Canada. The data were analyzed using qualitative content analysis methods.
General Population RCS and First Nations RCS experienced challenges accessing timely medical care close to home, resulting in unmet medical needs. Emotional support services were rarely available, and, if they did exist, were difficult to access or not tailored to cancer survivors. Travel and distance were barriers to medical and psychological support and services, not only in terms of the cost of travel, but also the toll this took on family members. Many of the RCS lacked access to trusted and useful information. Financial assistance, for follow-up care and rehabilitation services, was rarely available, as was appropriate employment assistance.
Medical and supportive care can be inaccessible, unavailable, and unaffordable for cancer survivors living in rural northern communities.
A consistent methodology for assessing the accumulating effects of natural and manmade change on riverine systems has not been developed for a whole host of reasons including a lack of data, disagreement over core elements to consider, and complexity. Accumulated state assessments of aquatic systems is an integral component of watershed cumulative effects assessment. The Yukon River is the largest free flowing river in the world and is the fourth largest drainage basin in North America, draining 855,000 km(2) in Canada and the United States. Because of its remote location, it is considered pristine but little is known about its cumulative state. This review identified 7 "hot spot" areas in the Yukon River Basin including Lake Laberge, Yukon River at Dawson City, the Charley and Yukon River confluence, Porcupine and Yukon River confluence, Yukon River at the Dalton Highway Bridge, Tolovana River near Tolovana, and Tanana River at Fairbanks. Climate change, natural stressors, and anthropogenic stresses have resulted in accumulating changes including measurable levels of contaminants in surface waters and fish tissues, fish and human disease, changes in surface hydrology, as well as shifts in biogeochemical loads. This article is the first integrated accumulated state assessment for the Yukon River basin based on a literature review. It is the first part of a 2-part series. The second article (Dubé et al. 2013a, this issue) is a quantitative accumulated state assessment of the Yukon River Basin where hot spots and hot moments are assessed outside of a "normal" range of variability.
British Columbia's central prescription database, PharmaNet, is often used for both clinical and research applications. However, PharmaNet details prescription transactions, not actual medication consumption, resulting in many potential sources of inaccuracy when the information is assumed to reflect population or individual drug utilization.
To assess the accuracy of PharmaNet for adherence assessment in patients with heart failure who are taking beta-blockers.
A 6-month prospective, longitudinal assessment of adherence to the prescribed beta-blocker regimen was carried out using both PharmaNet data and the Medication Event Monitoring System (MEMS) for each patient enrolled. The limit of agreement between the 2 adherence assessment methods was assessed using the Bland-Altman approach.
Fifteen of 58 patients initially enrolled in the study were excluded, most due to misuse of MEMS or failure to return the MEMS vial despite thorough follow-up. For the 43 patients included in the final analysis, mean +/- SD adherence was 97.8 +/- 11.8% when assessed by PharmaNet and 97.1 +/- 7.3% when MEMS was used. However, the limit of agreement, reported as the mean of the differences +/- 2SD, was 6.8 +/- 18.5%, indicating a moderate-to-high level of agreement between the 2 methods when the confidence interval is taken into consideration.
These results suggest that PharmaNet data accurately reflect medication adherence for most patients. The MEMS system proved unreliable in several cases, illustrating the difficulty of identifying a gold standard for adherence assessment.
To describe the causes, sites, and types of eye anomaly and associated handicaps in children identified in the last 30 years with ocular visual impairment of 20/200 (6/60) or worse in the better eye with correction.
Children in British Columbia younger than 19 years with visual loss diagnosed between January 1960 and December 1989 who were referred for multidisciplinary assessment.
The incidence of acquired ocular visual impairment has decreased from 0.6 to less than 0.2 per 10,000 people aged 19 years or younger during the last 30 years. The most common cause was a genetic cause, followed by tumor, injury, infection and autoimmune disorders. Optic nerve atrophy and retinal disorders together resulted in more than 90% of all ocular lesions. Gender distribution revealed more males than females to be affected. Sixty-six percent of children had enough sight to read. The percentage of affected children with neurologic disabilities has increased overall in the last 30 years because more children with profound brain damage have survived.
Acquired ocular visual impairment is rare. The incidence of such impairment has been reduced by two thirds in the last 30 years. This decline has had little impact, however, because most cases of blindness are due to congenital conditions. The number of cases of acquired blindness is only one fourth that of congenital blindness, which has begun to increase again owing to the reemergence of retinopathy of prematurity.