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Rittberg R, Decker K, Lambert P, Bravo J, St. John P, Turner D, Czaykowski P, Dawe D. 1843P Impact of age, comorbidities and polypharmacy on receipt of systemic therapy in advanced cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Dawe D, Rittberg R, Decker K, Lambert P, Bravo J, St. John P, Turner D, Czaykowski P. 1840P Impact of age, comorbidities and polypharmacy on survival in advanced cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Decker K, Moineddin R, Kendell C, Urquhart R, Biswanger N, Groome P, McBride ML, Winget M, Whitehead M, Grunfeld E. Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study. BMC FAMILY PRACTICE 2019; 20:161. [PMID: 31752693 PMCID: PMC6873454 DOI: 10.1186/s12875-019-1052-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/15/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Primary care providers (PCPs) have always played an important role in cancer diagnosis. There is increasing awareness of the importance of their role during treatment and survivorship. We examined changes in PCP utilization from pre-diagnosis to survival for women diagnosed with breast cancer, factors associated with being a high user of primary care, and variation across four Canadian provinces. METHODS The cohorts included women 18+ years of age diagnosed with stage I-III invasive breast cancer in years 2007-2012 in British Columbia (BC), Manitoba (MB), Ontario (ON), and Nova Scotia (NS) who had surgery plus adjuvant chemotherapy and were alive 30+ months after diagnosis (N = 19,589). We compared the rate of PCP visits in each province across phases of care (pre-diagnosis, diagnosis, treatment, and survival years 1 to 4). RESULTS PCP use was greatest during treatment and decreased with each successive survival year in all provinces. The unadjusted difference in PCP use between treatment and pre-diagnosis was most pronounced in BC where PCP use was six times higher during treatment than pre-diagnosis. Factors associated with being a high user of primary care during treatment included comorbidity and being a high user of care pre-diagnosis in all provinces. These factors were also associated with being a higher user of care during diagnosis and survival. CONCLUSIONS Contrary to the traditional view that PCPs focus primarily on cancer prevention and early detection, we found that PCPs are involved in the care of women diagnosed with breast cancer across all phases of care.
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Jalili F, O'Conaill C, Templeton K, Lotocki R, Fischer G, Manning L, Cormier K, Decker K. Assessing the impact of mailing self-sampling kits for human papillomavirus testing to unscreened non-responder women in Manitoba. ACTA ACUST UNITED AC 2019; 26:167-172. [PMID: 31285661 DOI: 10.3747/co.26.4575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background CervixCheck, Manitoba's cervical cancer screening program, conducted a pilot study to assess whether screening participation could be improved in unscreened women by offering a mailed self-sampling kit for human papillomavirus (hpv) testing instead of a Pap test. Methods In a prospective cohort study design, a sample of unscreened women (n = 1052) who had been sent an invitation letter from CervixCheck in the past but who did not respond were randomized to either an intervention group or a control group. The intervention group received a mailed hpv self-sampling kit; the control group received no additional communication. Returned hpv self-sampling swabs were analyzed by a provincial laboratory. After 6 months, screening participation in the two study groups was compared using a logistic regression model adjusted for age and area of residence (urban or rural). Secondary outcomes included hpv positivity, specimen inadequacy, compliance with follow-up, and time to colposcopy. Results Screening participation was significantly higher in the intervention group than in the control group (n = 51, 9.6%, vs. n = 13, 2.5%; odds ratio: 4.7; 95% confidence interval: 2.56 to 8.77). Geographic area of residence (urban or rural) and age were not statistically significant. Conclusions The study demonstrated that hpv self-sampling kits can enhance screening participation in unscreened non-responder women in the setting of an organized screening program. Next steps should include additional research to determine the best implementation strategy for hpv self-sampling in Manitoba.
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Decker K, Baines N, Muzyka C, Lee M, Mayrand MH, Yang H, Fung S, Mercer D, McFaul S, Kupets R, Savoie R, Lotocki R, Bentley J. Measuring colposcopy quality in Canada: development of population-based indicators. ACTA ACUST UNITED AC 2019; 26:e286-e291. [PMID: 31285670 DOI: 10.3747/co.26.4709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Colposcopy is a key part of cervical cancer control. As cervical cancer screening and prevention strategies evolve, monitoring colposcopy performance will become even more critical. In the present paper, we describe population-based colposcopy quality indicators that are recommended for ongoing measurement by cervical cancer screening programs in Canada. Methods The Pan-Canadian Cervical Cancer Screening Network established a multidisciplinary expert working group to identify population-based colposcopy quality indicators. A systematic literature review was conducted to ascertain existing population and program-level colposcopy quality indicators. A systems-level cervical cancer screening pathway describing each step from an abnormal screening test, to colposcopy, and back to screening was developed. Indicators from the literature were assigned a place on the pathway to ensure that all steps were measured. A prioritization matrix scoring system was used to score each indicator based on predetermined criteria. Proposed colposcopy quality indicators were shared with provincial and territorial screening programs and subsequently revised. Results The 10 population-based colposcopy quality indicators identified as priorities were colposcopy uptake, histologic investigation (biopsy) rate, colposcopy referral rate, failure to attend colposcopy, treatment frequency in women 18-24 years of age, re-treatment proportion, colposcopy exit-test proportion, histologic investigation (biopsy) frequency after low-grade Pap test results, length of colposcopy episode of care, and operating room treatment rate. Two descriptive indicators were also identified: colposcopist volume and number of colposcopists per capita. Summary High-quality colposcopy services are an essential component of provincial cervical cancer screening programs. The proposed quality and descriptive indicators will permit colposcopy outcomes to be compared between provinces and across Canada so as to identify opportunities for improving colposcopy services.
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Busolo D, Woodgate R, Hack T, Decker K. Kenyan Youth Understanding of Cancer, Cancer Risk and Cancer Prevention: An Ethnographic Study. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.11600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Cancer incidence and mortality continues to rise worldwide including in Kenya. Among the groups that are likely to get cancer in future are Kenyan youth that engage in behavior that can increase their lifetime cancer risk. Despite this awareness, little is known about Kenyan youth's understanding of cancer, cancer risk, and cancer prevention. Such awareness is needed to inform germane cancer prevention and health promotion initiatives. Aim: The purpose of this ethnographic study was to explore Kenyan youth's understanding of cancer, cancer risk, and cancer prevention. Methods: Fifty-three youth (ages 12-19) took part in individual interviews and focus group discussions. Results: In their conceptualization of cancer, youth described cancer in ways that are grouped into two themes: there is no other disease like it and lay understanding through metaphors. In their conceptualization of cancer risk, youth described cancer in ways that are grouped as cancer risk as lifestyle factors and the process of risk perception. Finally, in conceptualization of cancer prevention, youth described cancer prevention in ways that are grouped into the following themes: avoiding cancer risk factors, avoiding peers who partake in risk factors, and being healthy. Conclusion: This study is the first of its kind to be conducted in Kenya and adds to the body of knowledge in this area. Despite limited cancer control plans, youth described the grim consequences of getting cancer, their chances of getting the disease, and proposed opportunities for prevention. The study results will create a platform for future cancer prevention research and health promotion programs in Kenya and other part of Africa.
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O'Brien MA, Carroll JC, Manca DP, Miedema B, Groome PA, Makuwaza T, Easley J, Sopcak N, Jiang L, Decker K, McBride ML, Moineddin R, Permaul JA, Heisey R, Eisenhauer EA, Krzyzanowska MK, Pruthi S, Sawka C, Schneider N, Sussman J, Urquhart R, Versaevel C, Grunfeld E. Multigene expression profile testing in breast cancer: is there a role for family physicians? ACTA ACUST UNITED AC 2017; 24:95-102. [PMID: 28490923 DOI: 10.3747/co.24.3457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing. METHODS We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program. We determined the number of visits by breast cancer patients to a fp between the first medical oncology visit and the start of chemotherapy, a period when patients might be considering results of gep testing. RESULTS The fps and cancer specialists felt that ordering gep tests and explaining the results was the role of the oncologist. A new fp role was identified relating to the fp-patient relationship: supporting patients in making adjuvant therapy decisions informed by gep tests by considering the patient's comorbid conditions, social situation, and preferences. Lack of fp knowledge and resources, and challenges in fp-oncologist communication were seen as significant barriers to that role. Between 28% and 38% of patients visited a fp between the first oncology visit and the start of chemotherapy. CONCLUSIONS Our findings suggest an emerging role for fps in supporting patients who are making adjuvant treatment decisions after receiving the results of gep testing. For success in this new role, education and point-of-care tools, together with more effective communication strategies between fps and oncologists, are needed.
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Decker K. Just Getting Started: Almonds Make Breakfast Worth Waking Up for. CEREAL FOOD WORLD 2016. [DOI: 10.1094/cfw-61-6-0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Major D, Armstrong D, Bryant H, Cheung W, Decker K, Doyle G, Mai V, McLachlin CM, Niu J, Payne J, Shukla N. Recent trends in breast, cervical, and colorectal cancer screening test utilization in Canada, using self-reported data from 2008 and 2012. ACTA ACUST UNITED AC 2015; 22:297-302. [PMID: 26300668 DOI: 10.3747/co.22.2690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In Canada, self-reported data from the Canadian Community Health Survey 2008 and 2012 provide an opportunity to examine overall utilization of breast, cervical, and colorectal cancer screening tests for both programmatic and opportunistic screening. Among women 50-74 years of age, utilization of screening mammography was stable (62.0% in 2008 and 63.0% in 2012). Pap test utilization for women 25-69 years of age remained high and stable across Canada in 2008 and 2012 (78.9% in 2012). The percentage of individuals 50-74 years of age who reporting having at least 1 fecal test within the preceding 2 years increased in 2012 (to 23.0% from 16.9% in 2008), but remains low. Stable rates of screening mammography utilization (about 30%) were reported in 2008 and 2012 among women 40-49 years of age, a group for which population-based screening is not recommended. Although declining over time, cervical cancer screening rates were high for women less than 25 years of age (for whom screening is not recommended). Interestingly, an increased percentage of women 70-74 years of age reported having a Pap test. In 2012, a smaller percentage of women 50-69 years of age reported having no screening test (5.9% vs. 8.5% in 2008), and more women reported having the three types of cancer screening tests (19.0% vs. 13.2%). Efforts to encourage use of screening within the recommended average-risk age groups are needed, and education for stakeholders about the possible harms of screening outside those age groups has to continue.
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Mey N, Brandt I, Mieghem C, Decker K, Cammu G, Foubert L. High-sensitive cardiac troponins and CK-MB concentrations in patients undergoing cardiac surgery. Crit Care 2015. [PMCID: PMC4470713 DOI: 10.1186/cc14238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Gloger M, Decker K. Zum Mechanismus der Induktion nicotinabbauender Enzyme in Artbrobacter oxydans. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1969-0816] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Die Induktion der Enzyme Nicotin-oxidase, L-6-Hydroxynicotin-oxidase, D-6-Hydroxynicotinoxidase und Keton-oxidase in Arthrobacter oxydans durch die optischen Antipoden und das Racemat des Nicotins und 6-Hydroxynicotins wurde in Gegenwart einer leicht metabolisierbaren C- und N-Quelle untersucht. Die Induktion der beiden Schlüsselenzyme des Nicotinabbaus, L-6-Hydroxynicotin-oxidase und D-6-Hydroxynicotin-oxidase, erfolgte nicht absolut stereospezifisch durch die optischen Antipoden des Nicotins oder 6-Hydroxynicotins, jedoch stimulierten die D-Antipoden stark die Induktion von D-6-Hydroxynicotin-oxidase. Eine Nicotin- oder eine 6-Hydroxynicotin-racemase ließ sich nicht nachweisen. D,L-6-Amino-nicotin erwies sich als ein schwacher Inducer für die nicotinabbauenden Enzyme in Arthrobacter oxydans.
Während sich aus Wachstumsversuchen eine Koordination für alle vier Enzyme ergab, führte die kinetische Analyse der Induktion zu einer Aufteilung in die Gruppen Nicotin-oxidase, L-6-Hydroxynicotin-oxidase, Keton-oxidase und D-6-Hydroxynicotin-oxidase. Die Induktion wurde durch D-Chloramphenicol und durch Actinomycin C gehemmt.
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Gloger M, Decker K. Notizen: Methode zur mikrobiologischen Gewinnung der optischen Antipoden des 6-Hydroxynicotins. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1969-0133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Decker K. The Displacement of the Posterior Cerebral Artery in Vertebral Angiograms. Acta Radiol 2013. [DOI: 10.1177/028418515304000202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Adambounou K, Farin F, Adjenou V, N’dakena K, Gbeassor M, Tossou A, Akohin L, Decker K, Arbeille P. Plateforme de télémédecine moindre coût pour les pays en développement. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.eurtel.2013.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Poliquin V, Decker K, Altman AD, Lotocki R. Changes in cervical cancer screening behavior for women attending Pap Test Week clinics. Int J Womens Health 2013; 5:141-8. [PMID: 23596357 PMCID: PMC3627342 DOI: 10.2147/ijwh.s41214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This retrospective study of all women who accessed the 2006 Manitoba Pap Test Week clinics was designed to determine factors associated with inadequate cervical cancer screening and changes in cervical cancer screening behavior. Methods Data were acquired using the CervixCheck Manitoba registry and an ancillary database of demographic information collected from clinic attendees. Results The study included 1124 women. Of these, 53% (n = 598) were under-screened (no Pap test in the previous 2 years) prior to accessing the clinics. Logistic regression analyses demonstrated that older age (odds ratio [OR] = 1.02, 95% confidence interval [CI] 1.01–1.03), no doctor (OR = 1.4, 95% CI 1.05–1.54), and living in Canada < 1 year (OR = 5.5, 95% CI 2.73–11.12) were associated with being under-screened prior to accessing the Pap Test Week clinics. Thirty-seven percent (n = 223) of under-screened women demonstrated improved screening status subsequent to the 2006 Pap Test Week (had a subsequent Papanicolaou [Pap] test performed within 2 years) and these women were more likely to live in an urban setting (P = 0.003), be younger (P < 0.001), originate outside Canada (P = 0.006), have lived in Canada for less than 1 year (P = 0.006), and have had an abnormal Pap test result in 2006 (P < 0.001). Previously under-screened women were less likely to become adequately-screened subsequent to 2006 if they had a Pap test performed at a Pap Test Week clinic compared to having a Pap test performed elsewhere (37% versus 60%, P < 0.001). Conclusion This study identified a subset of under-screened women accessing Pap Test Week clinics whose screening status might be most modifiable.
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Forte T, Decker K, Lockwood G, McLachlin C, Fekete S, Bryant H. Corrigendum: A First Look at Participation Rates in Cervical Cancer Screening Programs in Canada. Curr Oncol 2013. [DOI: 10.3747/co.20.1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
K. Decker and and the Pan-Canadian Cervical Cancer Screening Initiative: Monitoring Program Performance Working Group is to be added to the author list. [...]
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Forte T, Decker K, Lockwood GA, McLachlin CM, Fekete S, Bryant HE. A first look at participation rates in cervical cancer screening programs in Canada. ACTA ACUST UNITED AC 2013; 19:269-71. [PMID: 23144575 DOI: 10.3747/co.19.1188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In 2011, the Pan-Canadian Cervical Cancer Screening Initiative (PCCSI), supported by the Canadian Partnership Against Cancer, released Cervical Cancer Screening in Canada: Monitoring Program Performance 2006–2008 and for the first time presented information on 12 national quality indicators relating to provincial and territorial cervical cancer screening programs. [...]
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Almonte T, Decker K, Seroski W, Walker I, Webert K, Bos C, Strike K, Waterhouse L, Goldsmith R, Chan AKC. The importance of haemophilia treatment centre administrators in patient care. Haemophilia 2012; 18:e366-7. [PMID: 22805734 DOI: 10.1111/j.1365-2516.2012.02900.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2012] [Indexed: 11/30/2022]
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Decker K, Fischgold H, Hacker H, Metzger J. Entwicklungsstörungen am atlanto-okzipitalen Übergang. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1212784] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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