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Pham TM, Lu X, Bu J, Tchir D, Pakseresht M, Wickham M, Scott A, Tian X, Karosas APV, Eckstrand A, Kaposhi B, Walker E, Shack L. Revisiting the Calculation for a Novel Measure of Average Lifespan Shortened: Real-World Examples From Cervical and Ovarian Cancers in Alberta, Canada, 2000 - 2020. J UOEH 2023; 45:217-220. [PMID: 38057110 DOI: 10.7888/juoeh.45.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
In this technical note, we primarily demonstrate the computation of confidence limits for a novel measure of average lifespan shortened (ALSS). We identified women who had died from cervical and ovarian cancer between 2000 and 2020 from the Alberta cancer registry. Years of life lost (YLL) was calculated using the national life tables of Canada. We estimated the ALSS as a ratio of YLL in relation to the expected lifespan. We computed the confidence limits of the measure using various approaches, including the normal distribution, gamma distribution, and bootstrap method. The new ALSS measure shows a modest gain in lifespan of women, particularly women with ovarian cancer, over the study period.
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Affiliation(s)
- Truong-Minh Pham
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Xiaoming Lu
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Jingyu Bu
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Devan Tchir
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Mohammadreza Pakseresht
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Maeve Wickham
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Allison Scott
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Xiaoyi Tian
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Anthony Paul Vytautas Karosas
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Angela Eckstrand
- Alberta Cancer Registry, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Bethany Kaposhi
- Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Emily Walker
- Precision Analytics, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
| | - Lorraine Shack
- Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Canada
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McPhail S, Swann R, Johnson SA, Barclay ME, Abd Elkader H, Alvi R, Barisic A, Bucher O, Clark GRC, Creighton N, Danckert B, Denny CA, Donnelly DW, Dowden JJ, Finn N, Fox CR, Fung S, Gavin AT, Gomez Navas E, Habbous S, Han J, Huws DW, Jackson CGCA, Jensen H, Kaposhi B, Kumar SE, Little AL, Lu S, McClure CA, Møller B, Musto G, Nilssen Y, Saint-Jacques N, Sarker S, Te Marvelde L, Thomas RS, Thomas RJS, Thomson CS, Woods RR, Zhang B, Lyratzopoulos G. Risk factors and prognostic implications of diagnosis of cancer within 30 days after an emergency hospital admission (emergency presentation): an International Cancer Benchmarking Partnership (ICBP) population-based study. Lancet Oncol 2022; 23:587-600. [PMID: 35397210 PMCID: PMC9046095 DOI: 10.1016/s1470-2045(22)00127-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Greater understanding of international cancer survival differences is needed. We aimed to identify predictors and consequences of cancer diagnosis through emergency presentation in different international jurisdictions in six high-income countries. METHODS Using a federated analysis model, in this cross-sectional population-based study, we analysed cancer registration and linked hospital admissions data from 14 jurisdictions in six countries (Australia, Canada, Denmark, New Zealand, Norway, and the UK), including patients with primary diagnosis of invasive oesophageal, stomach, colon, rectal, liver, pancreatic, lung, or ovarian cancer during study periods from Jan 1, 2012, to Dec 31, 2017. Data were collected on cancer site, age group, sex, year of diagnosis, and stage at diagnosis. Emergency presentation was defined as diagnosis of cancer within 30 days after an emergency hospital admission. Using logistic regression, we examined variables associated with emergency presentation and associations between emergency presentation and short-term mortality. We meta-analysed estimates across jurisdictions and explored jurisdiction-level associations between cancer survival and the percentage of patients diagnosed as emergencies. FINDINGS In 857 068 patients across 14 jurisdictions, considering all of the eight cancer sites together, the percentage of diagnoses through emergency presentation ranged from 24·0% (9165 of 38 212 patients) to 42·5% (12 238 of 28 794 patients). There was consistently large variation in the percentage of emergency presentations by cancer site across jurisdictions. Pancreatic cancer diagnoses had the highest percentage of emergency presentations on average overall (46·1% [30 972 of 67 173 patients]), with the jurisdictional range being 34·1% (1083 of 3172 patients) to 60·4% (1317 of 2182 patients). Rectal cancer had the lowest percentage of emergency presentations on average overall (12·1% [10 051 of 83 325 patients]), with a jurisdictional range of 9·1% (403 of 4438 patients) to 19·8% (643 of 3247 patients). Across the jurisdictions, older age (ie, 75-84 years and 85 years or older, compared with younger patients) and advanced stage at diagnosis compared with non-advanced stage were consistently associated with increased emergency presentation risk, with the percentage of emergency presentations being highest in the oldest age group (85 years or older) for 110 (98%) of 112 jurisdiction-cancer site strata, and in the most advanced (distant spread) stage category for 98 (97%) of 101 jurisdiction-cancer site strata with available information. Across the jurisdictions, and despite heterogeneity in association size (I2=93%), emergency presenters consistently had substantially greater risk of 12-month mortality than non-emergency presenters (odds ratio >1·9 for 112 [100%] of 112 jurisdiction-cancer site strata, with the minimum lower bound of the related 95% CIs being 1·26). There were negative associations between jurisdiction-level percentage of emergency presentations and jurisdiction-level 1-year survival for colon, stomach, lung, liver, pancreatic, and ovarian cancer, with a 10% increase in percentage of emergency presentations in a jurisdiction being associated with a decrease in 1-year net survival of between 2·5% (95% CI 0·28-4·7) and 7·0% (1·2-13·0). INTERPRETATION Internationally, notable proportions of patients with cancer are diagnosed through emergency presentation. Specific types of cancer, older age, and advanced stage at diagnosis are consistently associated with an increased risk of emergency presentation, which strongly predicts worse prognosis and probably contributes to international differences in cancer survival. Monitoring emergency presentations, and identifying and acting on contributing behavioural and health-care factors, is a global priority for cancer control. FUNDING Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; National Health Service England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; the Scottish Government; Western Australia Department of Health; and Wales Cancer Network.
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Affiliation(s)
- Sean McPhail
- National Disease Registration Service, NHS Digital, Leeds, UK
| | - Ruth Swann
- National Disease Registration Service, NHS Digital, Leeds, UK; Cancer Research UK, London, UK
| | | | - Matthew E Barclay
- Epidemiology of Cancer Healthcare and Outcomes, Department of Behavioural Science and Health, Institute of Epidemiology and Health Care (IEHC), University College London, London, UK
| | | | - Riaz Alvi
- Department of Epidemiology and Performance Measurement, Saskatchewan Cancer Agency, Saskatoon, SK, Canada
| | | | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | | | | | - Bolette Danckert
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | | | - David W Donnelly
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Jeff J Dowden
- Provincial Cancer Care Program, Eastern Health, St John's, NL, Canada
| | - Norah Finn
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia; Cancer Support, Treatment and Research, Department of Health, Melbourne, VIC, Australia
| | - Colin R Fox
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Sharon Fung
- Canadian Partnership against Cancer, Toronto, ON, Canada
| | - Anna T Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | | | - Steven Habbous
- Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Jihee Han
- Canadian Partnership against Cancer, Toronto, ON, Canada
| | - Dyfed W Huws
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Data, Knowledge and Research Directorate, Public Health Wales, Cardiff, UK; Population Data Science, Swansea University Medical School, Swansea, UK
| | | | - Henry Jensen
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Bethany Kaposhi
- Surveillance and Reporting, Advanced Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton
| | - S Eshwar Kumar
- New Brunswick Cancer Network, Department of Health, New Brunswick, Fredericton, NB, Canada
| | | | | | - Carol A McClure
- Prince Edward Island Cancer Registry, Queen Elizabeth Hospital, Charlottetown, PE, Canada
| | | | - Grace Musto
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada
| | | | | | - Sabuj Sarker
- Department of Epidemiology and Performance Measurement, Saskatchewan Cancer Agency, Saskatoon, SK, Canada
| | - Luc Te Marvelde
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Rebecca S Thomas
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Data, Knowledge and Research Directorate, Public Health Wales, Cardiff, UK; Department of the Dean, Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Robert J S Thomas
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Data, Knowledge and Research Directorate, Public Health Wales, Cardiff, UK; Department of the Dean, Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Ryan R Woods
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Bin Zhang
- Health Analytics, Department of Health, Fredericton, NB, Canada
| | - Georgios Lyratzopoulos
- National Disease Registration Service, NHS Digital, Leeds, UK; Epidemiology of Cancer Healthcare and Outcomes, Department of Behavioural Science and Health, Institute of Epidemiology and Health Care (IEHC), University College London, London, UK.
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Walker E, Fu Y, Sadowski DC, Stewart D, Tang P, Kaposhi B, Chappell H, Robson P, Veldhuyzen van Zanten S. Delayed Colorectal Cancer Diagnosis during the COVID-19 Pandemic in Alberta: A Framework for Analyzing Barriers to Diagnosis and Generating Evidence to Support Health System Changes Aimed at Reducing Time to Diagnosis. Int J Environ Res Public Health 2021; 18:ijerph18179098. [PMID: 34501687 PMCID: PMC8430515 DOI: 10.3390/ijerph18179098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
The frequency of colorectal cancer (CRC) diagnosis has decreased due to the COVID-19 pandemic. Health system planning is needed to address the backlog of undiagnosed patients. We developed a framework for analyzing barriers to diagnosis and estimating patient volumes under different system relaunch scenarios. This retrospective study included CRC cases from the Alberta Cancer Registry for the pre-pandemic (1 January 2016–4 March 2020) and intra-pandemic (5 March 2020–1 July 2020) periods. The data on all the diagnostic milestones in the year prior to a CRC diagnosis were obtained from administrative health data. The CRC diagnostic pathways were identified, and diagnostic intervals were measured. CRC diagnoses made during hospitalization were used as a proxy for severe disease at presentation. A modified Poisson regression analysis was used to estimate the adjusted relative risk (adjRR) and a 95% confidence interval (CI) for the effect of the pandemic on the risk of hospital-based diagnoses. During the study period, 8254 Albertans were diagnosed with CRC. During the pandemic, diagnosis through asymptomatic screening decreased by 6·5%. The adjRR for hospital-based diagnoses intra-COVID-19 vs. pre-COVID-19 was 1.24 (95% CI: 1.03, 1.49). Colonoscopies were identified as the main bottleneck for CRC diagnoses. To clear the backlog before progression is expected, high-risk subgroups should be targeted to double the colonoscopy yield for CRC diagnosis, along with the need for a 140% increase in monthly colonoscopy volumes for a period of 3 months. Given the substantial health system changes required, it is unlikely that a surge in CRC cases will be diagnosed over the coming months. Administrators in Alberta are using these findings to reduce wait times for CRC diagnoses and monitor progression.
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Affiliation(s)
- Emily Walker
- Surveillance and Reporting, Advanced Analytics, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada; (Y.F.); (B.K.)
- Correspondence:
| | - Yunting Fu
- Surveillance and Reporting, Advanced Analytics, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada; (Y.F.); (B.K.)
| | - Daniel C. Sadowski
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB T6G 2X8, Canada; (D.C.S.); (S.V.v.Z.)
| | - Douglas Stewart
- Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3H1, Canada;
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N2, Canada;
| | - Patricia Tang
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N2, Canada;
| | - Bethany Kaposhi
- Surveillance and Reporting, Advanced Analytics, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada; (Y.F.); (B.K.)
| | - Heather Chappell
- Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3C6, Canada; (H.C.); (P.R.)
| | - Paula Robson
- Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3C6, Canada; (H.C.); (P.R.)
| | - Sander Veldhuyzen van Zanten
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB T6G 2X8, Canada; (D.C.S.); (S.V.v.Z.)
- Digestive Health Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
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Pham TM, Thanh NX, Wasylak T, Hill MD, Jeerakathil T, Sikdar KC, Kaposhi B, Shack L, Cheung WY. Average Lifespan Shortened due to Stroke in Canada: A Nationwide Descriptive Study From 1990 to 2015. Stroke 2021; 52:573-581. [PMID: 33406864 DOI: 10.1161/strokeaha.120.032028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE There are challenges in comparability when using existing life lost measures to examine long-term trends in premature mortality. To address this important issue, we have developed a novel measure termed average lifespan shortened (ALSS). In the present study, we used the ALSS measure to describe temporal changes in premature mortality due to stroke in the Canadian population from 1990 to 2015. METHODS Mortality data for stroke were obtained from the World Health Organization mortality database. Years of life lost was calculated using Canadian life tables. ALSS was calculated as the ratio of years of life lost in relation to the expected lifespan. RESULTS Over a 25-year timeframe, the age-standardized rates adjusted to the World Standard Population for deaths from all strokes and stroke types substantially decreased in both sexes. The ALSS measure indicated that men who died of stroke lost 12.1% of their lifespan in 1990 and 11.4% in 2015, whereas these values among women were 11.1% and 10.0%, respectively. Patients with subarachnoid hemorrhagic stroke lost the largest portion whereby both sexes lost about one-third of their lifespan in 1990 and one-fourth in 2015. Men with intracerebral hemorrhagic stroke lost around 18% of their lifespan in 1990 and 14% in 2015 as compared to women who lost about 16% and 12% over the same timeframe. The loss of lifespan for patients with ischemic stroke and other stroke types combined was relatively stable at about 10% throughout the study period. CONCLUSIONS Our study demonstrated a modest improvement in lifespan among patients with stroke in Canada between 1990 and 2015. Our novel ALSS measure provides intuitive interpretation of temporal changes in lifespan among patients with stroke and helps to enhance our understanding of the burden of strokes in the Canadian population.
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Affiliation(s)
- Truong-Minh Pham
- Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta (T.-M.P., B.K., L.S.), Alberta Health Services, Edmonton and Calgary, Canada
| | - Nguyen Xuan Thanh
- Strategic Clinical Networks (N.X.T., T.W.), Alberta Health Services, Edmonton and Calgary, Canada
| | - Tracy Wasylak
- Strategic Clinical Networks (N.X.T., T.W.), Alberta Health Services, Edmonton and Calgary, Canada
| | - Michael D Hill
- Department of Clinical Neurosciences, Hotchkiss Brain (M.D.H.), University of Calgary, Canada.,Department of Community Health Sciences (K.C.S., M.D.H.), University of Calgary, Canada
| | - Thomas Jeerakathil
- Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada (T.J.)
| | - Khokan C Sikdar
- Surveillance and Reporting, Public Health Surveillance and Infrastructure, Population, Public and Indigenous (K.C.S.), Alberta Health Services, Edmonton and Calgary, Canada.,Department of Community Health Sciences (K.C.S., M.D.H.), University of Calgary, Canada
| | - Bethany Kaposhi
- Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta (T.-M.P., B.K., L.S.), Alberta Health Services, Edmonton and Calgary, Canada
| | - Lorraine Shack
- Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta (T.-M.P., B.K., L.S.), Alberta Health Services, Edmonton and Calgary, Canada
| | - Winson Y Cheung
- Department of Oncology, Cumming School of Medicine (W.Y.C.), University of Calgary, Canada
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Pham TM, Sikdar KC, Cheung WY, Roa W, Eckstrand A, Kaposhi B, Shack L. Premature Mortality Due to Malignancies of the Central Nervous System in Canada, 1980-2010. Neuroepidemiology 2018; 50:195-200. [PMID: 29694962 DOI: 10.1159/000488145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 03/06/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In this study, we investigated whether there has been an improvement in premature mortality due to central nervous system (CNS) cancers among the Canadian population from 1980 through 2010. METHODS Mortality data for CNS cancers were obtained from World Health Organization mortality database. Years of life lost (YLL) was estimated using Canadian life tables. Average lifespan shortened (ALSS) was calculated and defined as the ratio of YLL relative to the expected lifespan. RESULTS Over this study period, we observed decreases in age standardized rates to the World Standard Population for mortality due to CNS cancers from 5.3 to 4.1 per 100,000 men, and from 3.6 to 2.9 per 100,000 women. Average YLL decreased from 23.6 to 21.5 years of life among men, and from 27.0 to 23.1 years among women in 1980 and 2010, respectively. The ALSS showed that men with CNS cancers lost 30.1% of their life span and women lost 32.5% in 1980, whereas they lost 25.8 and 26.6% in 2010, respectively. CONCLUSION Our study shows that -Canadian people with CNS cancers have had their lives prolonged at the end of the study period.
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Affiliation(s)
- Truong-Minh Pham
- Surveillance and Reporting, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Khokan C Sikdar
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Winson Y Cheung
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Wilson Roa
- Division of Radiation Oncology, Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Angela Eckstrand
- Surveillance and Reporting, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Bethany Kaposhi
- Surveillance and Reporting, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Lorraine Shack
- Surveillance and Reporting, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada.,Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Pham TM, Sikdar KC, Kaposhi B, Lupichuk S, Yang H, Shack L. Premature mortality due to breast cancer among Canadian women: an analysis of a 30-year period from 1980 through 2010. Eur J Public Health 2017; 28:348-352. [DOI: 10.1093/eurpub/ckx195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Truong-Minh Pham
- Surveillance and Reporting, C-MORE, CancerControl Alberta, Alberta Health Services, Edmonton and Calgary, AB, Canada
| | - Khokan C Sikdar
- Surveillance and Reporting, C-MORE, CancerControl Alberta, Alberta Health Services, Edmonton and Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bethany Kaposhi
- Surveillance and Reporting, C-MORE, CancerControl Alberta, Alberta Health Services, Edmonton and Calgary, AB, Canada
| | - Sasha Lupichuk
- Department of Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Huiming Yang
- Screening Population, Public and Indigenous Health, Alberta Health Services, Calgary, AB, Canada
| | - Lorraine Shack
- Surveillance and Reporting, C-MORE, CancerControl Alberta, Alberta Health Services, Edmonton and Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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