Chronic Diseases in Canada

Volume 27, No. 3, 2006

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Chronic Diseases in Canada (CDIC) is a quarterly scientific journal focussing on current evidence relevant to the control and prevention of chronic (i.e. non-communicable) diseases and injuries in Canada. Since 1980 the journal has published a unique blend of peer-reviewed feature articles by authors from the public and private sectors and which may include research from such fi elds as epidemiology, public/community health, biostatistics, the behavioural sciences, and health services or economics. Only feature articles are peer reviewed. Authors retain responsibility for the content of their articles; the opinions expressed are not necessarily those of the CDIC editorial committee nor of the Public Health Agency of Canada.

Abstracts from Feature Articles in Chronic Diseases in Canada Volume 27, No 3, 2006

Article 1: Assessment of mental health and illness by telephone survey: Experience with an Alberta mental health survey

Authors: Scott B Patten, Carol E Adair, Jeanne V A Williams, Rollin Brant, Jian Li Wang, Ann Casebeer and Pierre Beauséjour

Abstract:
Mental health is an emerging priority for health surveillance. It has not been determined that the existing data sources can adequately meet surveillance needs. The objective of this project was to explore the use of telephone surveys as a means of collecting supplementary surveillance information. A computer-assisted telephone interview was administered to 5,400 subjects in Alberta. The interview included a set of brief, validated measures for evaluating mental disorder prevalence and related variables. The individual subject response rate was 78%, but a substantial number of refusals occurred at the initial household contact. The age and sex distribution of the study sample differed from that of the provincial population prior to weighting. Prevalence proportions did not vary substantially across administrative health regions. There is a potential role for telephone data collection in mental health surveillance, but these results highlight some associated methodological challenges. They also draw into question the importance of regional variation in mental disorder prevalence - which might otherwise have been a key advantage of telephone survey methodologies.

Article 2: Trends in cancer prevalence in Quebec

Authors: Rabiâ Louchini, Michel Beaupré, Alain A Demers, Patricia Goggin and Clermont Bouchard

Abstract:
Cancer prevalence is of prime interest in public health because of its use in estimating the disease’s burden on the heath care system. This study’s objective was to estimate five-year prevalence of tumours from 1989 to 1999 and ten-year prevalence of tumours from 1994 to 1999 in the Province of Quebec (Canada). Five-year prevalence was used to represent tumours for which people are more likely to obtain primary treatment; ten-year prevalence included those tumours in addition to tumours that can be considered cured but still need follow-up. Information was extracted from the Quebec Cancer Registry. Prostate cancer was the most prevalent malignancy among males (25%, fi ve-year prevalent tumours), while breast cancer was most prevalent among females (38%, five-year prevalent tumours). For both sexes, the greatest observed prevalence increase was for endocrine glands. On average, five-year prevalence proportions were 16% higher in men than in women; those of ten year were 14% higher in men. Furthermore, the largest differences were observed for bladder and lung cancer. The change in cancer prevalence in Quebec was dependent on the tumour site.

Article 3: Validity of death and stillbirth certificates and hospital discharge summaries for the identification of neural tube defects in Quebec City

Authors: Fassiatou Tairou, Philippe De Wals and Adrien Bastide

Abstract:
The objectives of this study were 1) to assess the validity of different databases which identify neural tube defect (NTD) cases in the population, and 2) to examine the temporal trends in NTD rates and the impact of prenatal diagnoses among pregnancies referred to a tertiary care hospital in Quebec City, Canada, from 1993 to 2002. Infant death and stillbirth certificates were a highly reliable source for ascertaining NTD cases, but their overall sensitivity was poor (13%). Med-Echo had very good sensitivity (92%), but there were many coding errors in the database and some diagnostic categories were not specific for NTD. The average NTD prevalence proportion was 6.5/1,000 births during the entire study period, decreasing from 12.2/1,000 in 1993 to 3.9/1,000 in 2002. Overall, 78.6% of NTD cases were diagnosed prenatally and the pregnancy was terminated in 52.6% of these. These two proportions were stable over the study years. To conclude, the combination of hospital discharge summaries and infant death and stillbirth certificates is a highly sensitive method for the ascertainment of NTD cases, including terminations of pregnancies, but medical records must be reviewed to exclude coding errors and to clarify unspecific diagnostic categories.

Article 4: Epidemiology of hepatocellular carcinoma in Canada, 1995: Analysis of death certificates

Authors: Susie ElSaadany and Antonio Giulivi

Abstract:
A descriptive analysis of hepatocellular carcinoma (HCC) deaths in Canada for 1995 was undertaken. Cases (ICD-9 155.0) were identified from the Statistics Canada annual mortality file; age-adjusted death rates by age, sex and province were calculated. Antecedent causes and conditions leading to death listed on the death certificate, including viral hepatitis infection and cirrhosis, were examined, in addition to birthplace information. The 403 cases identified resulted in an annual age-standardized mortality rate of 2.11 deaths per 100,000 persons among men and 0.64 deaths per 100,000 persons among women. Mean age at death was 65.5 years with male-to-female ratio approximately 3:1. Compared to the age-standardized rate for birthplace of Canada of 0.96 per 100,000 (95% CI: 0.84, 1.10), the age-standardized mortality rates were significantly elevated for birthplace of Europe 1.72 (95% CI: 1.37, 2.28), Asia 5.17 (95% CI: 4.11, 6.44), and non-significantly elevated for all other countries 1.54 (95% CI: 0.94, 2.39). In total, 60 patients (15%) were reported to have had viral hepatitis; sufficient information was not provided for the remainder. Of the total population, 8.7 % were reported to have had viral hepatitis B and 5.2 % had viral hepatitis C. Information on cirrhosis was provided in 103 (26%) of cases. Of these, the largest proportion (45%) was of unknown type while 23 patients (22%) had alcohol-related cirrhosis. Prevalence of antecedent causes was slightly lower than reported previously and may be considered minimum estimates since inadequate information was provided in over 50% of deaths.

Article 5: Building connections for young adults with type 1 diabetes mellitus in Manitoba: Feasibility and acceptability of a transition initiative

Authors: Norma Van Walleghem, Catherine A MacDonald and Heather J Dean

Abstract:
During the transition from pediatric to adult diabetes care there is often a high rate of medical dropout and increased rates of acute and chronic complications. Building Connections: The Maestro Project was initiated in September 2002 by the Diabetes Education Resource for Children and Adolescents and the City of Winnipeg Regional Health Authority in Manitoba, Canada to examine the feasibility and acceptability of an administrative support and systems navigation service for young adults with type 1 diabetes. The participation rate on February 28, 2005 was 78.9% (373/473). Of the 323 young adult participants 18 to 30 years of age, 127 requested 230 community contacts for access care and education. Specifically, 46 re-referrals were made for specialty care (adult endocrinologists or general internists), 34 contact numbers were given for family physician care, and there were 121 contacts to reconnect with diabetes education and counseling services and 29 contacts for an optometrist. The first 22 years of the project have demonstrated the feasibility and acceptability of this model of service for young adults with type 1 diabetes as they move from pediatric to adult care.