Biomedical subjects

Heather Bryant

Publications and source records attributed to Heather Bryant.

6 recordsLinked to original sources

PubMed2007

Adaptation and evaluation of the National Cancer Institute's Diet History Questionnaire and nutrient database for Canadian populations.

BACKGROUND AND OBJECTIVE: Despite assumed similarities in Canadian and US dietary habits, some differences in food availability and nutrient fortification exist. Food-frequency questionnaires designed for the USA may therefore not provide the most accurate estimates of dietary intake in Canadian populations. Hence, we undertook to evaluate and modify the National Cancer Institute's Diet History Questionnaire (DHQ) and nutrient database. METHODS: Of the foods queried on the DHQ, those most likely to differ in nutrient composition were identified. Where possible these foods were matched to comparable foods in the Canadian Nutrient File. Nutrient values were examined and modified to reflect the Canadian content of minerals (calcium, iron, zinc) and vitamins (A, C, D, thiamin, riboflavin, niacin, B6, folate and B12). DHQs completed by 13 181 Alberta Cohort Study participants aged 35-69 years were analysed to estimate nutrient intakes using the original US and modified versions of the DHQ databases. Misclassification of intake for meeting the Dietary Reference Intake (DRI) was determined following analysis with the US nutrient database. RESULTS: Twenty-five per cent of 2411 foods deemed most likely to differ in nutrient profile were subsequently modified for folate, 11% for vitamin D, 10% for calcium and riboflavin, and between 7 and 10% for the remaining nutrients of interest. Misclassification with respect to meeting the DRI varied but was highest for folate (7%) and vitamin A (7%) among men, and for vitamin D (7%) among women over 50 years of age. CONCLUSION: Errors in nutrient intake estimates owing to differences in food fortification between the USA and Canada can be reduced in Canadian populations by using nutrient databases that reflect Canadian fortification practices.

Adult↗

PubMed2006

Population-based cohort development in Alberta, Canada: a feasibility study.

In a climate of increasing privacy concerns, the feasibility of establishing new cohorts to examine chronic disease etiology has been debated. Our primary aim was to ascertain the feasibility of enrolling a geographically dispersed, population-based cohort in Alberta. We also examined whether enrolees would grant access to provincial health care utilization data and consider providing blood for future analysis. Using random digit dialling, 22,652 men and women aged 35 to 69 years, without diagnosed cancer, were recruited. Of these, 52.4 percent (N=11,865) enrolled; 84 percent of Alberta communities were represented. Approximately 97 percent of enrolees consented to linkage with health care data, and 91 percent indicated willingness to consider future blood sampling. Comparisons between the cohort and the Canadian Community Health Survey (Cycle 1.1) for Alberta demonstrated similarities in marital status and income. However, the cohort had a smaller proportion who had not finished high school, a greater proportion of nonsmokers and a higher prevalence of obesity. These findings indicate that establishment of a geographically dispersed cohort is feasible in the Canadian context, and that data linkage and biomarker studies may be viable.

Adult↗

PubMed2005

Colorectal cancer screening: practices and attitudes of gastroenterologists, internists and surgeons.

BACKGROUND: The Canadian Task Force on Preventive Health Care has recommended the use of annual or biennial fecal occult blood testing (FOBT) and flexible sigmoidoscopy in the periodic health examination of asymptomatic people over 50 years of age. Therefore, we decided to ascertain the current colorectal cancer (CRC) screening practices and attitudes of surgeons, gastroenterologists and internists. METHODS: In June 2002 (with a final mailing in December 2002), a questionnaire was sent to all gastroenterologists, internists and surgeons in Alberta. It included items on demographic and practice characteristics, CRC screening practices and opinions about CRC screening. RESULTS: Responses were received from 42 gastroenterologists, 83 internists and 68 surgeons. Overall, 141 of 187 respondents (75.4%, 95% confidence interval [CI] 68.6%-81.4%) recommended that average-risk adults undergo CRC screening. Internists were less likely to recommend screening than either gastroenterologists or surgeons (95% CI for the difference 7.2%-32.8%). The most commonly recommended screening test was colonoscopy (70%), followed by FOBT (65%), flexible sigmoidoscopy (47%) and air-contrast barium enema (31%). Colonoscopy was the only test recommended by 7 (22.6%) of 33 gastroenterologists, 9 (16.4%) of 59 surgeons and 3 (6.1%) of 49 internists. Respondents were more likely to list barriers to the use of colonoscopy (mean 5 barriers) for screening than for either FOBT or flexible sigmoidoscopy (mean 2 barriers for both tests). Only 3 respondents indicated that they themselves would not undergo screening. Colonoscopy was the only screening test that 135 (70.0%) of the 193 would themselves undergo. CONCLUSIONS: The majority of Alberta specialists recommend CRC screening for average-risk adults. Colonoscopy was the most commonly recommended test, despite the perception of more barriers to that technique and the 2001 guidelines prepared by the Canadian Task Force for Preventive Health Care, which did not support colonoscopy.

Adult↗

PubMed2004

Breast Cancer in Canadian Women.

HEALTH ISSUE: Although lung cancer is the leading cause of cancer deaths for Canadian women, breast cancer is the most frequently diagnosed. About 5400 women are expected to die from this disease in 2003. In 1998, a woman's lifetime risk of breast cancer was about one in nine. KEY FINDINGS: A number of risk factors for breast cancer have been identified. These include advancing age, hormonal factors (eg. early menarche, late menopause and late age at first full-term pregnancy), familial risk, BRCA-1 and BRCA-2 gene mutations, diet and postmenopausal obesity.Several interventions have been introduced to assist women at high risk for breast cancer, including genetic counseling and testing for women who have strong family histories of breast cancer; selective estrogen receptor modifiers, such as tamoxifen, that has been shown to reduce breast cancer rates; prophylactic mastectomy and screening. DATA GAPS AND RECOMMENDATIONS: Guidelines are unclear in several areas, particularly in screening. Where clinical guidelines are available, health services research or ongoing monitoring (by provincial/territorial cancer agencies) is needed to assess compliance with the guidelines and to ensure equity of access within the provinces/territories.Key components of organized screening programs need to be established, in part to ensure that screening is carried out in high-quality, co-ordinated programs. There is also a need to develop ways to involve women fully in informed decision-making and to address several policy issues to prevent disparities in access to high-quality services. Patenting issues associated with genetic tests also need to be clarified.

Journal Article↗

PubMedDate not supplied

Canada: agreement between patient and proxy information about colorectal cancer therapies.

Proxies, such as next of kin, often provide information to healthcare professionals about a cancer patient they know, particularly when this information is not available from the patient. Understanding the extent to which proxies offer reliable information about patients is important for improving the quality of patient care and also for assessing the quality of research, evaluation, and administrative data when proxy response is utilized. This study determined Levels of agreement between information reported by colorectal cancer patients and by their proxies about complementary and alternative medicine obtained by questionnaire response. Patient-proxy agreement was also compared for conventional therapies, patient demographics, lifestyle, and symptoms.

Adult↗

PubMedDate not supplied

Complementary and alternative medicine use among colorectal cancer patients in Alberta, Canada.

CONTEXT: No population-based data are available on the use of complementary and alternative medicine (CAM) specifically among colorectal cancer patients. OBJECTIVE: To examine the prevalence and determinants of CAM use among colorectal cancer patients in Alberta, Canada. DESIGN: Population-based questionnaire. SETTING AND PARTICIPANTS: Patients (871 of 1240 surveyed), or their close relatives or friends, who were diagnosed with colorectal cancer in 1993 or 1995 in Alberta, Canada. MAIN OUTCOME MEASURES: Demographics, lifestyle, health status, symptoms and coping mechanisms, and attitudes about cancer cause, conventional treatments and practitioners, and CAM and practitioners. RESULTS: Seventy percent (871) of 1240 participants completed the questionnaire, and 49% used CAM. The most frequently used CAM therapies among users were psychological and spiritual therapies (65%), vitamins and minerals (46%), and herbs (42%). Sixty-eight percent of CAM users informed their medical doctors, and 69% used CAM after conventional care. Logistic regression suggested the strongest predictors of CAM use to be vegetarian diet, aged less than 50 years, female, having therapy options other than conventional treatment recommended by conventional doctors, experiencing changes in bowel habits orfatigue before diagnosis, and recommendation of chemotherapy. Nonsurviving patients were more likely to have used CAM than were survivors. CONCLUSIONS: Cancer patients are using CAM and communicating usage to physicians. This finding suggests that physicians should be prepared to discuss CAM with patients, and evidence-based information about CAM should be sought, including where CAM may pose risks. This study serves as a baseline for studies on the efficacy and safety of CAM.

Adult↗