Preoperative irradiation in rectal cancer: initial comparison of clinical tolerance, surgical and pathologic findings.
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Biomedical subjects
Publications and source records attributed to M Tepper.
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To assess the risk of hepatitis C in Canada and to predict the burden that this disease may pose to the Canadian society in the near future, expected numbers of persons at different stages of the disease currently and in the next decade were estimated by simulation using a published hepatitis C natural history model with no treatment effect being applied. Based on the estimate of 240,000 persons who are currently infected with the hepatitis C virus in Canada, the simulation analysis demonstrated that the number of hepatitis C cirrhosis cases would likely increase by 92% from 1998 to the year 2008. It was also projected that the number of liver failures and hepatocellular carcinomas related to hepatitis C would increase by 126% and 102%, respectively, in the next decade. The number of liver-related deaths associated with hepatitis C is expected to increase by 126% in 10 years. The medical and social care systems in Canada may not be ready to support these large increases. These results highlight the importance of both the control of disease progression of hepatitis C virus-infected persons and the primary prevention of hepatitis C infections in Canada.
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Mortality data from Statistics Canada were analyzed to measure the temporal trends and burden of illness attributed to viral hepatitis in Canada. Analysis of age-standardized mortality rates from 1979 to 1997 showed an increasing trend in mortality for both hepatitis B and non-A, non-B hepatitis (NANBH), most of which are attributed to hepatitis C infections. Hepatitis B and NANBH age-standardized mortality rates increased respectively, from 0.03 and 0.12 deaths per 100,000 population in 1979 to 0.26 and 0.41 deaths per 100,000 in 1997. Male mortality rates were consistently higher than female for both diseases. Among deaths from chronic liver disease, over 1,000 deaths were estimated to have been caused by hepatitis B and hepatitis C annually. Although the hepatitis B or NANBH recorded deaths largely underestimate the true burden of HBV and HCV in Canada, the temporal trends are useful as they reflect changes in the impact of both diseases.