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Objective: To examine national trends in mortality rates for injuries among Canadian children younger than 15 years in 1979–2002. Methods: Data on injury deaths were obtained from the Canadian Vital Statistics system at Statistics Canada. Injuries were classified using the codes for external cause of injury and poisoning (E-codes) by intent and by mechanism. Mortality rates were age adjusted to the 1990 world standard population. Negative binomial regression was used to estimate the secular trends. Results: Annual mortality rates for total and unintentional injuries declined substantially (from 23.8 and 21.7 in 1979 to 7.2 and 5.8 in 2002, respectively), whereas suicide deaths among children aged 10–14 showed an increasing trend. All Canadian provinces and territories showed a decreasing trend in mortality rates of total injuries. Motor vehicle related injuries were the most common cause of injury deaths (accounted for an average of 36.4% of total injury deaths), followed by suffocation (14.3%), drowning (13.5%), and burning (11.1%); however, suffocation was the leading cause for infants. The number of potential years of life lost due to injury before age 75 decreased from 89 343 in 1979 to 27 948 in 2002 for children aged 0–14 years. Conclusions: During the period 1979–2002, there were dramatic decreases in childhood mortality for total injuries and unintentional injuries as well as various degrees of reduction for all causes of injury except suffocation in children aged 10–14 years and drowning in infants. The reason for the reduction in injury mortality might be multifactoral. [ABSTRACT FROM AUTHOR]

Background: Sexual and gender minority populations experience elevated risks for suicidality. This study aimed to assess prevalence and disparities in non-fatal suicidality and potential protective factors related to social support and health care access among sexual and gender minority youth and adults and their heterosexual and cisgender counterparts in Canada. The second objective was to examine changes in the prevalence of suicidal ideation and protective factors during the COVID-19 pandemic., Methods: Pooled data from the 2015, 2016 and 2019 Canadian Community Health Surveys were used to estimate pre-pandemic prevalence of suicidal ideation, plans and attempts, and protective factors. The study also estimated changes in the prevalence of recent suicidal ideation and protective factors in fall 2020, compared with the same period pre-pandemic., Results: The prevalence of suicidality was higher among the sexual minority populations compared with the heterosexual population, and the prevalence was highest among the bisexual population, regardless of sex or age group. The pre-pandemic prevalence of recent suicidal ideation was 14.0% for the bisexual population, 5.2% for the gay/lesbian population, and 2.4% for the heterosexual population. The prevalence of lifetime suicide attempts was 16.6%, 8.6%, and 2.8% respectively. More than 40% of sexual minority populations aged 15-44 years had lifetime suicidal ideation; 64.3% and 36.5% of the gender minority population had lifetime suicidal ideation and suicide attempts. Sexual and gender minority populations had a lower prevalence of protective factors related to social support and health care access. The prevalence of recent suicidal ideation among sexual and gender minority populations increased in fall 2020, and they tended to experience longer wait times for immediate care needed., Conclusions: Sexual and gender minority populations had a higher prevalence of suicidality and less social support and health care access compared to the heterosexual and cisgender populations. The pandemic was associated with increased suicidal ideation and limited access to care for these groups. Public health interventions that target modifiable protective factors may help decrease suicidality and reduce health disparities., (© 2023. Crown.)

In this retrospective cohort of 165,188 singleton pregnancies and 44,674 multiple-fetal pregnancies in Canada from 1984 to 2000, we compared the incidence of maternal complications. Multiple gestation pregnancies were associated with significant increases in cardiac morbidity, haematologic morbidity, amniotic fluid embolus, pre-eclampsia, gestational diabetes, postpartum haemorrhage, prolonged hospital stay, the need for obstetric intervention, hysterectomy and blood transfusion. Multiple gestation pregnancies are associated with an increased risk of morbidity for the mother. This should be taken into consideration in antenatal care of these women.

Background: A U.S. analysis suggested a relation between self-reported residential proximity to industrial plants and non-Hodgkin lymphoma (NHL) risk., Methods: Using lifetime residential histories collected from a population-based sample of 1499 Canadians with newly diagnosed, histologically confirmed NHL and 5039 population controls, we evaluated the association of residential proximity to 7 types of major heavy industry with NHL risk., Results: Overall, having lived within 0.8 km or within 3.2 km of an industrial plant was not associated with increased NHL risk. For the follicular subtype of NHL, an odds ratio (OR) of 1.48 (95% confidence interval [CI] = 1.10-1.99) was observed for women who had lived within 3.2 km (83 cases/689 controls). ORs for NHL were elevated for proximity within 3.2 km of copper smelters (OR = 5.1; CI = 1.5-17.7; 7 cases, 4 controls) and within 0.8 km of sulfite pulp mills (OR = 3.7; CI = 1.5-9.4; 9 cases, 10 controls)., Conclusions: We have identified possible associations between NHL and proximity to industrial plants, which could be the result of chance or other factors associated with proximity. Studies are needed to confirm these associations and to determine whether residential proximity can result in meaningful exposure.

A population-based case-control study of 2,128 cases with histologically confirmed incident lung cancer and 3,106 population controls aged 20-76 years was conducted to assess the impact of recreational physical activity on lung cancer risk in Canada in 1994-1997. The multivariable-adjusted odds ratios and 95% confidence intervals for the second, third, and fourth quartiles versus the lowest quartile of total recreational physical activity were, respectively, 0.82 (95% confidence interval: 0.68, 0.98), 0.76 (95% confidence interval: 0.63, 0.92), and 0.73 (95% confidence interval: 0.60, 0.89) (p for trend=0.0008). The risk reduction was observed for both men and women and was attributed to both moderate and vigorous activities. A greater risk reduction was found for squamous cell carcinoma in women, small cell carcinoma in men, and other types/unspecified histologic subtypes in both genders. The physical-activity-associated risk reduction was more profound among smokers and those with low and medium body mass indexes. This study provides additional evidence that recreational physical activity reduces lung cancer risk. More studies are needed to confirm the differences between histologic subtypes and between genders and to address the underlying biologic mechanisms.

We conducted a population-based case-control study of 1,447 incident rectal cancer cases and 3,106 population controls aged 20-76 years to assess the effect of recreational physical activity, energy intake and obesity on rectal cancer risk in 7 of 10 Canadian provinces in 1994-97. After adjustment for the effect of various potential confounding factors, total recreational physical activity in the highest quartile was associated with an odds ratio (OR) for rectal cancer risk of 0.88 (95% confidence interval [CI] = 0.64-1.20) in women and 1.15 (95% CI = 0.88-1.49) in men. Women and men in the highest quartile of caloric intake (> = 56,741 and > = 63,143 kJ/week) had ORs of 1.50 (95% CI = 1.00-2.25) and 1.61 (95% CI = 1.13-2.28), respectively. Total dietary fat intake was not associated with a risk of rectal cancer after adjustment for caloric intake. Obesity (BMI > = 30 kg/m(2)) was associated with an OR of 1.44 (95% CI = 1.06-1.95) for women and 1.78 (95% CI = 1.36-2.34) for men. Men and women with lifetime maximum body mass index (BMI) > = 30 kg/m(2) had respective ORs of 1.70 (95% CI = 1.30-2.23) and 1.26 (95% CI = 0.96-1.66). The greatest increase in rectal cancer risk was observed in men and women with simultaneous high energy intake, high BMI and low physical activity. Our study provides evidence that physical inactivity, high energy intake and obesity are associated with the risk of rectal cancer, and there is a probable synergic effect among the 3 risk factors., (Copyright 2003 Wiley-Liss, Inc.)

Relatively little attention has been paid to the aetiology of male breast cancer and the current understanding of female breast cancer, primarily related to reproductive events, cannot be readily transferred to understanding the cancer in males. However, since male breast cancer occurs in the absence of factors related to childbearing and menstruation, its aetiology may provide special insights into the causes of breast cancer in women. We examined lifestyle risk factors for male breast cancer as part of a Canadian, multi-site, population-based, case-control study. Eighty-one newly diagnosed, histologically confirmed cases and 1905 male controls aged 42-74 were analysed using unconditional logistic regression. Increased risks were found for men with a mother or sister with breast cancer (adjusted odds ratio (OR) 3.65, 95% confidence interval (95% CI) 1.62-8.19). Higher physical activity levels (moderate, and strenuous recreational plus occupational) were associated with a decreased risk of male breast cancer (highest quartile, adjusted OR 0.48, 95% CI 0.26-0.91). Similarly, higher risks were associated with higher weight 2 years before interview (2.19, 95% CI 1.08-4.43), maximum weight (OR 2.66) and higher body mass index (OR 1.60). Higher vegetable consumption and coffee consumption were associated with decreased risk, whereas higher beta-carotene, vitamin E and calcium supplementation were associated with statistically significant increased risk. The small number of cases and multiple comparisons preclude strong conclusions, but our study is consistent with studies suggesting obesity and family history increase risk, and physical activity decreases risk of breast cancer.