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Background: Monitoring the progress of cancer survival in a population over time is an important part of cancer surveillance. Data and methods: Data are from the Canadian Cancer Registry with mortality follow-up through record linkage to the Canadian Vital Statistics Death Database and tax files. Net survival (NS) was derived using the Pohar Perme method. Predicted estimates of NS for the period from 2012 to 2014 were calculated using the period method. Age-standardized and age-specific changes in five-year NS between the periods from 1992 to 1994 and 2012 to 2014 were determined for 30 individual cancers. Results: Predicted five-year NS for 2012 to 2014 ranged from 98% for thyroid cancer to 7% for mesothelioma. Between 1992 to 1994 and 2012 to 2014, improvements in five-year age standardized NS were greatest for chronic myeloid leukemia (23.9 percentage points), though a large majority of the increase occurred in the first decade. Increases exceeding 15.0 percentage points were also observed for non-Hodgkin lymphoma (19.5), cancer of the small intestine (17.4) and multiple myeloma (16.9). In contrast, little to no improvement was observed for cancers of the anus, larynx, soft tissue or uterus, or for mesothelioma. Increases in five-year NS were greatest for chronic myeloid leukemia in each age group with the exception of those aged 75 to 84 years (thyroid). Interpretation: This study reveals important areas of progress in cancer outcomes in Canada since the early 1990s. It also sheds light on cancers for which there has seemingly been no improvement in five-year net survival over a 20-year period. [ABSTRACT FROM AUTHOR]

Background: Current recommendations for rescue and resuscitation of people buried in avalanches are based on Swiss avalanche survival data. We analyzed Canadian survival patterns and compared them with those from Switzerland. Methods: We extracted relevant data for survivors and nonsurvivors of complete avalanche burials from Oct. 1, 1980, to Sept. 30, 2005, from Canadian and Swiss databases. We calculated survival curves for Canada with and without trauma-related deaths as well as for different outdoor activities and snow climates. We compared these curves with the Swiss survival curve. Results: A total of 301 people in the Canadian database and 946 in the Swiss database met the inclusion criteria. The overall proportion of people who survived did not differ significantly between the two countries (46.2% [139/301] v. 46.9% [444/946]; p = 0.87). Significant differences were observed between the overall survival curves for the two countries (p = 0.001): compared with the Swiss curve, the Canadian curve showed a quicker drop at the early stages of burial and poorer survival associated with prolonged burial. The probability of survival fell quicker with trauma-related deaths and in denser snow climates. Poorer survival probabilities in the Canadian sample were offset by significantly quicker extrication (median duration of burial 18 minutes v. 35 minutes in the Swiss sample; p < 0.001). Interpretation: Observed differences in avalanche survival curves between the Canadian and Swiss samples were associated with the prevalence of trauma and differences in snow climate. Although avoidance of avalanches remains paramount for survival, the earlier onset of asphyxia, especially in maritime snow climates, emphasizes the importance of prompt extrication, ideally within 10 minutes. Protective devices against trauma and better clinical skills in organized rescue may further improve survival. [ABSTRACT FROM AUTHOR]

Health determinants important to homeless persons living in Canada were identified in a five-stage study that used a sequential triangulation design. Beginning evidence of reliability and validity indicated that the McCormack Assessment Scale for the Health of Homeless Persons operationalized an internal structure of health that extended the scholarly understanding of the Determinants of Health Model. [ABSTRACT FROM AUTHOR]