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Cancer diagnoses dropped sharply in Alberta during COVID-19 response

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Breast-cancer patient Christine Van Deven sits in her backyard with her dog Charlie in London, Ont., on June 9, 2023. Ms. Van Deven wonders what might have happened if her cancer had been caught earlier.Nicole Osborne/The Globe and Mail

Significantly fewer cases of cancer were picked up in Alberta during the first wave of COVID-19 than in the past, according to new research that reinforces other Canadian findings that many patients were denied crucial early diagnoses in the beginning months of the pandemic.

The Canadian Medical Association Journal (CMAJ) study, published Monday, concluded that new diagnoses in Alberta of four types of cancer plunged in the spring of 2020, when much of the health system was shuttered to deal with the new virus.

Diagnoses of melanoma, an aggressive skin cancer, were 43 per cent lower than expected in the province during the first three months of the pandemic. New cases of prostate and colorectal cancer were down by 36 per cent, while breast cancer diagnoses were lower by a third. Some of the biggest drops were in early-stage cancers.

The common factor uniting all four types of cancer is that screening tests such as mammograms, colonoscopies and skin tests can catch them before patients begin feeling seriously ill. Usually, the earlier that cancer is found, the easier it is to treat. But during the first wave of the pandemic, pro-active cancer screening programs were all but shut down across the country.

“This really shows the importance of these cancer screening activities,” said Darren Brenner, a cancer epidemiologist at the University of Calgary and one of the authors of the CMAJ study. “It shows that they are working, because as soon as they go away, even for three months, we see a major drop in early-stage cancer diagnoses.”

The phenomenon of missed or delayed cancer diagnoses during the pandemic has been well-documented in Canada and around the world. Just last month, Statistics Canada reported that cancer incidence was 12.3 per cent lower in 2020 than the average annual rate over the previous five years, after adjustments for the growing and aging population.

The question now is what impact those missed diagnoses will have on cancer survival rates in the future. The new Alberta study found that patients with three types of cancer – colorectal, uterine and non-Hodgkin lymphoma – diagnosed in 2020 had slightly lower one-year survival rates than patients diagnosed with the same diseases in 2018.

However, Dr. Brenner said it was too early to say whether that was a true pandemic effect or a random year-to-year variation. Most other Canadian and international research has found no reduction in short-term cancer survival among those diagnosed in 2020.

In Ontario, researchers at ICES, formerly known as the Institute for Clinical Evaluative Sciences, mined multiple administrative databases to determine that an estimated 16,000 cases of cancer in adults were missed between the start of the pandemic and October, 2021.

But when they compared mortality among patients diagnosed in that period to patients diagnosed in 2018 and 2019, they found no difference in one-year survival rates. When they adjusted for age, sex, prediagnosis health, cancer type and other variables, they discovered that patients diagnosed during the pandemic were slightly more likely to survive, unless they had melanoma.

“This was a surprising result. We’re not seeing a negative pandemic impact,” said Rui Fu, a post-doctoral fellow at the Sunnybrook Research Institute in Toronto. “Just from the statistical analysis … there’s a protective effect of the pandemic on one-year overall survival.”

One possible explanation is that cancer patients who were fortunate enough to be diagnosed during the first 18 months of the pandemic went on to receive treatment and surgery faster because missed diagnoses meant there were fewer oncology patients in the pipeline, according to Dr. Fu.

But she and other cancer trackers agree it will take several more years – at least – to get a clear picture of how the pandemic affected cancer outcomes.

“I would personally expect to see more impact on the survival of the cancer cases that were diagnosed later in 2021 because I think that those are the cancers whose diagnoses were delayed, not the ones diagnosed in 2020,” said Talía Malagón, a cancer epidemiologist at McGill University.

Christine Van Deven, 53, of London, Ont., is one of those cancer patients diagnosed later in the pandemic. She turned 50 – the age at which Ontario recommends all women begin getting regular mammograms – in February, 2020, just as COVID-19 took off.

Ms. Van Deven, a mother of two and the general manager of a retirement home, didn’t get her first mammogram until the summer of 2021, after her doctor found a lump in her right breast. The mammogram found nothing of concern, but Ms. Van Deven’s doctor, still worried about the lump, sent her to a cancer surgeon for a second opinion.

That appointment took place in January, 2022, as the Omicron variant and staff shortages battered the health care system. Delays in MRIs and biopsies added up to Ms. Van Deven not being diagnosed until early May.

By that point, her invasive lobular carcinoma was at Stage 3. She had three tumours in her right breast, one of which was the size of a tennis ball. The cancer had spread to her lymph nodes. She had a double mastectomy, followed by chemotherapy and radiation.

Ms. Van Deven wonders what might have happened if her cancer had been caught earlier.

“I believe it could have been a smaller procedure. I really believe it wouldn’t have gone to my lymph nodes. But I can’t say for sure. I just don’t know,” she said.

 

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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