Adherence to breast screening guidelines and breast cancer mortality: a population cohort study.

Background: Population-based breast screening programs diagnose cancers at earlier stage when they are easier to treat. Indeed, individuals screened as part of the Ontario Breast Screening Program (OBSP) are diagnosed with a lower stage of breast cancer than those who have never been screened. We sought to determine if adherence to OBSP guidelines is associated with differences in the rate of death from breast cancer in addition to cancer stage at diagnosis.

Trends in contralateral breast cancer and contralateral prophylactic mastectomy from 2009 to 2016.

This study characterizes trends in contralateral breast cancer (CBC) and contralateral prophylactic mastectomy (CPM) in Ontario, Canada, by breast cancer risk level. Overall, there has been a decline in CBC rates and the concomitant rise in CPM rates after unilateral breast cancer diagnosis, largely driven by high-risk individuals. Considerations for breast cancer risk level are recommended in evaluations of CBC and CPM trends.

Psychological and emotional impacts of communicating breast cancer risk using multifactorial assessment with polygenic risk score: Findings from PERSPECTIVE I&I.

Purpose: To examine the psychological and emotional outcomes of personalized breast cancer risk communication up to 1 year after disclosure in a risk-stratified breast screening preimplementation study (Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation).

Methods: Among 3753 females aged 40 to 69, unaffected by breast cancer, with a prior mammogram, and who underwent multifactorial risk assessment to estimate their 10-year breast cancer risk, 2734 completed follow-up questionnaires up to 1 year after risk communication: 78.5% were at average risk, 16.

Primary care providers' experience and satisfaction with personalised breast cancer screening risk communication: a descriptive cross-sectional study.

Objective: To describe primary care providers' (PCPs) experience and satisfaction with receiving risk communication documents on their patient's breast cancer (BC) risk assessment and proposed screening action plan.

Design: Descriptive cross-sectional study.

Setting: A survey was distributed to all 763 PCPs linked to 1642 women participating in the Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I) research project in Quebec, approximately 1-4 months after the delivery of the risk communication documents.

Barriers and Facilitators to Delivering Multifactorial Risk Assessment and Communication for Personalized Breast Cancer Screening: A Qualitative Study Exploring Implementation in Canada.

Many jurisdictions are considering a shift to risk-stratified breast cancer screening; however, evidence on the feasibility of implementing it on a population scale is needed. We conducted a prospective cohort study in the PERSPECTIVE I&I project to produce evidence on risk-stratified breast screening and recruited 3753 participants to undergo multifactorial risk assessment from 2019-2021. This qualitative study explored the perspectives of study personnel on barriers and facilitators to delivering multifactorial risk assessment and risk communication.

Impact of menopause and age on breast density and background parenchymal enhancement in dynamic contrast-enhanced magnetic resonance imaging.

Purpose: Breast density (BD) and background parenchymal enhancement (BPE) are important imaging biomarkers for breast cancer (BC) risk. We aim to evaluate longitudinal changes in quantitative BD and BPE in high-risk women undergoing dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), focusing on the effects of age and transition into menopause.

Approach: A retrospective cohort study analyzed 834 high-risk women undergoing breast DCE-MRI for screening between 2005 and 2020.

Correction: Canadian COVID-19 host genetics cohort replicates known severity associations.

[This corrects the article DOI: 10.1371/journal.pgen.

Associations of CD4 Cell Count Measures With Infection-Related and Infection-Unrelated Cancer Risk Among People With HIV.

Background: People with HIV are at higher risk of infection-related cancers than the general population, which could be due, in part, to immune dysfunction. Our objective was to examine associations between 4 CD4 count measures as indicators of immune function and infection-related and infection-unrelated cancer risk.

Setting: We conducted a cohort study of adults with HIV who were diagnosed with cancer in Ontario, Canada.

Implementing Multifactorial Risk Assessment with Polygenic Risk Scores for Personalized Breast Cancer Screening in the Population Setting: Challenges and Opportunities.

Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40-69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment.

Canadian COVID-19 host genetics cohort replicates known severity associations.

The HostSeq initiative recruited 10,059 Canadians infected with SARS-CoV-2 between March 2020 and March 2023, obtained clinical information on their disease experience and whole genome sequenced (WGS) their DNA. We analyzed the WGS data for genetic contributors to severe COVID-19 (considering 3,499 hospitalized cases and 4,975 non-hospitalized after quality control). We investigated the evidence for replication of loci reported by the International Host Genetics Initiative (HGI); analyzed the X chromosome; conducted rare variant gene-based analysis and polygenic risk score testing.

Breast and bowel cancers diagnosed in people 'too young to have cancer': A blueprint for research using family and twin studies.

Young breast and bowel cancers (e.g., those diagnosed before age 40 or 50 years) have far greater morbidity and mortality in terms of years of life lost, and are increasing in incidence, but have been less studied.

Sense of community belonging and influenza vaccine uptake in Canada.

Objectives: The objectives of this study are to determine the prevalence of influenza vaccine uptake across Canadians aged 18 to 64 years with different sense of community belonging (SoCB) and whether SoCB is associated with uptake of the seasonal influenza vaccine.

Methods: We combined the 2007 to 2014 cycles of the nationally representative Canadian Community Health Survey (N = 301,802). The main exposure, SoCB, was measured as "strong" vs "weak.

Correlates of Circulating Osteoprotegerin in Women with a Pathogenic or Likely Pathogenic Variant in the BRCA1 Gene.

Background: Lower levels of osteoprotegerin (OPG), the decoy receptor for receptor activator of NFκB (RANK)-ligand, have been reported among women with a BRCA1 mutation, suggesting OPG may be marker of cancer risk. Whether various reproductive, hormonal, or lifestyle factors impact OPG levels in these women is unknown.

Methods: BRCA1 mutation carriers enrolled in a longitudinal study, no history of cancer, and a serum sample for OPG quantification, were included.

Linkage of whole genome sequencing and administrative health data in autism: A proof of concept study.

Whether genetic testing in autism can help understand longitudinal health outcomes and health service needs is unclear. The objective of this study was to determine whether carrying an autism-associated rare genetic variant is associated with differences in health system utilization by autistic children and youth. This retrospective cohort study examined 415 autistic children/youth who underwent genome sequencing and data collection through a translational neuroscience program (Province of Ontario Neurodevelopmental Disorders Network).

Canadian Healthcare Professionals' Views and Attitudes toward Risk-Stratified Breast Cancer Screening.

Given the controversy over the effectiveness of age-based breast cancer (BC) screening, offering risk-stratified screening to women may be a way to improve patient outcomes with detection of earlier-stage disease. While this approach seems promising, its integration requires the buy-in of many stakeholders. In this cross-sectional study, we surveyed Canadian healthcare professionals about their views and attitudes toward a risk-stratified BC screening approach.

Association between estimated cardiorespiratory fitness and breast cancer: a prospective cohort study.

Objective: To examine the association between cardiorespiratory fitness (CRF) and the risk of breast cancer in postmenopausal women.

Methods: This study used data from 17 840 cancer-free postmenopausal women with a CRF assessment from the UK Biobank. High estimated CRF (eCRF) was categorised as being 80th percentile within 10-year age bands.

Validation of the International Breast Cancer Intervention Study (IBIS) model in the High Risk Ontario Breast Screening Program: A retrospective cohort study.

Purpose: Women with a remaining lifetime risk of breast cancer of ≥25%, estimated using the International Breast Cancer Intervention Study (IBIS) model, were eligible for the High Risk Ontario Breast Screening Program. This study examined the performance of IBIS 10-year risk estimates in the program.

Methods: This retrospective study included 7487 women aged 30 to 69 years referred to the High Risk Ontario Breast Screening Program between July 1, 2011, and December 31, 2016, with follow-up until December 31, 2018.

Screening behaviours, demographics, and stage at diagnosis in the publicly funded Ontario Breast Screening Program.

Purpose: The Ontario Breast Screening Program (OBSP) offers free screening mammograms every 2 years, to women aged 50-74. Study objectives were to determine demographic characteristics associated with the adherence to OBSP and if women screened in the OBSP have a lower stage at diagnosis than non-screened eligible women.

Methods: We used the Ontario cancer registry (OCR) to identify 48,927 women, aged 51-74 years, diagnosed with breast cancer between 2010 and 2017.

An Accommodation for Whom? Has the COVID-19 Pandemic Changed the Landscape of Flexible and Remote Work for Workers with Disabilities?

At the start of the COVID-19 pandemic, flexible and remote work was viewed as a silver bullet that would increase employment rates among people with disabilities. This view fails to recognize that not all workers with disabilities can obtain jobs that can be done remotely or on a flexible schedule. Data from the 2019 and 2021 years of the Current Population Survey and the American Community Survey were used to examine if disabled workers' gender, race, ethnicity, age, and education, increase (or decrease) their chances of accessing flexible and remote work and if the group of workers with disabilities who access such options expanded since the COVID-19 pandemic.

Considerations of biomarker application for cancer continuum in the era of precision medicine.

Purpose Of The Review: The goal of this review is to highlight emerging biomarker research by the key phases of the cancer continuum and outline the methodological considerations for biomarker application.

Recent Findings: While biomarkers have an established role in targeted therapy and to some extent, disease monitoring, their role in early detection and survivorship remains to be elucidated. With the advent of omics technology, the discovery of biomarkers has been accelerated exponentially, therefore careful consideration to ensure an unbiased study design and robust validity is crucial.

MRI background parenchymal enhancement, breast density and breast cancer risk factors: A cross-sectional study in pre- and post-menopausal women.

Breast tissue enhances on contrast MRI and is called background parenchymal enhancement (BPE). Having high BPE has been associated with an increased risk of breast cancer. We examined the relationship between BPE and the amount of fibroglandular tissue on MRI (MRI-FGT) and breast cancer risk factors.

The burden of cancer among people living with HIV in Ontario, Canada, 1997-2020: a retrospective population-based cohort study using administrative health data.

Background: With combination antiretroviral therapy (ART) and increased longevity, cancer is a leading cause of morbidity among people with HIV. We characterized trends in cancer burden among people with HIV in Ontario, Canada, between 1997 and 2020.

Methods: We conducted a population-based, retrospective cohort study of adults with HIV using linked administrative health databases from Jan.

Maternal acetaminophen use and cognitive development at 4 years: the Ontario Birth Study.

Background: Studies have suggested a link between prenatal maternal acetaminophen use and adverse developmental outcomes in children. However, there exists a knowledge gap regarding overall cognitive development and use of acetaminophen, especially concerning the timing of use in pregnancy. This study aimed to characterize the relationship between maternal acetaminophen use and cognitive development at 4 years.