Surveillance

By its very nature, screening is characterised by administering a test to presymptomatic or early symptomatic individuals who may benefit from a more effective intervention if it is performed before the usual time of diagnosis.

Far from being a trivial intervention, screening can lead to significant consequences to the people screened. Therefore, before offering screening to workers, its effectiveness and the predominance of benefits over disadvantages must be demonstrated at the population level. Furthermore, screening should have the recommended characteristics in order that the expected benefits can be observed in practice.

Approaches using algorithms or flowcharts are generally meant to be sequential. Our approach had to be flexible and allow for compromises. The proposed approach involves three key decision-making nodes, which must generally be addressed in a sequential manner. Generally speaking, a satisfactory response to one of them is required before moving…

To our knowledge no data on cancer incidence and mortality among the Aboriginal population of Québec has been published. The only known reference was in a study examining the creation of a cancer registry during a specific period of the 1970s and 1980s. The study found that cancer was virtually non-existent within this population. Indeed, between 1969 and 1989 only 180 cases were reported in Nunavik, though the numbers tended to increase each year during that period. Studies in Canada and the United States suggest that the profile of Aboriginal populations is different from the general population. This small population group shows a low cancer incidence and a low cancer mortality rate.

Notwithstanding these low rates, an increase in cancer (incidence and mortality) has been observed. The change in lifestyle of these populations may prompt the emergence of chronic pathologies, including cancer, which has previously been present mainly in non- Aboriginal populations. This chan…

The survey was conducted during the summer of 2003 using a representative sample of residents aged 12 and older from the nine communities in Iiyiyiu Aschii: Chisasibi, Eastmain, Mistissini, Nemaska, Oujé- Bougoumou, Waskaganish, Waswanipi, Wemindji, and Whapmagoostui.

• During a twelve-month period, 10% of the region's residents sustained an injury which limited their normal activities.
• Every year, more than 1,000 persons 12 years of age or older sustain at least one injury which limits their activities.
• Men and young persons constitute the groups reporting the greatest number of injuries.
• The region of Iiyiyiu Aschii does not differ from the rest of Quebec as to the prevalence of reported injuries.
• Sprains, wrenches, and fractures are the types of injury most often reported.
• Falls are the main cause of injuries (42%).
• 48% of all injuries occur in sports or leisure activities and 25%* occur in the home.
…

Aboriginal people generally have higher traumabased death and hospitalization rates than the rest of the population. Nunavik residents were characterized by much higher death rates and lost potential years of life due to trauma (intentional and non intentional) than Quebecers as a whole during the periods 1991-1993 to 1997-1998. The Inuit of Nunavik also have higher hospitalization rates for trauma than do Quebecers as a whole, with a predominance of falls, off-road vehicle accidents, attempted murders and attempted suicides. This summary presents the results of the Nunavik Inuit Health Survey on transportation injuries and safety; it allows describing the prevalence of injuries among residents living in private households in Nunavik as reported during the 2004 survey.

Injuries reported during the 12 previous months are defined as those that were sufficiently serious to limit the individual’s regular activities. Injuries reported in this survey are relatively infrequent and…

Initial observational studies presented the Inuit as a population particularly protected against cardiovascular diseases (CVD), the plague of developed countries. However, because of the abandonment of traditional lifestyles, and the high prevalence of some risk factors (such as smoking 73% and obesity 19%), conclusions from the 1992 Santé Québec health survey of the Inuit population from Nunavik anticipated an increase in CVD. Twelve years later, the Nunavik Inuit Health Survey 2004 produced a new portrait of the health of this Inuit population in order to determine, among other health conditions, the prevalence of CVD and diabetes as well as their corresponding risk factors, and to assess the evolution of these health outcomes since 1992.

In this major health study, 1056 Inuit (men and women) in the 14 Nunavik communities were recruited and accepted to participate. The ensuing results are from 925 participants (aged 18 and over) who answered the clinical questionnaire, pro…

SurvUDI is a network for the epidemiological surveillance of human immunodeficiency virus infection among injection drug users. The network was established in 1995, and covers eight districts in Québec, and Ottawa. Individuals who participate report injecting drugs during the six preceding months and are recruited mainly through centres that provide access to sterile injection equipment. A two-part study on hepatitis C (HCV) was appended to the SurvUDI network. This report presents the results of the epidemiological component; the psychosocial component will be discussed in a subsequent report.

As of June 30, 2004, 14,773 questionnaires had been administered to 8,964 individuals (Table 1).

Three-quarters of participants are men (6,542/8,964) with an average age of 33. The average age of female participants is 28 (Table 1).

Educational levels are low, with only one in four (269/1,105) participants having completed high school (Table 3; 2003-04 data).

Cocaine is the injection drug most often used (88% of the 8,939 respondents had used cocaine), followed by heroin at 36% (Table 5). Cocaine is also the drug most frequently injected by 75% (6,639/8,897) of participants (Table 9).

Injection drug use varies a lot by region (Table 5). While cocaine is the most pervasive drug in all regions (84-98% of respondents in each region), heroin use is particularly widespread in Montreal (53% of 3,994 respondents), as is dilaudid in Quebec City (10% of 2,420 respondents), non-prescription morphine in Ottawa (35% of 1,367 respondents), and PCP in Saguenay-Lac-…

Since 2000, cancer has been the main cause of death in Quebec (Institut de la statistique du Québec, 2003). However, the standardized death rate due to cancer, like most other causes of death, has been declining steadily since the early 1990s (ministère de la Santé et des Services sociaux, 2003; ministère de la Santé et des Services sociaux, 2004), while life expectancy at birth of the Quebec population has increased in recent decades. With the number of seniors growing steadily and the risk of cancer increasing with age, there is a parallel increase in the incidence of cancer. In addition, as a result of earlier diagnoses and more effective treatments, cancer patients are surviving longer, leading to a high demand for health care as follow‑up for these individuals.

A number of indicators can be used to monitor cancer and measure the burden that it represents for society. The most well‑known ones are the number of new cases reported annually (incidence), mortality, relative…

If the prevalence of diabetes is high in the general Québec population, studies done of Aboriginal communities show that the prevalence in this population are three to four times greater than those observed in the general population (Canada 1999). The prevalence of diabetes has increased significantly over the last 20 years among the Cree population of Northern Québec (Eeyou Istchee) aged 20 years and over, from a few cases before the 1980s, to about 5.2% in the late eighties, to 7.1% in 1991, and climbing to about 15% in 2002 (Brassard, Robinson et al. 1993; CHSSB-JB 2002) (Brassard, Robinson et al. 1993; CCSSSBJ 2002). These results are consistent with the epidemiological data observed in the United States and in other regions of Canada. Data from the Cree Board of Health and Social Services of James Bay shows that in 2002, there were 1,064 known cases of diabetes for all ages in the Eeyou population, or proportionally three times more than in the population residing in Southern Q…

Premature mortality caused by cancer and the public health challenge it represents have given rise to a myriad of studies on the contribution of material and social living conditions to varying risks of morbidity and mortality. Thus, European and American studies have shown that cancer mortality—and some cancers more than others—often hits disadvantaged socioeconomic groups and regions hardest, and that this relationship persists even when individual behavior is taken into account. Numerous studies have focused mainly on men, who are easier to characterize socioeconomically than women. Indeed, it has proven difficult to determine the socioeconomic position of women, and the indicators used are often inadequate. An examination of the social health inequalities between the sexes shows that the mortality is sensitive to the inequality measure, the causes of mortality differ for men and women, these inequalities are generally less pronounced among women, and the social condition of wome…