Publications by authors named "Anna Dare"

Background And Objectives: Prospective data on presentation and outcomes of colorectal cancer (CRC) in Nigeria are limited; however, emergency presentation with advanced disease is thought common.

Methods: Consecutive CRC patients presenting at six sites over 6 years were included. Risk factors for emergency presentation were evaluated using logistic regression methods.

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  • - The study examines out-of-pocket costs for breast cancer treatment in Nigeria, highlighting that most patients face significant financial burdens, with a majority experiencing catastrophic health expenditures (CHE) due to the high costs of care.
  • - Data was gathered from 71 patients undergoing treatment, revealing that 78.9% to 100% experienced CHE, as their healthcare costs often exceeded 40% of their ability to pay or set income thresholds, and most patients lacked health insurance.
  • - The findings underscore the urgent need for policy changes to improve access to affordable cancer care in Nigeria, given that over 70% of patients at a major facility are financially strained by their treatment.
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Purpose: The incidence of GI cancers is increasing in sub-Saharan African countries. We described the oncological care pathway and assessed presentation, diagnosis, and treatment intervals and delays among patients with GI cancer who presented to the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife, Nigeria.

Methods: We analyzed data from 545 patients with GI cancer in the African Research Group for Oncology (ARGO) database.

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  • Robotic surgery adoption is growing worldwide, but Canada is lagging behind in integrating it into surgical training programs.
  • A national survey revealed program directors believe many trainees lack adequate exposure and experience with robotic surgery, despite its availability in most hospitals.
  • To better prepare future surgeons, there needs to be a stronger emphasis on incorporating robotic surgery training in general surgery residency and fellowship programs in Canada.
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Strategies to ramp up breast cancer screening after COVID-19 require data on the influence of the pandemic on groups of women with historically low screening uptake. Using data from Ontario, Canada, our objectives were to 1) quantify the overall pandemic impact on weekly bilateral screening mammography rates (per 100,000) of average-risk women aged 50-74 and 2) examine if COVID-19 has shifted any mammography inequalities according to age, immigration status, rurality, and access to material resources. Using a segmented negative binomial regression model, we estimated the mean change in rate at the start of the pandemic (the week of March 15, 2020) and changes in weekly trend of rates during the pandemic period (March 15-December 26, 2020) compared to the pre-pandemic period (January 3, 2016-March 14, 2020) for all women and for each subgroup.

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  • There is a significant gap in access and quality of surgical cancer care between wealthy and low-resource areas, affecting patient outcomes.
  • As cancer cases and deaths are expected to rise dramatically in the coming years, this issue of inequity in cancer surgery becomes increasingly urgent.
  • The text explores the reasons behind these disparities and suggests possible solutions to improve global access to effective cancer surgery.
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The African Research Group for Oncology (ARGO) was formed in 2013 to undertake methodologically rigorous cancer research in Nigeria, and to strengthen cancer research capacity in the country through training and mentorship of physicians, scientists, and other healthcare workers. Here, we describe how ARGO's work in colorectal cancer (CRC) has evolved over the past decade. This includes the consortium's scientific contributions to the understanding of CRC in Nigeria and globally and its research capacity-building program.

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Background: Physicians were directed to prioritize using nonsurgical cancer treatment at the beginning of the COVID-19 pandemic. We sought to quantify the impact of this policy on the modality of first cancer treatment (surgery, chemotherapy, radiotherapy or no treatment).

Methods: In this population-based study using Ontario data from linked administrative databases, we identified adults diagnosed with cancer from January 2016 to November 2020 and their first cancer treatment received within 1 year postdiagnosis.

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Background: Little is known about the association between the COVID-19 pandemic and early survival among newly diagnosed cancer patients.

Methods: This retrospective population-based cohort study used linked administrative datasets from Ontario, Canada. Adults (≥18 years) who received a cancer diagnosis between March 15 and December 31, 2020, were included in a pandemic cohort, while those diagnosed during the same dates in 2018/2019 were included in a pre-pandemic cohort.

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Essential cancer treatments are not accessible, affordable, or available to patients who need them in many parts of the world. A new Access to Oncology Medicines (ATOM) Coalition, using public-private partnerships, aims to bring essential cancer medicines and diagnostics to patients in low- and lower middle-income countries.

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Importance: The impact of COVID-19 on the modality and timeliness of first-line cancer treatment is unclear yet critical to the planning of subsequent care.

Objective: To explore the association of the COVID-19 pandemic with modalities of and wait times for first cancer treatment.

Design, Setting, And Participants: This retrospective population-based cohort study using administrative data was conducted in Ontario, Canada, among adults newly diagnosed with cancer between January 3, 2016, and November 7, 2020.

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No population-based study exists to demonstrate the full-spectrum impact of COVID-19 on hindering incident cancer detection in a large cancer system. Building upon our previous publication in JNCCN, we conducted an updated analysis using 12 months of new data accrued in the pandemic era (extending the study period from September 26, 2020, to October 2, 2021) to demonstrate how multiple COVID-19 waves affected the weekly cancer incidence volume in Ontario, Canada, and if we have fully cleared the backlog at the end of each wave.

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Due to the ramping down of cancer surgery in early pandemic, many newly diagnosed patients received other treatments first. We aimed to quantify the pandemic-related shift in rate of surgery following chemotherapy. This is a retrospective population-based cohort study involving adults diagnosed with cancer between 3 January 2016 and 7 November 2020 in Ontario, Canada who received chemotherapy as first treatment within 6-months of diagnosis.

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Background: The estimated incidence of colorectal cancer is rising in Nigeria, where most patients present with advanced disease. Earlier detection of colorectal cancer is a goal of the Nigerian National Cancer Control Plan, but the utility of fecal-based screening is unclear. This study aimed to assess the fecal immunochemical test as a colorectal cancer screening modality in average-risk individualS in Nigeria.

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Cancer research currently is heavily skewed toward high-income countries (HICs), with little research conducted in, and relevant to, the problems of low- and middle-income countries (LMICs). This regional discordance in cancer knowledge generation and application needs to be rebalanced. Several gaps in the research enterprise of LMICs need to be addressed to promote regionally relevant research, and radical rethinking is needed to address the burning issues in cancer care in these regions.

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Article Synopsis
  • This study assesses the impact of the COVID-19 pandemic on emergency department (ED) visits for patients who underwent cancer-directed surgeries.
  • It compares ED usage before and during the pandemic, analyzing a large cohort of patients from Ontario, Canada.
  • Findings indicate that while general ED visits declined during the pandemic, surgical patients still visited the ED at similar rates, and the acuity of their visits increased significantly.
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Global surgery has seen exponential growth over the past few years, and Canadian trainees' interest in the field has followed. Global surgery is defined by a commitment to health equity and community partnership. Engagement with its core principles is relevant for all Canadian surgical trainees and offers a perspective into inequities in surgical access and outcomes for patients and communities, both locally and globally.

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Background: Resource restrictions were established in many jurisdictions to maintain health system capacity during the COVID-19 pandemic. Disrupted healthcare access likely impacted early cancer detection. The objective of this study was to assess the impact of the pandemic on weekly reported cancer incidence.

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Article Synopsis
  • Cancer cases are increasing in low- and middle-income countries, with breast, cervix, lung, and colorectal cancers being the most common types, leading to a projection of two-thirds of cancer deaths occurring in these regions by 2030.!* -
  • Effective prevention and early detection strategies, such as tobacco taxation and HPV vaccination, are essential for reducing cancer mortality, especially for high-risk populations in middle-income countries.!* -
  • Improving national cancer surveillance and data collection is crucial for tailoring cancer control programs, as the lack of information about at-risk groups hampers effective strategy development.!*
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Introduction: There are significant differences in the phenotype of CRC by race in the U.S. A similar CRC phenotype-race relationship also appears to exist in South Africa (SA).

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Cancer has not been an explicit priority of Canada's international health and development agenda, but it is key to realising the country's Sustainable Development Goal commitments. Multiple converging political, health, and social forces could now drive support for a more integrated Canadian approach to global cancer control. Success will depend on the extent to which Canadian leaders and institutions can build consensus as a community and agree to work together.

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Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary tumor syndrome, with a wide clinicopathologic spectrum. It is defined by characteristic central nervous system, cutaneous and osseous manifestations, and by mutations in the NF1 gene, which is involved in proliferation via p21, RAS, and MAP kinase pathways. Up to 25% of NF1 patients develop intra-abdominal neoplastic manifestations including neurogenic (commonly plexiform neurofibromas and malignant peripheral nerve sheath tumors), interstitial cells of Cajal (hyperplasia, gastrointestinal stromal tumors), neuroendocrine, and embryonal tumors (rhabdomyosarcoma).

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