Publications by authors named "Meghan Walker"

Background: A prospective cohort study was undertaken within the PERSPECTIVE I&I project to evaluate healthcare resource utilization and costs associated with breast cancer risk assessment and screening and overall costs stratified by risk level, in Ontario, Canada.

Methods: From July 2019 to December 2022, 1997 females aged 50 to 70 years consented to risk assessment and received their breast cancer risk level and personalized screening action plan in Ontario. The mean costs for risk-stratified screening-related activities included risk assessment, screening and diagnostic costs.

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AbstractBleeding of horseshoe crabs () for the biomedical industry can have both sublethal and lethal impacts. Bleeding induces a significant drop in the concentration of hemolymph hemocyanin, as well as decreased levels of activity. Furthermore, horseshoe crabs with low hemocyanin prior to being bled have been found to be more likely to die after the procedure.

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  Previous non-fatal overdose may increase risk of overdose fatality for women reentering the community following incarceration, but pre-incarceration overdose experiences are understudied. This study describes the prevalence and correlates of non-fatal overdose prior to jail among women with opioid use disorder (OUD).  Women ( = 700) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed as part of the NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) trial.

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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.

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Globally, lung cancer is the leading cause of cancer death. Previous trials demonstrated that low-dose computed tomography lung cancer screening of high-risk individuals can reduce lung cancer mortality by 20% or more. Lung cancer screening has been approved by major guidelines in the United States, and over 4,000 sites offer screening.

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Article Synopsis
  • The study investigates the role of social media in promoting human papillomavirus (HPV) screening and cervical cancer awareness, responding to a global initiative by the WHO to eliminate cervical cancer.
  • A total of 58 peer-reviewed articles were analyzed, revealing that platforms like Twitter and Facebook were primarily used for evaluating content, recruiting participants, and disseminating health information related to HPV and cervical screening.
  • The research highlights opportunities for future studies, particularly in utilizing newer platforms like Instagram and TikTok to enhance HPV education and explore effective communication strategies for increasing cervical screening participation.
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Background: Adverse childhood experiences (ACEs) and mental health problems are interrelated. However, less is known about this relationship in incarcerated women and how self-esteem impacts this relationship.

Objective: To investigate the relationship between ACEs and mental health problems (traumatic stress, depression, and anxiety) in incarcerated women with opioid use disorder (OUD) and, the possible role of self-esteem as a mediator of the relationship.

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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.

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Introduction: Low-dose computed tomography screening in high-risk individuals reduces lung cancer mortality. To inform the implementation of a provincial lung cancer screening program, Ontario Health undertook a Pilot study, which integrated smoking cessation (SC).

Methods: The impact of integrating SC into the Pilot was assessed by the following: rate of acceptance of a SC referral; proportion of individuals who were currently smoking cigarettes and attended a SC session; the quit rate at 1 year; change in the number of quit attempts; change in Heaviness of Smoking Index; and relapse rate in those who previously smoked.

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Article Synopsis
  • Health care professionals must actively engage in cancer prevention strategies, but this study found many lack familiarity with polygenic risk scores (PRS) and knowledge about risk-stratified breast cancer screening.
  • A survey of 593 professionals showed that a significant number were unfamiliar with PRS, with 61% feeling they lacked adequate knowledge for effective BC screening.
  • Most participants expressed a need for more training, preferring online courses and webinars for continuing professional development.
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Importance: The COVID-19 pandemic has impacted cancer systems worldwide. Quantifying the changes is critical to informing the delivery of care while the pandemic continues, as well as for system recovery and future pandemic planning.

Objective: To quantify change in the delivery of cancer services across the continuum of care during the COVID-19 pandemic.

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Background: Breast cancer screening in Ontario, Canada, was deferred during the first wave of the COVID-19 pandemic, and a prioritization framework to resume services according to breast cancer risk was developed. The purpose of this study was to assess the impact of the pandemic within the Ontario Breast Screening Program (OBSP) by comparing total volumes of screening mammographic examinations and volumes of screening mammographic examinations with abnormal results before and during the pandemic, and to assess backlogs on the basis of adherence to the prioritization framework.

Methods: A descriptive study was conducted among women aged 50 to 74 years at average risk and women aged 30 to 69 years at high risk, who participated in the OBSP.

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Article Synopsis
  • The study investigates how Canadian women's understanding of genetic discrimination (GD) affects their willingness to participate in breast cancer screening programs informed by genetic risk assessments.
  • It reveals that a significant portion of women (about 34.7%) are very concerned about potential misuse of their health information by employers and insurance companies, suggesting anxiety over GD.
  • The findings highlight a gap in knowledge regarding legal protections against GD and emphasize the need for better public education to improve participation in genetic testing for breast cancer risk assessment.
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Purpose: Although some studies have shown increasing radiologists' mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets.

Methods: This retrospective cohort study included 493 radiologists in the Ontario Breast Screening Program who interpreted 1,762,173 screening mammograms in participants ages 50-90 between 2014 and 2016.

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It is essential to quantify the impacts of the COVID-19 pandemic on cancer screening, including for vulnerable sub-populations, to inform the development of evidence-based, targeted pandemic recovery strategies. We undertook a population-based retrospective observational study in Ontario, Canada to assess the impact of the pandemic on organized cancer screening and diagnostic services, and assess whether patterns of cancer screening service use and diagnostic delay differ across population sub-groups during the pandemic. Provincial health databases were used to identify age-eligible individuals who participated in one or more of Ontario's breast, cervical, colorectal, and lung cancer screening programs from January 1, 2019-December 31, 2020.

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Early detection of breast cancer through screening reduces breast cancer mortality. The benefits of screening must also be considered within the context of potential harms (e.g.

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Article Synopsis
  • Risk-stratified screening for breast cancer (BC) is gaining interest in Canada but faces implementation challenges and must be acceptable to women.
  • A survey conducted with 4,293 women aged 30 to 69 showed that the majority had positive attitudes towards this screening method and were comfortable sharing personal information for risk assessment.
  • Most women were open to adjusting their screening frequency based on their risk level, indicating strong support for the adoption of risk-based BC screening in Canada.
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The purpose of this rapid review was to identify and synthesize evidence on the impact of postal correspondence letters on participation in cancer screening and to determine whether impact varied by cancer site or inclusion of the participant's physician's name within the letter (i.e., physician-linked).

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This systematic review examined the risk of cervical dysplasia among women who have undergone a colposcopy episode of care to inform their return to population-based cervical screening. PubMed, Embase, and grey literature were searched between January 2000 and 2018. One reviewer screened citations against pre-defined eligibility criteria.

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Intramuscular administration of anesthetic agents in chelonians may result in a prolonged (≥1 hr) return of spontaneous movement and breathing, which increases the probability for peri- and postoperative complications. The acupuncture point governing vessel (GV)-26 has been demonstrated to reduce anesthetic recovery times from inhalant anesthesia in other species. In this study, 30 eastern box turtles (EBT; Terrapene carolina carolina), presented to the Turtle Rescue Team at North Carolina State University's College of Veterinary Medicine for treatment of aural abscess, were divided into four groups: control (no treatment); GV-26 acupuncture; GV-1 and GV-26 acupuncture; or GV-1 and GV-26 electroacupuncture.

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Objectives: We conducted a systematic review and meta-analysis of the risk of advanced adenomas (AAs), colorectal cancer (CRC), and/or CRC-related death among individuals with low-risk adenomas (LRAs).

Methods: We searched PubMed and Embase for studies published between January 2006 and July 2015. Quality and strength of the evidence were rated using the Newcastle-Ottawa Scale (NOS) and the GRADE framework, respectively.

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While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25-72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression.

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Although several studies have found screen-detected cancers in women with familial breast cancer risk have favorable prognostic features compared with symptomatic cancers, the impact of level of familial risk is unknown. A cohort of 899 first-degree female relatives of cases of breast cancer from the Ontario site of the Breast Cancer Family Registry was followed for 2 years. Logistic regression analyses compared diagnoses of breast cancer or benign breast disease (BBD) between women at high (n = 258, 28.

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Evidence of the accuracy of self-reported mammography use among women with familial breast cancer risk is limited. This study examined the accuracy of self-reported screening mammography dates in a cohort of 1,114 female relatives of breast cancer cases, aged 26 to 73 from the Ontario site of the Breast Cancer Family Registry. Self-reported dates were compared to dates abstracted from imaging reports.

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Objectives: A small positive association has been consistently demonstrated between perceived breast cancer risk and mammography use. Evidence specific to women with familial breast cancer risk has not been previously reviewed.

Methods: A literature search was conducted.

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