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Background: We have previously reported on the development of a cancer-specific screening instrument for anxiety and depression (PSSCAN). No information on cut-off scores or their meaning for diagnosis was available when PSSCAN was first described. Needed were additional analyses to recommend empirically justified cut-off scores as well as data norms for healthy adult samples so as to lend meaning to the recommended cut-off scores.

BackgroundWe are reporting on the development of a psychosocial screening tool for cancer patients. The tool was to be brief, at a relatively low reading level, capture psychological variables relevant to distress and health-related quality-of-life in cancer patients, possess good reliability and validity, and be free of copyright protection.MethodItem derivation is described, data on reliability and validity as well as norms are reported for three samples of cancer patients (n = 1057; n = 570, n = 101).ResultsThe resulting 21-item psychological screen for cancer (PSCAN) assesses perceived social support, desired social support, health-related quality-of-life, anxiety and depression. It has good psychometrics including high internal consistency (alpha averaging .83, and acceptable test-retest stability over 2 months (averaging r = .64). Validity has been established for content, construct and concurrent validity.ConclusionPSCAN is considered ready for use as a screening tool and also for following changes in patient distress throughout the cancer care trajectory. It is freely available to all interested non-profit users.

Prevalence and type of use were found to vary as a function of the degree of acculturation. Health care practitioners would be well advised to discuss TCM/CAM use with their patients, especially those who are less acculturated to Western society, since they are the most likely users of TCM/CAM.

Study objective: To explore the impact of de-industrialisation over a 20 year period on working conditions and health among sawmill workers, in the province of British Columbia (BC), Canada. Design and Setting: This investigation is based on a sample of 3000 sawmill workers employed in 1979 (a year before the beginning de-industrialisation) and interviewed in 1998. The sample was obtained by random selection from an already gathered cohort of approximately 28 000 BC sawmill workers. Change in working conditions from 1979 to 1998 are described. Self reported health status, in 1998, was used as a dependent variable in logistic regression after controlling for confounders. Main results: Downsizing in BC sawmills eliminated 60% of workers between 1979 and 1998. Working conditions in 1998 were better for those who left the sawmill industry and obtained re-employment elsewhere. Workers who remained employed in restructuring sawmills were approximately 50% more likely to report poor health than those re-employed elsewhere. Conclusions: Working conditions and health status were better for workers who, under pressure of de-industrialisation, left the sawmill industry and obtained re-employment outside this sector.

Cancer incidence patterns in BC Indo-Canadian men and women differed from those in India, being more similar to the BC general population.

BackgroundRacial and ethnic disparities in breast cancer incidence, stage at diagnosis, survival and mortality are well documented; but few studies have reported on disparities in breast cancer treatment. This paper compares the treatment received by breast cancer patients in British Columbia (BC) for three ethnic groups and three time periods. Values for breast cancer treatments received in the BC general population are provided for reference.MethodsInformation on patients, tumour characteristics and treatment was obtained from BC Cancer Registry (BCCR) and BC Cancer Agency (BCCA) records. Treatment among ethnic groups was analyzed by stage at diagnosis and time period at diagnosis. Differences among the three ethnic groups were tested using chi-square tests, Fisher exact tests and a multivariate logistic model.ResultsThere was no significant difference in overall surgery use for stage I and II disease between the ethnic groups, however there were significant differences when surgery with and without radiation were considered separately. These differences did not change significantly with time. Treatment with chemotherapy and hormone therapy did not differ among the minority groups.ConclusionThe description of treatment differences is the first step to guiding interventions that reduce ethnic disparities. Specific studies need to examine reasons for the observed differences and the influence of culture and beliefs.

Complementary and alternative medicine (CAM) is widely used around the world for cancer. Preliminary research indicates that cultural factors influence cancer patients' decisions to use, with significant associations seen between ethnicity and prevalence and type of CAM use. To enhance a culturally-appropriate understanding of CAM use in Chinese cancer patients in BC, this study explored a sample of Chinese cancer patients to gain: (1) the general conceptualization of CAM use; (2) the meaning of CAM use in relation to cancer; (3) the patterns of CAM use prior to and after cancer diagnosis; (4) the reasons for CAM use; and (5) the socio-cultural process in making decision about CAM use. A naturalistic, descriptive study design was used that incorporated semistructural ethnographic interviewing and qualitative data analysis. The results of this study provide insights about the pattern, reasons, meaning, as well as cultural and socioeconomic factors underpinning the use of CAM. The CAM decision-making (DM) process was found to be nonlinear and comprised of four distinct phases: fitting with the cultural belief framework/ lifestyle, seeking information and clarification, evaluating the effectiveness of CAM use, and balancing the cost and benefits of CAM use.