Le syndrome métabolique (SMét) est un ensemble de marqueurs de risques qui semble favoriser l'apparition de maladies chroniques. Nous avons examiné le fardeau lié au SMét au Canada et son association actuelle et projetée avec les maladies chroniques. Nous avons utilisé les données de l'Enquête canadienne sur les mesures de la santé 2007-2009 pour déterminer la prévalence du SMét chez les adultes canadiens et pour examiner les associations entre divers facteurs sociodémographiques et les principales maladies chroniques. Nous avons estimé l'incidence cumulative projetée du diabète et le risque, en pourcentage, d'événements cardiovasculaires mortels en utilisant l'algorithme DPoRT (Diabetes Population Risk Tool) et l'algorithme de Framingham. Après ajustement en fonction de l'âge, nous avons pu déterminer que 14,9 % des adultes canadiens présentaient un SMét. Les taux étaient similaires pour les deux sexes, mais ils étaient plus élevés chez les non-Blancs et chez les personnes présentant un embonpoint ou obèses (p $lt; 0,001 dans les trois cas). L'importance du SMét sur le plan de la santé publique découle du fait qu'il est associé de manière statistiquement significative avec des maladies chroniques, en particulier avec le diabète de type 2 diagnostiqué (11,2 % contre 3,4 %) et non diagnostiqué (6,0 % contre 1,1 %). Le taux estimé d'incidence sur 10 ans associé au diabète et le risque moyen en pourcentage d'événements cardiovasculaires mortels étaient plus élevés chez les personnes atteintes de SMét que chez celles qui ne l'étaient pas (18,0 % contre 7,1 % pour le diabète et 4,1 % contre 0,8 % pour les maladies cardiovasculaires). Le SMét est répandu chez les adultes canadiens, et une forte proportion de personnes souffrant d'un SMét ont également des affections chroniques, diagnostiquées ou non. Les estimations projetées du taux d'incidence de maladies chroniques associées à un SMét sont plus élevées chez les personnes aux prises avec ce syndrome. Par conséquent, le SMét pourrait être un facteur de risque pertinent dans l'apparition de maladies chroniques.

INTRODUCTIONMetabolic syndrome (MetS) is a combination of risk markers that appear to promote the development of chronic disease. We examined the burden of MetS in Canada through its current and projected association with chronic disease.METHODSWe used measures from the Canadian Health Measures Survey 2007-2009 to identify the prevalence of MetS in Canadian adults and examine associations between sociodemographic factors and major chronic diseases. We estimated the projected cumulative incidence of diabetes and percent risk of a fatal cardiovascular event using the Diabetes Population Risk Tool (DPoRT) and Framingham algorithms.RESULTSAfter adjusting for age, we found that 14.9% of Canadian adults had MetS. Rates were similar in both sexes, but higher in those who are non-Caucasian or overweight or obese (p < .001 for all three). The importance of MetS for public health was demonstrated by its significant association with chronic disease relative to the general population, particularly for diagnosed (11.2% vs. 3.4%) and undiagnosed (6.0% vs. 1.1%) type 2 diabetes. The ten-year incidence estimate for diabetes and mean percent risk of a fatal cardiovascular disease (CVD) event were higher in those with MetS compared to those without (18.0% vs. 7.1% for diabetes, and 4.1% vs. 0.8% for CVD).CONCLUSIONMetS is prevalent in Canadian adults and a high proportion of individuals with MetS have diagnosed or undiagnosed chronic conditions. Projection estimates for the incidence of chronic disease associated with MetS demonstrate higher rates in individuals with this condition. Thus, MetS may be a relevant risk factor in the development of chronic disease.

Although hospitalization and mortality rates for ischemic heart disease (IHD) have declined since the 1970s, IHD remains a leading cause of death and disability in Canada. This is the first study to estimate the incidence and prevalence of IHD at the national level in Canada from fiscal years 1999/00 to 2009/10. Data from the Canadian Chronic Disease Surveillance System (CCDSS) were used in this study. Diagnostic codes 410-414 and I20-I25 from the International Classification of Diseases Ninth (ICD-9-CM) and Tenth (ICD-10-CA) Revisions as well as procedure codes for percutaneous coronary intervention and coronary artery bypass graft were used to estimate the prevalence and incidence of IHD among individuals aged 20 years and older. These individuals were captured in the CCDSS if they received at least one hospital discharge abstract with an IHD diagnostic code or procedure code in any field or at least two physician claims with an IHD diagnostic code in a one-year period. From 1999/00 to 2009/10, age-standardized incidence rates decreased from 10.6 per 1,000 people to 6.1 per 1,000 people. Rates decreased similarly among males and females and decreased the most among individuals aged 85 years and older (from 65.1 per 1,000 to 35.3 per 1,000) over the study period. Rates increased with age and were highest among females (33.0 per 1,000 people) and males (40.6 per 1,000 people) aged 85 years and older in 2009/10. Overall, age-standardized prevalence increased from 5.5% to 6.6% during the study period. However, the prevalence peaked in 2006/07 among females and in 2007/08 among males and then slowly started to decline through to 2009/10. IHD prevalence increased with age for both males and females. As with incidence, the highest prevalence was observed among females (38.6%) and males (46.3%) aged 85 years and older in 2009/10. The incidence of IHD declined and the prevalence increased between 1999/00 and 2009/10. Much of this decline in the incidence and increase in the prevalence of IHD may be due to improved primary prevention, management and treatment of cardiovascular diseases in Canada. However, with the continued increase in the number of seniors aged 65 years and older, it is too early to conclude whether this trend will be maintained.

INTRODUCTION:The Survey on Living with Chronic Diseases in Canada--hypertension component (SLCDC-H) is a 20-minute cross-sectional telephone survey on hypertension diagnosis and management. Sampled from the 2008 Canadian Community Health Survey (CCHS), the SLCDC-H includes Canadians (aged ≥ 20 years) with self-reported hypertension from the ten provinces.METHODS:The questionnaire was developed by Delphi technique, externally reviewed and qualitatively tested. Statistics Canada performed sampling strategies, recruitment, data collection and processing. Proportions were weighted to represent the Canadian population, and 95% confidence intervals (CIs) were derived by bootstrap method.RESULTS:Compared with the CCHS population reporting hypertension, the SLCDC-H sample (n = 6142) is slightly younger (SLCDC-H mean age: 61.2 years, 95% CI: 60.8-61.6; CCHS mean age: 62.2 years, 95% CI: 61.8-62.5), has more post-secondary school graduates (SLCDC-H: 52.0%, 95% CI: 49.7%-54.2%; CCHS: 47.5%, 95% CI: 46.1%-48.9%) and has fewer respondents on hypertension medication (SLCDC-H: 82.5%, 95% CI: 80.9%-84.1%; CCHS: 88.6%, 95% CI: 87.7%-89.6%).CONCLUSION:Overall, the 2009 SLCDC-H represents its source population and provides novel, comprehensive data on the diagnosis and management of hypertension. The survey has been adapted to other chronic conditions--diabetes, asthma/chronic obstructive pulmonary disease and neurological conditions. The questionnaire is available on the Statistics Canada website; descriptive results have been disseminated by the Public Health Agency of Canada.

L'Enquête sur les personnes ayant une maladie chronique au Canada – composante de l'hypertension (EPMCC-H) est une enquête téléphonique transversale de 20 minutes sur le diagnostic et la prise en charge de l'hypertension. L'échantillon de l'EPMCC-H, sélectionné à partir des répondants à l'Enquête sur la santé dans les collectivités canadiennes (ESCC) de 2008, était composé de Canadiens (de 20 ans et plus) des dix provinces ayant déclaré avoir reçu un diagnostic d'hypertension. Le questionnaire a été élaboré au moyen de la technique Delphi et a fait l'objet d'un examen externe ainsi que de tests qualitatifs. Statistique Canada s'est chargé des stratégies d'échantillonnage, du recrutement, de la collecte et du traitement des données. Les proportions ont été pondérées afin de représenter la population canadienne et les intervalles de confiance (IC) à 95 % ont été calculés au moyen de la méthode de rééchantillonnage bootstrap. Si on le compare à la population de l'ESCC ayant déclaré souffrir d'hypertension, l'échantillon de l'EPMCC-H (n = 6 142) est légèrement plus jeune (âge moyen des répondants à l'EPMCC-H : 61,2 ans, IC à 95 % : 60,8 à 61,6; âge moyen des répondants à l'ESCC : 62,2 ans, IC à 95 % : 61,8 à 62,5), comporte plus de détenteurs d'un diplôme d'études postsecondaires (EPMCC-H : 52,0 %, IC à 95 % : 49,7 % à 54,2 %; ESCC : 47,5 %, IC à 95 % : 46,1 % à 48,9 %) et moins de répondants prenant un médicament pour l'hypertension (EPMCC-H : 82,5 %, IC à 95 % : 80,9 % à 84,1 %; ESCC : 88,6 %, IC à 95 % : 87,7 % à 89,6 %). Dans l'ensemble, l'EPMCC-H de 2009 est représentatif de sa population source et fournit des données nouvelles et exhaustives sur le diagnostic et la prise en charge de l'hypertension. L'enquête a été adaptée à d'autres maladies chroniques – diabète, asthme/maladie pulmonaire obstructive chronique et troubles neurologiques. Le questionnaire est accessible à partir du site Web de Statistique Canada; des résultats descriptifs ont été publiés par l'Agence de la santé publique du Canada.

"Diabetes in Canada: facts and figures from a public health perspective" is the first comprehensive diabetes surveillance report published by the Public Health Agency of Canada. The report aims to support public health professionals and organizations in developing effective, evidence-based public health policies and programs to prevent and manage diabetes and its complications. The report, developed in collaboration with provincial and territorial governments, the Canadian Diabetes Association, Juvenile Diabetes Research Foundation, CNIB, Health Canada and the academic community, uses data from national health surveys and vital statistics, as well as population-based administrative data from the Canadian Chronic Disease Surveillance System (CCDSS). For the first time, the CCDSS contains data from all 13 Canadian jurisdictions. Using CCDSS data representing cases of diagnosed diabetes among Canadians aged one year and older, Diabetes in Canada presents prevalence and incidence national rates from the fiscal year 2008/2009 and national trends from 1998/1999 onwards. The report also outlines sub-populations at higher risk, ways of reducing the risks of developing the disease and its complications, and estimates of related economic costs. In addition, it contains sections on specific populations, including children and youth and First Nations, Inuit and Métis populations.

Hospitalizations and mortality for stroke have been declining. However, stroke remains a leading cause of death and disability for Canadians. This study provides an overall picture of the burden of hospitalized stroke in Canada. Acute care hospital separations from the most recent three fiscal years (2007/08 to 2009/10) with a primary diagnosis of stroke (ICD-10-CA: I60-I69) were identified. The number of stroke hospitalizations, average length of stay (LOS), and discharge dispositions, by age, gender, and province/territory were calculated using IBM/Cognos Data Cubes. The number of stroke hospitalizations remained steady over the three years. The proportion by gender was similar, with males accounting for 51.7% of stroke hospitalizations in 2007/08, 52.3% in 2008/09, and 52.2% in 2009/10. There were more male than female stroke hospitalizations in younger age groups, and more female than male hospitalizations after 80 years of age. The average LOS was 15.3 days over the three years, with females staying longer than males (16.5 vs. 14.1 days). Longer LOS was seen in PEI (22.3 days), NS (21.3 days), and MB (19.9 days); shorter LOS was seen in NB (13.5 days), ON (13.9 days), and SK (14.6 days). The average rate of discharge home was 41.4% over the three years (males: 45.6%; females: 36.8%). Higher rates of discharge home were seen in PEI (57.2%), NT (50.3%), and BC (48.5%); lower rates were seen in NL (22.8%), ON (33.7%), and SK (38.8%). The average in-hospital case-fatality rate was 15.5% (males: 13.6%; females: 17.5%). Higher rates of case-fatality were in NL (18.2%) and NS (17.8%); lower rates were in AB (13.2%), PEI (13.8%), and NB (13.9%). Further, the overall rate for transfer to another health care facility was 43.2% (males: 40.8%; females: 45.7%). In comparison, hospitalized cardiovascular diseases (I00-I99) over the three years had a shorter LOS (8.6 days, males: 7.9; females: 9.7), and a higher discharge home rate (61.6%, males: 64.3%; females: 57.6%), a lower in-hospital case fatality rate (6.6%, males: 5.7%; females: 7.7%). This study provides an overall picture of hospitalized stroke across Canada. In general, stroke hospitalizations have a longer hospital stay, higher in-hospital case fatality, and lower rate of discharge home, which increases the burden per case on the Canadian health care system. Further, characteristics of stroke hospitalizations varied across Canadian provinces and territories. Significant differences in stroke management in Canada need to be addressed.

Individuals with hypertension should lower and maintain their blood pressure levels through lifestyle modification and/or pharmacotherapy. To determine whether perception of blood pressure control is related to behaviours and intentions for improving blood pressure, data from 6142 Canadians age 20+ years with self-reported hypertension were analysed. Relationships between perception of control, current behaviours for blood pressure control and intentions to improve these behaviours were examined. Although individuals who reported uncontrolled blood pressure were equally likely to report engaging in lifestyle behaviours for blood pressure control, they were more likely to indicate an intention to improve their health, compared with those who reported well-controlled/low blood pressure. These individuals were also less likely to report having enough information to control their blood pressure. In addition, they were less likely to report having been advised to take antihypertensive medication, and to be taking and adhering to medications. Individuals who perceive their blood pressure as uncontrolled have intentions to make health-enhancing changes but may lack the information to do so. The study highlights the potential need for programmes/services to help those with uncontrolled blood pressure make lifestyle changes and/or take appropriate medication.

The purpose of this report is to define a core set of performance indicators for organized cervical cancer screening programs in Canada.The goals for establishing a pan-Canadian set of performance indicators are to promote high quality screening through monitoring and evaluation.Over time, with regular monitoring and reporting of these indicators, an evidence base will grow which will permit the setting of pan-Canadian targets.Cervical cancer control is undergoing tremendous development as knowledge of the causal relationship between the human papillomavirus (HPV) and cervical cancer continues to increase.Regular monitoring and reporting of these indicators will facilitate the evaluation of the impact of new technologies and interventions.