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Article ; Online: Thinking Differently-On Solitude and Productivism.

Sue-Chue-Lam, Colin

2023 Volume 183, Issue 12, Page(s) 1411–1412

MeSH term(s)	Humans ; Loneliness ; Interpersonal Relations
Language	English
Publishing date	2023-10-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2699338-7
ISSN	2168-6114 ; 2168-6106
ISSN (online)	2168-6114
ISSN	2168-6106
DOI	10.1001/jamainternmed.2023.5521
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Article ; Online: The counterintuitive role of efficiency: implications for the ecological impact of health care.

Sue-Chue-Lam, Colin / Shove, Elizabeth / Xie, Edward

The Lancet. Planetary health

2022 Volume 6, Issue 12, Page(s) e929–e930

Language	English
Publishing date	2022-11-17
Publishing country	Netherlands
Document type	Journal Article
ISSN	2542-5196
ISSN (online)	2542-5196
DOI	10.1016/S2542-5196(22)00256-X
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Article ; Online: Change the Trainee, or Change the Training Environment?

Sue-Chue-Lam, Colin

JAMA surgery

2020 Volume 155, Issue 12, Page(s) 1172–1173

MeSH term(s)	Clinical Competence ; Education, Medical ; Humans ; Surgeons
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2020.3775
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Article ; Online: From Low-Hanging Fruit to Deep Decarbonization-Sustainable Health Systems Beyond the Operating Room.

Sue-Chue-Lam, Colin / Lalande, Annie / MacNeill, Andrea

JAMA surgery

2022 Volume 157, Issue 11, Page(s) 1064–1065

MeSH term(s)	Humans ; Operating Rooms ; Fruit
Language	English
Publishing date	2022-09-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2022.3896
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Article ; Online: Promoting surgical research in the Global South: Perspectives from surgical trainee researchers.

Naganathan, Gayathri / Sue-Chue-Lam, Colin / Brar, Amanpreet / Azzie, Georges

Surgery

2022 Volume 171, Issue 4, Page(s) 1131–1132

MeSH term(s)	Biomedical Research ; Humans ; Research Personnel
Language	English
Publishing date	2022-01-26
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2021.09.020
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Article ; Online: The Association of Oxaliplatin-Containing Adjuvant Chemotherapy Duration with Overall and Cancer-Specific Mortality in Individuals with Stage III Colon Cancer: A Population-Based Retrospective Cohort Study.

Sue-Chue-Lam, Colin / Brezden-Masley, Christine / Sutradhar, Rinku / Yu, Amy Y X / Baxter, Nancy N

Current oncology (Toronto, Ont.)

2023 Volume 30, Issue 7, Page(s) 6508–6532

Abstract: Purpose: Few studies have examined the relationship between duration of oxaliplatin-containing adjuvant chemotherapy for stage III colon cancer and mortality in routine practice. We examined the association between treatment with 50% versus >85% of a ... ...

Abstract	Purpose: Few studies have examined the relationship between duration of oxaliplatin-containing adjuvant chemotherapy for stage III colon cancer and mortality in routine practice. We examined the association between treatment with 50% versus >85% of a maximal course of adjuvant therapy (eight cycles of CAPOX, twelve cycles of FOLFOX) and mortality in stage III colon cancer. Methods: Using linked databases, we identified Ontarians aged ≥18 years at diagnosis of stage III colon cancer between 2007 and 2019. In the primary comparison, we compared patients who received 50% or >85% of a maximal course of adjuvant therapy; in a secondary comparison, we evaluated a dose effect across patients who received FOLFOX in one-cycle increments from six to ten cycles against >85% (more than ten cycles) of a maximal course of FOLFOX. The main outcomes were overall and cancer-specific mortality. Follow-up began 270 days after adjuvant treatment initiation and terminated at the first of the outcome of interest, loss of eligibility for Ontario's Health Insurance Program, or study end. Overlap propensity score weights accounted for baseline between-group differences. We determined the hazard ratio, estimating the association between mortality and treatment. Non-inferiority was concluded in the primary comparison for either outcome if the upper limit of the two-sided 95% CI was ≤1.11, which is the margin used in the International Duration Evaluation of Adjuvant Chemotherapy Collaboration. Results: We included 3546 patients in the analysis of overall mortality; 486 (13.7%) received 50% and 3060 (86.3%) received >85% of a maximal course of therapy. Median follow-up was 5.4 years, and total follow-up was 20,510 person-years. There were 833 deaths. Treatment with 50% of a maximal course of adjuvant therapy was associated with a hazard ratio of 1.13 (95% CI 0.88 to 1.47) for overall mortality and a subdistribution hazard ratio of 1.31 (95% CI 0.91 to 1.87) for cancer-specific mortality versus >85% of a maximal course of therapy. In the secondary comparison, there was a trend toward higher overall mortality in patients treated with shorter durations of therapy, though confidence intervals overlapped considerably. Conclusion: We could not conclude that treatment with 50% of a maximal course is non-inferior to >85% of a maximal course of adjuvant therapy for mortality in stage III colon cancer. Clinicians and patients engaging in decision-making around treatment duration in this context should carefully consider the trade-off between treatment effectiveness and adverse effects of treatment.
MeSH term(s)	Humans ; Adolescent ; Adult ; Oxaliplatin/therapeutic use ; Fluorouracil/therapeutic use ; Capecitabine ; Retrospective Studies ; Disease-Free Survival ; Antineoplastic Combined Chemotherapy Protocols ; Leucovorin/therapeutic use ; Neoplasm Staging ; Organoplatinum Compounds/therapeutic use ; Colonic Neoplasms/drug therapy ; Colonic Neoplasms/pathology ; Chemotherapy, Adjuvant
Chemical Substances	Oxaliplatin (04ZR38536J) ; Fluorouracil (U3P01618RT) ; Capecitabine (6804DJ8Z9U) ; Leucovorin (Q573I9DVLP) ; Organoplatinum Compounds
Language	English
Publishing date	2023-07-06
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol30070478
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Article ; Online: Trends and Prescriber Variation in the Duration of Oxaliplatin-Containing Adjuvant Chemotherapy for Stage III Colon Cancer From 2007 to 2019: A Population-Based Retrospective Cohort Study.

Sue-Chue-Lam, Colin / Brezden-Masley, Christine / Sutradhar, Rinku / Yu, Amy Y X / Baxter, Nancy N

Clinical colorectal cancer

2023 Volume 22, Issue 4, Page(s) 431–441.e9

Abstract: Introduction: The International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration in 2017 established 3 months of adjuvant therapy as an alternative to 6 months of therapy for stage III colon cancer. We determined the association between the ... ...

Abstract	Introduction: The International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration in 2017 established 3 months of adjuvant therapy as an alternative to 6 months of therapy for stage III colon cancer. We determined the association between the IDEA publication, changes in clinical practice, and prescriber variation. Patients and methods: Using linked databases, we identified Ontarians aged ≥18 years at diagnosis of stage III colon cancer between 2007 and 2019 who received oxaliplatin-containing adjuvant therapy. The outcome was duration of therapy, categorized as ≤25%, >25% to ≤50%, >50% to ≤75%, and >75% of a 6-month course of therapy to approximate treatment durations in the IDEA collaboration. We examined trends in duration over time using an interrupted time series regression model. We analyzed treatment duration after accounting for patient and prescriber characteristics, using multivariable mixed effects logistic regression models to quantify between-prescriber variation. Results: We included 4695 patients with stage III colon cancer who received oxaliplatin-containing adjuvant chemotherapy, of whom 77.5% initiated treatment pre-IDEA and 22.5% initiated treatment post-IDEA. Post-IDEA, there was a 16.4% (95% CI, 12.5%-20.3%) absolute increase in the proportion of patients treated with ≤50% of a maximal course of therapy. This trend was greatest among patients with low-risk tumors. Prescriber variation increased pre-IDEA to 15.6% post-IDEA (variance partition coefficient 5.4% pre-IDEA and 15.6% post-IDEA). Conclusion: The publication of IDEA was associated with increases in short duration adjuvant therapy and prescriber-level practice variation for stage III colon cancer. Clinicians should be better supported to make consistent recommendations about adjuvant duration under conditions of uncertainty and trade-offs.
MeSH term(s)	Humans ; Adolescent ; Adult ; Oxaliplatin ; Fluorouracil ; Retrospective Studies ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Colonic Neoplasms/pathology ; Chemotherapy, Adjuvant/adverse effects ; Neoplasm Staging
Chemical Substances	Oxaliplatin (04ZR38536J) ; Fluorouracil (U3P01618RT)
Language	English
Publishing date	2023-08-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2112638-0
ISSN	1938-0674 ; 1533-0028
ISSN (online)	1938-0674
ISSN	1533-0028
DOI	10.1016/j.clcc.2023.08.003
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Article: Building Environmentally Sustainable Health Systems in Canada: The Time Is Now for Emergent and Strategic Leadership.

Toccalino, Danielle / Reed, Anna Cooper / Sue-Chue-Lam, Colin / Cheung, Anson / Haldane, Victoria

Healthcare quarterly (Toronto, Ont.)

2021 Volume 24, Issue 3, Page(s) 76–81

Abstract: Canada's healthcare sector produces the third highest healthcare-related emissions per capita globally. However, Canada has no national strategy toward environmentally sustainable healthcare. Transforming Canada's health systems to be environmentally ... ...

Abstract	Canada's healthcare sector produces the third highest healthcare-related emissions per capita globally. However, Canada has no national strategy toward environmentally sustainable healthcare. Transforming Canada's health systems to be environmentally sustainable requires leadership from many stakeholders and collaboration between trainees and health leaders. This article provides an overview of student and trainee leadership among health-related fields in response to the climate crisis and highlights the formation of a trainee-led organization focused on building capacity among emerging leaders in healthcare. We share key lessons learned by this group that are essential for all leaders seeking to leverage interdisciplinary action toward sustainable health systems in Canada.
MeSH term(s)	Canada ; Delivery of Health Care ; Government Programs ; Health Care Sector ; Humans ; Leadership
Language	English
Publishing date	2021-11-18
Publishing country	Canada
Document type	Journal Article
ISSN	1710-2774
ISSN	1710-2774
DOI	10.12927/hcq.2021.26614
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Article ; Online: Time to diagnosis and treatment in younger adults with colorectal cancer: A systematic review.

Castelo, Matthew / Sue-Chue-Lam, Colin / Paszat, Lawrence / Kishibe, Teruko / Scheer, Adena S / Hansen, Bettina E / Baxter, Nancy N

PloS one

2022 Volume 17, Issue 9, Page(s) e0273396

Abstract: Background: The incidence of colorectal cancer is rising in adults <50 years of age. As a primarily unscreened population, they may have clinically important delays to diagnosis and treatment. This study aimed to review the literature on delay intervals ...

Abstract	Background: The incidence of colorectal cancer is rising in adults <50 years of age. As a primarily unscreened population, they may have clinically important delays to diagnosis and treatment. This study aimed to review the literature on delay intervals in patients <50 years with colorectal cancer (CRC), and explore associations between longer intervals and outcomes. Methods: MEDLINE, Embase, and LILACS were searched until December 2, 2021. We included studies published after 1990 reporting any delay interval in adults <50 with CRC. Interval measures and associations with stage at presentation or survival were synthesized and described in a narrative fashion. Risk of bias was assessed using the Newcastle-Ottawa Scale, Institute of Health Economics Case Series Quality Appraisal Checklist, and the Aarhus Checklist for cancer delay studies. Results: 55 studies representing 188,530 younger CRC patients were included. Most studies used primary data collection (64%), and 47% reported a single center. Sixteen unique intervals were measured. The most common interval was symptom onset to diagnosis (21 studies; N = 2,107). By sample size, diagnosis to treatment start was the most reported interval (12 studies; N = 170,463). Four studies examined symptoms onset to treatment start (total interval). The shortest was a mean of 99.5 days and the longest was a median of 217 days. There was substantial heterogeneity in the measurement of intervals, and quality of reporting. Higher-quality studies were more likely to use cancer registries, and be population-based. In four studies reporting the relationship between intervals and cancer stage or survival, there were no clear associations between longer intervals and adverse outcomes. Discussion: Adults <50 with CRC may have intervals between symptom onset to treatment start greater than 6 months. Studies reporting intervals among younger patients are limited by inconsistent results and heterogeneous reporting. There is insufficient evidence to determine if longer intervals are associated with advanced stage or worse survival. Other: This study's protocol was registered with the Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42020179707).
MeSH term(s)	Adult ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/therapy ; Humans ; Incidence ; Neoplasm Staging ; Registries
Language	English
Publishing date	2022-09-12
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0273396
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Article ; Online: Clinical Delays and Comparative Outcomes in Younger and Older Adults with Colorectal Cancer: A Systematic Review.

Castelo, Matthew / Sue-Chue-Lam, Colin / Paszat, Lawrence / Scheer, Adena S / Hansen, Bettina E / Kishibe, Teruko / Baxter, Nancy N

Current oncology (Toronto, Ont.)

2022 Volume 29, Issue 11, Page(s) 8609–8625

Abstract: Outcome disparities between adults <50 with colorectal cancer (CRC) and older adults may be explained by clinical delays. This study synthesized the literature comparing delays and outcomes between younger and older adults with CRC. Databases were ... ...

Abstract	Outcome disparities between adults <50 with colorectal cancer (CRC) and older adults may be explained by clinical delays. This study synthesized the literature comparing delays and outcomes between younger and older adults with CRC. Databases were searched until December 2021. We included studies published after 1990 reporting delay in adults <50 that made comparisons to older adults. Comparisons were described narratively and stage between age groups was meta-analyzed. 39 studies were included representing 185,710 younger CRC patients and 1,422,062 older patients. Sixteen delay intervals were compared. Fourteen studies (36%) found significantly longer delays among younger adults, and nine (23%) found shorter delays among younger patients. Twelve studies compared time from symptom onset to diagnosis (N younger = 1538). Five showed significantly longer delays for younger adults. Adults <50 years also had higher odds of advanced stage (16 studies, pooled OR for Stage III/IV 1.76, 95% CI 1.52-2.03). Ten studies compared time from diagnosis to treatment (N younger = 171,726) with 4 showing significantly shorter delays for younger adults. All studies showing longer delays for younger adults examined pre-diagnostic intervals. Three studies compared the impact of delay on younger versus older adult. One showed longer delays were associated with advanced stage and worse survival in younger but not older adults. Longer delays among younger adults with CRC occur in pre-diagnostic intervals.
MeSH term(s)	Humans ; Aged ; Databases, Factual ; Colorectal Neoplasms/therapy ; Colorectal Neoplasms/diagnosis
Language	English
Publishing date	2022-11-12
Publishing country	Switzerland
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol29110679
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