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In brief
s emergency departments buckle under pressure due to staffing shortages and Canadians struggle to find the care they need in a timely manner, a newly released survey illustrates the despair Canadian physicians are experiencing amidst the biggest health care crisis of our times.
The Canadian Medical Association (CMA) has released the full results of its 2021 National Physician Health Survey. Conducted in November 2021, the survey shows a physician workforce that is struggling under the weight of an under-resourced health system and pandemic challenges.
Key findings include: • Nearly half of respondents (48%) screened positive for depression, up significantly since the CMA’s 2017 survey (33%). • One-quarter (25%) of physicians and residents experience severe (10%) or moderate (15%) anxiety • Eight in 10 (79%) physicians and medical learners score low on professional fulfillment; less than six in 10 physicians and medical learners indicate being satisfied with their career in medicine
Preliminary results released in March showed that more than half of physicians and medical learners (53%) had experienced high levels of burnout and that nearly half of respondents (49%) were considering reducing their clinical work in the next 24 months.
“Every day, we hear physicians expressing despair at the state of our health system, the strain that all health workers are facing and the fact that our patients are suffering,” says Dr. Alika Lafontaine, CMA president. “Since this survey was completed, the
National survey shows physician workforce in despair A “EVERY DAY, WE HEAR PHYSICIANS EXPRESSING DESPAIR AT THE STATE OF OUR HEALTH SYSTEM, THE STRAIN THAT ALL strain on health workers has continued to grow with no signs of a break coming. Physicians need help and support so they can continue to provide HEALTH WORKERS ARE FACING AND THE FACT THAT OUR PATIENTS ARE SUFFERING,” quality care to patients.” The 2021 National Physician Health Survey is available online . It illustrates the many factors impacting physician health and wellness including the pandemic, increased administrative burden, lack of work-life integration, bullying and harassment in the workplace and lack of professional fulfillment. Between October and December 2021, more than 4,100 physicians, medical residents and medical students completed the survey, up from nearly 3,000 CMA members in 2017. ■ H Pharmaceutical drug security Continued from page 4 should be a priority in Canada Canada’s poor health data
We need a system that enables health providers to do their best work, where they’re surrounded by a team that relies on each other, and where the whole team, including patients, have access to the information they need.
As Dr. Ewan Affleck puts it, “information is the currency of care.” Health information systems must be intentionally designed to enable teams to provide safe care by giving access to information whenever decisions are being made.
For patients to be engaged partners who participate in making decisions in their own care as contributing members of their team, they also need access to their information.
A recently released series of reports from the Pan-Canadian Health Data Strategy Expert Advisory Group honestly outlines the current problems in health information in the country and provide an actionable strategy to create the healthcare system that
we need and deserve. They call for a learning health system that uses interoperable data standards and person-centred data architecture, with collaboration across health jurisdictions and stakeholders. This would create a robust health system based on data-supported insights and evidence-based decisions. Bold collaboration is needed for success, and we all have a role to play. Before Greg’s death, we assumed that healthcare, like other sectors, had evolved over time to adopt tools for effective communication and information sharing. We were wrong. As citizens across Canada, we need to support the system changes and mindset shifts needed. This isn’t going to happen overnight. There isn’t a single sector, organization, or jurisdiction that can independently cause this change. Just as a team is required for patient care, we need collective action to prevent more people from falling through the cracks. ■ H Teri Price is the Executive Director of Greg’s Wings Projects. S hortages of essential medicines threaten Canadians’ health and ensuring access to critical drugs at all times should be a government priority, write authors in an analysis in CMAJ (Canadian Medical Association Journal).
“Canada’s pharmaceutical supply has become highly dependent on foreign imports and vulnerable supply chains and recent Canadian investments for pandemic preparedness do not address the entirety of pharmaceutical shortcomings,” writes Dr. Shoo Lee, Department of Paediatrics, University of Toronto and Mount Sinai Hospital, Toronto, with coauthors. “A cohesive national policy is needed to address this problem.”
For more than a decade, Canada has experienced ongoing drug shortages, such as the shortage of epinephrine self-injectors (i.e., EpiPens) over the last five years, and recent shortages of hydroxychloroquine for the treatment of rheumatoid arthritis and inflammatory bowel disease owing to use by some to treat COVID-19.
Canada’s pharmaceutical market is small, making up just 2% ($18 billion USD) of total global revenue in 2019. The country relies heavily on imported medications, making it vulnerable to supply chain disruptions and drug shortages. In June 2022, 23 Tier 3 drugs were in short supply; this category includes critical drugs with the potential for the greatest negative impact on drug supply and the health system.
The authors suggest several steps to improve the security of pharmaceutical drugs in Canada including: • Developing a list of medicines essential to prevent death or severe illness • Stockpiling these medications in the national emergency strategic stockpile (NESS) or requiring drug companies to do so • Strengthening domestic manufacturing of pharmaceuticals • Collaborating with international partners to strengthen supply chains
“Investment in API [active pharmaceutical ingredient] and pharmaceutical manufacturing technologies should be integral to Canada’s strategy to become pharmaceutically self-sufficient,” they write.
“Pharmaceutical security for Canada” was published August 22, 2022. ■ H
SPONSORED CONTENT Understanding privacy’s role in enabling interoperability
By Abigail Carter-Langford
There are many challenges to enabling interoperability in health care within and across jurisdictions – there is a plethora of IT systems speaking different languages in a multitude of care settings across several jurisdictions, each with unique needs and requirements. A lot of work needs to be done – and is being done – to enable data to flow across these silos. However, one misperceived barrier isn’t really a barrier at all, but can in fact provide guidance and clarity when building interoperability into systems and workflows. This misperceived barrier? Privacy laws.
To understand how privacy laws can aid interoperability in health care, we must first understand what interoperability is and why it is so important that information be shared between health care providers.
Interoperability is a means of enabling health information to flow seamlessly and consistently across the health care continuum. It not only means that data flows between different systems but that these systems are speaking the same language.
Why is this important? When patients are dealing with a complex health issue, it often means seeing a variety of providers – primary care providers, specialists and perhaps even the occasional trip to the emergency department (ED). Additionally, patients who live in one province may become injured in another while on vacation or experience a flare up of an existing condition. When information flows smoothly between these settings, it improves the continuity of care.
Access to information about the medications patients are taking or any allergies they have can, for example, help EDs avoid potentially fatal errors. Interoperability prevents duplications and delays, and helps improve patient outcomes. Interoperability is also aimed at improving patients’ access to their personal health information (PHI). The ability to access one’s own PHI is a cornerstone of providing patient-centred care.
Unfortunately, there is a common misconception that privacy laws in Canada are a barrier designed to prevent the sharing of information between authorized providers. Privacy laws, in fact, support the protection of PHI and access to that information as deemed necessary, including providing access directly to patients and health care providers when required for the provision of care.
Enabling interoperability and the flow of data between systems can open up a host of questions. How can a clinician obtain meaningful consent from the patient for sharing a patient record? Can a clinician block or mask personal health information within a patient’s record? What if a clinician does not want to share a patient’s information? Which clinician is responsible for the patient’s record when information is shared?
Privacy laws can provide some clarity when it comes to these types of questions. Canadian privacy laws include guidance on rules for the collection, use, disclosure and security of PHI. They also make clear that while health care providers are the custodians of the information the data belongs to the patients. Canadians have a right not only to access their PHI, but to correct the information. Privacy laws also provide processes for the independent review of decisions made by PHI custodians and recourses for violation of the legislation.
Privacy legislation can also provide guidance for roles and responsibilities when information is shared between multiple providers. When custodians share information, they not only share custody and control of PHI, but they also share accountability. Shared accountabilities may pose unique legislative compliance challenges, since custodians may be unsure which obligations are applicable to them.
As technologies and practices change, privacy laws, too, are evolving, with a number of new laws and changes proposed. These include calls for changes to consent provisions, stronger enforcement powers and a balanced approach for data protection that enables appropriate access for health innovation.
These types of proposed changes could help Canada shift to a truly patient-centric model. They would entail further embedding data sharing requirements in privacy legislation, implementing pan-Canadian standards for data sharing to make it easier to share data across jurisdictions and a more robust data governance model. Improving digital literacy and privacy education for patients, third-party service providers and data custodians could also help further establish the notion of patient agency over PHI.
Canada Health Infoway (Infoway) is committed to driving interoperability in Canada by working to establish collaborative frameworks to engage stakeholders in priority projects, and to support and publish terminology standards. Equally important, Infoway is also working to clarify the role privacy laws can play in building interoperable solutions. To learn more about how privacy laws can help enable interoperability, download Privacy as an Enabler: Sharing Personal Health Information for Interoperability Primer. www.infoway-inforoute.ca. H
IN BRIEF Autoimmune rheumatic diseases cause increased risk of COVID-19 complications
People living with autoimmune rheumatic diseases and transplant recipients face an increased risk of complications and death from COVID-19, according to a new Arthritis Research Canada study.
Researchers specifically looked at COVID-19 hospitalizations, intensive care unit admissions, ventilation and mortality among individuals who have autoimmune types of arthritis and found they have a 30 per cent increased risk of hospitalization and ICU admission. They also have a 60 per cent increased risk of being placed on a ventilator. These risks vary across different types of autoimmune rheumatic disease.
For people living with ankylosing spondylitis, an inflammatory disease that affects the spine and causes bones to fuse together, those risks are even higher. The research showed a 103 per cent increased risk of ICU admission, 163 per cent increased risk of being placed on a ventilator and a 118 per cent increased risk of death. The reason for this spike in risk is unknown, but could be linked to persistent chest immobility and impaired respiratory function. “These findings demonstrate a need for further research on the effectiveness of COVID-19 vaccination in vulnerable groups of people,” said THE RESEARCH SHOWED A 103 PER CENT INCREASED RISK OF ICU ADMISSION, 163 PER CENT INCREASED RISK OF BEING PLACED ON A VENTILATOR AND A 118 PER CENT INCREASED RISK OF DEATH.
Shelby Marozoff, a research coordinator at Arthritis Research Canada. “It’s concerning that the risk of mortality attributed to COVID goes up by 24 per cent for people living with autoimmune rheumatic diseases and the mortality risk for transplant recipients is five times greater than in the general population.”
This study also proves medical care teams at rheumatology and transplant medicine practices need to pay careful attention to people with autoimmune types of arthritis in order to support early COVID-19 diagnosis and care interventions, as well as fast treatment with new therapies, including oral antiviral therapies indicated for adults with mild-to-moderate COVID-19.
Mask mandates and paid sick leave may also continue to be effective tools in reducing the number of individuals infected with COVID and experiencing severe complications.
“This research will ensure patients with autoimmune disease are treated with more urgency following a positive COVID test,” said Dr. Antonio Aviña-Zubieta, a rheumatologist and senior scientist at Arthritis Research Canada. “In order to improve outcomes, decision-makers must keep vulnerable people, including the chronically ill, top of mind when making decisions about public health.” ■ H
Dr. Alika Lafontaine to lead CMA in 2022-23
Canadian Medical Association (CMA) members and delegates attending the Annual general meeting welcomed Dr. Alika Lafontaine as the organization’s 155th President. Dr. Lafontaine becomes the first indigenous President in the organization’s history. Born and raised in Treaty 4 Territory (Southern Saskatchewan), Dr. Lafontaine has Metis, Oji-Cree and Pacific Islander ancestry.
As an anesthesiologist in Grande Prairie, Alberta, Dr. Lafontaine has been using his voice to create spaces where Indigenous communities can partner with physicians, politicians and policy-makers to improve Indigenous health care. Committed to eliminating the gap in the quality of care between Indigenous and non-Indigenous patients across Canada, Dr. Lafontaine drafted and co-led a national strategy with territorial organizations representing 150 First Nations and several national health organizations. That proposal was then submitted to the federal government on behalf of
$2M in support for palliative care for persons who are homeless or vulnerably housed
The Government of Canada is committed to improving the quality and availability of palliative care for all people in Canada. Budget 2021 provided nearly $30 million to help advance the Government’s Action Plan on Palliative Care and build a better foundation for coordinated action on long-term and supportive care needs.
On behalf of Minister Jean-Yves Duclos, Minister of Health, Élisabeth Brière, Parliamentary Secretary to the Minister of Mental Health and Addictions and Associate Minister of Health, along with Francis Scarpaleggia, Member of Parliament for Lac-Saint-Louis, announced $2 million in funding over 4 years to Healthcare Excellence Canada (HEC) to improve access to palliative care for persons who are homeless or vulnerably housed.
This funding will allow HEC, working with partner organizations such as the Canadian Partnership Against Cancer (CPAC), to help improve the delivery of palliative care services so that people experiencing homelessness or who are vulnerably housed receive safe, timely, appropriate care in the place of their choosing. Hospice palliative care is a critical part of the health care continuum, improving quality of life for as long as possible. Care is provided wherever the person is, be it in a facility or in their community.
The Government of Canada continues to work with provinces and territories, people living with life-limiting illness, caregivers, stakeholders, and communities to improve the quality and availability of palliative care for everyone in Canada, including those who are most vulnerable. ■ H
those First Nations – the Indigenous Health Alliance – to advance health care transformation.
“As I take on the role of CMA president, I want my fellow physicians to know that I see their struggles and I am deeply committed to making progress toward a better future,” says Dr. Lafontaine. “Together we will rewrite the narrative of what it means to be a physician, how to better partner with patients and teambased care. We will build a future for healthcare in Canada.”
In addition to his advocacy work, Dr. Lafontaine is a seasoned advisor who has served in medical leadership positions for almost two decades, including at the Alberta Medical Association, the Royal College of Physicians and Surgeons of Canada, HealthCareCAN and the Indigenous Physicians Association of Canada. ■ H
Healthcare HR and COVID-19: Our need to focus on cancer
By Dr. Craig Earle
Canada’s cancer care professionals continue to do their utmost to provide excellent care through wave after wave of the COVID-19 pandemic, despite overwhelming pressures. However, the disruptions are taking their toll. Attrition and burnout are on the rise. More and more job vacancies are going unfilled.
The burden on healthcare workers is heavy, and it is contributing to delays in cancer screening, diagnosis and treatment. The implications will be felt for years to come.
Canada needs a coordinated effort to boost system capacity and save lives – and it is needed now. The Canadian Partnership Against Cancer’s recent report, The road to recovery: Cancer in the COVID-19 era, identifies actions that can be taken and innovations that are already underway in some jurisdictions to provide a path forward even as COVID-19 continues to disrupt health and cancer care.
THE IMPACT OF COVID-19 ON CANCER
The onset of the pandemic saw the cancellation or postponement of clinical exams and procedures, leading to many cancers going undiagnosed or untreated. The impact has been dire because the longer a cancer goes undetected, the worse a person’s outcomes are likely to be: a more advanced stage at diagnosis, poorer survival rates, and greater disease-and treatment-related issues.
The effect of these delays and the rising backlog of undiagnosed cases is magnified for populations that have been underserved due to differences in access to resources, power and privilege.
The burden of disease and the magnitude of avoidable deaths are greater for cancer than other conditions, and cancer must remain a priority when allocating healthcare resources.
Key to that is a focus on healthcare human resources.
BY THE NUMBERS:
79% 13% 40%
79% increase in total vacancies in the health and social assistance sector between 2019 and 20211 13% of registered nurses in Ontario aged 26–35 said they were very likely to leave the profession in 2021 – 4x the normal rate2 40% of medical oncologists said they are very concerned about burnout3
SOLVING THE PANDEMIC HEALTHCARE HUMAN RESOURCES CHALLENGE
The Canadian Partnership Against Cancer’s report shows that three areas need to be addressed:
HIRE MORE HEALTHCARE PRACTITIONERS
More practitioners are needed right now to handle the surge in demand for cancer care services. Some jurisdictions are hiring back retired nurses, incentivizing currently employed technicians and practitioners, and bringing more nursing students and international trainees into the system.
Alberta, for instance, hired 648 student nurses to provide care at hospitals and alleviate staff shortages, and Quebec is recruiting 1,000 international nurses.
INTRODUCE PROCESSES TO MAXIMIZE SYSTEM PERFORMANCE
Within the cancer system, some providers may be significantly backlogged while others have capacity. Centralizing the intake of cancer patients for diagnostic procedures and discrete treatments could relieve specific pressure points and maximize available capacity system-wide.
Another way to address this is to deliver low-risk, frequent activities, such as colonoscopies and imaging, in outpatient settings, and to move less-intensive non-oncology procedures such as cataract and hernia surgeries into ambulatory surgery centres to free up hospital rooms for cancer patients. The Ontario Medical Association, for instance, is looking at creating integrated ambulatory centres that would focus on specific day surgeries which may allow them to deliver care more efficiently than inside a hospital.
INCREASE TRAINING, ACTIVATE RECRUITMENT AND IMPROVE RETENTION
The multi-year training requirements for technicians, nurses and physicians limit how quickly the system can bring on new cohorts of healthcare professionals. Raising enrolment limits on Canadian nursing programs would help to address this, as would modifying immigration policies, in an ethical way, to fast-track qualified cancer care workers from other countries. As noted above, this is already starting to happen in parts of Canada.
Another solution is to introduce training that allows health professionals to work at the maximum of their scope of practice. For example, British Columbia has developed a General Practitioner in Oncology program to strengthen the oncology skills of non-specialist physicians so they can deliver chemotherapy in rural and remote communities and relieve the pressure on urban cancer centres and their staff.
LEARN MORE ABOUT THE IMPORTANCE OF KEEPING A FOCUS ON CANCER
Burnout and attrition among cancer care providers and other healthcare professionals must be addressed quickly or the already-stretched cancer system will struggle to meet patient needs as the pandemic continues.
Understanding the actions needed and innovations already underway can help ensure health system leaders and partners can move quickly and collaboratively to address these significant challenges – which is critical because, with cancer, time is of the essence.
Find out more in The road to recovery: Cancer in the COVID-19 era, available here: https://www. partnershipagainstcancer.ca/topics/ cancer-in-covid-19-era/summary H
Dr. Craig Earle is CEO of the Canadian Partnership Against Cancer
1. Statistics Canada. Job vacancies, third quarter 2021. https://www150.statcan.gc.ca/n1/daily-quotidien/211220/dq211220a-eng.htm 2. Registered Nurses’ Association of Ontario. Work and wellbeing survey results. 2021. https://rnao.ca/sites/rnao-ca/files/Nurses_Wellbeing_Survey_Results_-_March_31.pdf 3. Gill S, Hao D, Hirte H, Campbell A, Colwell B. Impact of COVID-19 on Canadian medical oncologist and cancer care: Canadian Association of Medical Oncologists survey report.
Blood on Board Program saving lives and time
By Joshua McNamara
Acar crashes on a rural highway, 60 minutes from the closest hospital. Ornge’s Operations Control Centre receives a request from the Central Ambulance Communications Centre to respond to the scene with an air ambulance helicopter. Local paramedics work to stabilize the lone occupant as the fire department works to extricate them from the mangled wreck. The driver is trapped in the car during a lengthy extrication, their pelvis pinned by the dashboard with significant bleeding from a lower extremity injury. As the patient is extricated, a tourniquet is applied by the paramedics to stop the bleeding, but they remain profoundly hypotensive.
Ornge lands at the scene of the crash as the patient is being wheeled toward the land ambulance. The Ornge paramedics exit the helicopter and assume care of the patient as they are loaded into the awaiting helicopter, blades still turning and ready for a quick departure. Every minute counts. The patient will be transported by Ornge to a lead trauma hospital based on the Field Trauma Triage Standards. On route, Ornge Critical Care Paramedics are able to transfuse blood to the patient, thanks to the Blood on Board program, improving the drivers blood pressure and perfusion on the way to definitive care.
This intervention and outcome is the direct result of the Blood on Board program, a collaboration between Ornge the Division of Transfusion Medicine & Supply Bank at Sunnybrook Health Sciences Centre, an academic health sciences centre fully affiliated with the University of Toronto and a Level One trauma centre. Launched in August 2021, the program reached its 12-month milestone on August 31, 2022. Over the last 12 months, the program has transfused 63 units of blood to 38 patients ranging from interfacility trauma and medical calls to direct from scene trauma cases like the story above.
“For patients experiencing a life-threating injury or catastrophic hemorrhage, an emergency transfusion to replace lost blood can be life saving,” says Dr. Bruce Sawadsky, Chief Medical Officer for Ornge. “Research shows the faster that lost blood is restored with a transfusion, the better the patient outcome. This new program will lead to improved and faster access to blood products as a life-saving therapy.”
As a result of this program, the time to first transfusion for patients picked up directly from scene has been cut in half. These improvements don’t only occur for direct scene calls, similar improvements were seen for patients retrieved from regional and community hospitals. These reductions in delays to the first unit of transfused blood are significant and are directly attributable to the Blood on Board collaboration.
Ornge paramedics have received this initiative positively. “Paramedic crews report a great sense of accomplishment and patient advocacy in having the ability to provide this treatment modality in the field,” says Justin Smith, Chief Flight Paramedic at Ornge. “This allows our paramedics to provide the right care, for the right patient, at the right time.”
Sunnybrook and Ornge have been fortunate to speak about the team’s experience developing a Blood on Board program at regional, provincial and national conferences. Additionally, the team is part of the newly formed Canadian Prehospital and Transport Transfusion (CAN-PATT) group, a multi-disciplinary group of transport and transfusion programs from across Canada.
“Launching ‘Blood on Board’ has been a true team effort for everyone involved, from our partners at Ornge to the lab technologists in our blood bank,” says Dr. Yulia Lin, Division Head, Transfusion Medicine & Tissue Bank at Sunnybrook. “We look forward to helping other hospitals across the province join the program in the near future.”
As the program continues to develop, Ornge is looking to other Ontario regional transfusion programs to build partnerships to expand the reach of the Blood on Board program across the province. The goal is to be able to bring blood to the patients that need it in the prehospital and transport environment across all of Ontario. ■ H
SPONSORED CONTENT Milk and Colorectal Cancer: what does the research say?
By: Cara Rosenbloom, RD
Colorectal cancer is the fourth most common cancer in Canada and is more common among men than women.1 Over 24,000 Canadians will be diagnosed with colorectal cancer in 2022, representing 10 percent of all new cancer cases.2 Research shows that certain dietary patterns can help reduce the risk of developing colorectal cancer. This includes diets that are high in fibre, calcium, and dairy products.3
Studies from the World Cancer Research Fund and the American Institute for Cancer research (AICR) say there is “strong probable evidence” that dairy products decrease the risk of colorectal cancer.4 In their definition, “dairy” includes total dairy, milk, and cheese. Globally, diets that are low in milk and calcium, or are high in alcohol or cigarette use, are the main contributors to colorectal cancer.5
In addition to dairy foods, AICR says that milk products should be part of a dietary pattern that also includes whole grains, vegetables, fruit, and beans, since high fibre foods also decrease the risk of colorectal cancer.6
STUDIES ON MILK AND COLORECTAL CANCER
A 2020 systematic review and meta-analysis of dairy and colorectal cancer included 15 cohort studies and 14 case-control studies comprising a total of 22,000 people.7 Collectively, the studies showed that high consumption of total dairy products and total milk was associated with a lower risk of developing colorectal cancer. Cheese consumption was also inversely associated with the risk of colorectal cancer.
Another 2020 systematic review and meta-analysis looked at 31 prospective cohort studies. The researchers found a 29 percent lower risk of death from colorectal cancer in subjects with high dairy consumption compared with those with low intakes of dairy products.8
A 2021 meta-analysis looked at three cohort studies and nine case-control studies and found that fermented dairy products, such as cheese and yogurt, had a decreased risk of precursors of colorectal cancer. The risk decreased by 12 percent for an increment of 200 grams a day of total dairy, and by eight percent for an increment of 50 grams a day of yogurt.9 A 2022 meta-analysis further supported the link between fermented dairy foods and a decrease in colorectal cancer risk.10
DAIRY FOODS SUCH AS MILK, CHEESE AND YOGURT CAN HELP REDUCE THE RISK OF COLORECTAL CANCER, LIKELY DUE TO THEIR HIGH CALCIUM CONTENT
WHY ARE DAIRY PRODUCTS PROTECTIVE AGAINST COLORECTAL CANCER?
There’s no definitive reason why dairy is linked to reduced colorectal cancer risk, but researchers suspect that it’s likely linked to calcium, vitamin D, and probiotics found in dairy foods.11 Calcium seems to be the main component offering protection. In studies, total calcium intake of 1,400 vs. <600 mg/d was associated with a statistically significant lower risk of colon cancer.12 Other components in milk products that may have a protective effect include conjugated linoleic acid, butyric acid (a short-chain fatty acid), lactic acid bacteria, and sphingolipids.13 , 14 Research is ongoing.
HOW MUCH DAIRY SHOULD PEOPLE CONSUME?
There are no concrete recommendations for the exact amount of dairy foods to eat each day to reduce colorectal cancer risk, but studies show “inverse associations of colorectal cancer risk per 400 g/day of total dairy consumption and 200 g/day of milk consumption.”15 , 16 For perspective, one cup of milk is 240 grams.
Studies also show a seven percent lower risk of colorectal cancer with 50 grams a day of cheese consumption, and an inverse association of colorectal cancer risk with 200 grams per day of fermented dairy products such as yogurt and kefir.17
To reduce the risk of colorectal cancer, talk to patients about following a high-fibre diet that includes plenty of vegetables fruit, whole grains and beans, and make sure to recommend dairy foods as part of the balanced eating plan.
For more information, visit milk.org H
Cara Rosenbloom RD is a registered dietitian, journalist and author in Toronto.
1. https://cancer.ca/en/cancer-information/cancer-types/colorectal/statistics 2. https://cancer.ca/en/cancer-information/cancer-types/colorectal/statistics 3. https://www.aicr.org/research/the-continuous-update-project/colorectal-cancer/ 4. https://www.aicr.org/research/the-continuous-update-project/meat-fish-dairy/ 5. https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00044-9/fulltext 6. https://www.aicr.org/research/the-continuous-update-project/meat-fish-dairy/ 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518136/ 8. https://aacrjournals.org/cebp/article/29/11/2309/72050/Dairy-Consumption-and-Risks-of-Colorectal-Cancer 9. https://www.hindawi.com/journals/jo/2021/9948814/ 10. https://www.frontiersin.org/articles/10.3389/fonc.2022.812679/full 11. https://www.gastrojournal.org/article/S0016-5085(15)00011-6/fulltext 12. https://onlinelibrary.wiley.com/doi/10.1002/ijc.30293 13. https://pubmed.ncbi.nlm.nih.gov/33231228/ 14. https://www.tandfonline.com/doi/full/10.1080/15384047.2017.1345396 15. https://aacrjournals.org/cebp/article/29/11/2309/72050/Dairy-Consumption-and-Risks-of-Colorectal-Cancer 16. https://onlinelibrary.wiley.com/doi/10.1002/ijc.31198 17. https://aacrjournals.org/cebp/article/29/11/2309/72050/Dairy-Consumption-and-Risks-of-Colorectal-Cancer
