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Hospitals play an important role in the care of patients with advanced cancer: nearly half of all cancer deaths occur in acute-care settings. The need for increasing access to palliative care and related support services for patients with cancer in acute-care hospitals is therefore growing. Here, we examine how often and how early in their illness patients with cancer might be receiving palliative care services in the 2 years before their death in an acute-care hospital in Canada. The palliative care code from inpatient administrative databases was used as a proxy for receiving, or being referred for, palliative care. Currently, the palliative care code is the only data element routinely collected from patient charts that allows for the tracking of palliative care activity at a pan-Canadian level. Our findings suggest that most patients with cancer who die in an acute-care hospital receive a palliative designation; however, many of those patients are identified as palliative only in their final admission before death. Of the patients who received a palliative designation before their final admission, nearly half were identified as palliative less than 2 months before death. Findings signal that delivery of services within and between jurisdictions is not consistent, that the palliative care needs of some patients are being missed by physicians, and that palliative care is still largely seen as end-of-life care and is not recognized as an integral component of cancer care. Measuring the provision of system-wide palliative care remains a challenge because comprehensive national data about palliative care are not currently reported from all sectors. To advance measurement and reporting of palliative care in Canada, attention should be focused on collecting comparable data from regional and provincial palliative care programs that individually capture data about palliative care delivery in all health care sectors.

This cross-sectional survey study analyzes findings from a nationwide survey of adult cancer survivors in Canada, including the physical, emotional, and practical concerns and associated unmet needs 1 year or more after the end of treatment., Key Points Question Are the health care needs of cancer survivors in Canada being met after the end of their treatment? Findings In this cross-sectional survey study of 10 717 adult cancer survivors who participated in the Experiences of Cancer Patients in Transitions Study, almost 8 of 10 respondents who reported health care concerns across emotional, physical, and practical domains also reported an inadequate level of support, with minimal differences across cancer types. Survivors also faced a median of 6 concerns concurrently, but help was not sought or was not available for a median of 4 concerns. Meaning Findings from this study suggest that a high level of unmet need exists among a growing number of cancer survivors, highlighting the need to enhance or implement survivorship care models that involve integrated care and a smoother transition from cancer treatment., Importance Understanding the challenges faced by an increasing number of cancer survivors can guide the development and implementation of effective survivorship care models. Objective To identify the physical, emotional, and practical concerns and associated unmet needs reported by cancer survivors. Design, Setting, and Participants This cross-sectional survey study obtained data from the Experiences of Cancer Patients in Transitions Study of the Canadian Partnership Against Cancer, in collaboration with cancer agencies in the 10 Canadian provinces, that was disseminated in 2016. This analysis included only adult survivors aged 30 years or older who underwent chemotherapy, radiation therapy, surgical treatment, or a combination of these therapies for breast, prostate, colorectal, melanoma, or hematological cancer within the past 1 to 3 years. Data synthesis and quality assessment were conducted in 2017. Data analysis was completed in July 2019. Main Outcomes and Measures The outcomes were the (1) quantification of the magnitude and multiplicity of the physical, emotional, and practical concerns of adult survivors of breast, colorectal, prostate, melanoma, or hematological cancer; (2) exploration of the magnitude of associated unmet needs; and (3) identification of patient-, treatment-, and cancer-specific factors associated with the reporting of unmet needs. Results Overall, 10 717 adult respondents were included (5660 [53%] female and 6367 [60%] aged ≥65 years). The median number of concerns per respondent was 6 (interquartile range [IQR], 3-10). Among respondents with concerns, help was sought for a median of 2 (IQR, 0-4) concerns. Unmet needs were reported for a median of 4 (IQR, 2-7) concerns. Emotional concerns were reported by 8330 respondents (78%), physical concerns by 9236 respondents (86%), and practical concerns by 4668 respondents (44%). At least 1 unmet need was reported by 7033 survivors (84%) with emotional concerns, 7475 (81%) with physical concerns, and 3459 (74%) with practical concerns. Age, sex, annual income, marital status, geographic location, language, and treatment type were significant factors associated with unmet needs. Survivors of melanoma cancer had a significantly higher likelihood of reporting unmet emotional needs (odds ratio [OR], 1.75; 95% CI, 1.17-2.61; P = .01), whereas survivors of prostate (OR, 0.60; 95% CI, 0.43-0.84; P

Communication with health care providers during diagnosis and treatment planning is of special importance because it can influence a patient&rsquo, s emotional state, attitude, and decisions about their care. Qualitative evidence suggests that some patients experience poor communication with health care providers and have negative experiences when receiving their cancer diagnosis. Here, we use survey data from 8 provinces to present findings about the experiences of Canadian patients, specifically with respect to patient&ndash, provider communication, during the diagnosis and treatment planning phases of their cancer care. Data from the Ambulatory Oncology Patient Satisfaction Survey, representing 17,809 survey respondents, were obtained for the study. Most respondents (92%) felt that their care provider told them of their cancer diagnosis in a sensitive manner. Most respondents (95%) also felt that they were provided with enough information about their planned cancer treatment. In contrast, more than half the respondents who had emotional concerns upon diagnosis (56%) were not referred to services that could help with their anxieties and fears. Also, 18% of respondents reported that they were not given the opportunity to discuss treatment options with a care provider, and 17% reported that their care providers did not consider their travel concerns while planning for treatment. Measuring the patient experience allows for an understanding of how well the cancer control system is addressing the physical, emotional, and practical needs of patients during diagnosis and treatment planning. Although results suggest high levels of patient satisfaction with some aspects of care, quality improvement efforts are still needed to provide person-centred care.

Value-based care, which balances high-quality care with the most efficient use of resources, has been considered the next frontier in cancer care and a means to maintain health system sustainability. Created to promote value-based care, Choosing Wisely Canada—modelled after Choosing Wisely in the United States—is a national clinician-driven campaign to identify unnecessary or harmful services that are frequently used in Canada. As part of the campaign, national medical societies have developed recommendations for tests and treatments that clinicians and patients should question. Here, we present baseline indicator findings about current practice patterns associated with 7 cancer-related recommendations from Choosing Wisely Canada and about the effects of those practices on patients and the health care system. Indicator findings point to substantial variations in cancer system performance between Canadian jurisdictions, most notably for breast cancer screening practices, treatment practices for men with low-risk localized prostate cancer, and radiation therapy practices for early-stage breast cancer and bone metastases. Extrapolating indicator findings to the entire country, it was estimated that 740,000 breast and cervical cancer screening tests were performed outside of the recommended age ranges, and within 1 year of diagnosis, 17,000 patients received treatments that could be low-value. A 15% reduction in the use of the 7 screening and treatment practices examined could lead to multiple benefits for patients and the health care system: 9000 false-positive results and 3000 treatments and related side effects could be avoided, and 4500 h of linear accelerator capacity could be freed up each year. Interjurisdictional performance variations suggest potential differences in clinical practice patterns in the planning and delivery of cancer control services, and in some cases, in disease management outcomes. Although the cancer screening and treatment practices described might be unnecessary for some patients, it is important to realize that they could, in fact, be necessary for other patients. Further research into appropriate rates of use could help to determine how much cancer care represents overuse of practices that are not supported by evidence or underuse of practices that are supported by evidence.

Cancer research is essential in evaluating the safety and effectiveness of emerging cancer treatments, which in turn can lead to ground-breaking advancements in cancer care. Given limited research funding, allocating resources in alignment with societal burden is essential. However, evidence shows that such alignment does not typically occur. The objective of the present study was to provide an updated overview of site-specific cancer research investment in Canada and to explore potential discrepancies between the site-specific burden and the level of research investment. The 10 cancer sites with the highest mortality in 2015&mdash, which included brain, female breast, colorectal, leukemia, lung, non-Hodgkin lymphoma, ovary, pancreas, prostate, and uterus&mdash, were selected for the analysis. Information about site-specific research investment and cancer burden (raw incidence and mortality) was obtained from the Canadian Cancer Research Survey and Statistics Canada&rsquo, s cansim (the Canadian Socio-Economic Information Management System) respectively. The ratio of site-specific research investment to site-specific burden was used as an indicator of overfunding (ratio > 1) or underfunding (ratio < 1). The 3 cancer sites with the highest research investments were leukemia, prostate, and breast, which together represented 51.3% of 2015 cancer research funding. Conversely, the 3 cancer sites with the lowest investments were uterus, pancreas, and ovary, which together represented 7.8% of 2015 research funding. Relative to site-specific cancer burden, the lung, uterus, and colorectal sites were consistently the most underfunded. Observed discrepancies between cancer burden and research investment indicate that some cancer sites (such as lung, colorectal, and uterus) seem to be underfunded when site-specific incidence and mortality are taken into consideration.

IntroductionThe Canadian Partnership Against Cancer reports on pan-Canadian system performance across the cancer control continuum, including how sociodemographic disparities create barriers in access and utilization of cancer control services. This has been done using mostly ecological data, which does not contain the individual level information required to identify the extent of disparities. Objectives and ApproachThe Partnership collaborated with Statistics Canada (STC) to build individual level datasets that will allow researchers to investigate the relationship between sociodemographic factors, cancer outcomes and treatment patterns in Canada.The record linkage was conducted at STC within the Social Data Linkage Environment. Data from the Canadian Cancer Registry were linked to the Discharge Abstract Database, the National Ambulatory Care Reporting System and the Canadian Vital Statistics Death Database to obtain treatment information and deathand death outcomes. To obtain sociodemographic information the following datasets are also being linked: T1 Personal Master File (income), Immigrant Landing File and the Census Long Form (education and geography). ResultsLinkage of all datasets is expected to complete by the end of January 2019. For the first time in Canada, record-level linkage of national cancer registry data with key datasets containing sociodemographic information will be available for exploratory analysis. The challenges with linkage and data limitations will be discussed, as well as the application of these linked databases to answer current disparities-related research questions. Conclusion/ImplicationsThis initiative illustrates the value of collaboration between data custodians and health researchers as well as how linkage of existing datasets can leverage the full potential of available data, and broaden cancer research in supporting efforts to create a more equitable cancer control system.

Colorectal cancer (CRC) is the 2nd most common cancer in Canada and the 2nd leading cause of cancer death. That heavy burden can be mitigated given the preventability of crc through lifestyle changes and screening. Here, we describe the extent of the variation in CRC incidence rates across Canada and the disparities, by jurisdiction, in the prevalence of modifiable risk factors known to contribute to the CRC burden. Findings suggest that there is a north–south and east–west gradient in CRC modifiable risk factors, including excess weight, physical inactivity, excessive alcohol consumption, and low fruit and vegetable consumption, with the highest prevalence of risk factors typically found in the territories and Atlantic provinces. In general, that pattern reflects the CRC incidence rates seen across Canada. Given the substantial interjurisdictional variation, more work is needed to increase prevention efforts, including promoting a healthier diet and lifestyle, especially in jurisdictions facing disproportionately higher burdens of CRC. Based on current knowledge, the most effective approaches to reduce the burden of CRC include adopting public policies that create healthier environments in which people live, work, learn, and play; making healthy choices easier; and continuing to emphasize screening and early detection. Strategic approaches to modifiable risk factors and mechanisms for early cancer detection have the potential to translate into positive effects for population health and fewer Canadians developing and dying from cancer.

Purpose To understand the experiences of adult cancer survivors as they transition from the end of cancer treatment to follow-up care as a basis for developing actionable recommendations to integrate cancer care delivery and survivorship care. Methods A national survey was conducted in collaboration with ten Canadian provinces to identify unmet needs and experiences with follow-up for cancer survivors between 1 and 3 years post-treatment. Surveys were available in English and French and completed either on paper or on-line. Samples were drawn from provincial cancer registries and packages distributed by mail. Results A total of 40,790 survey packages were mailed out across the ten provinces and 12,929 surveys were completed by adults (age 30+ years), and 329 surveys were completed by adolescents and young adults (age 18 to 29 years) giving an overall response rate of 33.3%. For the purposes of this publication, the focus will be on the adult sample. In the adult cohort (age 30+ years), 51% of the sample were females, 60% were 65 years of age or older, and 77% had not experienced metastatic spread. Three-quarters reported their health as good/very good and 82% that their quality of life was good/very good. Overall, 87% experienced at least one physical concern, 78% experienced at least one emotional concern, and 44% experienced at least one practical concern. The average number of concerns reported for each domain ranged from 2.0 to 3.8. For those who sought help, a third experienced difficulty obtaining assistance or did not receive it. The most frequently cited reasons for not seeking help was that someone had told them what they were experiencing was normal. Conclusions The results indicate that many adult survivors have concerns about physical, emotional, and practical issues but are not receiving help to reduce their suffering. It is imperative we take action to correct this current reality.

Patient-reported outcomes measures (proms) are an important component of the shift from disease-centred to person-centred care. In oncology, proms describe the effects of cancer and its treatment from the patient perspective and ideally enable patients to communicate to their providers the physical symptoms and psychosocial concerns that are most relevant to them. The Edmonton Symptom Assessment System&ndash, revised (esas-r) is a commonly used and validated tool in Canada to assess symptoms related to cancer. Here, we describe the extent to which patient-reported outcome programs have been implemented in Canada and the severity of symptoms causing distress for patients with cancer.

In general, guideline-recommended treatment options for men with low-risk prostate cancer (pca) include active surveillance, radical prostatectomy, and external-beam radiation therapy or brachytherapy. Because of the concern about overdiagnosis and consequent overtreatment of pca, patients with low-risk disease are increasingly being managed with active surveillance. Using data from six provincial cancer registries, we examined treatment patterns within a year of a diagnosis of localized low-risk pca, and we assessed differences by age. Of patients diagnosed in 2010 in four of the six reporting provinces, most received surgery or radiation therapy within 1 year of diagnosis. Depending on the province, either surgery or radiation therapy was the most commonly used primary treatment. In the other two provinces, most patients had no record of treatment within a year of diagnosis. Examining treatment patterns by age demonstrated a lesser likelihood of receiving surgery or radiation therapy within 1 year of diagnosis among men more than 75 years of age than among men 75 years of age or younger (no record of treatment in 69.1% and 46.3% respectively). In conclusion, we observed interprovincial and age-specific variations in the patterns of care for men with lowrisk pca. The findings presented in this report are intended to identify opportunities for improvement in clinical practice that could lead to improved care and experience.

Acute care hospitals have a role in managing the health care needs of people affected by cancer when they are at the end of life. However, there is a need to provide end-of-life care in other settings, including at home or in hospice, when such settings are more appropriate. Using data from 9 provinces, we examined indicators that describe the current landscape of acute care hospital use at the end of life for patients who died of cancer in hospital in Canada. Interprovincial variation was observed in acute care hospital deaths, length of stay in hospital, readmission to hospital, and intensive care unit use at the end of life. High rates of acute care hospital use near the end of life might suggest that community and home-based end-of-life care might not be suiting patient needs.

Meaningful performance measures are an important part of the toolkit for health system improvement. The Canadian Partnership Against Cancer has been reporting on pan-Canadian cancer system performance indicators since 2009&mdash, work that has led to the availability of standardized measures that can help to shed light on the extent of variation and opportunities for quality improvement across the country. Those measures include a core set of system indicators ranging from prevention and screening, through diagnosis and treatment, to survivorship and end-of-life care.

As part of Choosing Wisely Canada (a national campaign to encourage patient&ndash, provider conversations about unnecessary medical tests, treatments, and procedures), a list of ten oncology practices that could be low-value in some instances was developed. Of those practices, two were specific to radiation therapy (rt): conventional fractionation as part of breast-conserving therapy (bct) for women with early-stage breast cancer, and multifraction radiation for palliation of uncomplicated painful bone metastases. Here, we report baseline findings for the current utilization rates of those two rt practices in Canada. The use of conventional fractionation as part of bct varied substantially from province to province. Of women 50 years of age and older, between 8.8% (Alberta) and 36.5% (Saskatchewan) received radiation in 25 fractions (excluding boost irradiation) as part of bct. The use of hypofractionated rt (that is, 16 fractions excluding boost irradiation)&mdash, a preferred approach for many patients&mdash, was more common in all 6 reporting provinces, ranging from 43.2% in Saskatchewan to 94.7% in Prince Edward Island. The use of multifraction rt for palliation of bone metastases also varied from province to province, ranging from 40.3% in British Columbia to 69.0% in Saskatchewan. The most common number of fractions delivered to bone metastases was 1, at 50.2%, the second most common numbers were 2&ndash, 5 fractions, at 41.7%. Understanding variation in the use of potentially low-value rt practices can help to inform future strategies to promote higher-value care, which balances high-quality care with the efficient use of limited system resources. Further work is needed to understand the factors contributing to the interprovincial variation observed and to develop benchmarks for the appropriate rate of use of these rt practices.

Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoking behaviours of current cancer patients compared with the non-cancer patient population in Canada. Minimal differences in smoking behaviours were noted between current cancer patients and the rest of the population. Based on 2011–2014 data from the Canadian Community Health Survey, 1 in 5 current cancer patients (20.1%) reported daily or occasional smoking. That estimate is comparable to findings in the surveyed non-cancer patient population, of whom 19.3% reported smoking daily or occasionally. Slightly more male cancer patients than female cancer patients identified as current smokers. A similar distribution was observed in the non-cancer patient population. There is an urgent need across Canada to better support cancer patients in quitting smoking. As a result, the quality of patient care will improve, as will cancer treatment and survival outcomes, and quality of life for these patients.

Many prostate cancers (pcas) are indolent and, if left untreated, are unlikely to cause death or morbidity in a man&rsquo, s lifetime. As a result of testing for prostate-specific antigen, more such cases are being identified, leading to concerns about &ldquo, overdiagnosis&rdquo, and consequent overtreatment of pca. To mitigate the risks associated with overtreatment (that is, invasive therapies that might cause harm to the patient without tangible benefit), approaches such as active surveillance are now preferred for many men with low-risk localized pca (specifically, T1/2a, prostate-specific antigen &le, 10 ng/mL, and Gleason score &le, 6). Here, we report on patterns of care and treatment trends for men with localized low-risk pca. The provinces varied substantially with respect to the types of primary treatment received by men with localized low-risk pca. From 2010 to 2013, many men had no record of surgical or radiation treatment within 1 year of diagnosis&mdash, a proxy for active surveillance, the proportion ranged from 53.3% in Nova Scotia to 80.8% in New Brunswick. Among men who did receive primary treatment, the use of radical prostatectomy ranged from 12.0% in New Brunswick to 35.9% in Nova Scotia. The use of radiation therapy (external-beam radiation therapy or brachytherapy) ranged from 4.1% in Newfoundland and Labrador to 17.6% in Alberta. Treatment trends over time suggest an increase in the use of active surveillance. The proportion of men with low-risk pca and no record of surgical or radiation treatment rose to 69.9% in 2013 from 46.1% in 2010 for all provinces combined. The provinces varied substantially with respect to patterns of care for localized low-risk pca. Treatment trends over time suggest an increasing use of active surveillance. Those findings can further the discussion about the complex care associated with pca and identify opportunities for improvement in clinical practice.

Background: Access to cancer care is a significant concern for Canadians. Prolonged delays between cancer diagnosis and treatment have been associated with anxiety, stress, and perceived powerlessness for patients and their family members. Longer wait times can also be associated with poorer prognosis, although the evidence is inconclusive. Here, we report national wait times for radiation therapy and surgery for localized prostate cancer (pca) and the effect of wait time on patient perceptions of their care. Results: Treatment wait times showed substantial interprovincial variation. The longest 90th percentile wait times for radiation therapy and surgery were, respectively, 40 days and 105 days. In all provinces, waits for radiation therapy were longer for pca patients than for patients with breast, colorectal, or lung cancer. In the focus groups and interviews conducted with 47 men treated for pca, many participants did not perceive that wait times for treatment were prolonged. Those who experienced delays between diagnosis and treatment voiced issues with a lack of communication about when they would receive treatment and a lack of support or information to make an informed decision about treatment. Minimizing treatment delays was an aspect of the cancer journey that participants would like to change because of the stress it caused. Conclusions: Although wait time statistics are useful, a review of cancer control in Canada cannot be considered complete unless an effort is made to give voice to the experiences of individuals with cancer. The findings presented here are intended to provide a snapshot of national care delivery for localized pca and to identify opportunities for improvement in clinical practice.

Evidence-based treatment guidelines exist to improve quality of care for patients and are based on randomized trials that show evidence of benefit. In making treatment decisions, that evidence has to be balanced with the specific circumstances and individual choices of patients and their families. That balance is particularly relevant for older patients who are variably represented in clinical trials and for whom the benefits of adjuvant or neoadjuvant chemotherapy and radiation therapy might come with increased toxicity, specific quality-of-life implications, and competing health issues. In the present article, we examined the impact of patient age on rates of recommended treatment in three evidence-based guidelines: neoadjuvant radiation therapy for rectal cancer, adjuvant chemotherapy for colon cancer, and adjuvant chemotherapy for non-small-cell lung cancer. The objective was to assess the extent to which older patients, relative to younger patients, receive guideline-recommended therapies.

Acute inpatient hospital stays represent a major portion of cancer care costs. All complex surgery and a significant portion of palliative care are delivered in the inpatient setting. Although a vast proportion of those services can be appropriate, ongoing cost pressures threatening the sustainability of the cancer care system warrant an examination of cases in which expensive inpatient care might not be the most cost-effective option. Here, we present two indicators that might help point to such cases: the percentage of day-surgery mastectomies for breast cancer and the use of the intensive care unit (icu) for cancer patients in the last 14 days of life. Although relatively invasive in nature, mastectomies can be safely performed as day surgery1. Day surgeries can be preferable to inpatient surgeries (in which a patient is admitted to a hospital bed after the operation to recover) when they consume fewer hospital resources, without at the same time compromising patient outcomes. Hospital icus are among the most resource-intensive patient care areas. Excessive use of critical care near end of life might indicate inappropriate utilization of resource-intensive acute care in situations in which palliative and supportive care in a non-acute setting might be more appropriate for the patient’s quality of life and constitute a better use of system resources2.

Background: Acute-care hospitals have a role in managing the needs of people with cancer when they are at the end-of-life; however, overutilization of hospital care at the end-of-life results in poorer quality of life and can worsen the patient's experience. Early integration of comprehensive palliative care can greatly reduce unplanned visits to the emergency department, reduce avoidable admissions to hospital, shorten hospital stays, and increase the number of home deaths as well as improve the quality of life of patients with advanced cancer. Aim: To describe the current landscape of acute-care hospital utilization near the end-of-life across Canada and indirectly examine access to palliative care in cancer patients who die in hospital. Methods: Data were obtained from the Canadian Institute for Health Information. The analysis was restricted to adults aged 18+ who died in an acute care hospital in 2014/15 and 2015/16 for nine provinces and three territories. The Discharge Abstract Database was used to extract acute-care cancer death abstracts. Data on intensive care unit (ICU) admissions includes only facilities that report ICU data. Results: Acute care utilization at end-of-life remains commonplace. In Canada (excluding Québec), 43% (48,987) of deaths from cancer occurred in acute-care hospitals, with 70% admitted through the emergency department (ED). In the last six months of life, cancer patients dying in hospital had a median cumulative length of stay ranging from 17 to 25 days, depending on the province. Between 18.1% and 32.8% of patients experienced two or more admissions to the hospital in the last month of life. The proportion of cancer patients admitted to the ICU in the last 14 days of life ranged from 6.4% to 15.1%. Patient demographics (age, sex, place of residence) and clinical factors (cancer type) were often predictors of hospital utilization at end-of-life and likely point to inequities in access to palliative and end-of-life care. Conclusion: Despite previous patient surveys indicating that patients would prefer to receive care and spend their finals days at home or in a hospice, there appears to be overuse of and overreliance on acute care hospital services near the end-of-life in Canada. The high rates of hospital deaths and admissions through the ED at the end-of-life for cancer patients may signal a lack of planning for impeding death and inadequate availability of or access to community- and home-based palliative and end-of-life care services. Acute care hospitals may have a role in managing the health care needs of people affected by cancer; however, end-of-life care should be an option in other settings that align with patient preferences. Standards or practice guidelines to identify, assess and refer patients to palliative care services earlier in their cancer journey should be developed and implemented to ensure optimal quality of life.

Background: Being diagnosed with cancer can be overwhelming, with many physical and emotional challenges. As needs of survivors shift from disease management to recovery, the adjustment is often not seamless. Ideally, a health care system is integrated and responsive to the needs of survivors, however, when cancer treatment is complete, they often face lingering concerns. Limited patient-reported data were available in Canada on experiences and barriers survivors face posttreatment. Aim: The Experiences of Cancer Patients in Transition study is the first national survey gathering data from cancer survivors in Canada as they transition from cancer care to the broader health care system. Methods: A survey was developed in consultation with patients/survivors, health care providers and researchers to address experiences related to physical, emotional, informational and practical needs. Ethics approvals were obtained and 10 provinces participated. Cancer survivors expected to have completed treatment within 1-3 years were identified from provincial cancer registries. Included were those aged 30+ at diagnosis of nonmetastatic breast, colorectal, prostate, melanoma or hematologic cancer; or aged 15-29 at diagnosis of any nonmetastatic cancer or metastatic testicular cancer. Despite the intention of the sampling, the final sample included some survivors diagnosed with a site other than the target sites, and some whose time since treatment was outside 1-3 years. All respondents are included in this analysis. Results are not weighted to represent the true distribution of cancer survivors. Results: From a total survey population of 40,790 Canadian cancer survivors, 33% completed the survey. The respondents were 48% male, 51% female; 2.5% were under 30 years old, 60% were 65+. 68% of respondents reported challenging periods posttreatment, with 48% of these saying that the first 6 months to 1 year were most challenging. Cancer survivors continued to live with side-effects: 87% reported physical challenges; 78% reported emotional challenges; 45% reported practical challenges. The most prevalent concerns were fatigue (68%), anxiety about cancer returning (68%) and returning to work/school (23%). Less than half of those with emotional or practical concerns received useful information (42% and 46%, respectively). 42% of respondents could not get help to address their most difficult concern. Of those who could get help, 10.7% waited a year or more. Conclusion: The results provide insight into the nature of challenges cancer survivors face, as well as needed supports and barriers faced in accessing them. There is a clear need for health systems to ensure a seamless patient experience throughout the cancer journey, for instance, through development and adoption of resources to help health care providers and their patients identify and address challenges from diagnosis through to survivorship.

Background: Colorectal cancer is the third most common cancer worldwide. There is wide geographic variation in incidence with rates varying ten-fold between high- and low-income countries. This heavy burden can be mitigated given previous research has estimated that nearly half of all colorectal cancer cases could have been prevented through healthier diets and physically active lifestyles. In Canada, there is considerable geographic variation in age-adjusted incidence rates for colorectal cancer between jurisdictions, greater than that seen for many other cancers. These wide variations likely reflect differences in the prevalence of risk factors across provinces and territories. Aim: To describe the extent of the variation in colorectal cancer incidence rates across Canada and the disparities in the prevalence of modifiable risk factors across jurisdictions known to contribute to this burden. Methods: Colorectal cancer incident cases were obtained from the Canadian Cancer Registry; 2014 was used for provinces (except Quebec where 2010 was the most recent year available) and years 2012 to 2014 were combined to achieve more stable rates for the territories, which are much smaller in population. Data on four known modifiable risk factors for colorectal cancer (excess weight, physical inactivity, alcohol intake and low fruit and vegetable consumption) were obtained from the 2015-16 combined Canadian Community Health Survey. Results: Findings suggest that there is a north-south and east-west gradient in colorectal cancer modifiable risk factors in Canada. For instance, the percentage of adults with excess body weight ranged from 56.8% in British Columbia (west) to 73.1% in New Brunswick (east) and the percentage of adults not meeting physical activity guidelines ranged from 31.8% in Yukon (north) to 50.3% in New Brunswick (east). Generally, this pattern also reflects colorectal cancer incidence rates. The highest prevalence of modifiable risk factors and rates of colorectal cancer are typically in the northern (territories) and eastern provinces of Canada. Conclusion: The global burden of colorectal cancer is expected to increase by nearly 60% by 2030; therefore, targeted interventions are needed to ensure there is not a widening gap in colorectal cancer burden worldwide. Based on current knowledge, the most effective approaches to reduce the burden of colorectal cancer include: 1) adopting public policies that make healthy choices easier and create healthier environments where people live, work and play, and 2) continuing emphasis on screening and early detection. Strategic approaches to addressing modifiable risk factors, as well as mechanisms for detecting colorectal cancer before it develops, have the potential to translate into positive effects on population health and less people developing and dying from cancer.

Approximately 9200 people in Canada die from colorectal cancer each year1, and about 20% of those tumours involve the rectum2. Surgery is the first-line treatment for nonmetastatic rectal cancer; the goal is complete removal of the tumour with no residual cancer cells left behind. Rectal cancer care has become increasingly multidisciplinary. Most treatment guidelines suggest that neoadjuvant therapy, including chemotherapy and radiation, be considered in the treatment of stage ii and iii rectal cancer, both to shrink the tumour and to improve surgical and overall outcomes3. The circumferential resection margin (crm), also called the radial margin, is very important in rectal cancer surgery, being a prognostic factor in patients who undergo such surgery. As recorded in the pathology report, a positive crm has been defined as a margin of normal tissue that is 1 mm or less from the edge of the original tumour, a measurement that comes from evidence-based guidelines4. A crm of less than 1 mm has been shown to be a strongly negative prognostic factor: specifically, it predicts for subsequent locoregional recurrence and poorer overall survival4. Guidelines recommend negative margins (>1 mm) for all rectal cancer patients who undergo resection5,6, and the rate of crm positivity is widely used as a quality indicator in rectal cancer care. Two major changes in rectal cancer treatment since the early 1990s are recognition of the importance of surgical technique (and specifically the adoption of total mesorectal excision) and increased use of neoadjuvant therapies. Those changes have contributed both to a reduction in positive crm rates and in local and regional recurrences. However, despite best efforts, concern remains about potential variations in rectal cancer treatment and outcomes. The System Performance Initiative at the Canadian Partnership Against Cancer regularly reports on standardized indicators at a national level to help identify opportunities for pan-Canadian system improvements. Recognizing that surgical resection is generally recommended as first-line treatment for nonmetastatic disease, the first indicator presented in this rectal cancer surgery–focused report is the rectal cancer resection rate. The second indicator is the rate of crm positivity among patients undergoing rectal cancer resection. A better understanding of the data can help to identify best practices, which in turn can inform quality improvements.

Positron-emission tomography (pet) has emerged as an effective imaging method for diagnosing, staging, and treating lung cancer1. Studies show that information derived from pet has led to a change in the intended treatment plan in 36%–50% of cases2. At December 2011, approximately 31 centres were operating publicly funded pet scanners in 8 Canadian provinces (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, and Nova Scotia)3. Historically, the number of pet scanners per million population has been reported to an indicator of diagnostic technology capacity in cancer care2,4. Although that number is an acceptable indicator for the availability of pet scanners in Canada, it provides no evidence about the actual utilization of the technology. The goal of the present study was to describe the use of publicly funded pet in the diagnosis and staging of patients with non-small-cell lung cancer (nsclc) in provinces with active publicly funded pet scanners. Analyzing utilization patterns can help to inform opportunities for increasing the evidence-based use of pet, while lowering use outside the evidence base; for developing meaningful pet utilization indicators; and for standardizing the manner in which pet technology is used to diagnose, stage, and manage the treatment of nsclc across Canada. This is the first pan-Canadian analysis on the topic.

Ovarian cancer is the fifth leading cause of cancer death among women in Canada, with an estimated 1750 deaths and 2600 new cases occurring in 20121. Identifying opportunities for preventing ovarian cancer is particularly important given the high case fatality ratio in this disease and the absence of effective screening. Often, by the time ovarian cancer is detected, it is at an advanced stage of iii or iv. Recent research has shown that some ovarian cancers (the high-grade serous type) may originate in the fallopian tube mucosa rather than the ovaries2,3. These ovarian cancers represent the most common subtype and have the highest mortality3,4. Other subtypes originating in the ovary may also use the fallopian tube as a conduit for development3. An emerging hypothesis suggests that removal of the fallopian tubes may represent an opportunity to prevent certain types of ovarian cancer from developing, particularly in women already undergoing a hysterectomy for benign indications2–6. The present analysis examines the use of salpingectomy (surgical removal of the fallopian tubes) with hysterectomy in Canada. Identifying recent use of salpingectomy with hysterectomy across various jurisdictions will help to assess the impact over time of pursuing this emerging hypothesis and whether practice patterns are changing.

The 2012 Cancer System Performance Report is the 4th annual report on the Canadian cancer control system produced by the System Performance initiative at the Canadian Partnership Against Cancer, in collaboration with its provincial and national partners. The 2012 report presents, for 4 provinces, the percentage of all resected stage ii and iiia non-small-cell lung cancer (nsclc) patients receiving adjuvant chemotherapy consistent with treatment guidelines from the National Comprehensive Cancer Network1 and the results of a chart review undertaken to validate the indicator results and to examine reasons for non-concordant treatment.

As part of the system performance initiative of the Canadian Partnership Against Cancer, indicators measuring treatment practice patterns across the country relative to evidence-based guidelines were first published in 20101 and are updated annually. Among the treatment indicators examined is the percentage of resected stage ii and iii rectal cancer patients receiving neoadjuvant (preoperative) radiation therapy (rt), the treatment approach recommended for locally advanced rectal cancer2. Using administrative data from the provincial cancer registries, data from 2008 showed that an average of 45% of patients diagnosed with stage ii and iii rectal cancer received rt before surgical resection, ranging from 36% to 48% across provinces3. To validate those findings, and to better understand factors that may influence acceptance of and concordance with evidence-based practices, a retrospective medical chart review study was undertaken.

BACKGROUND Surgery is a common and important component of breast cancer treatment. We assessed the rates of breast cancer surgery across Canada from 2007/08 to 2009/10. METHODS We used hospital and day surgery data from the Canadian Institute for Health Information to assemble a cohort of women who had undergone breast cancer surgery. We identified the index surgical procedure and subsequent surgical procedures performed within 1 year for each woman included in the analysis. We calculated the crude mastectomy rate for each province, and we calculated the adjusted mastectomy rate for select jurisdictions using a logistic regression model fitted using age, neighbourhood income quintile and travel time. RESULTS In total, 57 840 women underwent breast cancer surgery during the study period. Among women with unilateral invasive breast cancer, the crude mastectomy rate was 39%. Adjusted rates for mastectomy varied widely by province (26%-69%). The rate of re-excision within 1 year for women who had breast-conserving surgery as their index procedure was 23% and varied by province in terms of frequency and type (mastectomy or repeat breast-conserving surgery). Among women who underwent mastectomy for unilateral invasive breast cancer, 6% also underwent contralateral prophylactic mastectomy, and 7% had immediate breast reconstruction following surgery. Of mastectomy procedures, 20% were performed as day surgery; for breast-conserving surgery, 70% were performed as day surgery. INTERPRETATION There is substantial interprovincial variation in surgical care for breast cancer in Canada. Further research is needed to better understand such variation, and continued monitoring should be the focus of quality initiatives.

Overall, the results demonstrate that geographic location poses a potential challenge to access, although it is only one facet of access to care. Our findings suggest that there are opportunities to better understand and potentially to improve care for Canadians residing in areas remote from cancer treatment facilities. More information about this report can be found at http://www.cancerview.ca/systemperformancereport. Downloadable slides of the figures in this communication can be downloaded at http://www.cancerview.ca/downloadableslides.

Because health behaviours can be influenced at many different levels, there is value in examining differences in risk factors and health behaviours between the largest cities in Canada. A recent Cancer System Performance Spotlight Report on population health produced by the System Performance Initiative at the Canadian Partnership Against Cancer examines differences in risk factors and health behaviours for the largest cities in Canada1. Approximately one third of cancers can be prevented by not smoking; another third can be prevented through a combination of eating nutritious food, limiting alcohol consumption, participating in regular physical activity, and maintaining a healthy body weight2. Understanding the role of risk factors and their prevalence in urban communities can help to guide prevention at the municipal level, where urban planning and infrastructure, policies, and bylaws can influence the behaviour of residents. For the largest metropolitan areas in Canada, indicators are presented for these risk factors: tobacco use, exposure to second-hand smoke, and overweight and obesity. The results identify substantial differences in the prevalence of risk factors in different metropolitan areas across Canada. Although the general trend was for healthier lifestyles in cities in the western parts of the country compared with their eastern counterparts (and better cancer-risk profiles as a result), there were often striking differences between cities in the same province.

Colorectal cancer is the second leading cause of cancer death and the third most commonly diagnosed cancer in Canada, with an estimated 9200 deaths and 23,300 new cases in 20121. Evidence-based diagnosis and treatment of colon cancer can help to improve outcomes. As part of the System Performance Initiative at the Canadian Partnership Against Cancer, we report on indicators measuring concordance with two evidence-based guidelines (per the National Comprehensive Cancer Network2) for the diagnosis and treatment of colon cancer in a number of Canadian provinces for patients diagnosed between 2007 and 2009. The first indicator assesses the resection and examination of a minimum of 12 lymph nodes in colon cancer resections, which is recommended by most clinical guidelines to more definitively establish N stage2 (indicating the extent of cancer spread to lymph nodes), because the chance of a false-negative diagnosis is reduced to acceptable levels beyond the threshold of 12 nodes examined. The second indicator assesses the rate of adjuvant chemotherapy in patients with surgically resected stage iii colon cancer. Several large randomized controlled trials have demonstrated that treatment with chemotherapy after surgery improves outcomes3–5. Measuring concordance with these two guidelines at a national level allows for identification of best practices, which in turn can inform quality improvements.

As part of its System Performance initiative, the Canadian Partnership Against Cancer released Breast Cancer Control in Canada: A System Performance Special Focus Report in September 2012, presenting a broad range of system performance indicators that measure breast cancer control across the continuum. Among the indicators reported for the first time at the national level is the percentage of women with invasive breast cancer who were tested for tumour biomarkers. Data for that measure have just recently become available through the population-wide collection of collaborative stage in the provincial cancer registries.

International audience; This study describes a method derived from ISO/TC 206/SC specifications to assess the bactericidal activity against a bacterial strain, Pseudomonas fluorescens, of various photocatalytic fabrics, under UVA and filtered visible light. The experimental method allowed the accurate quantification of bacteria survival on photoactive surfaces and films under UVA and UV-free visible irradiation. Cotton fabrics coated with TiO2, anthraquinone or anthraquinone-sensitized TiO2 display a significant bactericidal efficiency. TiO2-coated fabrics are very efficient against P. fluorescens after 4 h UVA irradiation (bacteria survival below the detection limit). Under UVA-free visible light, anthraquinone-sensitized TiO2 coated fabrics induced a significant bactericidal activity after 2 h irradiation, while anthraquinone alone-coated fabrics were not as efficient and TiO2 coated fabrics were almost inefficient. These results show that although exhibiting a weak n-π* band in the 350-420 nm range, anthraquinone is a good candidate as an efficient visible light photosensitizer. A synergy effect between anthraquinone and TiO2 was demonstrated. A possible reaction mechanism, involving a synergy effect for singlet oxygen formation with anthraquinone-sensitized TiO2 is proposed to account for these results. © 2012 Elsevier B.V. All rights reserved.

289 Background: Because treatment options for localized prostate cancer (PCa) have similar survival outcomes but varying side effects, it is important that patients are meaningfully involved in the decision-making process to ensure the chosen treatment aligns with their needs, wants and preferences. Here, we describe PCa patients’ experience with informed decision-making as well as treatment patterns and trends over time. Methods: Focus groups were conducted with 47 men treated for PCa across Canada to understand their cancer journey experience. Thematic analysis was conducted. A subset of this data on informed decision-making is described. Men (≥ 35 years) diagnosed with localized, low-risk PCa from 2011-2013 were identified using data from six provincial cancer registries. Treatment data were identified by linking hospital/cancer centre data with registry data. Descriptive statistics were generated to describe treatment patterns and trends. Results: Focus group participants expressed a desire to be involved in the treatment decision-making process. While many participants felt completely informed about the treatment choices available to them, others felt they had not been properly engaged in the treatment decision-making process. Some participants felt they had opted for surgery or radiation therapy (RT) without full knowledge of the trade-offs between potential benefits and side effects. Others felt they may have made different decisions about their care had they been more informed. From registry data, in 2013 surgery was the most common primary treatment for men with low-risk PCa ranging from 12.0% in New Brunswick to 41.7% in Nova Scotia. RT was the second most common ranging from 6.4% in New Brunswick to 18.3% in Saskatchewan. Varying majorities of men had no record of surgical or radiation treatment, a proxy for active surveillance. Treatment trends over time suggest an increase in the use of non-active treatment approaches from 60.7% in 2011 to 69.9% in 2013. Conclusions: System performance indicators yield useful information about oncology practice patterns and trends. This information is enhanced when combined with patient level information on how men felt about decision-making around their PCa care.

Five-year relative survival statistics are often used to measure cancer control across jurisdictions, and international comparisons such as the CONCORD or EUROCARE studies often point to substantial survival differences across participating countries [...]

The system performance initiative of the Canadian Partnership Against Cancer is the first pan-Canadian report to offer indicators for measuring treatment practice patterns by province and for comparing practice with current guidelines. The 2011 Cancer System Performance Report 1 presents data on guideline-based treatment indicators for the second year, allowing for a preliminary trend analysis. The decision to examine indicators measuring treatment practice patterns came from several workshops and consultations involving a broad range of experts and knowledge leaders from across the cancer care landscape. Among the treatment indicators examined is the percentage of resected stage II and III rectal cancer cases receiving neoadjuvant (preoperative) radiation therapy (RT).

A simple and reproducible one-pot process for the elaboration of cotton fabrics coated with sensitized TiO 2 was developed. A molecular precursor [Ti(OR) 3 (O 2 C-AQ)] was prepared starting with anthraquinone-2-carboxylic acid (AQ-COOH) and characterized by FTIR, CPMAS NMR and XPS. Hydrolysis of mixtures of [Ti(OR) 3 (O 2 C-AQ)] and Ti(OR) 4 at low temperature in an aqueous medium leads to pale yellow cotton fabrics together with the corresponding free P-TiO 2 /AQ powders. The diffuse reflectance UV spectra confirmed the shift of absorption towards the visible range. From FTIR, CPMAS NMR and XPS analysis of the samples (cotton pieces and powders), it was shown that AQ-COOH was not only adsorbed on Titania but tightly bond through a carboxylate complex as in the molecular precursor. Anatase polymorph was always characterized by XRD even in the absence of a calcination step. Examination by SEM of treated cotton tissues before and after washing showed stable and homogeneous coating of TiO 2 particles on the cotton fibers. The photocatalytic properties of the samples were investigated, with special care to visible light activation. Under UV light, acetone mineralization was observed, while under filtered visible light, no acetone mineralization occurred. However efficient singlet oxygen addition to di- n -butyl sulfide was evidenced under visible light. Sulfoxide and sulfone were obtained in better yields using sensitized TiO 2 than using un-modified TiO 2 or Anthraquinone alone treated fabrics. Optimum results were obtained with low level of sensitizing AQ-COOH relative to TiO 2 (8%) and no reactivity improvement was noticed with higher AQ-COOH levels. The cotton pieces coated with sensitized TiO 2 also displayed self-cleaning properties towards wine stain, either under solar illumination or even in indoor light. The better efficiency of sensitized TiO 2 -coated cotton is accounted for by a synergy effect between TiO 2 and AQ-COOH, enhancing the formation of Reactive Oxygen Species (singlet oxygen and/or superoxide radical-anion). However, under these conditions, the production of hydroxyl radical seems to be ruled out.

A number of microlensing dark-matter surveys have produced tens of millions of light curves of individual background stars. These data provide an unprecedented opportunity for systematic studies of whole classes of variable stars and their host galaxies. We aim to use the EROS-2 survey of the Magellanic Clouds to detect and study the population of beat Cepheids (BCs) in both Clouds. BCs pulsating simultaneously in the first overtone and fundamental modes (FO/F) or in the second and first overtone modes (SO/FO) are of particular interest. Using special software designed to search for periodic variables, we have scanned the EROS-2 data base for variables in the typical period range of Cepheids. Metallicities of FO/F objects were then calculated from linear nonadiabatic convective stellar models. We identify 74 FO/F BCs in the LMC and 41 in the SMC, and 173 and 129 SO/FO pulsators in the LMC and SMC, respectively; 185 of these stars are new discoveries. For nearly all the FO/F objects we determine minimum, mean, and maximum values of the metallicity. The EROS data have expanded the samples of known BCs in the LMC by 31%, in the SMC by 110%. The FO/F objects provide independent measures of metallicities in these galaxies. The mean value of metallicity is 0.0045 in the LMC and 0.0018 in the SMC., Comment: 10 pages, 7 figures, accepted for publication in A&A

The EROS-2 project has been designed to search for microlensing events towards any dense stellar field. The densest parts of the Galactic spiral arms have been monitored to maximize the microlensing signal expected from the stars of the Galactic disk and bulge. 12.9 million stars have been monitored during 7 seasons towards 4 directions in the Galactic plane, away from the Galactic center. A total of 27 microlensing event candidates have been found. Estimates of the optical depths from the 22 best events are provided. A first order interpretation shows that simple Galactic models with a standard disk and an elongated bulge are in agreement with our observations. We find that the average microlensing optical depth towards the complete EROS-cataloged stars of the spiral arms is $\bar{\tau} =0.51\pm .13\times 10^{-6}$, a number that is stable when the selection criteria are moderately varied. As the EROS catalog is almost complete up to $I_C=18.5$, the optical depth estimated for the sub-sample of bright target stars with $I_C.11\times 10^{-6}$) is easier to interpret. The set of microlensing events that we have observed is consistent with a simple Galactic model. A more precise interpretation would require either a better knowledge of the distance distribution of the target stars, or a simulation based on a Galactic model. For this purpose, we define and discuss the concept of optical depth for a given catalog or for a limiting magnitude., Comment: 22 pages submitted to Astronomy & Astrophysics

For seven years, the EROS-2 project obtained a mass of photometric data on variable stars. We present a peculiar Cepheid-like star, in the direction of the Small Magellanic Cloud, which demonstrates unusual photometric behaviour over a short time interval. We report on data of the photometry acquired by the MARLY telescope and spectroscopy from the EFOSC instrument for this star, called EROS2 J005135-714459(sm0060n13842), which resembles the unusual Cepheid HR 7308. The light curve of our target is analysed using the Analysis of Variance method to determine a pulsational period of 5.5675 days. A fit of time-dependent Fourier coefficients is performed and a search for proper motion is conducted. The light curve exhibits a previously unobserved and spectacular change in both mean magnitude and amplitude, which has no clear theoretical explanation. Our analysis of the spectrum implies a radial velocity of 104 km s$^{-1}$ and a metallicity of -0.4$\pm$0.2 dex. In the direction of right ascension, we measure a proper motion of 17.4$\pm$6.0 mas yr$^{-1}$ using EROS astrometry, which is compatible with data from the NOMAD catalogue. The nature of EROS2 J005135-714459(sm0060n13842) remains unclear. For this star, we may have detected a non-zero proper motion for this star, which would imply that it is a foreground object. Its radial velocity, pulsational characteristics, and photometric data, however, suggest that it is instead a Cepheid-like object located in the SMC. In such a case, it would present a challenge to conventional Cepheid models., Comment: Correction of typos in the abstract

Rare types of variable star may give unique insight into short-lived stages of stellar evolution. The systematic monitoring of millions of stars and advanced light curve analysis techniques of microlensing surveys make them ideal for discovering also such rare variable stars. One example is the R Coronae Borealis (RCB) stars, a rare type of evolved carbon-rich supergiant. We have conducted a systematic search of the EROS-2 database for the Galactic catalogue Bulge and spiral arms to find Galactic RCB stars. The light curves of $\sim$100 million stars, monitored for 6.7 years (from July 1996 to February 2003), have been analysed to search for the main signature of RCB stars, large and rapid drops in luminosity. Follow-up spectroscopy has been used to confirm the photometric candidates. We have discovered 14 new RCB stars, all in the direction of the Galactic Bulge, bringing the total number of confirmed Galactic RCB stars to about 51. After reddening correction, the colours and absolute magnitudes of at least 9 of the stars are similar to those of Magellanic RCB stars. This suggests that these stars are in fact located in the Galactic Bulge, making them the first RCB stars discovered in the Bulge. The localisation of the 5 remaining RCBs is more uncertain: 4 are either located behind the Bulge at an estimated maximum distance of 14 kpc or have an unusual thick circumstellar shell; the other is a DY Per RCB which may be located in the Bulge, even if it is fainter than the known Magellanic DY Per. From the small scale height found using the 9 new Bulge RCBs, $61, Comment: 20 pages, 26 figures, Accepted in A&A

We present a new EROS-2 measurement of the microlensing optical depth toward the Galactic Bulge. Light curves of $5.6\times 10^{6}$ clump-giant stars distributed over $66 \deg^2$ of the Bulge were monitored during seven Bulge seasons. 120 events were found with apparent amplifications greater than 1.6 and Einstein radius crossing times in the range $5 {\rm d}, Comment: accepted A&A, minor revisions

The OGLE-II event sc5_2859 was previously identified as the third longest microlensing event ever observed. Additional photometric observations from the EROS (Experience de Recherche d'Objets Sombres) survey and spectroscopic observations of the candidate star are used to test the microlensing hypothesis.The combined OGLE and EROS data provide a high quality coverage of the light curve. The colour of the sc5_2859 event is seen to change with time. A spectrum taken in 2003 exhibits a strong Halpha emission line. The additionnal data show that the OGLE-II sc5_2859 event is actually a classical nova outburst., Comment: Accepted for publication in Astronomy and Astrophysics

We present the type Ia rate measurement based on two EROS supernova search campaigns (in 1999 and 2000). Sixteen supernovae identified as type Ia were discovered. The measurement of the detection efficiency, using a Monte Carlo simulation, provides the type Ia supernova explosion rate at a redshift ~ 0.13. The result is $0.125^{+0.044+0.028}_{-0.034-0.028} h_{70}^2$ SNu where 1 SNu = 1 SN / $10^{10} L_{sun}^B$ / century. This value is compatible with the previous EROS measurement (Hardin et al. 2000), done with a much smaller sample, at a similar redshift. Comparison with other values at different redshifts suggests an evolution of the type Ia supernova rate., Comment: Accepted for publication in Astronomy & Astrophysics (15 pages, 16 figures)

Five years of EROS data towards the Small Magellanic Cloud have been searched for gravitational microlensing events, using a new, more accurate method to assess the impact of stellar blending on the efficiency. Four long-duration candidates have been found which, if they are microlensing events, hint at a non-halo population of lenses. Combined with results from other EROS observation programs, this analysis yields strong limits on the amount of Galactic dark matter made of compact objects. Less than 25% of a standard halo can be composed of objects with a mass between 2 10^-7 Msol and 1 Msol at the 95% C.L., 6 pages, 3 figures. Accepted for publication in A&A