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Background: Biological sample collection and data linkage can expand the utility of population health surveys. The present study investigates factors associated with population health survey respondents' willingness to provide biological samples and personal health information. Methods: Using data from the 2019 Centre for Addiction and Mental Health (CAMH) Monitor survey (n = 2,827), we examined participants' willingness to provide blood samples, saliva samples, probabilistic linkage, and direct linkage with personal health information. Associations of willingness to provide such information with socio-demographic, substance use, and mental health details were also examined. Question order effects were tested using a randomized trial. Results: The proportion of respondents willing to provide blood samples, saliva samples, probabilistic linkage, and direct linkage with personal health information were 19.9%, 36.2%, 82.1%, and 17%, respectively. Willingness significantly varied by age, race, employment, non-medical prescription opioid use (past year), cocaine use (lifetime), and psychological distress. Significant question order effects were observed. Respondents were more likely to be willing to provide a saliva sample when this question was asked first compared to first being asked for direct data linkage. Similarly, respondents were more likely to be willing to allow for probabilistic data linkage when this question was asked first compared to first being asked for a saliva sample. Conclusion: A lack of willingness to provide biological samples or permit data linkage may lead to representivity issues in studies which rely on such information. The presence of question order effects suggests that the willingness of respondents can be increased through strategic ordering of survey structures. [ABSTRACT FROM AUTHOR]

Background: Low‐Risk Alcohol Drinking Guidelines (LRDGs) aim to reduce the harms caused by alcohol. However, considerable discrepancies exist in the 'low‐risk' thresholds employed by different countries. Argument/analysis: Drawing upon Canada's LRDGs update process, the current paper offers the following propositions for debate regarding the establishment of 'low‐risk' thresholds in national guidelines: (1) as an indicator of health loss, years of life lost (YLL) has several advantages that could make it more suitable for setting guidelines than deaths, premature deaths or disability adjusted years of life (DALYs) lost. (2) Presenting age‐specific guidelines may not be the most appropriate way of providing LRDGs. (3) Given past overemphasis on the so‐called protective effects of alcohol on health, presenting cause‐specific guidelines may not be appropriate compared with a 'whole health' effect derived from a weighted composite risk function comprising conditions that are causally related to alcohol consumption. (4) To help people reduce their alcohol use, presenting different risk zones associated with alcohol consumption instead of a single low risk threshold may be advantageous. Conclusions: National LRDGs should be based on years of life lost and should be neither age‐specific nor cause‐specific. We recommend using risk zones rather than a single drinking threshold to help people assess their own risk and encourage the adoption of behaviours with positive health impacts across the alcohol use spectrum. [ABSTRACT FROM AUTHOR]

Objective To refine estimates of the burden of alcohol-related oesophageal cancer In Japan. Methods We searched PubMed for published reviews and original studies on alcohol intake, aldehyde dehydrogenase polymorphisms, and risk for oesophageal cancer in Japan, published before 2014. We conducted random-effects meta-analyses, Including subgroup analyses by aldehyde dehydrogenase variants. We estimated deaths and loss of disability-adjusted life years (DALYs) from oesophageal cancer using exposure distributions for alcohol based on age, sex and relative risks per unit of exposure. Findings We identified 14 relevant studies. Three cohort studies and four case-control studies had dose-response data. Evidence from cohort studies showed that people who consumed the equivalent of 100 g/day of pure alcohol had an 11.71 fold, (95% confidence Interval, 0:2.67-51.32) risk of oesophageal cancer compared to those who never consumed alcohol. Evidence from case-control studies showed that the Increase in risk was 33.11 fold (95% CI: 8.15-134.43) in the population at large. The difference by study design is explained by the 159 fold (95% CI: 27.2-938.2) risk among those with an Inactive aldehyde dehydrogenase enzyme variant. Applying these dose-response estimates to the national profile of alcohol Intake yielded 5279 oesophageal cancer deaths and 102988 DALYs lost-- almost double the estimates produced by the most recent global burden of disease exercise. Conclusion Use of global dose-response data results In an underestimate of the burden of disease from oesophageal cancer In Japan. Where possible, national burden of disease studies should use results from the population concerned. Objectif Affiner les estimations de la charge du cancer de l'oesophage lie a l'alcool au Japon. Methodes Nous avons effectue une recherche bibliographique dans PubMed pour trouver les revues publiees et les etudes originales sur la consommation d'alcool, les polymorphismes de l'aldehyde deshydrogenase et le risque de developpement d'un cancer de l'oesophage au Japon, publiees avant 2014. Nous avons reallse des meta-analyses a effet aleatoire, y comprls des analyses de sous-groupe par variant de l'aldehyde deshydrogenase. Nous avons estime les deces et l'esperance de vie corrlgee de l'incapacite (EVCI) dus au cancer de l'oesophage en utilisant les distributions de l'exposition a l'alcool en fonction de l'age, du sexe et des risques relatifs par unlte d'exposition. Resultats Nous avons identifie 14 etudes pertinentes. Trois etudes de cohortes et quatre etudes de cas-temoins presentaient des donnees de dose-reponse. Les donnees issues des etudes de cohortes montrent que les personnes ayant consomme Equivalent de 100 g/jour d'alcool pur avaient un risque 11,71 fois superieur (intervalle de confiancea 95% [IC]: 2,67-51,32) de developper un cancer de l'oesophage par rapport aux personnes qui n'ont jamais consomme d'alcool. Les donnees obtenues a partir des etudes de cas-temoins ont montre que ['augmentation du risque etait 33,11 fois superieure (IC a 95%: 8,15-134,43) par rapport a la population en general. La difference par la conception de l'etude est expliquee par un risque 159 fois superieur (IC a 95%: 27,2-938,2) parmi les personnes presentant un variant enzymatique inactif de l'aldehyde deshydrogenase. En appliquant ces estimations de dose-reponse au profil national de consommation d'alcool, nous sommes arrives a 5279 deces et 102 988 EVCI dus au cancer de l'oesophage--soit presque le double des estimations produites par la plus recente charge globale de la maladie. Conclusion L'utilisatlon de donnees globales de dose-reponse se traduit par une sous-estimation de la charge de morbidite pour le cancer de l'oesophage au Japon. Dans la mesure du possible, la charge nationale des etudes portant sur les maladies devralt utiliser les resultats obtenus sur la population concernee. Objetivo Refinar las estimaciones de la carga del cancer esofagico relacionado con el consumo de alcohol en Japon. Metodos Se buscaron revisiones y estudios originales publicados antes de 2014 sobre la ingesta de alcohol, polimorfismos del aldehido deshidrogenasa y el riesgo de cancer de esofago en Japon en la base de datos PubMed. Se efectuaron metaanalisis de efectos aleatorios, que incluian analisis de subgrupos de variantes del aldehido deshidrogenasa y se estimaron las muertes y la perdida de anos de vida ajustados por discapacidad (AVAD) por cancer de esofago mediante distribuciones de exposicion para el alcohol basadas en la edad, el sexo y los riesgos relativos por unidad de exposicion. Resultados Se identificaron 14 estudios pertinentes. Tres estudios de cohorte y cuatro estudios de casos y controles contenian datos sobre la respuesta en relacion con la dosis. Las pruebas de los estudios de cohorte demostraron que el riesgo de cancer esofagico de que quienes consumen el equivalente a 100 g/dia de alcohol puro era 11,71 veces mayor (intervalo de confianza del 95 % [IC]: 2,67-51,32) en comparacion con aquellos que nunca consumieron alcohol. Las pruebas de los estudios de casos y controles demostraron que el riesgo aumento 33,11 veces (IC del 95 %: 8,15-134,43) en la poblacion en general. La diferencia por el diseno del estudio se explica por el aumento en 159 veces (IC del 95 %: 27,2-938,2) del riesgo entre las personas con una variante inactiva de la enzima aldehido deshidrogenasa. La aplicacion de estas estimaciones de la respuesta en relacion con la dosis al perfil nacional del consumo de alcohol dio lugar a la notificacion de 5279 muertes de cancer esofagico y 102 988 AVAD perdidos, lo equivale a casi el doble de las estimaciones producidas por la carga mundial mas reciente de la actividad de la enfermedad. Conclusion El uso de datos mundiales sobre la respuesta en relacion con la dosis da lugar a una subestimacion de la carga de enfermedad de cancer esofagico en Japon. Siempre que sea posible, los estudios sobre la carga nacional de la enfermedad deben utilizar los resultados de la poblacion afectada., Introduction Alcohol consumption is a major contributor to the global burden of disease (1,2) and is a major risk factor for cancer. (3-6) Of all alcohol-related cancers, oesophageal has the [...]