CMAJ Podcasts

While overall cancer rates in Canada continue to decline, reflecting decades of progress in screening and treatment, younger survivors face troubling gaps in their follow-up care. In the research article “Projected estimates of cancer in Canada in 2026” overall cancer incidence and mortality rates continue to decline when adjusted for population size, reflecting advances in screening, early detection, and treatment. But for adolescents and young adults, surviving cancer may mark the start of a more complex and less coordinated phase of care.Dr. Darren Brenner, a molecular cancer epidemiologist at the University of Calgary, reports that more than 250,000 Canadians are expected to be diagnosed with cancer in 2026, with rates per 100,000 continuing to fall. Mortality has declined for several major cancers, though increases in pancreatic and uterine cancers highlight uneven progress. Brenner notes that a growing number of survivors are now living with elevated risk of second primary cancers and will require long-term follow-up.Dr. Miranda Fidler-Benaoudia, a cancer epidemiologist at Cancer Care Alberta and co-author of the article, article “Subsequent primary neoplasm risk among survivors of cancer in adolescence and young adulthood: a population-based study from Alberta, Canada,” examines what happens after treatment for patients diagnosed between ages 15 and 39. Her study finds these survivors are twice as likely to develop a second primary cancer as their peers, often at younger ages than current screening programmes anticipate. Despite this, survivorship care is inconsistent. Patients treated in paediatric settings often receive lifelong, specialized follow-up, while those treated in adult systems may be discharged within a few years to primary care without standardized guidance or documentation. Many lack access to a family physician, and clinicians may not be equipped to manage the long-term risks associated with early cancer treatment.For clinicians, these findings raise questions about how to manage a growing population of younger cancer survivors who face elevated risks over decades. Earlier onset of second cancers and the absence of clear follow-up pathways suggest current screening frameworks and transition practices may not be sufficient for this group.Comments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X  @BlairBigham and @DrmojolaomoleX (in English):  @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

On this ENCORE of our most popular episode of 2025, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with two authors of the latest “Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care”The discussion reflects a shared urgency: despite past successes, Canada’s hypertension control rates are declining. The new guidelines aim to reverse this trend by simplifying diagnosis and treatment for frontline clinicians.Dr. Rémi Goupil, a nephrologist and clinician researcher at Sacré-Cœur Hospital in Montreal, and Dr. Greg Hundemer, a nephrologist and clinician scientist at The Ottawa Hospital, explain that the updated guideline is deliberately designed for primary care providers. They highlight key shifts: lowering the diagnostic threshold for hypertension to  ≥ 130/80 mm Hg, simplifying blood pressure targets, and emphasizing accurate, standardized measurement techniques both in clinic and at home. The guidelines were created with input from a majority-primary care committee—including family physicians, nurses, pharmacists, and patient partners—to ensure clinical applicability.Together, the panel outlines a streamlined nine-step treatment algorithm, emphasizing combination therapy as first-line pharmacologic management. They explain the evidence supporting ARB–thiazide combinations, discuss cost considerations for drug selection, and address adherence challenges. They also explore red flags for secondary hypertension and how the algorithm supports—but does not replace—clinical judgment.For physicians, this guideline offers a clear and practical roadmap: measure blood pressure correctly, aim for systolic pressure below 130 mm Hg, and use the simplified treatment sequence to improve adherence and outcomes. Designed to be easy to implement, the new approach aims to empower primary care providers to act with confidenceComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X  @BlairBigham and @DrmojolaomoleX (in English):  @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions