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Bruun-Rasmussen NE, Napolitano G, Christiansen C, Bojesen SE, Ellervik C, Jepsen R, Rasmussen K, Lynge E. Allostatic load as predictor of mortality: a cohort study from Lolland-Falster, Denmark. BMJ Open 2022; 12:e057136. [PMID: 35623757 PMCID: PMC9327798 DOI: 10.1136/bmjopen-2021-057136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The purposes of the present study were to determine the association between (1) 10 individual biomarkers and all-cause mortality; and between (2) allostatic load (AL), across three physiological systems (cardiovascular, inflammatory, metabolic) and all-cause mortality. DESIGN Prospective cohort study. SETTING We used data from the Lolland-Falster Health Study undertaken in Denmark in 2016-2020 and used data on systolic blood pressure (SBP) and diastolic blood pressure (DBP), pulse rate (PR), waist-hip ratio (WHR) and levels of low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, glycated haemoglobin A1c (HbA1c), C-reactive protein (CRP) and serum albumin. All biomarkers were divided into quartiles with high-risk values defined as those in the highest (PR, WHR, triglycerides, HbA1c, CRP) or lowest (HDL-c, albumin) quartile, or a combination hereof (LDL-c, SBP, DBP). The 10 biomarkers were combined into a summary measure of AL index. Participants were followed-up for death for an average of 2.6 years. PARTICIPANTS We examined a total of 13 725 individuals aged 18+ years. PRIMARY OUTCOME MEASURE Cox proportional hazard regression (HR) analysis were performed to examine the association between AL index and mortality in men and women. RESULTS All-cause mortality increased with increasing AL index. With low AL index as reference, the HR was 1.33 (95% CI: 0.89 to 1.98) for mid AL, and HR 2.37 (95% CI: 1.58 to 3.54) for high AL. CONCLUSIONS Elevated physiological burden measured by mid and high AL index was associated with a steeper increase of mortality than individual biomarkers.
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Affiliation(s)
| | - George Napolitano
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Stig Egil Bojesen
- Department of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark
| | - Christina Ellervik
- Department of Data and Development Support, Region Sjaelland, Soro, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Randi Jepsen
- Centre for Epidemiological Research, Nykobing Falster Hospital, Nykobing, Denmark
| | - Knud Rasmussen
- Department of Data and Development Support, Region Sjaelland, Soro, Denmark
| | - Elsebeth Lynge
- Centre for Epidemiological Research, Nykobing Falster Hospital, Nykobing, Denmark
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152
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Ness-Jensen E, Bringeland EA, Mjønes P, Lagergren J, Grønbech JE, Waldum H, Fossmark R. Hypergastrinemia and mortality in gastric adenocarcinoma: a population-based cohort study, the HUNT study. Scand J Gastroenterol 2022; 57:558-565. [PMID: 35068320 DOI: 10.1080/00365521.2022.2026462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose: Hypergastrinemia increases the risk of developing proximal gastric adenocarcinoma. However, it is unclear if hypergastrinemia affects the survival in patients with gastric adenocarcinoma. This study aimed to examine the hypothesis that hypergastrinemia is associated with increased risk of mortality in patients with gastric adenocarcinoma.Materials and methods: This prospective population-based cohort study based on the Trøndelag Health Study (HUNT) included 78,962 adult individuals (≥20 years). During the baseline assessment period (1995-2008) of these participants, serum samples were collected and frozen. All participants with a newly diagnosed gastric adenocarcinoma in the cohort in 1995-2015 were identified and their gastrin levels were measured in the pre-diagnostic serum samples. Gastrin levels were analysed in relation to all-cause mortality until year 2020 using multivariable Cox regression providing hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for sex, age, body mass index (BMI), tobacco smoking, tumour stage, completeness of surgical resection, and peri-operative chemotherapy.Results: Among 172 patients with gastric adenocarcinoma, 81 (47%) had hypergastrinemia (serum gastrin >60 pmol/L) and 91 (53%) had normal gastrin level. The tumour location was proximal in 83 patients (43%) and distal in 78 (41%). Hypergastrinemia was not associated with any increased risk of all-cause mortality in all patients (adjusted HR 0.8, 95% CI 0.5-1.1), or in sub-groups of patients with proximal tumour location (HR 0.9, 95% CI 0.4-2.2) or distal tumour location (HR 0.9, 95% CI 0.5-1.7).Conclusion: This population-based cohort study indicates that hypergastrinemia may not increase the risk of mortality in patients with gastric adenocarcinoma.
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Affiliation(s)
- Eivind Ness-Jensen
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway.,Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Erling Audun Bringeland
- Department of Gastrointestinal Surgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Patricia Mjønes
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Jon Erik Grønbech
- Department of Gastrointestinal Surgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Helge Waldum
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Reidar Fossmark
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Gastroenterology and Hepatology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
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153
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Persson MSM, Yin W, Döring N, Risnes K, Weiderpass E, Steliarova-Foucher E, Sandin S. Gestational age and cancer risk up to young adulthood in Swedish population born 1974 to 2013: A population-based cohort study. Int J Cancer 2022; 150:1269-1280. [PMID: 34855204 DOI: 10.1002/ijc.33886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022]
Abstract
We examined the association between gestational age and risk of any primary cancer and observed whether the risk patterns differed by sex, birth weight for gestational age categories, cancer site and age of onset. All people live-born in Sweden 1974 to 2013 were prospectively followed up from birth until 2016 using national registers. Gestational age was extracted from the Medical Birth Register and primary malignant cancer diagnoses were from the Swedish cancer register. The adjusted hazard ratios (aHR) for any primary cancer according to weekly gestational age and gestational age categories were determined using cox proportional hazards models adjusted for birth year and parental age. The study included 3 137 691 people; 180 363 (5.8%) born preterm and 254 790 (8.1%) born postterm. They were followed up for 71 691 112 person-years, to a maximum of 43 years and recorded 22 604 new cancers. Although aHRs for the predefined GA categories were only increased for moderate to late preterm delivery (aHR 1.07, 95% CI 1.01-1.14), gestational week-specific aHRs were increased for gestational weeks 30 to 35, with greatest aHR observed for 31 weeks (aHR 1.18, 95% CI 1.05-1.32). Increased cancer risk related to shorter gestational ages were observed particularly for women, those born small for gestational age, childhood cancers and for cancers originating at certain sites (eg, testicular and liver cancer). We provide the first evidence that those born between 30 and 35 weeks gestation may have increased risk of any primary malignant cancer up to young adulthood. Additionally, increasing gestational ages may reduce the risk of testicular and liver cancer.
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Affiliation(s)
- Monica S M Persson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Weiyao Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Nora Döring
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, New York, USA
- Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York, USA
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154
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Hakala JO, Pahkala K, Juonala M, Salo P, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Laitinen TP, Jokinen E, Taittonen L, Tossavainen P, Viikari JS, Raitakari OT, Rovio SP. Repeatedly Measured Serum Creatinine and Cognitive Performance in Midlife: The Cardiovascular Risk in Young Finns Study. Neurology 2022; 98:e2268-e2281. [PMID: 35410906 DOI: 10.1212/wnl.0000000000200268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/08/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Serum creatinine is typically used to assess kidney function. Impaired kidney function and thereby high serum creatinine increases risk of poor cognitive performance. However, serum creatinine might have a non-linear association as low serum creatinine has been linked with cardiovascular risk and impaired cognitive performance. We studied the longitudinal association between serum creatinine and cognitive performance in midlife. METHODS Since 2001, participants from the Cardiovascular Risk in Young Finns Study were followed up for 10 years. Serum creatinine was measured repeatedly in 2001, 2007, and 2011. Sex-specific longitudinal trajectories for serum creatinine among participants without kidney disease were identified using latent class growth mixture modeling. Overall cognitive function and four specific domains such as 1) working memory, 2) episodic memory and associative learning, 3) reaction time, and 4) information processing were assessed using a computerized cognitive test. RESULTS Four serum creatinine trajectory groups all with clinically normal serum creatinine were identified for both men (N=973) and women (N=1,204). After 10 years of follow-up, cognitive testing was performed for 2,026 participants aged 34 to 49 years (mean age 41.8 years). In men and women, consistently low serum creatinine was associated with poor childhood school performance, low adulthood education, low adulthood annual income, low physical activity, and smoking. Compared to the men in the low serum creatinine trajectory group, those in the high serum creatinine group had better overall cognitive performance (β=0.353 SD, 95%CI 0.022-0.684) and working memory (β=0.351 SD, 95%CI 0.034-0.668), while those in the moderate (β=0.247 SD, 95%CI 0.026-0.468) or the normal (β=0.244 SD, 95%CI 0.008-0.481) serum creatinine groups had better episodic memory and associative learning. No associations were found for women. DISCUSSION Our results indicate that, in men, compared to low serum creatinine levels consistently high levels may associate with better memory and learning function in midlife.
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Affiliation(s)
- Juuso O Hakala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Pia Salo
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Leena Taittonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, University of Oulu, and Oulu University Hospital Oulu, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, University of Oulu, and Oulu University Hospital Oulu, Finland
| | - Jorma Sa Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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155
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Abuhasanein S, Jahnson S, Aljabery F, Gårdmark T, Jerlström T, Liedberg F, Sherif A, Ströck V, Kjölhede H. Standardized care pathways for patients with suspected urinary bladder cancer: the Swedish experience. Scand J Urol 2022; 56:227-232. [PMID: 35389306 DOI: 10.1080/21681805.2022.2058605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To compare time intervals to diagnosis and treatment, tumor characteristics, and management in patients with primary urinary bladder cancer, diagnosed before and after the implementation of a standardized care pathway (SCP) in Sweden. MATERIALS AND METHODS Data from the Swedish National Register of Urinary Bladder Cancer was studied before (2011-2015) and after (2016-2019) SCP. Data about time from referral to transurethral resection of bladder tumor (TURBT), patients and tumor characteristics, and management were analyzed. Subgroup analyses were performed for cT1 and cT2-4 tumors. RESULTS Out of 26,795 patients, median time to TURBT decreased from 37 to 27 days after the implementation of SCP. While the proportion of cT2-T4 tumors decreased slightly (22-21%, p < 0.001), this change was not stable over time and the proportions cN + and cM1 remained unchanged. In the subgroups with cT1 and cT2-4 tumors, the median time to TURBT decreased and the proportions of patients discussed at a multidisciplinary team conference (MDTC) increased after SCP. In neither of these subgroups was a change in the proportions of cN + and cM1 observed, while treatment according to guidelines increased after SCP in the cT1 group. CONCLUSION After the implementation of SCP, time from referral to TURBT decreased and the proportion of patients discussed at MDTC increased, although not at the levels recommended by guidelines. Thus, our findings point to the need for measures to increase adherence to SCP recommendations and to guidelines.
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Affiliation(s)
- Suleiman Abuhasanein
- Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,Department of Surgery, Urology Section, NU Hospital Group, Trollhättan, Sweden
| | - Staffan Jahnson
- Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
| | - Firas Aljabery
- Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
| | - Truls Gårdmark
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - Tomas Jerlström
- Department of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Fredrik Liedberg
- Department of Urology, Skåne University Hospital, Malmö, Sweden.,Institution of Translational Medicine, Lund University, Malmö, Sweden
| | - Amir Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Viveka Ströck
- Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Göteborg, Sweden
| | - Henrik Kjölhede
- Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Göteborg, Sweden
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156
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Girbardt J, Luck T, Kynast J, Rodriguez FS, Wicklein B, Wirkner K, Engel C, Girbardt C, Wang M, Polyakova M, Witte AV, Loeffler M, Villringer A, Riedel-Heller SG, Schroeter ML, Elze T, Rauscher FG. Reading cognition from the eyes: association of retinal nerve fibre layer thickness with cognitive performance in a population-based study. Brain Commun 2022; 3:fcab258. [PMID: 35350710 PMCID: PMC8936429 DOI: 10.1093/braincomms/fcab258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 11/20/2022] Open
Abstract
With the eye as a window to the brain, non-invasive fast screening of retinal nerve fibre layer thickness poses the opportunity for early detection of cognitive decline leading to dementia. Our objective is to determine whether performance in various neurocognitive tests has an association with itemized retinal nerve fibre layer thickness. Detailed investigation of associations factored in sex and eye-side. The large population-based LIFE-Adult study (Leipzig Research Centre for Civilization Diseases) was conducted at Leipzig University, Germany from 2011 to 2014. Randomly selected participants (N = 10 000) were drawn from population registry in an age- and gender-stratified manner, focusing on 40–80 years. Cognitive function was examined with the CERAD-NP Plus test-battery (Consortium to Establish a Registry for Alzheimer’s Disease), Stroop-Test, Reading the Mind in the Eyes-Test and Multiple-Choice Vocabulary Intelligence Test. Circumpapillary retinal nerve fibre layer thickness was measured with Optical Coherence Tomography. Subjects with reliable measurements (≥50 B-scan repetitions, signal-to-noise-ratio ≥20 dB, ≤5% missing A-scans) and without clinical eye pathology (sample A) and additional exclusion due to conditions of the central nervous system (sample B) were evaluated. The relationship between cognitive function and retinal nerve fibre layer thickness was investigated for six segments: temporal, temporal-superior, temporal-inferior, nasal, nasal-superior and nasal-inferior. For comparison with other studies, global mean is given. Brain-side projection analysis links results to the corresponding brain hemisphere. We analysed 11 124 eyes of 6471 subjects [55.5 years of age (19.1–79.8 years), 46.9% male]. Low cognitive performance was predominantly associated with thinner retinal nerve fibre layer thickness. Correlation analysis indicated emphasis on global and temporally located effects. Multivariable regression analysis with adjustments (age, sex and scan radius) presented individual results for each test, differentiating between sex and eye-side. For instance, verbal fluency tests and Trail Making Test-B show stronger association in females; Trail Making Test-A shows right-eye dominance. Findings in Trail-Making-Test-A projected to left brain hemisphere, and the ratio incongruent to neutral in the Stroop test projected to right brain-hemisphere. Separate assessment for sex and eye-side is presented for the first time in a population-based study. Location-specific sectorial retinal nerve fibre layer thickness was found to be an indicator for cognitive performance, giving an option for early detection of cognitive decline and the potential of early treatment. The eye as a window to the brain was studied with optical coherence tomography and connected to cognition. Girbardt et al. report that thinner retinal nerve fibre layer thickness was found to be a meaningful index for poorer cognitive performance which presents the potential for prediction of future cognitive decline.
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Affiliation(s)
- Johanna Girbardt
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
| | - Tobias Luck
- Faculty of Applied Social Sciences, University of Applied Sciences Erfurt, 99085 Erfurt, Germany
| | - Jana Kynast
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
| | - Francisca S Rodriguez
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig University, 04103 Leipzig, Germany.,German Centre for Neurodegenerative Diseases (DZNE), Research Group Psychosocial Epidemiology and Public Health, 17489 Greifswald, Germany
| | - Barbara Wicklein
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Christian Girbardt
- Department of Ophthalmology, Leipzig University Medical Center, 04103 Leipzig, Germany
| | - Mengyu Wang
- Schepens Eye Research Institute, Harvard Medical School, Boston, MA 02114, USA
| | - Maryna Polyakova
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
| | - A Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany.,Clinic of Cognitive Neurology, Leipzig University Medical Center, 04103 Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig University, 04103 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
| | - Matthias L Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany.,Clinic of Cognitive Neurology, Leipzig University Medical Center, 04103 Leipzig, Germany
| | - Tobias Elze
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany.,Schepens Eye Research Institute, Harvard Medical School, Boston, MA 02114, USA
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, 04107 Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, 04103 Leipzig, Germany
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157
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Attauabi M, Dahlerup JF, Poulsen A, Hansen MR, Vester-Andersen MK, Prahm AP, Pedersen N, Larsen L, Jess T, Neumann A, Haderslev KV, Molazahi A, Lødrup AB, Glerup H, Oppfeldt AM, Jensen MD, Theede K, Kiszka-Kanowitz M, Seidelin JB, Burisch J. Association Between the Clinical, Biochemical, and Endoscopic Activity of Inflammatory Bowel Diseases and Severity and Long-term Outcomes of Coronavirus Disease 2019-A Population-based Study. Inflamm Bowel Dis 2022; 28:1618-1622. [PMID: 35325137 PMCID: PMC8992288 DOI: 10.1093/ibd/izac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Indexed: 12/29/2022]
Abstract
This brief report investigated the impact of clinical, biochemical, and endoscopic activity of IBD on the severity and long-term outcomes of COVID-19 in a prospective population-based cohort. The study did not identify any association between IBD activity and COVID-19 outcomes.
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Affiliation(s)
- Mohamed Attauabi
- Address correspondence to: Mohamed Attauabi, MD, PhD Fellow, Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Denmark, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark ()
| | - Jens Frederik Dahlerup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Anja Poulsen
- Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Malte Rosager Hansen
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
| | | | | | - Natalia Pedersen
- Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark
| | - Lone Larsen
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Tine Jess
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark,National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease PREDICT, Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark
| | - Anders Neumann
- Department of Internal Medicine, Region Hospital Viborg, Viborg, Denmark
| | - Kent V Haderslev
- Department of Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Akbar Molazahi
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Anders Berg Lødrup
- Department of Internal Medicine, Region Hospital West Jutland, Herning, Denmark
| | - Henning Glerup
- Department of Internal Medicine, Region Hospital Silkeborg, Silkeborg, Denmark
| | | | - Michael Dam Jensen
- Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital, Vejle, Denmark
| | - Klaus Theede
- Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark,Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark
| | - Marianne Kiszka-Kanowitz
- Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark,Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark
| | - Jakob Benedict Seidelin
- Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Johan Burisch
- Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark,Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark
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158
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Osterlund E, Ristimäki A, Kytölä S, Kuopio T, Heervä E, Muhonen T, Halonen P, Kallio R, Soveri LM, Sundström J, Keinänen M, Ålgars A, Ristamäki R, Sorbye H, Pfeiffer P, Nunes L, Salminen T, Lamminmäki A, Mäkinen MJ, Sjöblom T, Isoniemi H, Glimelius B, Osterlund P. KRAS-G12C Mutation in One Real-Life and Three Population-Based Nordic Cohorts of Metastatic Colorectal Cancer. Front Oncol 2022; 12:826073. [PMID: 35251991 PMCID: PMC8889930 DOI: 10.3389/fonc.2022.826073] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background KRAS mutations, present in over 40% of metastatic colorectal cancer (mCRC), are negative predictive factors for anti-EGFR therapy. Mutations in KRAS-G12C have a cysteine residue for which drugs have been developed. Published data on this specific mutation are conflicting; thus, we studied the frequency and clinical characteristics in a real-world and population-based setting. Methods Patients from three Nordic population-based cohorts and the real-life RAXO-study were combined. RAS and BRAF tests were performed in routine healthcare, except for one cohort. The dataset consisted of 2,559 patients, of which 1,871 could be accurately classified as KRAS, NRAS, and BRAF-V600E. Demographics, treatments, and outcomes were compared using logistic regression. Overall survival (OS) was estimated with Kaplan–Meier, and differences were compared using Cox regression, adjusted for baseline factors. Results The KRAS-G12C frequency was 2%–4% of all tested in the seven cohorts (mean 3%) and 4%–8% of KRAS mutated tumors in the cohorts (mean 7%). Metastasectomies and ablations were performed more often (38% vs. 28%, p = 0.040), and bevacizumab was added more often (any line 74% vs. 59%, p = 0.007) for patients with KRAS-G12C- vs. other KRAS-mutated tumors, whereas chemotherapy was given to similar proportions. OS did not differ according to KRAS mutation, neither overall (adjusted hazard ratio (HR) 1.03; 95% CI 0.74–1.42, reference KRAS-G12C) nor within treatment groups defined as “systemic chemotherapy, alone or with biologics”, “metastasectomy and/or ablations”, or “best supportive care”, RAS and BRAF wild-type tumors (n = 548) differed similarly to KRAS-G12C, as to other KRAS- or NRAS-mutated (n = 66) tumors. Conclusions In these real-life and population-based cohorts, there were no significant differences in patient characteristics and outcomes between patients with KRAS-G12C tumors and those with other KRAS mutations. This contrasts with the results of most previous studies claiming differences in many aspects, often with worse outcomes for those with a KRAS-G12C mutation, although not consistent. When specific drugs are developed, as for this mutation, differences in outcome will hopefully emerge.
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Affiliation(s)
- Emerik Osterlund
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Ari Ristimäki
- Department of Pathology, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Soili Kytölä
- Department of Genetics, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland.,Department of Genetics, University of Helsinki, Helsinki, Finland
| | - Teijo Kuopio
- Department of Pathology, Central Finland Hospital Nova, Jyväskylä, Finland.,Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä, Finland
| | - Eetu Heervä
- Department of Oncology, Turku University Hospital, Turku, Finland.,Department of Oncology, University of Turku, Turku, Finland
| | - Timo Muhonen
- Department of Oncology, South Carelia Central Hospital, Lappeenranta, Finland.,Department of Oncology, University of Helsinki, Helsinki, Finland
| | - Päivi Halonen
- Department of Oncology, University of Helsinki, Helsinki, Finland.,Department of Oncology, Helsinki University Hospital, Helsinki, Finland
| | - Raija Kallio
- Department of Oncology, Oulu University Hospital, Oulu, Finland.,Department of Oncology, University of Oulu, Oulu, Finland
| | - Leena-Maija Soveri
- Department of Oncology, Helsinki University Hospital, Helsinki, Finland.,Home Care, Geriatric Clinic and Palliative Care, Joint Municipal Authority for Health Care and Social Services in Keski-Uusimaa, Hyvinkää, Finland
| | - Jari Sundström
- Department of Pathology, Turku University Hospital, Turku, Finland.,Institute of Biomedicine, University of Turku, Turku, Finland
| | - Mauri Keinänen
- Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Annika Ålgars
- Department of Oncology, Turku University Hospital, Turku, Finland.,Department of Oncology, University of Turku, Turku, Finland
| | - Raija Ristamäki
- Department of Oncology, Turku University Hospital, Turku, Finland.,Department of Oncology, University of Turku, Turku, Finland
| | - Halfdan Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Per Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Luís Nunes
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Tapio Salminen
- Department of Oncology, Tampere University Hospital, Tampere, Finland.,Department of Oncology, University of Tampere, Tampere, Finland
| | - Annamarja Lamminmäki
- Department of Oncology, Kuopio University Hospital, Kuopio, Finland.,Department of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markus J Mäkinen
- Department of Pathology, Oulu University Hospital, Oulu, Finland.,Department of Pathology, Cancer and Translational Medicine Research Unit, University of Oulu, and Medical Research Center Oulu, Oulu, Finland
| | - Tobias Sjöblom
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Helena Isoniemi
- Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland.,Department of Surgery, University of Helsinki, Helsinki, Finland
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Pia Osterlund
- Department of Oncology, University of Helsinki, Helsinki, Finland.,Department of Oncology, Helsinki University Hospital, Helsinki, Finland.,Department of Oncology, Tampere University Hospital, Tampere, Finland.,Department of Oncology, University of Tampere, Tampere, Finland.,Department of Gastrointestinal Oncology, Karolinska Universitetssjukhuset, Stockholm, Sweden.,Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden
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159
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Nik Ab Kadir MN, Hairon SM, Yaacob NM, Ab Manan A, Ali N. Prognostic Factors for Bladder Cancer Patients in Malaysia: A Population-Based Study. Int J Environ Res Public Health 2022; 19:ijerph19053029. [PMID: 35270721 PMCID: PMC8910605 DOI: 10.3390/ijerph19053029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/24/2022]
Abstract
Background: Malaysia has the third highest crude mortality rates of bladder cancer within Southeast Asia. We aimed to identify the prognostic factors for bladder cancer patients in Malaysia. Methods: A retrospective population-based study was conducted among patients diagnosed between 2007 and 2011. Death date until 31 December 2016 was updated. Cox proportional hazard regression analysis was performed to examine clinical variables as prognostic factors of death. Results: Identified prognostic factors of 1828 analyzed patients were age groups, ethnicity, morphology, stage, and surgery. As compared to patients aged 15–44, the adjusted Hazard Ratio for those aged 45–54, 55–64, 65–74, and ≥75 were 1.59, 1.87, 2.46, and 3.47, respectively. Malay and other ethnic groups had 1.22- and 1.40-times the risk of death compared to Chinese. Patients with squamous cell carcinoma were at 1.47-times the hazard of death compared to urothelial carcinoma patients. Stages II, III and IV patients had 2.20-, 2.98-, and 4.12-times the risk of death as compared to stage I. Patients who did not receive surgery were at 50% increased hazard of death. Conclusion: Early detection and/or surgery, especially for those more than 75 years old, Malay, and squamous cell carcinoma could potentially improve survival. The findings could inform national cancer control programs.
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Affiliation(s)
- Mohd Nasrullah Nik Ab Kadir
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
- Correspondence:
| | - Najib Majdi Yaacob
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Azizah Ab Manan
- Timur Laut District Health Office, Penang State Health Department, Ministry of Health Malaysia, Georgetown 11600, Penang, Malaysia;
- Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya 62250, Selangor, Malaysia;
| | - Nabihah Ali
- Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya 62250, Selangor, Malaysia;
- Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
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160
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Willén L, Berglund A, Bergström S, Isaksson J, Bergqvist M, Wagenius G, Lambe M. Are older patients with non-small cell lung cancer receiving optimal care? A population-based study. Acta Oncol 2022; 61:309-317. [PMID: 34779354 DOI: 10.1080/0284186x.2021.2000637] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Results from studies addressing age-related patterns of cancer care have found evidence of unjustified differences in management between younger and older patients. METHODS We examined associations between age and clinical presentation, management and mortality in patients diagnosed with non-small cell lung cancer (NSCLC) between 2002 and 2016. Analyses were adjusted for comorbidity and other factors that may have affected management decisions and outcomes. RESULTS The study population encompassed 40,026 patients with NSCLC. Stage at diagnosis did not differ between age groups ≤ 84. The diagnostic intensity was similar in age groups <80 years. In patients with stage IA-IIB disease and PS 0-2, surgery was more common in the youngest age groups and decreased with increasing age, and was rarely performed in those ≥ 85 years. The use of stereotactic body radiotherapy (SBRT) increased with age (≤69 years 5.4%; ≥85 years 35.8%). In patients with stage IIIA disease and PS 0-2, concurrent chemoradiotherapy was more common in younger patients (≤69 years 55.3%; ≥85 years 2.2%). In stage IA-IIIA disease, no major differences in treatment-related mortality was observed. In stage IIIB-IV and PS 0-2, chemotherapy was more common in patients <80 years. However, 58.1% of patients 80-84 years and 30.3% ≥ 85 years received treatment. In stage IA-IIIA, overall and cause-specific survival decreased with increasing age. No age-differences in survival were observed in patients with stage IIIB-IV NSCLC. CONCLUSION Treatments were readily given to older patients with metastatic disease, but to a lesser degree to those with early stage disease. Significant differences in cause specific survival were observed in early, but not late stage disease. Our findings underscore the importance of individualized assessment of health status and life expectancy. Our results indicate that older patients with early stage lung cancer to a higher extent should be considered for curative treatment.
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Affiliation(s)
- Linda Willén
- Center for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
- Department of Radiation Sciences and Oncology, Umeå University, Umeå, Sweden
- Department of Oncology, Gävle Hospital, Gävle, Sweden
| | | | - Stefan Bergström
- Center for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
- Department of Radiation Sciences and Oncology, Umeå University, Umeå, Sweden
- Department of Oncology, Gävle Hospital, Gävle, Sweden
| | - Johan Isaksson
- Center for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
- Department of Pulmonary Medicine, Gävle Hospital, Gävle, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Michael Bergqvist
- Center for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
- Department of Radiation Sciences and Oncology, Umeå University, Umeå, Sweden
- Department of Oncology, Gävle Hospital, Gävle, Sweden
| | - Gunnar Wagenius
- Division of Oncology, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Regional Cancer Center Central Sweden, Uppsala, Sweden
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161
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Zaki TA, Singal AG, May FP, Murphy CC. Increasing Incidence Rates of Colorectal Cancer at Ages 50-54 Years. Gastroenterology 2022; 162:964-965.e3. [PMID: 34757141 PMCID: PMC8881296 DOI: 10.1053/j.gastro.2021.10.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/02/2021] [Accepted: 10/25/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Timothy A. Zaki
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Amit G. Singal
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Folasade P. May
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA
| | - Caitlin C. Murphy
- School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, TX
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162
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Seidel M, King JA, Ehrlich S. Executive functions and eating behavior: Commentary on Steegers et al. (2021). Int J Eat Disord 2022; 55:418-419. [PMID: 35080028 DOI: 10.1002/eat.23684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 11/08/2022]
Abstract
Alterations in executive functions have repeatedly been found in individuals suffering from eating and weight disorders. However, less is known about how these cognitive processes might contribute to the etiology of the disorders, as large prospective population-based studies have been missing. Here, we comment on the results of Steegers et al. (2021), a study that helped to fill this gap with a focus on set-shifting abilities predicting symptoms of anorexia nervosa (AN) in children. The main goal of this commentary is to encourage further interpretation of the population-based data beyond its relevance to AN. More specifically, we discuss the role of impaired inhibition as a risk factor for weight gain and obesity.
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Affiliation(s)
- Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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163
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van Dongen JC, van der Geest LGM, de Meijer VE, van Santvoort HC, de Vos-Geelen J, Besselink MG, Groot Koerkamp B, Wilmink JW, van Eijck CHJ. Age and prognosis in patients with pancreatic cancer: a population-based study. Acta Oncol 2022; 61:286-293. [PMID: 34935577 DOI: 10.1080/0284186x.2021.2016949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The diagnosis of pancreatic ductal adenocarcinoma (PDAC) has an enormous impact on patients, and even more so if they are of younger age. It is unclear how their treatment and outcome compare to older patients. This study compares clinicopathological characteristics and overall survival (OS) of PDAC patients aged <60 years to older PDAC patients. METHOD This is a retrospective, population-based cohort study using Netherlands Cancer Registry data of patients diagnosed with PDAC (1 January 2015-31 December 2018). Kaplan-Meier curves and Cox proportional hazards models were used to assess OS. RESULTS Overall, 10,298 patients were included, of whom 1551 (15%) were <60 years. Patients <60 years were more often male, had better performance status, less comorbidities and less stage I disease, and more often received anticancer treatment (67 vs. 33%, p < 0.001) than older patients. Patients <60 years underwent resection of the tumour more often (22 vs. 14%p < 0.001), more often received chemotherapy, and had a better median OS (6.9 vs. 3.3 months, p < 0.001) compared to older patients. No differences in median OS were demonstrated between both age groups of patients who underwent resection (19.7 vs. 19.4 months, p = 0.123), received chemotherapy alone (7.8 vs. 8.5 months, p = 0.191), or received no anticancer treatment (1.8 vs. 1.9 months, p = 0.600). Patients <60 years with stage-IV disease receiving chemotherapy had a somewhat better OS (7.5 vs. 6.3 months, p = 0.026). CONCLUSION Patients with PDAC <60 years more often underwent resection despite less stage I disease and had superior OS. Stratified for treatment, however, survival was largely similar.
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Affiliation(s)
| | | | - Vincent E. de Meijer
- Department of Surgery, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | | | - Judith de Vos-Geelen
- Division of Medical Oncology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Marc G. Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Johanna W. Wilmink
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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164
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Ladegaard TH, Sørensen CL, Nielsen R, Troelsen A, Al-Mousawi DAA, Bielefeldt R, Petersen MM, Sørensen MS. Surgical Treatment of Metastatic Bone Disease in the Appendicular Skeleton: A Population-Based Study. Cancers (Basel) 2022; 14. [PMID: 35267566 DOI: 10.3390/cancers14051258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Population-based studies of patients with bone metastases in the appendicular skeleton (aBM) requiring surgery for complete or impending fracture are rare. In this epidemiologically-based observational study we created a large population-based cohort of patients treated for aBM, aiming to: (1) monitor possible time-related changes of the incidence of surgical treatment of aBM-lesions, (2) examine differences in the population and care of patients treated at different treatment centers and (3) examine if findings from a previous pilot study regarding absence of a suitable biopsy of the lesions representing debut of cancer or a relapse has improved the awareness of aBM and hereby increased the focus on regular tumor biopsies and follow-up imaging of cancer patients. Methods: We examined a population-based cohort consisting of all patients treated for aBM 2014−2019. Procedures were performed at five secondary surgical centers (SSC) or one tertiary referral Musculoskeletal Tumor Center (MTC). Patients were followed until end of study (30 September 2021) or death. No patients were lost to follow-up. Results: Four-hundred-fifty-seven patients (493 primary aBM-lesions, 482 procedures) were included. Annual incidence of aBM-surgery was 46 aBM-lesions/million. MTC-patients had a significant better preoperative status than SSC-patients considering factors known for survival. Patients with complete fracture experienced longer surgical delay when treated at MTC compared to SSC: 4 (1−9) and 1 (1−3) days (p < 0.001), respectively. Overall survival for the entire cohort was 37% and 11% at 1 and 5 years (MTC and SSC 1 and 5 year respectively: 44% and 15% vs. 29% and 5%, p < 0.001). In patients with debut or relapse of cancer, 8% and 9% had insufficient biopsies, and 21% and 12% had no biopsy, respectively. Comparison showed no change over time. Conclusions: The current study highlights the low awareness on treating aBM at SSC and emphasizes the importance of caution in interpretation of studies not representing an entire population, thus introducing selection bias.
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165
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Domènech-Montoliu S, Puig-Barberà J, Pac-Sa MR, Vidal-Utrillas P, Latorre-Poveda M, Del Rio-González A, Ferrando-Rubert S, Ferrer-Abad G, Sánchez-Urbano M, Aparisi-Esteve L, Badenes-Marques G, Cervera-Ferrer B, Clerig-Arnau U, Dols-Bernad C, Fontal-Carcel M, Gomez-Lanas L, Jovani-Sales D, León-Domingo MC, Llopico-Vilanova MD, Moros-Blasco M, Notari-Rodríguez C, Ruíz-Puig R, Valls-López S, Arnedo-Pena A. Complications Post-COVID-19 and Risk Factors among Patients after Six Months of a SARS-CoV-2 Infection: A Population-Based Prospective Cohort Study. Epidemiologia (Basel) 2022; 3:49-67. [PMID: 36417267 DOI: 10.3390/epidemiologia3010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/12/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Abstract
In October 2020, we conducted a population-based prospective cohort study to determine post-COVID-19 complications, recovery, return to usual health, and associated risk factors in 536 cases of COVID-19 outbreak in Borriana (Spain) by administering an epidemiological questionnaire via phone interviews. A total of 484 patients participated (90.3%), age mean 37.2 ± 17.1 years, and 301 females (62.2%). Mild illness was the most common COVID-19 manifestation. After six months, 160 patients (33.1%) suffered at least one complication post-COVID-19, and 47 (29.4%) of them sought medical assistance. The most frequent persistent symptoms were hair loss, fatigue, loss of smell or taste, and headache. Risk factors associated with a complication were female sex (adjusted relative risk, [aRR] = 1.93 95% confidence interval [CI] 1.41-2.65), age 35 years and above (aRR = 1.50 95% CI 1.14-1.99), B blood group (aRR = 1.51 95% CI 1.04-2.16), current smoker (RR = 1.61 95% CI 1.02-2.54), and at least a COVID-19 exposure (aRR = 2.13 95% CI 1.11-4.09). Male sex, age younger than 35 years, and low COVID-19 exposures were associated with better recovery and return to usual health. A third of patients presented persistent symptoms compatible with the long-COVID-19 syndrome. In conclusion, an active medical follow-up of post-COVID-19 patients must be implemented.
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166
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Feiss R, Corrigan JD, Ding K, Beaulieu CL, Bogner J, Yang J. Rural-Urban Differences in Behavioral Outcomes among Adults with Lifetime History of Traumatic Brain Injury with Loss of Consciousness: 2016-2019 Ohio BRFSS. Int J Environ Res Public Health 2022; 19:ijerph19031678. [PMID: 35162700 PMCID: PMC8835472 DOI: 10.3390/ijerph19031678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/03/2021] [Accepted: 01/30/2022] [Indexed: 02/04/2023]
Abstract
This study examined if the associations between lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) and unhealthy alcohol use or mental health problems differ by location of living (rural vs. urban). The lifetime history data of TBI with LOC, location of living, unhealthy alcohol use (binge drinking, heavy drinking), and mental health problems (depression diagnosis, number of poor mental health days) were sourced from the 2016, 2017, 2018, and 2019 Ohio Behavioral Risk Factory Surveillance Surveys, and the final sample included 16,941 respondents. We conducted multivariable logistic regressions to determine the odds ratios for each of the five outcomes between individuals living in rural vs. urban areas and between individuals with vs. without a lifetime history of TBI with LOC. No interaction between location of living and lifetime history of TBI with LOC was observed for any outcomes, indicating rurality did not modify these relationships. Living in a rural area was associated with decreased binge drinking or heavy drinking but not mental health outcomes. Lifetime history of TBI with LOC was associated with an increased risk of binge drinking, heavy drinking, depression diagnoses, and poor general mental health, regardless of location of living. Our findings support the need for TBI screenings as part of mental health intake evaluations and behavioral health screenings. Though rurality was not associated with mental health outcomes, rural areas may have limited access to quality mental health care. Therefore, future research should address access to mental health services following TBI among rural residents.
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Affiliation(s)
- Robyn Feiss
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43215, USA;
| | - John D. Corrigan
- Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (J.D.C.); (C.L.B.); (J.B.)
| | - Kele Ding
- Department of Health Sciences, Kent State University, Kent, OH 44240, USA;
| | - Cynthia L. Beaulieu
- Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (J.D.C.); (C.L.B.); (J.B.)
| | - Jennifer Bogner
- Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH 43210, USA; (J.D.C.); (C.L.B.); (J.B.)
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43215, USA;
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
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167
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Barrenetxea J, Pan A, Feng Q, Koh WP. Factors associated with depression across age groups of older adults: The Singapore Chinese health study. Int J Geriatr Psychiatry 2022; 37. [PMID: 34816486 DOI: 10.1002/gps.5666] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We studied sociodemographic and health factors associated with depression across three age groups of community-dwelling older adults. METHODS/DESIGN We used data from 16,785 participants from the third follow-up of the Singapore Chinese Health Study (mean age: 73, range: 61-96 years). We defined depression as having a score of ≥5 using the 15-item Geriatric Depression Scale. We used regression splines to examine the pattern of depression risk with age and applied multivariable logistic regression to study factors associated with depression. RESULTS Increasing age was associated with depression in an inverted J-shape relationship with the highest odds ratio (OR) at age 75. Compared to the youngest-old (<70 years), the middle-old (70-80 years) had higher odds of depression [OR = 1.20, 95% confidence interval (CI) = 1.09-1.31], while the oldest-old (>80 years) had no increased risk (OR = 1.01, 95% CI = 0.89-1.15). We also found demographic (men, lower education, unemployment), social (living alone, poor social support, no social activity) and health factors (instrumental limitations, poor physical function, function-limiting pain, chronic diseases, cognitive impairment, poor sleep quality, poor self-rated health) associated with depression. In stratified analysis by age groups, the OR estimates for lower education level, instrumental limitations and cognitive impairment decreased with age, whereas the risk of depression for men increased with age (all p-values for interaction<0.03). CONCLUSIONS Compared to the youngest-old, the likelihood of depression was highest among middle-old adults and decreased to null in the oldest-old. The associations between some factors and depression were attenuated with age, suggesting a coping mechanism among oldest-old survivors.
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Affiliation(s)
- Jon Barrenetxea
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiushi Feng
- Department of Sociology & Centre for Family and Population Research, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
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168
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Søgaard KK, Farkas DK, Leisner MZ, Schmidt SAJ, Lash TL, Sørensen HT. Fever of unknown origin and incidence of cancer. Clin Infect Dis 2022; 75:968-974. [PMID: 35079799 DOI: 10.1093/cid/ciac040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Diagnostic tools for determining causes of fever of unknown origin (FUO) have improved over time. We examined if cancer incidence among these patients changed over a 20-year period. METHODS Population-based cohort study using nationwide Danish registries. We identified individuals diagnosed with FUO (1998-2017) to quantify the excess risk of cancer among these patients compared with the general population. Follow-up for cancer started 1 month after FUO. We computed absolute risks and standardized incidence ratios (SIRs) of cancer, and mortality rate ratios adjusted for age, sex, and cancer stage. RESULTS Among 6620 patients with FUO (46.9% male, median age: 39 years), 343 were diagnosed with cancer (median follow-up: 6.5 years). The 1 to <12-month risk was 1.2%, and the SIR was 2.3 (95% confidence interval, 1.8-2.9). The increased 1 to <12-months SIR was mainly due to an excess of Hodgkin lymphoma (SIR=41.7) non-Hodgkin lymphoma (SIR=16.1), myelodysplastic syndrome/chronic myeloproliferative diseases (SIR=6.0), lower gastrointestinal cancer (SIR=3.3), and urinary tract cancer (SIR=2.9). Beyond 1 year of follow-up, malignant melanoma, hepatobiliary tract/pancreatic cancer, and brain/CNS/eye cancer were diagnosed more often than expected. The 1 to <12-month cancer SIR attenuated over time, and for the 2013-2017 period we found no excess risk. Patients diagnosed with cancer within 1 year after FUO had similar mortality to cancer patients without this diagnosis. CONCLUSIONS Patients with FUO have a higher 1 to <12-month cancer SIR; thereafter, the incidence for most cancers equals that of the general population. Decreasing SIRs over time suggests improvements in the initial diagnostic work-up for FUO.
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Affiliation(s)
- Kirstine K Søgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Michelle Z Leisner
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Sigrun Alba Johannesdottir Schmidt
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Timothy L Lash
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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169
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Sharma R, Verna EC, Simon TG, Söderling J, Hagström H, Green PHR, Ludvigsson JF. Cancer Risk in Patients With Autoimmune Hepatitis: A Nationwide Population-Based Cohort Study With Histopathology. Am J Epidemiol 2022; 191:298-319. [PMID: 33913487 DOI: 10.1093/aje/kwab119] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 04/01/2021] [Accepted: 04/14/2021] [Indexed: 12/14/2022] Open
Abstract
We aimed to determine the risk of incident cancer in autoimmune hepatitis (AIH) compared with the general population and siblings. AIH was defined by the presence of a medical diagnosis of AIH and results of examination of a liver biopsy specimen in a nationwide Swedish population-based cohort study. We identified 5,268 adults with AIH diagnosed during 1969-2016 and 22,996 matched, general population, reference individuals and 4,170 sibling comparators. Using Cox regression, hazard ratios were determined for any incident cancer, and subtypes were determined from the Swedish Cancer Register. During follow-up, a cancer diagnosis was made in 1,119 individuals with AIH (17.2 per 1,000 person-years) and 4,450 reference individuals (12.0 per 1,000 person-years). This corresponded to a hazard ratio of 1.53 (95% confidence interval: 1.42, 1.66). Cancer risk was highest in those with cirrhosis. There was a 29.18-fold increased risk of hepatocellular carcinoma (HCC) (95% confidence interval: 17.52, 48.61). The annual incidence risk of HCC in individuals with AIH who had cirrhosis was 1.1% per year. AIH was also linked to nonmelanoma skin cancer (hazard ratio (HR) = 2.69) and lymphoma (HR = 1.89). Sibling analyses yielded similar risk estimates for any cancer (HR = 1.84) and HCC (HR = 23.10). AIH is associated with an increased risk of any cancer, in particular, HCC and extrahepatic malignancies. The highest risk for cancer, especially HCC, is in patients with cirrhosis.
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170
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Friman TK, Jäämaa-Holmberg S, Åberg F, Helanterä I, Halme M, Pentikäinen MO, Nordin A, Lemström KB, Jahnukainen T, Räty R, Salmela B. Cancer risk and mortality after solid organ transplantation - A population-based 30-year cohort study in Finland. Int J Cancer 2022; 150:1779-1791. [PMID: 35041762 PMCID: PMC9306582 DOI: 10.1002/ijc.33934] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022]
Abstract
Cancer is a significant cause of morbidity and mortality after solid organ transplantation (SOT) and related to lifelong immunosuppression. This retrospective registry study assessed for the first time in Finland population‐based cancer risk and cancer mortality after all SOTs (lung and childhood transplantations included) as standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs). Data from transplant registries were linked with the data of Finnish Cancer Registry and Statistics Finland. We followed 6548 consecutive first SOT recipients from 1 January 1987 to 31 December 2016 translating to 66 741 person‐years (median follow‐up time 8.9 years [interquartile range 4.0‐15.1]). In total, 2096 cancers were found in 1483 patients (23% of all patients). Majority of cancers (53%) were nonmelanoma skin cancers (NMSCs). The overall SIR was 3.6 (95% confidence interval [CI]: 3.5‐3.8) and the SIR excluding NMSCs was 2.2 (95% CI: 2.0‐2.3). SIR for all cancers was highest for heart (5.0) and lowest for liver (2.7) recipients. Most common cancer types after NMSCs were non‐Hodgkin lymphoma (NHL), SIR 9.9 (95% CI: 8.5‐11.4) and kidney cancer, SIR 7.3 (95% CI: 6.0‐8.8). Cancer‐related deaths were 17% (n = 408) of all deaths after first month post transplantation. SMR for all cancers was 2.5 (95% CI: 2.2‐2.7) and for NHL 13.6 (95% CI: 10.7‐16.8). Notably, overall SIR for cancer was lower in later period (2000‐2016), 3.0 (95% CI: 2.8‐3.2), than in earlier period (1987‐1999), 4.3 (95% CI: 4.0‐4.5), P < .001. Decrease in cancer incidence was temporally associated with major changes in immunosuppression in the 2000s.
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Affiliation(s)
- Terhi K Friman
- Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Salla Jäämaa-Holmberg
- Department of Cardiology, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Division of Cardiology, Department of Internal Medicine, Hyvinkää Hospital Area, Hyvinkää, Finland
| | - Fredrik Åberg
- Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Ilkka Helanterä
- Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Maija Halme
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Markku O Pentikäinen
- Department of Cardiology, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Arno Nordin
- Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karl B Lemström
- Department of Heart and thoracic surgery, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Jahnukainen
- New Children's Hospital, Department of Pediatric Nephrology and Transplantation, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Riikka Räty
- Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Birgitta Salmela
- Department of Cardiology, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Heart Center, Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
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171
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Sikjaer MG, Hilberg O, Ibsen R, Løkke A. Sarcoidosis-related mortality and the impact of corticosteroid treatment: A population-based cohort study. Respirology 2022; 27:217-225. [PMID: 35016255 DOI: 10.1111/resp.14202] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 12/02/2021] [Accepted: 12/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE The aims of this national cohort study were: (1) to evaluate mortality in patients with sarcoidosis, stratified by gender, age and systemic corticosteroid (SC) treatment and (2) to characterize comorbidities in this cohort. METHODS Patients diagnosed with sarcoidosis from 2001 to 2015 were identified in the Danish National Patient Registry. Subgroup analyses were performed on cases treated/not treated with SCs within 3 years of the initial sarcoidosis diagnosis (as a proxy for disease severity). The Deyo-Charlson Comorbidity Index was used to evaluate pre-diagnostic comorbidity. Cases were matched (1:4) with controls from the general population. RESULTS We identified 9795 cases with sarcoidosis. Mean age was 46.5 ± 15.9 years and 55% were male. The adjusted hazard ratio (HR) for death was 1.48 (95% CI 1.31-1.68). Mortality was higher than for controls in all age groups and in both genders. HR for death for cases treated with SCs was 1.78 (95% CI 1.49-2.13) and, for cases receiving no treatment, 1.24 (95% CI 1.04-1.48). Sarcoidosis was the most commonly registered cause of death (13.3%). CONCLUSION Patients with sarcoidosis have an increased mortality compared with matched controls. Mortality is particularly high in patients treated with SCs.
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Affiliation(s)
- Melina Gade Sikjaer
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ole Hilberg
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
| | | | - Anders Løkke
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
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172
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Abrahão R, Brunson AM, Kahn JM, Li QW, Wun T, Keegan THM. Second primary malignancy risk after Hodgkin lymphoma treatment among HIV-uninfected and HIV-infected survivors. Leuk Lymphoma 2022; 63:1091-1101. [PMID: 34989283 DOI: 10.1080/10428194.2021.2020775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We compared secondary primary malignancy risk (SPM) in HIV-uninfected and HIV-infected Hodgkin lymphoma (HL) survivors. We used data from the California Cancer Registry on patients diagnosed with HL from 1990 to 2015 (all ages included), and standardized incidence ratios (SIRs) and multivariable competing risk models for analyses. Of 19,667 survivors, 735 were HIV-infected. Compared with the general population, the risk of SPM was increased by 2.66-fold in HIV-infected and 1.92-fold in HIV-uninfected survivors. Among HIV-infected survivors, median time to development of SPM was shorter (5.4 years) than in HIV-uninfected patients (8.1 years). Additionally, the highest risk of SPM was observed <2 years after diagnosis in HIV-infected survivors (SIR = 4.47), whereas risk was highest ≥20 years after diagnosis (SIR = 2.39) in HIV-uninfected survivors. The risk of SPMs persisted for decades and was higher among HIV-infected survivors, suggesting that these patients should benefit from long-term surveillance and cancer prevention practices.
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Affiliation(s)
- Renata Abrahão
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA.,Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Ann M Brunson
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
| | - Justine M Kahn
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY, USA
| | - Qian W Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
| | - Ted Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
| | - Theresa H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
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173
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Jakobsen A, Skov MT, Larsen L, Petersen PT, Brandt C, Wiese L, Hansen BR, Lüttichau HR, Tetens MM, Helweg-Larsen J, Storgaard M, Nielsen H, Bodilsen J. Herpes simplex virus 2 meningitis in adults: A prospective, nationwide, population-based cohort study. Clin Infect Dis 2022; 75:753-760. [PMID: 34979025 DOI: 10.1093/cid/ciab1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Data on the clinical presentation are scarce and prognostic factors of Herpes simplex virus type 2 (HSV-2) meningitis remain unknown. METHODS Prospective, nationwide, population-based database identifying all adults treated for HSV-2 meningitis at departments of infectious diseases in Denmark from 2015-2020. Unfavorable outcome was defined as Glasgow Outcome Scale (GOS) score of 1-4 and extended GOS score of 1-6. Modified Poisson regression was used to compute relative risks with 95% confidence intervals (RR, 95% CI) for unfavorable outcome. RESULTS HSV-2 meningitis was diagnosed in 205 cases (76% female, median age 35 [IQR 27-49]) yielding an incidence of 0.7/100,000/year. Common symptoms were headache 195/204 (95%), photo/phonophobia 143/188 (76%), and neck stiffness 106/196 (54%). Median time to lumbar puncture was 2.0 hours (IQR 1-4.8) and cerebrospinal fluid (CSF) leukocyte count was 360x10 6/L (IQR 166-670) with a mononuclear predominance of 97% (IQR 91-99). Lumbar puncture was preceded by brain imaging in 61/205 (30%). Acyclovir/valaciclovir was administered in 197/205 (96%) cases for a median of 10 days (IQR 7-14).Unfavorable outcome was observed in 64/205 (31%) at discharge and 19/181 (11%) after six months and was not associated with female sex (RR 1.08, 95% CI 0.65-1.79), age ≥35 years (1.28, 0.83-1.97), immuno-compromise (1.07, 0.57-2.03), or CSF leukocyte count >1,000x10 6/L (0.78, 0.33-1.84). CONCLUSIONS HSV-2 meningitis often presented as meningeal symptoms in younger females. Unfavorable outcome at discharge was common and was not associated with sex, age, immune-compromise, or CSF leukocyte count. Sequelae persisted beyond six months in one tenth of patients.
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Affiliation(s)
- Anna Jakobsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Marie Thaarup Skov
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Lykke Larsen
- Research Unit for Infectious Diseases, Odense University Hospital, Odense, Denmark; University of Southern Denmark, Odense, Denmark
| | - Pelle Trier Petersen
- Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Hillerød, Denmark
| | - Christian Brandt
- Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Hillerød, Denmark.,Department of Infectious Diseases, Sjælland University Hospital, Roskilde, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Sjælland University Hospital, Roskilde, Denmark
| | | | - Hans Rudolf Lüttichau
- Department of Medicine and Infectious Diseases, Herlev Gentofte Hospital, Herlev Copenhagen, Denmark
| | - Malte Mose Tetens
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | | | - Merete Storgaard
- Department of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus N, Denmark
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jacob Bodilsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
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174
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Lindseth LRS, de Lange AMG, van der Meer D, Agartz I, Westlye LT, Tamnes CK, Barth C. Associations between reproductive history, hormone use, APOE ε4 genotype and cognition in middle- to older-aged women from the UK Biobank. Front Aging Neurosci 2022; 14:1014605. [PMID: 36760712 PMCID: PMC9907169 DOI: 10.3389/fnagi.2022.1014605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction Relative to men, women are at a higher risk of developing age-related neurocognitive disorders including Alzheimer's disease. While women's health has historically been understudied, emerging evidence suggests that reproductive life events such as pregnancy and hormone use may influence women's cognition later in life. Methods We investigated the associations between reproductive history, exogenous hormone use, apolipoprotein (APOE) ε4 genotype and cognition in 221,124 middle- to older-aged (mean age 56.2 ± 8.0 years) women from the UK Biobank. Performance on six cognitive tasks was assessed, covering four cognitive domains: episodic visual memory, numeric working memory, processing speed, and executive function. Results A longer reproductive span, older age at menopause, older age at first and last birth, and use of hormonal contraceptives were positively associated with cognitive performance later in life. Number of live births, hysterectomy without oophorectomy and use of hormone therapy showed mixed findings, with task-specific positive and negative associations. Effect sizes were generally small (Cohen's d < 0.1). While APOE ε4 genotype was associated with reduced processing speed and executive functioning, in a dose-dependent manner, it did not influence the observed associations between female-specific factors and cognition. Discussion Our findings support previous evidence of associations between a broad range of female-specific factors and cognition. The positive association between a history of hormonal contraceptive use and cognition later in life showed the largest effect sizes (max. d = 0.1). More research targeting the long-term effects of female-specific factors on cognition and age-related neurocognitive disorders including Alzheimer's disease is crucial for a better understanding of women's brain health and to support women's health care.
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Affiliation(s)
| | - Ann-Marie G. de Lange
- LREN, Department of Clinical Neurosciences, Centre for Research in Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Dennis van der Meer
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Ingrid Agartz
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm Health Care Services, Karolinska Institute, Stockholm County Council, Stockholm, Sweden
| | - Lars T. Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christian K. Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Claudia Barth
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- *Correspondence: Claudia Barth, ✉
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175
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Jarroch R, Tajik B, Tuomainen TP, Kauhanen J. Economic Recession and the Long Term Risk of Psychiatric Disorders and Alcohol Related Diseases-A Cohort Study From Eastern Finland. Front Psychiatry 2022; 13:794888. [PMID: 35250662 PMCID: PMC8891480 DOI: 10.3389/fpsyt.2022.794888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long-term development of psychiatric disorders and alcohol-related diseases after economic recessions is insufficiently studied. We investigated the overall impact of the economic recession between 1991 and 1994 in Finland on the long-term incidence of psychiatric and alcohol-related diseases. METHODS A population-based sample of 1,774 women and men aged 53-73 years were examined between 1998 and 2001 from the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Participants completed comprehensive questionnaires on the possible impact of the 1990s recession in Finland on their lives. They were followed-up until 2018. Cox proportional hazards regression was used to estimate hazard ratios (HR) of new incident psychiatric and alcohol-related disorders during the 20-years follow-up after linkage to the National Hospital Registry. Logistic regression was used to estimate odds ratios (OR) of psychiatric disorders at baseline. RESULTS At baseline, 93 participants had psychiatric disorders. During 20-years follow-up, 138 new psychiatric disorders and 45 alcohol-related diseases were developed. The covariate-adjusted risk of psychiatric disorders was over twice higher among men who experienced recession-induced hardships compared to those who did not (HR = 2.20, 95%CI = 1.04-4.70, p = 0.04). The risk of alcohol-related diseases was more than four times higher among men with hardships (HR = 4.44, 95%CI = 1.04-18.90, p = 0.04). No such associations were observed among women. No association was observed between recession-induced hardships and having psychiatric disorders at baseline in both genders (multivariate-adjusted p = 0.63 for women, multivariate-adjusted p = 0.36 for men). CONCLUSION Long-term risk of psychiatric disorders and alcohol-related diseases was increased after the 1990s economic recession in Finland, but only among middle-age and older men.
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Affiliation(s)
- Rand Jarroch
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Behnam Tajik
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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176
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Joo SW, Kim H, Jo YT, Ahn S, Choi YJ, Choi W, Park S, Lee J. One-Year Clinical Outcomes Following Electroconvulsive Therapy for Patients with Schizophrenia: A Nationwide Health Insurance Data-Based Study. Neuropsychiatr Dis Treat 2022; 18:1645-1652. [PMID: 35968513 PMCID: PMC9374090 DOI: 10.2147/ndt.s373222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although the use of electroconvulsive therapy (ECT) in the treatment of schizophrenia has decreased since the advent of antipsychotic drugs, ECT is still implemented in several clinical indications. However, a few population-based studies have examined its real-world effectiveness in schizophrenia. METHODS We used data from 2010 to 2019 from the Health Insurance Review and Assessment Service database in the Republic of Korea. We selected 380 schizophrenia patients having more than six ECT sessions and 1140 patient controls matched for age, sex, calendar year at entry, and the number of psychiatric hospitalizations before the time point of start of psychiatric hospitalization for ECT. Antipsychotic treatment discontinuation, psychiatric hospitalization, and direct medical costs were used as measures of clinical outcomes. Multiple regression analysis was used for any group-by-time interaction effect, and 1-year pre- and post-ECT periods were compared within and between the groups. RESULTS We found a significantly lower number of antipsychotic treatment discontinuations in the ECT group during the 1-year post-ECT period (t=2.195, p=0.028). A larger decrease was found in the number of psychiatric hospitalizations in the ECT group, with a group-by-time interaction effect (p=0.043). The direct medical costs in the 1-year pre- (t=-8.782, p<0.001) and post-ECT periods (t=-9.107, p<0.001) were higher in the ECT group than in the control group, with no significant change across both periods. CONCLUSION We found that the ECT group had a larger decrease in the number of psychiatric hospitalizations in the 1-year post-ECT period than the control group.
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Affiliation(s)
- Sung Woo Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Harin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Tak Jo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soojin Ahn
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Jae Choi
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woohyeok Choi
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soyeon Park
- Department of Psychiatry, Medical Foundation Yongin Mental Hospital, Yongin, Republic of Korea
| | - Jungsun Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Johanne Rozema, Christiaan L. Slim, Nic J.G.M. Veeger, Robby E. Kibbelaar, Harry de Wit, Eric N. van Roon, Mels Hoogendoorn. A clinical effect of disease-modifying treatment on alloimmunisation in transfused patients with myelodysplastic syndromes: data from a population-based study. Blood Transfus 2022; 20. [PMID: 33370223 DOI: 10.2450/2020.0168-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/09/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Alloimmunisation against blood products is an adverse event, causing time-consuming compatibility testing. Current literature has not yet identified the influence of treatment on the risk of alloimmunisation in patients with myelodysplastic syndromes (MDS). MATERIALS AND METHODS An observational, population-based study, using the HemoBase registry, was performed including all transfused patients who were diagnosed with MDS between 2005 and 2017 in Friesland, a province in the Netherlands. Information about transfusion dates, types, and treatment regimens was collected from the health records. Blood products were matched for ABO and Rhesus D. The effect of disease-modifying treatment was estimated with incidence rates and a Cox time-dependent analysis. RESULTS 233 patients were included in this study, with a median follow-up of 13.0 months. Alloimmunisation occurred in 21 patients (9.0%) and predominantly occurred early in follow-up. Three (5%) and 18 (11%) alloimmunisation events occurred in patients with and without disease-modifying treatment, respectively. The hazard ratio for alloimmunisation without treatment compared to during treatment was 2.7 (95% CI: 0.35-20.0), with incidence rates of 7.18 and 2.41 per 100 patient-years, respectively. DISCUSSION In a non-selected real-world population of MDS patients receiving blood transfusions, the percentage of patients with alloimmunisation was below 10%. The results of this study support the hypothesis that disease-modifying treatment affects the ability of the immune system to mount an antibody response to non-self blood group antigens.
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178
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Weir HK, Bryant H, Turner D, Coleman MP, Mariotto AB, Spika D, Matz M, Harewood R, Tucker TC, Allemani C. Population-Based Cancer Survival in Canada and the United States by Socioeconomic Status: Findings from the CONCORD-2 Study. J Registry Manag 2022; 49:23-33. [PMID: 37260622 PMCID: PMC10198415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Background Population-based cancer survival provides insight into the effectiveness of health systems to care for all residents with cancer, including those in marginalized groups. Methods Using CONCORD-2 data, we estimated 5-year net survival among patients diagnosed 2004-2009 with one of 10 common cancers, and children diagnosed with acute lymphoblastic leukemia (ALL), by socioeconomic status (SES) quintile, age (0-14, 15-64, ≥65 years), and country (Canada or United States). Results In the lowest SES quintile, survival was higher among younger Canadian adults diagnosed with liver (23% vs 15%) and cervical (78% vs 68%) cancers and with leukemia (62% vs 56%), including children diagnosed with ALL (92% vs 86%); and higher among older Americans diagnosed with colon (62% vs 56%), female breast (87% vs 80%), and prostate (97% vs 85%) cancers. In the highest SES quintile, survival was higher among younger Americans diagnosed with stomach cancer (33% vs 27%) and younger Canadians diagnosed with liver cancer (31% vs 23%); and higher among older Americans diagnosed with stomach (27% vs 22%) and prostate (99% vs 92%) cancers. Conclusions Among younger Canadian cancer patients in the lowest SES group, greater access to health care may have resulted in higher cancer survival, while higher screening prevalence and access to health insurance (Medicare) among older Americans during the period of this study may have resulted in higher survival for some screen-detected cancers. Higher survival in the highest SES group for stomach and liver may relate to treatment differences. Survival differences by age and SES between Canada and the United States may help inform cancer control strategies.
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Affiliation(s)
- Hannah K Weir
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Devon Spika
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rhea Harewood
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Bao J, Wang L, Hu P, Liu J, Tu J, Wang J, Li J, Ning X. Burden of Metabolic Syndrome Among a Low-Income Population in China: A Population-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:2713-2723. [PMID: 36091482 PMCID: PMC9451033 DOI: 10.2147/dmso.s377490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a chronic and complex disease associated with all-cause mortality, cardiovascular disease, and type 2 diabetes. The present study aimed to evaluate the prevalence of MetS and its risk factors among middle-aged and older adults in low-income, low-education rural areas with a high incidence of stroke. METHODS This cross-sectional study of the general population was performed from April 2019 to June 2019 in rural areas of Tianjin, China. All eligible residents aged ≥ 45 years and without active malignant tumors, hepatic failure, and severe renal disease underwent routine medical examinations, which included a questionnaire, physical examination, and routine blood and biochemical tests. The modified International Diabetes Federation criteria for the Asian population was used to identify patients with MetS. RESULTS A total of 3175 individuals (44.8% men, 55.2% women) were included in the final analysis. The prevalence of MetS was 52.8%, with higher prevalence in women than in men (62.4%and 40.9%, respectively). Of the five MetS components, high blood pressure and abdominal obesity were the two most prevalent in both women and men, accounting for 89.3% and 62.0%, respectively, followed by elevated fasting plasma glucose, low high-density lipoprotein cholesterol, and elevated triglycerides. Multivariate logistic regression analysis revealed the following traits to be risk factors for MetS: female sex, self-reported smoking, self-reported snoring, high body mass index, high waist-to-hip ratio, and high serum urate level. CONCLUSION The prevalence of MetS was quite high in rural areas with a low-income, low-education population. Implementing preventive and therapeutic interventions based on these risk factors is essential to prevent metabolic abnormalities.
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Affiliation(s)
- Jie Bao
- Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
| | - Lifeng Wang
- Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
| | - Peng Hu
- Department of Acupuncture Encephalopathy, Binhai New Area Hospital of TCM, Tianjin, 300451, People’s Republic of China
| | - Jie Liu
- Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Jun Tu
- Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Jinghua Wang
- Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
| | - Jidong Li
- Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Department of Neurosurgery, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Jidong Li, Department of Neurosurgery, Tianjin Jizhou People’s Hospital, Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of China, Tel/Fax +86-22- 60733586, Email
| | - Xianjia Ning
- Center of Clinical Epidemiology & Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China
- Correspondence: Xianjia Ning, Laboratory of Epidemiology, Tianjin Neurological Institute & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China, Tel +86-22-60817505, Fax +86-22-60817448, Email
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Bodilsen J, Helweg Larsen J, Jarløv JO, Ziebell M, Ellermand-Eriksen S, Justesen US, Frimodt-Møller N, Obel N, Omland LH. Dentist's visits and risk of brain abscess: a nationwide, population-based case control study. Clin Infect Dis 2021; 75:824-829. [PMID: 34967905 DOI: 10.1093/cid/ciab1054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Brain abscesses are frequently caused by oral cavity bacteria, but whether dental status and invasive dental procedures are important risk factors is unknown. METHODS A nationwide, population-based, case-control study examined the association between dentist's visits and invasive dental procedures and risk of brain abscess caused by oral cavity bacteria from 1989-2016. Date of brain abscess diagnosis was considered the index date. Using risk-set sampling, 10 population controls per case were individually matched by age, sex, and residential area. Conditional logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CIs), adjusted for comorbidity (aOR). RESULTS We identified 362 patients with culture-proven brain abscess caused by oral cavity bacteria. The median age was 53 years (IQR 39 - 65) and 220/362 (61%) were male. Invasive dental procedures within six months before the index date was observed in 21/362 (6%) brain abscess patients and 179/3257 (5%) population controls yielding an aOR of 1.07 (95% CI 0.67-1.70). A total of 213/362 (59%) brain abscess patients had visited their dentist within one year before the index date compared with 1944/3257 (60%) of population controls corresponding to an aOR of 0.99 (95% CI 0.77-1.26). Using no dentist's visits as reference, we observed aOR's of 0.95 (95% CI 0.64-1.40) for 1-2 visits within three years of the index date and 1.01 (95% CI 0.76-1.35) for 3 or more visits. CONCLUSIONS Recent invasive dental procedures and number of dentist's visits were not associated with culture verified brain abscess caused by oral cavity bacteria.
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Affiliation(s)
- Jacob Bodilsen
- Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark and Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Jannik Helweg Larsen
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jens Otto Jarløv
- Department of Clinical Microbiology, Copenhagen University Hospital, Herlev Hospital, Herlev, Denmark
| | - Morten Ziebell
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Ulrik S Justesen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Niels Frimodt-Møller
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Haukali Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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181
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Filler J, von Krüchten R, Wawro N, Maier L, Lorbeer R, Nattenmüller J, Thorand B, Bamberg F, Peters A, Schlett CL, Linseisen J, Rospleszcz S. Association of Habitual Dietary Intake with Liver Iron-A Population-Based Imaging Study. Nutrients 2021; 14:132. [PMID: 35011009 DOI: 10.3390/nu14010132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 01/04/2023] Open
Abstract
Iron-related disorders of the liver can result in serious health conditions, such as liver cirrhosis. Evidence on the role of modifiable lifestyle factors like nutrition in liver iron storage is lacking. Thus, we aimed to assess the association of habitual diet with liver iron content (LIC). We investigated 303 participants from the population-based KORA-MRI study who underwent whole-body magnetic resonance imaging (MRI). Dietary habits were evaluated using repeated 24 h food lists and a food frequency questionnaire. Sex-stratified multiple linear regression models were applied to quantify the association between nutrition variables of interest and LIC, adjusting for liver fat content (LFC), energy intake, and age. Mean age of participants was 56.4 ± 9.0 years and 44.2% were female. Mean LIC was 1.23 ± 0.12 mg/g dry weight, with higher values in men than in women (1.26 ± 0.13 and 1.20 ± 0.10 mg/g, p < 0.001). Alcohol intake was positively associated with LIC (men: β = 1.94; women: β = 4.98, p-values < 0.03). Significant negative associations with LIC were found for fiber (β = −5.61, p < 0.001) and potassium (β = −0.058, p = 0.034) for female participants only. Furthermore, LIC was highly correlated with liver fat content in both sexes. Our findings suggests that there are sex-specific associations of habitual dietary intake and LIC. Alcohol, fiber, and potassium may play a considerable role in liver iron metabolism.
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182
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McHugh JW, Talha KM, Baddour LM, Fischer KM, Crestanello J, Arghami A, DeSimone DC. Bloodstream Infection Following Cardiac Valve Repair: A Population-Based Study. Open Forum Infect Dis 2021; 8:ofab493. [PMID: 34938821 PMCID: PMC8687125 DOI: 10.1093/ofid/ofab493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/23/2021] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study was to determine the incidence, epidemiology, and
associated risk factors of bloodstream infection (BSI) in patients who had
previously undergone cardiac valve repair. Methods A population-based study that included 7 counties in southeastern Minnesota
using the expanded Rochester Epidemiology Project (e-REP) for adults
(≥18 years) who underwent valve repair between 1 January 2010 and 31
December 2018 was conducted. Electronic health records were screened for
development of BSI and infective endocarditis (IE) from the date of valve
repair through 30 July 2020. A 1:4 nested case-control analysis was
performed to determine an association, if any, of male sex, Charlson
comorbidity index (CCI), and county of residence with BSI. Results A total of 335 patients underwent valve repair, of whom 28 (8.3%) developed
an index case of BSI, with 14 episodes occurring within 1 year of surgery.
The median age of patients with BSI was 70 years, and 79% were male. The
crude incidence of BSI was 1671 cases per 100000 person-years and
Escherichia coli was the most common pathogen.
Case-control analysis demonstrated a significant correlation between CCI and
incidence of BSI (P < .001). Only 4 (14.3%)
patients developed IE concurrent with the onset of BSI, and no patients
developed IE subsequent to BSI. Conclusions The crude incidence of BSI following valve repair was higher in our e-REP
cohort than previous population-based studies, and half of the BSI cases
occurred within 1 year of surgery. Patients with a higher CCI at baseline
were at increased risk of subsequent BSI.
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Affiliation(s)
- Jack W McHugh
- Department of Internal Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Khawaja M Talha
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Larry M Baddour
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Cardiovascular Disease, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Karen M Fischer
- Department of Biomedical Statistics and Informatics, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Juan Crestanello
- Division of Cardiovascular Surgery, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Arman Arghami
- Division of Cardiovascular Surgery, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Daniel C DeSimone
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Cardiovascular Disease, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
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183
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Laupland KB, Shekar K, Tabah A, Clement P, Edwards F, Ramanan M. Excess Burden of Critical Illness Related to Inflammatory Bowel Disease. Intern Med J 2021; 53:812-818. [PMID: 34932276 DOI: 10.1111/imj.15672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although inflammatory bowel disease (IBD) is associated with major morbidity and mortality, few studies have evaluated its associated burden of critical illness. AIMS We sought to examine the epidemiology and outcome of ICU admission among patients with IBD in north Brisbane, Australia. METHODS A population-based cohort design was utilized. All admissions to ICUs serving the Metro North Hospital and Health Service among adult residents during 2017-2019 were included. Data were obtained from ICU clinical information systems with linkages to statewide admissions and death registries. RESULTS Among 9,011 ICU admissions, 101 (1.1%) were among patients with IBD of which 57 (0.6%) and 44 (0.5%) had UC and CD, respectively. The incidence of ICU admission was 379, 1,336, 1,514, and 1,429 per 100,000 annually among those without IBD, CD, UC and IBD, respectively. Patients with IBD were at excess risk for admission across all age groups with women at highest risk under age 50 and men thereafter. The all cause 90-day case-fatality rates following ICU admission were not significantly different among patient groups and were 18%, 12%, 15%, and 12% for CD, UC, IBD, and non-IBD, respectively. However, as compared to non-IBD patients, those with CD (151.8 vs. 39.4 per 100,000; RR 3.85; 95% CI, 1.25-9.02; p=0.013); UC (159.4 vs 39.4 per 100,000; RR 4.05; 95% CI, 1.48-8.84; p=0.005), and IBD 155.6 vs 39.4 per 100,000; RR 3.95; 95% CI, 1.96-7.10; p=0.002) were at significantly higher risk for mortality. CONCLUSIONS Patients with IBD suffer a major burden of critical illness. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kevin B Laupland
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kiran Shekar
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Intensive Care Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Alexis Tabah
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Intensive Care Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Pierre Clement
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Felicity Edwards
- Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Mahesh Ramanan
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Intensive Care Unit, Caboolture Hospital, Caboolture, Queensland, Australia
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Lastrucci V, Lorini C, Del Riccio M, Gori E, Chiesi F, Moscadelli A, Zanella B, Boccalini S, Bechini A, Puggelli F, Berti R, Bonanni P, Bonaccorsi G. The Role of Health Literacy in COVID-19 Preventive Behaviors and Infection Risk Perception: Evidence from a Population-Based Sample of Essential Frontline Workers during the Lockdown in the Province of Prato (Tuscany, Italy). Int J Environ Res Public Health 2021; 18:13386. [PMID: 34948995 DOI: 10.3390/ijerph182413386] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 01/04/2023]
Abstract
Background: The effectiveness of pandemic control measures requires a broad understanding from the population. This study aimed to evaluate the role played by health literacy (HL) in influencing the adherence to COVID-19 preventive measures and risk perception of essential frontline workers during the lockdown period. Methods: A cross-sectional survey was conducted on a population-based sample of frontline workers from Prato Province (Italy). Data on knowledge, attitudes and practices towards COVID-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Multivariate linear regression analyses were performed. Results: A total of 751 people participated in this study, and 56% of the sample showed a sufficient level of HL. In the multivariate models, HL resulted in being positively correlated with both knowledge (beta 0.32 for sufficient HL, 0.11 for problematic HL) and attitudes (beta 0.33 for sufficient HL, 0.17 for problematic HL) towards the importance of COVID-19 preventive measures. The HL level was not associated with the adoption of preventive behaviors and COVID-19 risk perception. Conclusions: HL may play a key role in maintaining a high adherence to infection prevention behaviors and may be a factor to take into account in the implementation of public health interventions in pandemic times.
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Rutherford MJ, Arnold M, Bardot A, Ferlay J, De P, Tervonen H, Little A, Bucher O, St Jacques N, Gavin A, Engholm G, Møller B, O'Connell DL, Merrett N, Parkin DM, Bray F, Soerjomataram I. Comparison of liver cancer incidence and survival by subtypes across seven high-income countries. Int J Cancer 2021; 149:2020-2031. [PMID: 34460109 DOI: 10.1002/ijc.33767] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 01/08/2023]
Abstract
International comparison of liver cancer survival has been hampered due to varying standards and degrees for morphological verification and differences in coding practices. This article aims to compare liver cancer survival across the International Cancer Benchmarking Partnership's (ICBP) jurisdictions whilst trying to ensure that the estimates are comparable through a range of sensitivity analyses. Liver cancer incidence data from 21 jurisdictions in 7 countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the United Kingdom) were obtained from population-based registries for 1995-2014. Cases were categorised based on histological classification, age-groups, basis of diagnosis and calendar period. Age-standardised incidence rate (ASR) per 100 000 and net survival at 1 and 3 years after diagnosis were estimated. Liver cancer incidence rates increased over time across all ICBP jurisdictions, particularly for hepatocellular carcinoma (HCC) with the largest relative increase in the United Kingdom, increasing from 1.3 to 4.4 per 100 000 person-years between 1995 and 2014. Australia had the highest age-standardised 1-year and 3-year net survival for all liver cancers combined (48.7% and 28.1%, respectively) in the most recent calendar period, which was still true for morphologically verified tumours when making restrictions to ensure consistent coding and classification. Survival from liver cancers is poor in all countries. The incidence of HCC is increasing alongside the proportion of nonmicroscopically verified cases over time. Survival estimates for all liver tumours combined should be interpreted in this context. Care is needed to ensure that international comparisons are performed on appropriately comparable patients, with careful consideration of coding practice variations.
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Affiliation(s)
- Mark J Rutherford
- International Agency for Research on Cancer, Lyon, France
- Biostatistics Research Group, University of Leicester, Leicester, UK
| | - Melina Arnold
- International Agency for Research on Cancer, Lyon, France
| | - Aude Bardot
- International Agency for Research on Cancer, Lyon, France
| | - Jacques Ferlay
- International Agency for Research on Cancer, Lyon, France
| | - Prithwish De
- Analytics and Informatics, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | | | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Nathalie St Jacques
- Nova Scotia Health Authority Cancer Care Program, Registry & Analytics, Halifax, Nova Scotia, Canada
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Gerda Engholm
- Danish Cancer Society Research Centre, Cancer Surveillance and Pharmacoepidemiology, Copenhagen, Denmark
| | - Bjørn Møller
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney (A Joint Venture with Cancer Council NSW), Camperdown, Australia
| | - Neil Merrett
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Donald Maxwell Parkin
- International Agency for Research on Cancer, Lyon, France
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
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186
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Tagliabue G, Fabiano S, Contiero P, Barigelletti G, Castelli M, Mazzoleni G, Boschetti L, Fanetti AC, Puppo A, Musolino A, Cirilli C, Seghini P, Mangone L, Caldarella A, Lotti F, Mazzucco W, Benedetto A, Dinaro YM, Sferrazza A, Pinna P, Perotti V. Molecular Subtypes, Metastatic Pattern and Patient Age in Breast Cancer: An Analysis of Italian Network of Cancer Registries (AIRTUM) Data. J Clin Med 2021; 10:jcm10245873. [PMID: 34945169 PMCID: PMC8706111 DOI: 10.3390/jcm10245873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Breast cancer stage at diagnosis, patient age and molecular tumor subtype influence disease progression. The aim of this study was to analyze the relationships between these factors and survival in breast cancer patients among the Italian population using data from the AIRTUM national database. We enrolled women with primary breast cancer from 17 population-based cancer registries. Patients were subdivided into older (>69 years), middle (50–69 years) and younger age groups (<50 years) and their primary tumors categorized into four molecular subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 8831 patients diagnosed between 2010 and 2012 included. The most represented age group was 50–69 years (41.7%). In 5735 cases the molecular subtype was identified: HER2–/HR+ was the most frequent (66.2%) and HER2+/HR− the least (6.2%). Of the 390 women with metastases at diagnosis, 38% had simultaneous involvement of multiple sites, independent of age and molecular profile. In women with a single metastatic site, bone (20% of cases), liver (11%), lung (7%) and brain (3%) were the most frequent. In the studied age groups with different receptor expression profiles, the tumor metastasized to target organs with differing frequencies, affecting survival. Five-year survival was lowest in women with triple-negative (HER2−/HR–) tumors and women with brain metastases at diagnosis.
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Affiliation(s)
- Giovanna Tagliabue
- Cancer Registry Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy; (S.F.); (G.B.); (V.P.)
- Correspondence:
| | - Sabrina Fabiano
- Cancer Registry Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy; (S.F.); (G.B.); (V.P.)
| | - Paolo Contiero
- Environmental Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Giulio Barigelletti
- Cancer Registry Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy; (S.F.); (G.B.); (V.P.)
| | - Maurizio Castelli
- Cancer Registry, Aosta Valley Health Authorities Department of Public Health, 11100 Aosta, Italy;
| | - Guido Mazzoleni
- Cancer Registry, South-Tyrol Local Health Trust, 39100 Bolzano, Italy;
| | - Lorenza Boschetti
- Cancer Registry, Epidemiology Monitoring Unit, Public Health Agency of Pavia, 27100 Pavia, Italy;
| | - Anna Clara Fanetti
- Sondrio Cancer Registry, Health Protection Agency, 23100 Sondrio, Italy;
| | - Antonella Puppo
- Clinical Epidemiology Unit, Liguria Cancer Registry, IRCCS-Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Antonino Musolino
- Department of Medicine and Surgery, University of Parma, Medical Oncology, Cancer Registry, University Hospital of Parma, 43100 Parma, Italy;
| | | | - Pietro Seghini
- Cancer Registry, Department of Epidemiology, Piacenza General Hospital, 29121 Piacenza, Italy;
| | - Lucia Mangone
- Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, 42121 Reggio Emilia, Italy;
| | - Adele Caldarella
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
| | - Fernanda Lotti
- Section of the Puglia Cancer Registry, Cancer Registry, Local Health Unit Brindisi, 72100 Brindisi, Italy;
| | - Walter Mazzucco
- Department of Sciences for Health Promotion and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, 90128 Palermo, Italy;
| | - Andrea Benedetto
- Integrated Cancer Registry of Catania-Messina-Enna, Department of Hygiene and Public Health, 95100 Catania, Italy;
| | | | - Ausilia Sferrazza
- Ragusa Cancer Registry, Provincial Health Unit, 97100 Ragusa, Italy;
| | - Pasquala Pinna
- Nuoro Cancer Registry, ASSL Nuoro/ATS Sardegna, 08100 Nuoro, Italy;
| | - Viviana Perotti
- Cancer Registry Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy; (S.F.); (G.B.); (V.P.)
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187
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N’Dri LA, Waters DD, Walsh K, Mehta F, Oliver BJ. System-Level Variation in Multiple Sclerosis Disease-Modifying Therapy Utilization: Findings From the Multiple Sclerosis Continuous Quality Improvement Research Collaborative. Perm J 2021; 25:21.025. [PMID: 35348092 PMCID: PMC8784072 DOI: 10.7812/tpp/21.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/30/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Multiple Sclerosis Continuous Quality Improvement (MS-CQI) Collaborative is the first multicenter improvement research collaborative for multiple sclerosis (MS). The main objective of this study is to describe baseline system-level variation in disease-modifying therapy (DMT) utilization across 4 MS centers participating in MS-CQI. METHODS Electronic health record data from the first year of the 3-year MS-CQI study were analyzed. Participants were adults ≥ 18 years with MS presenting to any of the 4 MS-CQI centers. DMT utilization was categorized into oral, infusion, and injection types. Multinomial logistic regression was used to investigate associations between centers and DMT utilization. RESULTS Overall, 2,029 patients were included in the analysis. Of those patients, 75.1% were female, mean age was 50 years, and 87.4% had relapsing-remitting MS. Overall, 32.7% were on an oral DMT, 23.5% on an infusion DMT, and 43.9% on an injection DMT. Overall, statistically significant differences (p < 0.01) were observed across centers for proportions of patients who received oral, infusion, and no DMTs. There were also overall significant differences (p < 0.01) across MS types for proportions of encounters who received oral, infusion, injection, no DMTs, and mean age varied significantly across centers. CONCLUSION System-level effects on MS treatment and outcomes have not been previously studied and our findings contribute initial evidence concerning system-level variation in DMT utilization. Results suggest system-level variation in DMT utilization (ie, after adjusting for individual level factors, MS center or location of care a person with MS engages in care influences DMT treatment choices), resulting in a lack of standardization in DMT management. Continued research and improvement efforts targeting system-level performance could improve outcomes for people with MS.
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Affiliation(s)
| | | | - Karen Walsh
- Jefferson College of Population Health, Philadelphia, PA
| | - Falguni Mehta
- Departments of Community and Family Medicine, Psychiatry, and the Dartmouth Institute for Health Policy and Clinical Practice (TDI), Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Brant J Oliver
- Departments of Community and Family Medicine, Psychiatry, and the Dartmouth Institute for Health Policy and Clinical Practice (TDI), Geisel School of Medicine at Dartmouth, Hanover, NH
- Dartmouth-Hitchcock Health, Lebanon, NH
- Department of Veterans Affairs National Quality Scholars (VAQS) and Health Professions Education and Evaluation Research (HPEER) Advanced Fellowship Programs, White River Junction, VT and Houston, TX
| | - for the MS-CQI Investigators
- Jefferson College of Population Health, Philadelphia, PA
- Departments of Community and Family Medicine, Psychiatry, and the Dartmouth Institute for Health Policy and Clinical Practice (TDI), Geisel School of Medicine at Dartmouth, Hanover, NH
- Dartmouth-Hitchcock Health, Lebanon, NH
- Department of Veterans Affairs National Quality Scholars (VAQS) and Health Professions Education and Evaluation Research (HPEER) Advanced Fellowship Programs, White River Junction, VT and Houston, TX
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188
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Yang Z, Wang F, Tan F, Cao W, Xu Y, Qin C, Yu Y, Zhao L, Wen Y, Wu Z, Zheng Y, Liu Y, Yu L, Wei D, Dong D, Cao J, Zhang S, Yan S, Wang N, Liao X, Du L, Li J, Li N, Chen W, He J. Menstrual factors, reproductive history, and risk of lung cancer: a multi-center population-based cohort study in Chinese females. Transl Lung Cancer Res 2021; 10:3912-3928. [PMID: 34858781 PMCID: PMC8577983 DOI: 10.21037/tlcr-21-552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/16/2021] [Indexed: 12/24/2022]
Abstract
Background Female menstrual and reproductive factors, as remarkable indicators of hormone effect, were hypothesized to be associated with lung cancer risk, whereas the existed epidemiological evidence was inconsistent. Our study aims to investigate the association between menstrual and reproductive factors and lung cancer risk based on the Chinese Lung Cancer Screening Program. Methods This study was based on a large-scale multi-center population cohort across China recruiting individuals aged 40–74 years old between 2013–2018. Cox regression model was applied to estimate the HRs and 95% CIs. Restricted cubic spline (RCS) analysis was used to estimate dose-response relationships and test for nonlinear associations. Results Among 553,434 female participants, 1,529 incident lung cancer cases were identified with a median follow-up of 3.61 years. With adjustment for multiple covariates and all significant hormonal factors, elevated lung cancer risk was associated with later age (15, or ≥16 years) at menarche (HR =1.27, 95% CI: 1.04–1.56; HR =1.45, 95% CI: 1.19–1.76), later age (25–29, or ≥30 years) at first live birth (HR =1.27, 95% CI: 1.13–1.43; HR =1.23, 95% CI: 1.00–1.51), and benign breast disease history (HR =1.25, 95% CI: 1.10-1.41). For postmenopausal females specifically, surgical menopause (HR =1.62; 95% CI: 1.29–2.05) and other surgeries on the reproductive system (HR =1.19; 95% CI: 1.01–1.40) both appeared to be predictive of elevated lung cancer risk. Concerning age at menopause, a nonlinear association was observed (P-nonlinear =0.0126). Increased lung cancer risk was observed among females with age at menopause especially above 50. Although we observed no significant associations between longer time (≥13 months) of breastfeeding and lung cancer risk among all participants (HR =0.86; 95% CI: 0.71–1.04), significant decreased adenocarcinoma risk (HR =0.65; 95% CI: 0.53–0.81) was noted among nonsmoking females. Conclusions Our findings add some support for the role of menstrual and reproductive factors in lung carcinogenesis. However, these relationships were complex, and required further investigations addressing the biological mechanisms.
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Affiliation(s)
- Zhuoyu Yang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Cao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongjie Xu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Qin
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiwen Yu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Zhao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Wen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Wu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yadi Zheng
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunyong Liu
- Department for Cancer Prevention and Treatment of Liaoning Province/Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China.,Division of Pneumoconiosis School of Public Health, China Medical University, Shenyang, China
| | - Lianzheng Yu
- Department of Noncommunicable Chronic Disease Prevention, Liaoning Center for Disease Control and Prevention, Shenyang, China
| | - Donghua Wei
- Cancer Department of Physical Examination, Anhui Provincial Cancer Hospital, Hefei, China
| | - Dong Dong
- Office of Cancer Prevention and Treatment, Xuzhou Cancer Hospital, Xuzhou, China
| | - Ji Cao
- Department of Experimental Pathology, Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Shipeng Yan
- Department of Cancer Prevention and Control, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ning Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xianzhen Liao
- Department of Cancer Prevention and Control, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Lingbin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/IBMC, Chinese Academy of Sciences, Hangzhou, China
| | - Jiang Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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189
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Majithia S, Tham YC, Chun Yuen CC, Yu M, Yim-Lui Cheung C, Bikbov MM, Kazakbaeva GM, Wang N, Hao J, Cao K, Wang YX, Sasaki M, Ito Y, Wong IY, Cheuk-Hung Chan J, Khanna R, Marmamula S, Nakano E, Mori Y, Aung T, Wong TY, Jonas JB, Miyake M, Cheng CY. Retinal Nerve Fiber Layer Thickness and Rim Area Profiles in Asians: Pooled Analysis from the Asian Eye Epidemiology Consortium. Ophthalmology 2021; 129:552-561. [PMID: 34856231 DOI: 10.1016/j.ophtha.2021.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate ethnic variations, ocular and systemic determinants of retinal nerve fibre layer (RNFL) thickness and neuroretinal rim area among Asians, using a large consortium of population-based eye studies. DESIGN Cross-sectional pooled-analysis. PARTICIPANTS 22436 participants (22436 eyes) from 10 population-based studies (China, Hong Kong, India, Japan, Russia and Singapore) of the Asian Eye Epidemiology Consortium. METHODS Participants aged ≥40 years without glaucoma were included. All participants underwent spectral domain optical coherence tomography (OCT) imaging, systemic and ocular examinations. Data were pooled from each study. Multivariable regression analysis was performed to evaluate inter-ethnic, inter-machine variations, ocular and systemic factors associated with RNFL thickness and rim area, adjusting for age, gender, diabetes, intraocular pressure (IOP), spherical equivalent (SE), ethnicity, OCT model, and study group. When evaluating body mass index, smoking, and hypertension as exposures, these factors were additionally adjusted in the model. MAIN OUTCOME MEASURE Average RNFL thickness (μm) and rim area (mm2) RESULTS: Indian and Japanese eyes showed thinner RNFL, compared to other Asian ethnicities (β values ranging 7.31-12.76μm, P<0.001 for all pair-wise comparisons). Compared to measurements by Cirrus HD-OCT, RNFL was on average 7.29μm thicker when measured by Spectralis, 12.85μm thicker by Nidek, and 17.48μm thicker by Optovue (all P<0.001). Additionally, older age (per decade, β=-2.70; 95% confidence interval [CI], -2.85 to -2.55), diabetes (β=-0.72; 95%CI, -1.20 to -0.24), ), higher IOP (per mmHg, β=-0.07; 95% CI, -0.10 to -0.04), more myopic SE (per dioptre, β=-1.13; 95% CI, -1.19 to -1.07), cardiovascular disease (CVD, β=-0.94; 95% CI, -1.49 to -0.40), and hypertension (β=-0.68; 95% CI, -1.04 to -0.32), were associated with thinner RNFL (all P≤0.003). Similarly, older age (β=-0.019; 95% CI, -0.028 to -0.009), higher IOP (β=-0.010; 95% CI, -0.013 to -0.008) and more myopic SE (β=-0.025; 95% CI, -0.029 to -0.021) were associated with smaller rim area (all P<0.001). CONCLUSIONS In this large pooled-analysis of multiple Asian population studies, Indian and Japanese eyes were observed to have thinner RNFL profiles. In addition to previously known determinants, hypertension and CVD were associated with thinner RNFL. These findings further suggest the need of ethnic-specific normative database to improve glaucoma detection.
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Affiliation(s)
- Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | | | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Carol Yim-Lui Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | | | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Jie Hao
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Mariko Sasaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshikazu Ito
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Ian Y Wong
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology, The Hong Kong Sanatorium & Hospital, Hong Kong SAR, China
| | - Jonathan Cheuk-Hung Chan
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Rohit Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Welcome Trust/Department of Biotechnology India Alliance Research Fellow, LV Prasad Eye Institute, Hyderabad, India
| | - Eri Nakano
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology Basel, Switzerland; Private Practice Professor Jonas and Dr. Panda-Jonas, Heidelberg, Germany
| | - Masahiro Miyake
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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190
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Montiel Ishino FA, Odame EA, Villalobos K, Rowan C, Whiteside M, Mamudu H, Williams F. Sociodemographic and Geographic Disparities of Prostate Cancer Treatment Delay in Tennessee: A Population-Based Study. Am J Mens Health 2021; 15:15579883211057990. [PMID: 34836465 PMCID: PMC8646205 DOI: 10.1177/15579883211057990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The relationship of social determinants of health, Appalachian residence, and prostate cancer treatment delay among Tennessee adults is relatively unknown. We used multivariate logistic regression on 2005–2015 Tennessee Cancer Registry data of adults aged ≥18 diagnosed with prostate cancer. The outcome of treatment delay was more than 90 days without surgical or nonsurgical intervention from date of diagnosis. Social determinants in the population-based registry were race (White, Black, Other) and marital status (single, married, divorced/separated, widow/widower). Tennessee residence was classified as Appalachian versus non-Appalachian (urban/rural). Covariates include age at diagnosis (18–54, 54–69, ≥70), health insurance type (none, public, private), derived staging of cancer (localized, regional, distant), and treatment type (non-surgical/surgical). We found that Black and divorced/separated patients had 32% (95% confidence interval [CI]: 1.22–1.42) and 15% (95% CI: 1.01–1.31) increased odds to delay prostate cancer treatment. Patients were at decreased odds of treatment delay when living in an Appalachian county, both urban (odds ratio [OR] = 0.89, 95% CI: 0.82–0.95) and rural (OR = 0.83, 95% CI: 0.78–0.89), diagnosed at ≥70 (OR = 0.59, 95% CI: 0.53–0.66), and received surgical intervention (OR = 0.72, 95% CI: 0.68–0.76). Our study was among the first to comprehensively examine prostate cancer treatment delay in Tennessee, and while we do not make clinical recommendations, there is a critical need to further explore the unique factors that may propagate disparities. Prostate cancer treatment delay in Black patients may be indicative of ongoing health and access disparities in Tennessee, which may further affect quality of life and survivorship among this racial group. Divorced/separated patients may need tailored interventions to improve social support.
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Affiliation(s)
- Francisco A Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Emmanuel A Odame
- Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kevin Villalobos
- Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Claire Rowan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Martin Whiteside
- Tennessee Cancer Registry, Tennessee Department of Health, Nashville, TN, USA
| | - Hadii Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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191
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Olson R, McLay M, Hamm J, Callaghan RC. Identification of Tobacco-Related Cancer Diagnoses among Individuals with Psychiatric Disorders: A Population-Based Matched Cohort Study Using a Competing Risks Approach from British Columbia. Curr Oncol 2021; 28:4953-4960. [PMID: 34898588 PMCID: PMC8628717 DOI: 10.3390/curroncol28060415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/15/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Individuals with psychiatric disorders (PD) have a high prevalence of tobacco use. Therefore, we assessed the hazard of receiving a tobacco-related (TR) cancer diagnosis among individuals with PD. METHODS Several population-based provincial databases were used to identify individuals in BC diagnosed with depression, schizophrenia, bipolar disorder, anxiety disorders, or multiple PD between 1990 and 2013. A primary population proxy comparison group (appendicitis) was also identified and matched to the psychiatric cohort based on age at cohort entry, gender, year of cohort entry, and postal code. We linked individuals in the cohort and comparison groups with the BC Cancer Registry. Using a competing risks approach, we estimated the effect of having a PD on the risk of receiving a TR cancer diagnosis, in light of the competing risk of mortality. RESULTS In total, 165,289 patients were included. Individuals with depression (HR = 0.81; p < 0.01; 95% CI: 0.73-0.91), anxiety disorders (HR = 0.84; p = 0.02; 95% CI: 0.73-0.97), or multiple PD (HR = 0.74; p < 0.01; 95% CI: 0.66-0.83) had a statistically significant lower risk of a TR cancer diagnosis compared to the comparison group. Individuals with schizophrenia (HR = 0.86; p = 0.40; 95% CI: 0.62-1.21) or bipolar disorder (HR = 0.58; p = 0.12; 95% CI: 0.29-1.14), however, showed no evidence of a statistically significant difference from the comparison group. INTERPRETATION We found that individuals with depression, anxiety disorders, or multiple PD diagnoses had a significantly reduced risk of receiving a tobacco-related cancer diagnosis. These results were unexpected and could be explained by individuals with a PD having barriers to a cancer diagnosis rather than a true decreased incidence.
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Affiliation(s)
- Robert Olson
- Department of Radiation Oncology, BC Cancer—Prince George, 1215 Lethbridge Street, Prince George, BC V2M 7E9, Canada
- Department of Surgery, Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Northern Medical Program, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada;
| | - Mary McLay
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Jeremy Hamm
- Department of Statistics, BC Cancer—Vancouver, Vancouver, BC V5Z 4E6, Canada;
| | - Russell C. Callaghan
- Northern Medical Program, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada;
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Bianchi E, Pupillo E, De Feudis A, Enia G, Vitelli E, Beghi E. Trends in survival of ALS from a population-based registry. Amyotroph Lateral Scler Frontotemporal Degener 2021; 23:344-352. [PMID: 34818115 DOI: 10.1080/21678421.2021.2004167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: To assess survival of ALS patients in general and in selected demographic and clinical subgroups comparing two periods (1998-2000 vs. 2008-2010). Methods: Newly diagnosed adults resident of Lombardy, Northern Italy from a population-based registry were included. Data were collected on age at diagnosis, sex, site of onset, diagnostic delay, and El-Escorial diagnostic category. Patients were followed until death or last observation. Survival was evaluated using Kaplan-Meier curves and Cox's proportional hazards models. Results: In 2008-2010 (267 patients), median survival was 2.4 years and 1-year, 2-year, 3-year and 5-year survival rates were 79%, 56%, 41% and 24%. Longer survival was associated with male sex, younger age, spinal onset, and longer diagnostic delay. Multivariable analysis confirmed higher death in 65-69yr (HR 2.8; 95% CI 1.4-5.6), 70-74yr (HR 3.2; 95% CI 1.6-6.3) and 75 + yr (HR 6.9; 95% CI 3.5-13.8) categories, compared to ≤49yr, in females (HR 1.4; 95% CI 1.02-1.8), compared to males, and in patients diagnosed after 6-12 months (HR 1.9; 95% CI 1.4-2.7), compared with longer diagnostic delay. In 1998-2000 (235 patients), median survival was 2.2 years. The 1-year, 2-year, 3-year and 5-year survival rates were 77%, 53%, 38% and 20%. When adjusting for demographic and clinical variables, the HR for death in 2008-2010 versus 1998-2000 was 0.80 (95% CI 0.66-0.98). A significant increase of survival in 2008-2010 was found only in patients aged 50-59yr and 70-74yr at diagnosis. Conclusions: Survival of ALS has increased over time in the last decades, especially in middle aged and elderly patients. The benefits of comprehensive care in selected age groups might explain our findings.
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Affiliation(s)
- Elisa Bianchi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Antonio De Feudis
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Gabriele Enia
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Eugenio Vitelli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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193
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Sun LM, Sun S, Lin CL, Kao CH. Adjuvant radiotherapy did not increase the risk of coronary heart disease in patients with non-metastatic breast cancer. Postgrad Med 2021; 134:413-419. [PMID: 34689679 DOI: 10.1080/00325481.2021.1997509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Adjuvant radiotherapy (RT) in patients with breast cancer can adversely cause the heart to receive some radiation doses, which may lead to cardiovascular diseases. The results of previous research regarding this issue are not consistent. Therefore, we conducted a nationwide population-based study in Taiwan to evaluate whether adjuvant RT for breast cancer patients increased the risk of developing coronary heart disease (CHD). METHODS This retrospective cohort study examined data from the National Health Insurance Research Database, Registry for Catastrophic Illness Patients, and Taiwan Cancer Registry Database. We identified 83,733 patients with breast cancer between 1 January 2000 and 31 December 2017. Individuals without breast cancer from the general population were frequency-matched by age and index year with individuals with breast cancer. Participants were followed until the occurrence of a CHD event, the end of follow-up, or patient record removal due to death or withdrawal from the NHI. A Cox proportional hazards regression analysis was conducted to compare the risk of CHD in breast cancer patients with that in patients in the comparison cohort. RESULTS Compared to breast cancer patients without RT, those who underwent RT had a similar risk of subsequently developing CHD (adjusted hazard ratio, 0.94; 95% confidence interval, 0.87-1.02). Similar results were observed in a subgroup of patients with left-sided breast cancer. However, among patients who received adjuvant RT, those with left-sided breast cancer had a significantly higher risk of CHD than did those with right-sided breast cancer (adjusted hazard ratio, 1.17; 95% confidence interval, 1.04-1.30). Patients who received RT in 2010 or later had a significantly lower risk of CHD compared with those who received RT before 2010 (adjusted hazard ratio, 0.64; 95% confidence interval, 0.45-0.91). Higher prescribed doses of RT to the left-sided breast did not correspond to a higher risk of CHD. CONCLUSION This large, nationwide cohort study suggests that adjuvant RT in patients with breast cancer did not increase the risk of CHD.
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Affiliation(s)
- Li-Min Sun
- Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.,Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Sean Sun
- Department of Perfusion, University of Florida Health Shands Hospital, Gainesville, FL, USA
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and Pet Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
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194
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Cuypers M, Schalk BWM, Boonman AJN, Naaldenberg J, Leusink GL. Cancer-related mortality among people with intellectual disabilities: A nationwide population-based cohort study. Cancer 2021; 128:1267-1274. [PMID: 34787906 PMCID: PMC9299498 DOI: 10.1002/cncr.34030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022]
Abstract
Background Concerns have been raised about access to cancer screening and the timely receipt of cancer care for people with an intellectual disability (ID). However, knowledge about cancer mortality as a potential consequence of these disparities is still limited. This study, therefore, compared cancer‐related mortality patterns between people with and without ID. Methods A historical cohort study (2015‐2019) linked the Dutch adult population (approximately 12 million people with an ID prevalence of 1.45%) and mortality registries. Cancer‐related mortality was identified by the underlying cause of death (according to the chapter on neoplasms in the International Classification of Diseases, Tenth Revision). Observed mortality and calculated age‐ and sex‐standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) were reported. Results There were 11,102 deaths in the ID population (21.7% cancer‐related; n = 2408) and 730,405 deaths in the general population (31.2%; n = 228,120) available for analysis. Cancer was noted as the cause of death more often among people with ID in comparison with the general population (SMR, 1.48; 95% CI, 1.42‐1.54), particularly in the young age groups. High‐mortality cancers included cancers within the national screening program (SMRs, 1.43‐1.94), digestive cancers (SMRs, 1.24‐2.56), bladder cancer (SMR, 2.07; 95% CI, 1.61‐2.54), and cancers of unknown primary (SMR, 2.48; 95% CI, 2.06‐2.89). Conclusions Cancer was reported as the cause of death approximately 1.5 times more often in people with ID compared with the general population. This mortality disparity may indicate adverse effects from inequalities in screening and cancer care experienced by people with ID. Lay Summary People with an intellectual disability (ID) may find it challenging to participate in cancer screening or to receive timely cancer care. To understand potential consequences in terms of mortality, this study compared cancer‐related mortality between people with and without ID in the Netherlands. Cancer was reported as the cause of death approximately 1.5 times more often among people with ID than others. Because large differences were found that were related to screening cancers and cancers for which the primary tumor was unknown, this study's results raise concerns about equality in screening practices and cancer care for people with ID.
Cancer is reported as the cause of death approximately 1.5 times more often in people with an intellectual disability compared with those without one. Differences are particularly noted for deaths related to cancers within the national screening program and cancers of unknown primary.
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Affiliation(s)
- Maarten Cuypers
- Department of Primary and Community CareRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenthe Netherlands
| | - Bianca W. M. Schalk
- Department of Primary and Community CareRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenthe Netherlands
| | - Anne J. N. Boonman
- Department of Primary and Community CareRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenthe Netherlands
| | - Jenneken Naaldenberg
- Department of Primary and Community CareRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenthe Netherlands
| | - Geraline L. Leusink
- Department of Primary and Community CareRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenthe Netherlands
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195
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Reisel D, Burnell M, Side L, Loggenberg K, Gessler S, Desai R, Sanderson S, Brady AF, Dorkins H, Wallis Y, Jacobs C, Legood R, Beller U, Tomlinson I, Wardle J, Menon U, Jacobs I, Manchanda R. Jewish cultural and religious factors and uptake of population-based BRCA testing across denominations: a cohort study. BJOG 2021; 129:959-968. [PMID: 34758513 DOI: 10.1111/1471-0528.16994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/11/2021] [Accepted: 09/30/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate the association of Jewish cultural and religious identity and denominational affiliation with interest in, intention to undertake and uptake of population-based BRCA (Breast Cancer Gene)-testing. DESIGN Cohort-study set within recruitment to GCaPPS-trial (ISRCTN73338115). SETTING London Ashkenazi-Jewish (AJ) population. POPULATION OR SAMPLE AJ men and women, >18 years. METHODS Participants were self-referred, and attended recruitment clinics (clusters) for pre-test counselling. Subsequently consenting individuals underwent BRCA testing. Participants self-identified to one Jewish denomination: Conservative/Liberal/Reform/Traditional/Orthodox/Unaffiliated. Validated scales measured Jewish Cultural-Identity (JI) and Jewish Religious-identity (JR). Four-item Likert-scales analysed initial 'interest' and 'intention to test' pre-counselling. Item-Response-Theory and graded-response models, modelled responses to JI and JR scales. Ordered/multinomial logistic regression modelling evaluated association of JI-scale, JR-scale and Jewish Denominational affiliation on interest, intention and uptake of BRCA testing. MAIN OUTCOME MEASURES Interest, intention, uptake of BRCA testing. RESULTS In all, 935 AJ women/men of mean age = 53.8 (S.D = 15.02) years, received pre-test education and counselling through 256 recruitment clinic clusters (median cluster size = 3). Denominational affiliations included Conservative/Masorti = 91 (10.2%); Liberal = 82 (9.2%), Reform = 135 (15.1%), Traditional = 212 (23.7%), Orthodox = 239 (26.7%); and Unaffiliated/Non-practising = 135 (15.1%). Overall BRCA testing uptake was 88%. Pre-counselling, 96% expressed interest and 60% intention to test. JI and JR scores were highest for Orthodox, followed by Conservative/Masorti, Traditional, Reform, Liberal and Unaffiliated Jewish denominations. Regression modelling showed no significant association between overall Jewish Cultural or Religious Identity with either interest, intention or uptake of BRCA testing. Interest, intention and uptake of BRCA testing was not significantly associated with denominational affiliation. CONCLUSIONS Jewish religious/cultural identity and denominational affiliation do not appear to influence interest, intention or uptake of population-based BRCA testing. BRCA testing was robust across all Jewish denominations. TWEETABLE ABSTRACT Jewish cultural/religious factors do not affect BRCA testing, with robust uptake seen across all denominational affiliations.
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Affiliation(s)
- D Reisel
- Institute for Women's Health, University College, London, UK
| | - M Burnell
- Institute for Women's Health, University College, London, UK
| | - L Side
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K Loggenberg
- Institute for Women's Health, University College, London, UK
| | - S Gessler
- Institute for Women's Health, University College, London, UK
| | - R Desai
- Institute for Women's Health, University College, London, UK
| | - S Sanderson
- Behavioral Sciences Unit, Dept Epidemiology and Public Health, University College London, London, UK
| | - A F Brady
- North West Thames Regional Genetics Service, Northwick Park Hospital, Harrow, UK
| | - H Dorkins
- St Peter's College, University of Oxford, Oxford, UK
| | - Y Wallis
- West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - C Jacobs
- Dept Clinical Genetics, Guy's Hospital, London, UK.,University of Technology Sydney, Ultimo, NSW, Australia
| | - R Legood
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - U Beller
- Department of Gynaecology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - I Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - J Wardle
- Behavioral Sciences Unit, Dept Epidemiology and Public Health, University College London, London, UK
| | - U Menon
- MRC Clinical Trials Unit, University College London, London, UK
| | - I Jacobs
- Institute for Women's Health, University College, London, UK.,University of New South Wales, Sydney, NSW, Australia
| | - R Manchanda
- MRC Clinical Trials Unit, University College London, London, UK.,Wolfson Institute of Population Health, CRUK Barts Centre, Queen Mary University of London, London, UK.,Department of Gynaecological Oncology, St Bartholomew's Hospital, London, UK
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196
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Gupta S, Sutradhar R, Li Q, Coburn N. The effectiveness of a provincial symptom assessment program in reaching adolescents and young adults with cancer: A population-based cohort study. Cancer Med 2021; 10:9030-9039. [PMID: 34738747 PMCID: PMC8683532 DOI: 10.1002/cam4.4401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/12/2021] [Accepted: 10/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background Symptom control is prioritized by cancer patients and may improve overall survival. Ontario, Canada thus offers all cancer patients screening using the Edmonton Symptom Assessment System (ESAS) at outpatient cancer‐related visits. We determined whether this initiative reached adolescents and young adults (AYA) and factors associated with screening in this population. Methods We linked all Ontario AYA diagnosed with cancer 2010–2018 aged 15–29 years to population‐based databases identifying outpatient visits and ESAS screening. For each 2‐week period in the year post‐diagnosis, AYA with cancer‐related visits were categorized as “unscreened” (no ESAS score) versus “screened” (≥1 ESAS score). Demographic and disease‐related covariates were examined. Results Among 5435 AYA, 4204 (77.4%) had ≥1 ESAS screen. Within any 2‐week period, only 30%–44% of AYA attending cancer‐related visits were screened. Patients with hematologic malignancies were least likely to be screened [odds ratio (OR) vs. breast cancer 0.77, 95% confidence interval (95% CI) 0.67–0.88; p < 0.001]. AYA in remote Northern or rural areas had equivalent or higher rates of ESAS screening compared to those in high‐income urban areas. However, AYA living in the lowest income urban neighborhoods were less likely to be screened (OR 0.86, 95% CI 0.77–0.97; p = 0.01). Conclusions Within a population‐wide symptom assessment program, while AYA living in rural and remote areas had high rates of screening, than those in low‐income urban areas were substantially less likely to be screened. Though patients with hematologic cancers suffer from particularly high symptom burdens, they were also less likely to be screened. Interventions targeting AYA are required to increase uptake.
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Affiliation(s)
- Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.,Cancer Research Program, ICES, Toronto, Canada.,Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Canada.,Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Rinku Sutradhar
- Cancer Research Program, ICES, Toronto, Canada.,Institute for Health Policy, Evaluation and Management, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Qing Li
- Cancer Research Program, ICES, Toronto, Canada
| | - Natalie Coburn
- Cancer Research Program, ICES, Toronto, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Surgery, University of Toronto, Toronto, Canada.,Sunnybrook Research Institute, Toronto, Canada
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197
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Amaador K, Kersten MJ, Visser O, Posthuma EFM, Minnema MC, Vos JMI, Dinmohamed AG. Conditional relative survival in Waldenström's macroglobulinaemia: a population-based study in The Netherlands. Br J Haematol 2021; 196:1205-1208. [PMID: 34738239 PMCID: PMC9297939 DOI: 10.1111/bjh.17926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/27/2022]
Abstract
Contemporary diagnosed WM patients, compared to the general population, continue to experience excess mortality regardless of having survived up to 15 years post‐diagnosis. This gradual increase in excess mortality might result from the incurable nature of this disease characterized by multiple relapses throughout the disease course with limited efficacious treatment options in the released/refractory setting.
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Affiliation(s)
- Karima Amaador
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam.,LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, the Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam.,LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, the Netherlands
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eduardus F M Posthuma
- Department of Internal Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands.,Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Monique C Minnema
- Department of Hematology, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Josephine M I Vos
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam.,LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, the Netherlands
| | - Avinash G Dinmohamed
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam.,LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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198
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Nolen E, Cubbin C, Brewer M. The effect of maternal food insecurity transitions on housing insecurity in a population-based sample of mothers of young children. AIMS Public Health 2021; 9:1-16. [PMID: 35071664 PMCID: PMC8755969 DOI: 10.3934/publichealth.2022001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies have shown a link between food insecurity and housing problems, including trouble paying rent. Additional research is needed to test the longitudinal effect of food insecurity on housing insecurity in a socio-demographically diverse, population-based sample. We tested whether food insecurity transitions predicted housing insecurity using a housing insecurity index consisting of housing and neighborhood factors. We also tested whether social cohesion or social support mediated the food/housing insecurity relationship. METHOD Data were analyzed from a sample of 2868 mothers of young children residing in California at two time points: the baseline Maternal and Infant Health Assessment (2003-2007) and follow-up Geographic Research on Wellbeing survey (2012-2013). Women were categorized as food insecure both times; became food insecure; became food secure; and food secure both times. We constructed linear regression models for housing insecurity: models regressing each variable separately; a model regressing sociodemographic covariates and food insecurity status; mediation models adding social cohesion or social support; and mediation models for each racial/ethnic group. RESULTS Food insecurity transitions were associated with housing insecurity in a gradient pattern. Compared to women who were food secure both times, housing insecurity was highest among women who were food insecure both times, followed by those who became food insecure, and then those who transitioned out of food insecurity (became food secure). Food insecurity remained a significant risk factor for housing insecurity even after adjusting sociodemographic covariates. While social support and social cohesion were negatively associated with housing insecurity, there was limited evidence that social support/cohesion mediated the food insecurity/housing insecurity relationships. CONCLUSIONS The lack of substantial mediation suggests that factors beyond social ties may explain the food and housing insecurity relationship. Efforts to reduce material hardship should consist of streamlined policy efforts that offer tangible supports for women and their families.
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Affiliation(s)
- Erin Nolen
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
- Dell Medical School, Department of Population Health, University of Texas at Austin, Austin, TX, USA
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199
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WRIGHT MA, DOLL KM, MYERS E, CARPENTER WR, GARTNER DR, ROBINSON WR. Changing trends in Black-White racial differences in surgical menopause: a population-based study. Am J Obstet Gynecol 2021; 225:502.e1-502.e13. [PMID: 34111405 PMCID: PMC9542172 DOI: 10.1016/j.ajog.2021.05.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 05/17/2021] [Accepted: 05/30/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Bilateral oophorectomy before menopause, or surgical menopause, is associated with negative health outcomes, including an increased risk for stroke and other cardiovascular outcomes; however, surgical menopause also dramatically reduces ovarian cancer incidence and mortality rates. Because there are competing positive and negative sequelae associated with surgical menopause, clinical guidelines have not been definitive. Previous research indicates that White women have higher rates of surgical menopause than other racial groups. However, previous studies may have underestimated the rates of surgical menopause among Black women. Furthermore, clinical practice has changed dramatically in the past 15 years, and there are no population-based studies in which more recent data were used. Tracking actual racial differences among women with surgical menopause is important for ensuring equity in gynecologic care. OBJECTIVE This population-based surveillance study evaluated racial differences in the rates of surgical menopause in all inpatient and outpatient settings in a large, racially diverse US state with historically high rates of hysterectomy. STUDY DESIGN We evaluated all inpatient and outpatient surgeries in North Carolina from 2011 to 2014 for patients aged between 20 and 44 years. Surgical menopause was defined as a bilateral oophorectomy, with or without an accompanying hysterectomy, among North Carolina residents. International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes were used to identify inpatient and outpatient procedures, respectively, and diagnostic indications. We estimated age-, race-, and ethnicity-specific rates of surgical menopause using county-specific population estimates based on the 2010 United States census. We used Poisson regression with deviance-adjusted residuals to estimate the incidence rate ratios in the entire state population. We tested changes in surgery rates over time (reference year, 2011), differences by setting (reference, inpatient), and differences by race and ethnicity (reference, non-Hispanic White). We then described the surgery rates between non-Hispanic White and non-Hispanic Black patients. RESULTS Between 2011 and 2014, 11,502 surgical menopause procedures for benign indications were performed in North Carolina among reproductive-aged residents. Most (95%) of these surgeries occurred concomitant with a hysterectomy. Over the 4-year study period, there was a 39% reduction in inpatient surgeries (incidence rate ratio, 0.61) and a 100% increase in outpatient surgeries (incidence rate ratio, 2.0). Restricting the analysis to surgeries among non-Hispanic White and Black patients, the increase in outpatient surgeries was significantly higher among non-Hispanic Black women (P<.01) for year-race interaction (reference, 2011 and non-Hispanic White). The overall rates of bilateral oophorectomy for non-Hispanic Black women rose more quickly than for non-Hispanic White women (P<.01). In 2011, the rate of surgical menopause was greater among White women than among Black women (17.7 vs 13.2 per 10,000 women). By 2014, the racial trends were reversed (rate, 24.8 per 10,000 for non-Hispanic White women and 28.4 per 10,000 for non-Hispanic Black women). CONCLUSION Our findings suggest that the rates of surgical menopause increased in North Carolina in the early 2010s, especially among non-Hispanic Black women. By 2014, the rates of surgical menopause among non-Hispanic Black women had surpassed that of non-Hispanic White women. Given the long-term health consequences associated with surgical menopause, we propose potential drivers for the racially-patterned increases in the application of bilateral oophorectomy before the age of 45 years.
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Affiliation(s)
- Maya A. WRIGHT
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina USA
| | - Kemi M. DOLL
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington USA
| | - Evan MYERS
- Division of Reproductive Sciences, Department of Obstetrics & Gynecology, Duke University School of Medicine, Durham, North Carolina USA
| | - William R. CARPENTER
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA,Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Danielle R. GARTNER
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan USA
| | - Whitney R. ROBINSON
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina USA,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA,Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Wendt A, Ricardo LIC, Costa CS, Knuth AG, Tenório MCM, Crochemore-Silva I. Socioeconomic and Gender Inequalities in Leisure-Time Physical Activity and Access to Public Policies in Brazil From 2013 to 2019. J Phys Act Health 2021; 18:1503-1510. [PMID: 34697257 DOI: 10.1123/jpah.2021-0291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study aims to describe changes in gender and wealth inequalities in leisure-time physical activity (PA) of Brazilians during a 6-year interval. It also aims to evaluate inequalities regarding PA public programs awareness, participation, and access to public spaces for PA. METHODS Data from 2 population-based surveys conducted in 2013 and 2019 were used. Leisure-time PA prevalence was assessed considering those reporting ≥150 minutes per week. The authors evaluated gender inequalities calculating differences and ratios, and wealth inequalities using the slope index of inequality and the concentration index- assessing changes over time. RESULTS National levels of leisure-time PA increased from 2013 to 2019, and an increase in inequalities was observed; women and the poorest groups still presented lower prevalence. A decline in socioeconomic inequalities was observed from 2013 to 2019 regarding the availability of public spaces and awareness about public programs. However, outcomes remained more common among the richest group. Inequalities did not vary for participation in public programs. CONCLUSION Although leisure-time PA increased from 2013 to 2019 at a national level, there were no improvements in gender inequalities, and wealth inequalities worsened over time. Indicators of public strategies for PA increased for the population, but inequalities remain.
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