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Grieger P, Eisemann N, Hammersen F, Rudolph C, Katalinic A, Waldmann A. Initial Evidence of a Possible Effect of HPV Vaccination on Cancer Incidence in Germany—Focus on Cervical Cancer. Dtsch Arztebl Int 2024:arztebl.m2024.0062. [PMID: 38652841 DOI: 10.3238/arztebl.m2024.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Infection with human papillomavirus (HPV) is one of the more common sexually transmitted diseases in Germany. Vaccination against HPV was introduced in Germany in 2007. In this study, we sought to detect a population-based decline in the incidence of cervical cancer in women under age 30 who were eligible for vaccination in the first 11 years after its introduction. METHODS Data on new diagnoses of HPV-associated cervical cancer from 2004 to 2018 were obtained from the cancer registries of the German federal states (Bundesländer) through the German Center for Cancer Registry Data (ZfKD). Trends in the incidence of invasive and in situ cervical cancer were determined with log-linear joinpoint regression and age-period-cohort models. RESULTS The incidence of cervical cancer, which had been rising in the previous decades, has been falling since 2010, with a marked decline among women in all age groups eligible for vaccination (e.g., from 70.0 to 41.8 cases per 100 000 persons per year from 2010 to 2018 in women aged 24 to 26). Women born in 1992 were the first to become eligible for vaccination and have a 24% lower incidence than the reference cohort of women born in 1989 (relative risk 0.76, 95% confidence interval [0.68; 0.86]). Larger effects were found in later birth cohorts, in which vaccination was more widespread. CONCLUSION Eleven years after the introduction of HPV vaccination, a drop in the incidence of cervical cancer was observable at the population level in the birth cohorts eligible for vaccination.
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Schumann L, Hadwiger M, Eisemann N, Katalinic A. Lead-Time Corrected Effect on Breast Cancer Survival in Germany by Mode of Detection. Cancers (Basel) 2024; 16:1326. [PMID: 38611004 PMCID: PMC11010975 DOI: 10.3390/cancers16071326] [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: 01/23/2024] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Screen-detected breast cancer patients tend to have better survival than patients diagnosed with symptomatic cancer. The main driver of improved survival in screen-detected cancer is detection at earlier stage. An important bias is introduced by lead time, i.e., the time span by which the diagnosis has been advanced by screening. We examine whether there is a remaining survival difference that could be attributable to mode of detection, for example, because of higher quality of care. (2) Methods: Women with a breast cancer (BC) diagnosis in 2000-2022 were included from a population-based cancer registry from Schleswig-Holstein, Germany, which also registers the mode of cancer detection. Mammography screening was available from 2005 onwards. We compared the survival for BC detected by screening with symptomatic BC detection using Kaplan-Meier, unadjusted Cox regressions, and Cox regressions adjusted for age, grading, and UICC stage. Correction for lead time bias was carried out by assuming an exponential distribution of the period during which the tumor is asymptomatic but screen-detectable (sojourn time). We used a common estimate and two recently published estimates of sojourn times. (3) Results: The analysis included 32,169 women. Survival for symptomatic BC was lower than for screen-detected BC (hazard ratio (HR): 0.23, 95% confidence interval (CI): 0.21-0.25). Adjustment for prognostic factors and lead time bias with the commonly used sojourn time resulted in an HR of 0.84 (CI: 0.75-0.94). Using different sojourn times resulted in an HR of 0.73 to 0.90. (4) Conclusions: Survival for symptomatic BC was only one quarter of screen-detected tumors, which is obviously biased. After adjustment for lead-time bias and prognostic variables, including UICC stage, survival was 27% to 10% better for screen-detected BC, which might be attributed to BC screening. Although this result fits quite well with published results for other countries with BC screening, further sources for residual confounding (e.g., self-selection) cannot be ruled out.
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Affiliation(s)
- Laura Schumann
- Institute of Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (N.E.); (A.K.)
| | - Moritz Hadwiger
- Institute of Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (N.E.); (A.K.)
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (N.E.); (A.K.)
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany (N.E.); (A.K.)
- Institute of Cancer Epidemiology, University of Luebeck, 23562 Luebeck, Germany
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Eisemann N, Schumann L, Baltus H, Labohm L, Kraywinkel K, Katalinic A. Longer Survival From Melanoma in Germany. Dtsch Arztebl Int 2024; 121:45-51. [PMID: 38054977 PMCID: PMC10979441 DOI: 10.3238/arztebl.m2023.0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND New treatment options for cutaneous melanomas with a poor prognosis have been available since 2011, including immune therapies and targeted drugs. Randomized controlled trials have demonstrated that these treatments improve survival, but no population- level studies have been available to date. METHODS All patients in the database of the Center for Cancer Registry Data (Zentrum für Krebsregisterdaten) who had a diagnosis of melanoma (ICD10: C43) in the years 2000 to 2019 were included in the study. The relative five-year survival (5YRS) was calculated for four 5-year periods (2000-04, 2005-09, 2010-14, 2015-19). The data were standardized/stratified according to sex, age group, and UICC stage to correct for differences between regions and over time. Regression models were used to detect statistically significant secular trends. RESULTS 301 486 individuals were included in the study. The overall 5YRS rose from 93% (2000-04) to 95% (2015-19). The 5YRS in 2015-19 was similar to or greater than that in 2000-04 for all subgroups. The largest rises in 5YRS were between 2010-14 and 2015-19, and specifically in advanced stages: for UICC stage IV tumors, the 5YRS rose from 31% to 36%. There was a significant rising trend across the four time periods (p < 0.001). CONCLUSION The survival of melanoma patients has improved over the past 20 years. From 2010-14 to the most recent period, the largest changes were seen in advanced tumor stages. This favorable development coincided with the introduction of new therapies.
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Affiliation(s)
- Nora Eisemann
- The Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- These authors share first authorship
| | - Laura Schumann
- The Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- These authors share first authorship
| | - Hannah Baltus
- The Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Louisa Labohm
- The Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Klaus Kraywinkel
- The Centre for Cancer Registry Data, Robert Koch-Institute, Berlin, Germany
| | - Alexander Katalinic
- The Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
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Garbe C, Augustin M, Augustin J, Baltus H, Eisemann N, Hübner J, Katalinic A, Wolf S, Hagenström K. Evaluation der Hautkrebsfrüherkennung in Deutschland - Teilnahme, Tumordetektion und Intervalltumoren auf Grundlage von GKV-Daten. J Dtsch Dermatol Ges 2023; 21 Suppl 5:3-12. [PMID: 38063277 DOI: 10.1111/ddg.15170_g] [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: 07/27/2022] [Accepted: 06/06/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrund und ZieleDie steigende Hautkrebshäufigkeit in Deutschland hat den Bedarf an sekundärpräventiven Maßnahmen erhöht. Hierfür wurde zum 01.07.2008 ein gesetzliches Hautkrebsscreening für Versicherte ab 35 Jahren eingeführt. Ziel dieses Arbeitspakets im Innovationsfonds‐Projekt „Perspektiven einer multimodalen Evaluation der Hautkrebsfrüherkennung“ (Pertimo) war die Erprobung einer Evaluation des Hautkrebsscreenings anhand von Sekundärdaten.Patienten und MethodikDatengrundlage waren gesetzlich Versicherte der DAK‐Gesundheit ab 35 Jahren, die zum 31.12.2010 versichert waren und bis Ende 2015 nachbeobachtet wurden. Die Raten der Teilnahme sowie der im Hautkrebsscreening entdeckten Hauttumoren (Tumordetektionen) und der Intervalltumoren, welche innerhalb von zwei Jahren nach einem befundfreien Hautkrebsscreening auftraten, wurden berechnet.ErgebnisseDie zweijährliche Hautkrebsscreening‐Inanspruchnahmerate in 2014 und 2015 lag bei Frauen bei 33,6% und bei Männern bei 32,6%. Von den Gescreenten hatten 4,2% im Zuge des Hautkrebsscreenings einen Hautkrebsbefund (Tumordetektion). Von allen inzidenten Hautkrebsdiagnosen (2012–2015) wurden 50,1% im Hautkrebsscreening entdeckt. Bei 1,5% der Versicherten mit Hautkrebsscreening ohne Befund wurde in den folgenden zwei Jahren ein inzidenter Hauttumor diagnostiziert (Intervalltumor).SchlussfolgerungenDie Daten der gesetzlichen Krankenversicherung bildeten das Hautkrebsscreening‐Geschehen in Deutschland ab und verdeutlichten die Wichtigkeit von Dermatologen im Screeningprozess. Die Analyse lieferte wichtige neue Erkenntnisse.
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Affiliation(s)
- Claudia Garbe
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP) Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP) Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Jobst Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP) Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Hannah Baltus
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Deutschland
| | - Nora Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Deutschland
| | - Joachim Hübner
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Deutschland
| | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Deutschland
| | - Sandra Wolf
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP) Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - Kristina Hagenström
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP) Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
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Wolf S, Augustin M, Hagenström K, Garbe C, Baltus H, Eisemann N, Hübner J, Katalinic A, Augustin J. Evaluation der Hautkrebsfrüherkennung in Deutschland - Raumzeitliche Assoziationen zwischen Hautkrebsfrüherkennung und Hautkrebsmortalität auf Grundlage ambulanter Abrechnungsdaten. J Dtsch Dermatol Ges 2023; 21 Suppl 5:22-32. [PMID: 38063279 DOI: 10.1111/ddg.15172_g] [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: 07/27/2022] [Accepted: 06/06/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrundEs bestehen regionale Unterschiede in der Hautkrebsfrüherkennungsinanspruchnahme in Deutschland. Bislang ist ungeklärt, ob eine hohe Inanspruchnahme von Früherkennungsleistungen zu einer Senkung der Mortalität führt. Dieser Beitrag präsentiert Studienergebnisse zur Untersuchung raumzeitlicher Assoziationen von Hautkrebsfrüherkennung und Mortalität. Die angewendeten Methoden werden hinsichtlich ihrer Eignung diskutiert.Material und MethodikGrundlage sind ambulante Abrechnungsdaten zur Inanspruchnahme von Hautkrebsfrüherkennung sowie Daten zur Hautkrebsmortalität aus der Todesursachenstatistik der Jahre 2011–2015 auf Ebene der Kreise und kreisfreien Städte in Deutschland. Neben einer deskriptiven Auswertung wurden raumzeitliche Clusteranalysen und Regressionsmodelle angewendet, um den Zusammenhang zwischen der Inanspruchnahme von Früherkennung und Mortalität zu untersuchen. Dabei wurde neben Alter auch nach weiteren ausgewählten sozioökonomischen und ‐grafischen Variablen adjustiert.ErgebnisseDie deskriptiven Ergebnisse zeigen markante räumliche Muster der Hautkrebsfrüherkennung und Mortalität. Mittels Clusteranalysen konnten Regionen mit signifikant höheren und niedrigeren Fällen an Früherkennung und Hautkrebsmortalität identifiziert werden. Die raumzeitlichen Regressionsanalysen zeigen keine eindeutige Assoziation. Lediglich die Früherkennung beim Dermatologen, adjustiert nach Alter, zeigt eine Assoziation mit Mortalität.DiskussionAus den Ergebnissen lässt sich kein eindeutiger Zusammenhang zwischen Hautkrebsfrüherkennung und ‐mortalität ableiten. Das verwendete Studiendesign mit einer raumzeitlichen Cluster‐ und Regressionsanalyse hat jedoch gezeigt, dass diese Methoden vertiefte Aussagen über den Zusammenhang von Hautkrebsfrüherkennung und ‐mortalität ermöglichen.
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Affiliation(s)
- Sandra Wolf
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristina Hagenström
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Garbe
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hannah Baltus
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Nora Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Joachim Hübner
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | | | - Jobst Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
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Hübner J, Baltus H, Eisemann N, Rohr M, Schumann L, Augustin J, Hagenström K, Wolf S, Garbe C, Augustin M, Katalinic A. Evaluation der Hautkrebsfrüherkennung in Deutschland mit Krebsregisterdaten - Herausforderungen, Lösungen und aktuelle Trends. J Dtsch Dermatol Ges 2023; 21 Suppl 5:13-21. [PMID: 38063278 DOI: 10.1111/ddg.15171_g] [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: 07/27/2022] [Accepted: 06/06/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrund und ZieleDie Evidenz für einen Nutzen des 2008 in Deutschland eingeführten Hautkrebsscreenings ist schwach. Wir untersuchen, inwieweit Daten der deutschen epidemiologischen Krebsregister geeignet sind zur Evaluation des Hautkrebsscreenings beizutragen, und berichten diese Evaluationsergebnisse.Material und MethodikDie Hautkrebsdaten der Krebsregister aus den Jahren 1999–2019 wurden hinsichtlich Vollzähligkeit und Vollständigkeit beschrieben. Regionale Datenpools unterschiedlicher Validität wurden definiert, fehlende Daten sofern sinnvoll mehrfach imputiert und zeitliche Trends analysiert. Ergänzend wurden Daten der Todesursachenstatistik herangezogen.ErgebnisseBelastbare Vollzähligkeitsschätzungen liegen nur für das maligne Melanom (ICD‐10: C43) vor. Auf Basis eines regionalen Datenpools, der circa 21% der deutschen Bevölkerung abdeckt, kann das melanombezogene Krankheitsgeschehen seit 2005 valide beschrieben werden. Für T‐Stadium und Lokalisation liegen ausreichend Informationen für eine multiple Imputation vor. Die Trendanalysen zeigen im zeitlichen Zusammenhang mit der Einführung der Früherkennung kurzfristig erwartbare Inzidenzänderungen, die in eine langanhaltende hohe Inzidenz übergehen. Die Rate fortgeschrittener Stadien geht nicht wesentlich zurück. Ab 2014 sinkt die bis dahin steigende Melanommortalität.SchlussfolgerungenAdäquat ausgewählte und aufbereitete Krebsregisterdaten eignen sich zur bevölkerungsbezogenen Bewertung des Hautkrebsscreenings. Eine Erklärung des anhaltend hohen Inzidenzniveaus gelingt auf Basis der Krebsregisterdaten nicht. In Betracht kommen insbesondere Überdiagnosen oder ein Anstieg der Hintergrundinzidenz. Der Nutzen des Hautkrebsscreenings bleibt offen.
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Affiliation(s)
- Joachim Hübner
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
- Klinische Landesauswertungsstelle Niedersachsen, Oldenburg, Germany
| | - Hannah Baltus
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
| | - Maren Rohr
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
| | - Laura Schumann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
| | - Jobst Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristina Hagenström
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sandra Wolf
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Garbe
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck, Germany
- Institut für Krebsepidemiologie, Universität zu Lübeck, Lübeck, Germany
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Schumann L, Eisemann N, Augustin J, Kieschke J, Meyer M, Kajüter H, Katalinic A. Zusammenhang zwischen der Inzidenz früher Stadien und der Mortalität beim malignen Melanom - eine bevölkerungsbasierte ökologische Studie. J Dtsch Dermatol Ges 2023; 21 Suppl 5:33-41. [PMID: 38063280 DOI: 10.1111/ddg.15218_g] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/21/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungHintergrundIn Deutschland wurde 2008 ein flächendeckendes Hautkrebsscreening eingeführt, um die Hautkrebsmortalität und ‐morbidität zu senken. Noch unklar ist jedoch die Wirksamkeit des Programms. Wir untersuchen den Zusammenhang zwischen der Inzidenz von Melanom‐Frühstadien und Melanom‐Mortalität in den Folgejahren, wobei die Inzidenz von Melanom‐Frühstadien als Surrogatparameter für Screening‐Teilnahme und Früherkennung verwendet wird.MethodikFür 244 deutsche Landkreise wurden Daten zur Melanom‐Inzidenz von 2005–2016 und zur Melanom‐Mortalität von 2005–2018 erhoben. Die Zusammenhänge zwischen verschiedenen Maßen der Inzidenz und Mortalität wurden mit Korrelationsanalysen und linearen Regressionen untersucht.ErgebnisseDie Melanom‐Inzidenz früher Stadien (in situ und T1) stieg nach Einführung des Screenings (2005–2007 vs. 2008–2010) um 69%. Im Gegensatz dazu gab es bei der Mortalität keinen zeitlichen Trend. Die Korrelationen zwischen Inzidenz‐ und Mortalitätsvariablen lagen zwischen –0,14 und 0,10 (nicht signifikant). Die linearen Regressionsanalysen ergaben, dass die Mortalität sechs Jahre nach Einführung des Screenings mit zunehmendem Anstieg der Inzidenz früher Stadien abnimmt (b = –0,0029, 95%‐Konfidenzintervall [–0,0066; 0,0007]).SchlussfolgerungenDie geschätzten bevölkerungsbezogenen Auswirkungen des Hautkrebsscreenings auf die Melanom‐Mortalität waren minimal und nicht signifikant. Eine mögliche Wirksamkeit kann daher nicht nachgewiesen werden.
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Affiliation(s)
- Laura Schumann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
| | - Nora Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
| | - Jobst Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | | | - Martin Meyer
- Zentralstelle für Krebsfrüherkennung und Krebsregistrierung, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Nürnberg
| | | | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
- Institut für Krebsepidemiologie, Universität zu Lübeck, Lübeck
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Hübner J, Baltus H, Eisemann N, Rohr M, Schumann L, Augustin J, Hagenström K, Wolf S, Garbe C, Augustin M, Katalinic A. Evaluation of early skin cancer detection in Germany with cancer registry data - challenges, solutions and current trends. J Dtsch Dermatol Ges 2023; 21 Suppl 5:13-20. [PMID: 38063276 DOI: 10.1111/ddg.15171] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 06/06/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND AND AIMS The evidence for the benefit of the skin cancer screening introduced in Germany in 2008 is weak. We investigate to what extent data from the German epidemiological cancer registries are suitable to contribute to the evaluation of skin cancer screening and report these evaluation results. MATERIAL AND METHODS Skin cancer-related cancer registry data from 1999-2019 were described in terms of completeness and comprehensiveness. Regional pools with data of different validity were defined, missing data were multiply imputed where appropriate, and temporal trends were analyzed. In addition, data from the cause of death statistics were used. RESULTS Reliable estimates of completeness are only available for malignant melanoma (ICD-10: C43). Based on a regional data pool covering approximately 21% of the German population, melanoma-related incidence can be validly described since 2005. Sufficient information for multiple imputation is available for T-stage and localization. The trend analyses show incidence changes that can be expected in the short term in the temporal context of the introduction of early detection, which changes into a long-lasting high incidence. The rate of advanced stages does not decrease significantly. From 2014 onwards, the melanoma mortality rate, which had been rising until then, decreases. CONCLUSIONS Adequately selected and processed cancer registry data are suitable for population-based evaluation of skin cancer screening. An explanation of the persistently high incidence level is not possible based on the cancer registry data. Overdiagnosis or an increase in the background incidence can be considered. The benefit of skin cancer screening remains open.
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Affiliation(s)
- Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Agency for Clinical Cancer Data of Lower Saxony, Oldenburg, Germany
| | - Hannah Baltus
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Maren Rohr
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Laura Schumann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristina Hagenström
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Sandra Wolf
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Garbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany
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Garbe C, Augustin M, Augustin J, Baltus H, Eisemann N, Hübner J, Katalinic A, Wolf S, Hagenström K. Evaluation of skin cancer screening in Germany - participation, tumor detection and interval tumors based on SHI data. J Dtsch Dermatol Ges 2023; 21 Suppl 5:3-11. [PMID: 38063281 DOI: 10.1111/ddg.15170] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 06/06/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND AND GOALS The rising incidence of skin cancer in Germany has increased the need for secondary prevention measures. For this purpose, a statutory skin cancer screening for insured persons aged 35 and older was introduced on 1 June 2008. The aim of this work package in the Innovation Fund project "Perspectives of a multimodal evaluation of early skin cancer detection" (Pertimo) was to test an evaluation of skin cancer screening using secondary data. PATIENTS AND METHODS The data basis was statutory insured persons of the DAK Health from the age of 35 who were insured as of 31 December 2010 and were followed up until the end of 2015. The rates of participation, skin tumors detected in skin cancer screening (tumor detections), and interval tumors that occurred within two years after a finding-free skin cancer screening were calculated. RESULTS The biennial skin cancer screening take-up rate in 2014 and 2015 was 33.6% for women and 32.6% for men. Of those screened, 4.2% had a skin cancer finding (tumor detection) in the course of skin cancer screening. Of all incident skin cancer diagnoses (2012-2015), 50.1% were detected in skin cancer screening. In 1.5% of the insured persons with skin cancer screening without findings, an incidental skin tumor was diagnosed in the following two years (interval tumor). CONCLUSIONS The data from the statutory health insurance mapped the skin cancer screening occurrence in Germany and highlighted the importance of dermatologists in the screening process. The analysis provided important new insights.
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Affiliation(s)
- Claudia Garbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hannah Baltus
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Sandra Wolf
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristina Hagenström
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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10
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Schumann L, Eisemann N, Augustin J, Kieschke J, Meyer M, Kajüter H, Katalinic A. Association of early-stage incidence and mortality in malignant melanoma - a population-based ecological study. J Dtsch Dermatol Ges 2023; 21 Suppl 5:33-40. [PMID: 38063282 DOI: 10.1111/ddg.15218] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/21/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Germany-wide skin cancer screening was introduced in 2008 to reduce skin cancer mortality and morbidity. However, the effectiveness of the program is still unclear. We explore the relationship between early-stage melanoma incidence and melanoma mortality in subsequent years, using early-stage melanoma incidence as surrogate for screening participation and early detection. PATIENTS AND METHODS Data on melanoma incidence for 2005-2016 and melanoma mortality for 2005-2018 were obtained for 244 German counties. We investigated the correlation between several measures of incidence and mortality with correlation analyses and linear regressions. RESULTS Melanoma incidence of early stages (in situ and T1) rose by 69% between pre-screening (2005-2007) and screening period (2008-2010). In contrast, there was no temporal trend in mortality over time. Correlation coefficients between incidence and mortality variables ranged between -0.14 and 0.10 (not significant). Linear regression indicated that mortality 6 years after screening introduction decreases with increasing change in early-stage incidence (b = -0.0029, 95% confidence interval [-0.0066, 0.0007]). CONCLUSIONS The estimated population-based effects of skin cancer screening on melanoma mortality were minimal and not significant. A potential effectiveness cannot be demonstrated.
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Affiliation(s)
- Laura Schumann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Martin Meyer
- Center for Early Cancer Detection and Cancer Registration, Bavarian Health and Food Safety Authority, Nuremberg, Germany
| | | | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
- Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
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11
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Wolf S, Augustin M, Hagenström K, Garbe C, Baltus H, Eisemann N, Hübner J, Katalinic A, Augustin J. Evaluation of skin cancer screening in Germany - Spatiotemporal associations between skin cancer screening and skin cancer mortality based on ambulatory claims data. J Dtsch Dermatol Ges 2023; 21 Suppl 5:22-31. [PMID: 38063275 DOI: 10.1111/ddg.15172] [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: 07/27/2022] [Accepted: 06/06/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND There are regional differences in skin cancer screening uptake in Germany. So far, it is unclear whether a high uptake of screening services leads to a reduction in mortality. This article presents study results on the investigation of spatiotemporal associations between skin cancer screening and mortality. The methods used are discussed regarding their suitability. MATERIAL AND METHODS The basis is ambulatory claims data on the utilization of early skin cancer detection as well as data on skin cancer mortality from the cause-of-death statistics of the years 2011-2015 at county level in Germany. In addition to a descriptive evaluation, spatiotemporal cluster analyses and regression models were used to investigate the relationship between the uptake of early detection and mortality. In addition to age, adjustments were also made for other selected socio-economic and socio-graphical variables. RESULTS The descriptive results show striking spatial patterns of skin cancer screening and mortality. Cluster analyses identified regions with significantly higher and lower cases of early detection and skin cancer mortality. The spatiotemporal regression analyses show no clear association. Only early detection by a dermatologist, adjusted for age, shows an association with mortality. CONCLUSIONS No clear association between early skin cancer detection and mortality can be derived from the results. However, the study design used with a spatiotemporal cluster and regression analysis has shown that these methods allow in-depth statements about the relationship between early skin cancer detection and mortality.
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Affiliation(s)
- Sandra Wolf
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristina Hagenström
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Garbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hannah Baltus
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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12
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Schiffner J, Eisemann N, Baltus H, Jensen S, Wunderlich K, Schuesseler S, Eicker C, Teegen B, Boniakowsky D, Solbach W, Mischnik A. Dynamics of immunity over time: decline of anti-SARS-CoV-2 IgG antibodies and T-cell responses after mRNA vaccination in residents and health care workers in nursing homes and homes with assisted living support. GMS Infect Dis 2023; 11:Doc02. [PMID: 37830111 PMCID: PMC10565841 DOI: 10.3205/id000082] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Background In the present study, we investigated the dynamics of immunity over time by measuring anti SARS-CoV-2 IgG antibodies and SARS-CoV-2 specific T-cell responses (interferon-gamma release assay) after two doses of vaccines in residents and health care workers (HCW). Mostly, 224 (98%) residents and 244 (89%) HCW received two doses of mRNA vaccine (BNT162b2, Pfizer-BioNTech); the rest of the participants received heterologous vaccinations with mRNA and vector vaccines. The study was conducted at the time when the Delta variant of SARS-CoV-2 prevailed. Methods We analyzed blood samples of 228 residents (median age 83.8 years) and of 273 HCW (median age 49.7 years) from five nursing homes and one home for the elderly with assisted living support at one specific time point. Participants received two vaccinations. The blood samples were analyzed for SARS-CoV-2 specific IgG antibody and T-cell responses. Results The initial immune responses in the younger participants were about 30% higher than in the older age group. Over time the estimated mean of the parameters (estimated from the study sample for the total population) decreased in all groups within the maximum observation period of 232 days. Comorbidities such as coronary heart disease or diabetes mellitus reduced the initial immune responses regardless of age. With regard to measured IgG antibody levels, absolute values decreased over time, whereas the interferon-gamma response remained at a constant level between day 120 and 180 and seemed to be less dependent on the time elapsed after vaccination. Conclusions Based on our data, it does not seem possible to determine a reliable threshold of robust immunity, but we suggest that high titres of neutralizing capacity and interferon-gamma response might be an indicator of protection against severe COVID-19 courses.
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Affiliation(s)
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Hannah Baltus
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Sina Jensen
- Health Protection Authority, Luebeck, Germany
| | | | | | | | - Bianca Teegen
- Klinisch-Immunologisches Labor Stoecker, Luebeck, Germany
| | | | - Werner Solbach
- Center for Infection and Inflammation Research, University of Luebeck, Germany
- German Center for Infection Research (DZIF), Luebeck, Germany
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13
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Eisemann N, Schnoor M, Rakusa E, Braren-von Stülpnagel CC, Katalinic A, Ludwig M, Sonntag B, Ludwig AK, Elsner SA. Psychosocial health and quality of life in ICSI and naturally conceived adolescents: a cross-sectional comparison. Qual Life Res 2023:10.1007/s11136-023-03382-5. [PMID: 36928650 PMCID: PMC10328861 DOI: 10.1007/s11136-023-03382-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Psychosocial health (PH) and quality of life (QoL) are important health outcomes. We compared PH and QoL of adolescents conceived with intrazytoplasmatic sperm injection (ICSI) and of naturally conceived controls. The impact of disclosure of ICSI-conception on QoL and PH was quantified. METHODS The cross-sectional sample consisted of 545 ICSI-conceived adolescents and 427 unmatched singleton controls aged 14-18 years. Adolescents reported PH with the 'Strengths and Difficulties Questionnaire' (low values indicating high PH), and QoL with the KINDL questionnaire (high values indicating high QoL). Because of clustering of multiples within families, adjusted linear regressions with generalized estimating equations were used to compare ICSI- and naturally conceived adolescents. Missing values were treated by multiple imputation. Minimal importance was defined as half a standard deviation. RESULTS Both ICSI and control adolescents had high PH (low mean 'total difficulties' score: 9 of 40) and high QoL (mean 'total KINDL' score: 75 of 100). Differences were generally in favour of the ICSI group. Significant differences occurred for 'impact of behavioural problems' (p = 0.033), the 'total KINDL' score (p = 0.021) and the dimensions 'physical wellbeing' (p = 0.031) and 'school' (p = 0.005), but all differences were far below minimal importance. About 80% of ICSI adolescents were informed about their mode of conception. PH and QoL were slightly higher in informed adolescents; behavioural difficulties ('total behavioural problems' and 'conduct problems') were significantly lower (p = 0.013 and p = 0.003), behavioural strengths ('prosocial behaviour') and 'physical QoL' significantly higher (p = 0.004 and p = 0.018), but differences remained clearly below minimal importance. CONCLUSIONS Our results are reassuring for parents using ICSI and their children. Speaking openly about an ICSI conception in the family may be beneficial.
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Affiliation(s)
- N Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - M Schnoor
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - E Rakusa
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - C C Braren-von Stülpnagel
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - M Ludwig
- SYNLAB Holding Deutschland GmbH, Augsburg, Germany
| | - B Sonntag
- amedes MVZ Hamburg GmbH, Facharztzentrum Für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie, Hamburg, Germany
| | - A K Ludwig
- Praxis Für Frauengesundheit Und Pränatalmedizin, Hamburg, Germany
| | - S A Elsner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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14
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Byng D, Eisemann N, Schüler D, Bunk S, Leibig C, Brehmer M, Elsner S, Katalinic A. Abstract OT3-18-03: The PRAIM study: A prospective multicenter observational study of an integrated Artificial Intelligence system with live monitoring. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-ot3-18-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background. Several retrospective studies have illustrated the potential clinical benefit of artificial intelligence (AI) systems for breast cancer screening. Some systems optimize normal mammography examination triaging, while others aim to improve cancer detection. However, no AI system has shown specificity high enough to replace human radiologists, suggesting that AI should play a different role in the breast screening pathway. The decision-referral approach is a promising alternative that has demonstrated the most potential to improve radiologist screening sensitivity and specificity while reducing workload. This collaborative human-AI approach combines AI pre-screening to triage normal examinations and post-screening to prevent missed cancers. The actual performance of decision-referral, including the interaction with human radiologists, can ideally be evaluated in a prospective real-world setting. Trial design. The PRAIM (PRospective, multicenter observational study of an integrated AI system with live monitoring to support breast cancer screening) study (German Trial Register: DRKS00027322) is a prospective controlled observational non-inferiority study to compare the use of CE-marked screening software including AI support (Vara) via the decision-referral approach, with standard screening for women participating in the German breast cancer screening program. Ethics approval was obtained from the University of Lübeck Research Ethics Committee (22-043). Examinations assessed by readers using Vara are compared to examinations without Vara (control). Eligibility criteria and target accrual. Women ages 50 to 69 years old undergoing biennial breast cancer screening within the national screening program are eligible for inclusion. We expect the inclusion of approximately 400,000 women within the inclusion period of 1.5 years. Statistical methods. The primary outcome is the screen-detected cancer rate, defined as biopsy-confirmed cancer diagnoses per 1000 screening examinations. For each screening site, rates over the prospective observation period are calculated for examinations read with AI and without. To control for systematically different screen-detected cancer rates across screening sites, a historical 5-year rate is computed for each site and subtracted from the corresponding prospective rates. Non-inferiority of the screen-detected cancer rate for the AI group compared to the control group is evaluated with a weighted, mixed-effects linear regression model. AI is considered as non-inferior if the lower bound of the two-sided 95 % confidence interval for the estimated difference in screen-detected cancer rates of AI and non-AI group is not below -10 %, which corresponds to a deviation of -0.6 screen-detected cancers per 1000 examinations.
Citation Format: Danalyn Byng, Nora Eisemann, Dominik Schüler, Stefan Bunk, Christian Leibig, Moritz Brehmer, Susanne Elsner, Alexander Katalinic. The PRAIM study: A prospective multicenter observational study of an integrated Artificial Intelligence system with live monitoring [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT3-18-03.
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Affiliation(s)
| | - Nora Eisemann
- 2Institute for Social Medicine and Epidemiology, University of Lübeck
| | | | | | | | | | - Susanne Elsner
- 7Institute for Social Medicine and Epidemiology, University of Lübeck
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16
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Heidenreich A, Eisemann N, Katalinic A, Hübner J. Study results from journals with a higher impact factor are closer to "truth": a meta-epidemiological study. Syst Rev 2023; 12:8. [PMID: 36653834 PMCID: PMC9847155 DOI: 10.1186/s13643-023-02167-8] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Scientists, physicians, and the general public legitimately expect scholarly publications to give true answers to study questions raised. We investigated whether findings from studies published in journals with higher Journal Impact Factors (JIFs) are closer to truth than findings from studies in less-cited journals via a meta-epidemiological approach. METHODS We screened intervention reviews from the Cochrane Database of Systematic Reviews (CDSR) and sought well-appraised meta-analyses. We used the individual RCT study estimates' relative deviation from the pooled effect estimate as a proxy for the deviation of the study results from the truth. The effect of the JIF on the relative deviation was estimated with linear regression and with local polynomial regression, both with adjustment for the relative size of studies. Several sensitivity analyses for various sub-group analyses and for alternative impact metrics were conducted. RESULTS In 2459 results from 446 meta-analyses, results with a higher JIF were on average closer to "truth" than the results with a lower JIF. The relative deviation decreased on average by -0.023 per JIF (95% CI -0.32 to -0.21). A decrease was consistently found in all sensitivity analyses. CONCLUSIONS Our results indicate that study results published in higher-impact journals are on average closer to truth. However, the JIF is only one weak and impractical indicator among many that determine a studies' accuracy.
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Affiliation(s)
- Andreas Heidenreich
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
| | - Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
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17
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Di Carlo V, Stiller CA, Eisemann N, Bordoni A, Matz M, Curado MP, Daubisse‐Marliac L, Valkov M, Bulliard J, Morrison D, Johnson C, Girardi F, Marcos‐Gragera R, Šekerija M, Larønningen S, Sirri E, Coleman MP, Allemani C. Does the morphology of cutaneous melanoma help to explain the international differences in survival? Results from 1 578 482 adults diagnosed during 2000-2014 in 59 countries (CONCORD-3). Br J Dermatol 2022; 187:364-380. [PMID: 35347700 PMCID: PMC9542891 DOI: 10.1111/bjd.21274] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/18/2022] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND CONCORD-3 highlighted wide disparities in population-based 5-year net survival for cutaneous melanoma during 2000-2014. Clinical evidence suggests marked international differences in the proportion of lethal acral and nodular subtypes of cutaneous melanoma. OBJECTIVES We aimed to assess whether the differences in morphology may explain global variation in survival. METHODS Patients with melanoma were grouped into the following seven morphological categories: malignant melanoma, not otherwise specified (International Classification of Diseases for Oncology, third revision morphology code 8720), superficial spreading melanoma (8743), lentigo maligna melanoma (8742), nodular melanoma (8721), acral lentiginous melanoma (8744), desmoplastic melanoma (8745) and other morphologies (8722-8723, 8726-8727, 8730, 8740-8741, 8746, 8761, 8770-8774, 8780). We estimated net survival using the nonparametric Pohar Perme estimator, correcting for background mortality by single year of age, sex and calendar year in each country or region. All-ages survival estimates were standardized using the International Cancer Survival Standard weights. We fitted a flexible parametric model to estimate the effect of morphology on the hazard of death. RESULTS Worldwide, the proportion of nodular melanoma ranged between 7% and 13%. Acral lentiginous melanoma accounted for less than 2% of all registrations but was more common in Asia (6%) and Central and South America (7%). Overall, 36% of tumours were classified as superficial spreading melanoma. During 2010-2014, age-standardized 5-year net survival for superficial spreading melanoma was 95% or higher in Oceania, North America and most European countries, but was only 71% in Taiwan. Survival for acral lentiginous melanoma ranged between 66% and 95%. Nodular melanoma had the poorest prognosis in all countries. The multivariable analysis of data from registries with complete information on stage and morphology found that sex, age and stage at diagnosis only partially explain the higher risk of death for nodular and acral lentiginous subtypes. CONCLUSIONS This study provides the broadest picture of distribution and population-based survival trends for the main morphological subtypes of cutaneous melanoma in 59 countries. The poorer prognosis for nodular and acral lentiginous melanomas, more frequent in Asia and Latin America, suggests the need for health policies aimed at specific populations to improve awareness, early diagnosis and access to treatment. What is already known about this topic? The histopathological features of cutaneous melanoma vary markedly worldwide. The proportion of melanomas with the more aggressive acral lentiginous or nodular histological subtypes is higher in populations with predominantly dark skin than in populations with predominantly fair skin. What does this study add? We aimed to assess the extent to which these differences in morphology may explain international variation in survival when all histological subtypes are combined. This study provides, for the first time, international comparisons of population-based survival at 5 years for the main histological subtypes of melanoma for over 1.5 million adults diagnosed during 2000-2014. This study highlights the less favourable distribution of histological subtypes in Asia and Central and South America, and the poorer prognosis for nodular and acral lentiginous melanomas. We found that later stage at diagnosis does not fully explain the higher excess risk of death for nodular and acral lentiginous melanoma compared with superficial spreading melanoma.
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Affiliation(s)
- Veronica Di Carlo
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
| | | | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of LübeckRatzeburger Allee160 23538LübeckGermany
| | - Andrea Bordoni
- Ticino Cancer Registry, Dipartimento Sanità e SocialitàDivisione della Salute PubblicaVia Ciseri10 6600LocarnoSwitzerland
| | - Melissa Matz
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
| | - Maria P. Curado
- Goiânia Cancer Registry, Group of Epidemiology and Statistics on CancerAC Camargo Cancer CenterRua Tamandaré 753 ‐ LiberdadeSP01525‐001São PauloBrazil
| | - Laetitia Daubisse‐Marliac
- Tarn Cancer RegistryInstitut Universitaire du Cancer Toulouse – Oncopole Institut C. Regaud1 Avenue Irène Joliot‐Curie31059ToulouseFrance
| | - Mikhail Valkov
- Northern State Medical UniversityProspekt Troitskiy51 163000ArkhangelskRussian Federation
| | - Jean‐Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté)University of LausanneLausanneSwitzerland
- Neuchâtel and Jura Tumour RegistryNeuchâtelSwitzerland
| | - David Morrison
- Scottish Cancer RegistryGyle Square, 1 South Gyle CrescentEH12 9EBEdinburghUK
| | - Chris Johnson
- Cancer Data Registry of Idaho, 615 North 7th StreetID83701‐1278BoiseUSA
| | - Fabio Girardi
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
- Cancer DivisionUniversity College London Hospitals NHS Foundation TrustEuston RoadWC1H 8NJLondonUK
- Division of Medical Oncology 2Veneto Institute of Oncology IOV‐IRCCSVia Gattamelata64 35128PadovaItaly
| | - Rafael Marcos‐Gragera
- Epidemiology Unit and Girona Cancer RegistryCatalan Institute of Oncology (ICO), IDIBGI, Oncology Coordination Plan, Department of Health Government of Catalonia17004GironaSpain
- University of Girona (UdG)17004GironaSpain
- CIBER of Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Mario Šekerija
- Croatian National Cancer RegistryCroatian Institute of Public HealthRockefeller Street7 10000ZagrebCroatia
| | | | - Eunice Sirri
- Epidemiological Cancer Registry of Lower SaxonyOffis Caree GmbHIndustriestr92 6121OldenburgGermany
| | - Michel P. Coleman
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
- Cancer DivisionUniversity College London Hospitals NHS Foundation TrustEuston RoadWC1H 8NJLondonUK
| | - Claudia Allemani
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
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Frielitz FS, Eisemann N, Werner K, Hiort O, Katalinic A, Lange K, von Sengbusch S. Direct Costs of Healthcare for Children with Type 1 Diabetes Using a CGM System: A Health Economic Analysis of the VIDIKI Telemedicine Study in a German Setting. Exp Clin Endocrinol Diabetes 2022; 130:614-620. [PMID: 34979571 DOI: 10.1055/a-1708-3134] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS The Virtual Diabetes Outpatient Clinic for Children and Adolescents (VIDIKI) study was a 6-month quasi-randomized, multicentre study followed by an extension phase to evaluate the effects of monthly video consultations in addition to regular care. A health economic analysis was conducted to assess the direct costs. METHODS The cost data of 240 study participants (1-16 years of age) with type 1 diabetes who were already using a continuous glucose monitoring system were collected in the first 6 months of the study. The intervention group (IG) received monthly video consultations plus regular care, and the waiting control group (WG) received only regular care. Cost data were collected for a comparable anonymized group of children from the participating health insurance companies during the 6-month period before the study started (aggregated data group [AG]). RESULTS Cost data were analysed for the AG (N=840) 6 months before study initiation and those for the study participants (N=225/240). Hospital treatment was the highest cost category in the AG. There was a cost shift and cost increase in the IG and WG, whereby diabetes supplies were the highest cost category. The mean direct diabetes-associated 6-month costs were € 4,702 (IG) and € 4,936 (WG). CONCLUSION The cost development within the cost collection period over two years possibly reflects the switch to higher-priced medical supplies. Video consultation as an add-on service resulted in a small but nonsignificant reduction in the overall costs.
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Affiliation(s)
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Kristin Werner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Olaf Hiort
- Universisty Medical Centre of Schleswig-Holstein, Campus Luebeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Karin Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
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Hüppe A, Herzog N, Eisemann N, Langbrandtner J, Raspe H. [Assessment of Psychosocial Problems in Inflammatory Bowel Diseases - Who Uses the Online Version at www.CED-aktiv-werden.de?]. Gesundheitswesen 2021; 84:466-473. [PMID: 33761557 DOI: 10.1055/a-1378-8859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM OF THE STUDY Taking into consideration and addressing patients' psychosocial problems is one of the characteristics of good clinical practice; this applies to IBD-patients as well. Since 2014, such patients have been offered an online questionnaire-based problem assessment linked to care recommendations. The primary aim of our data analysis was to carry out a comparative description of socio-demographic and disease-related characteristics of users of the free service. METHODOLOGY For a retrospective data analysis, the online sample (OG) comprising 2156 CD and UC patients was compared with 852 individuals who participated in 2 IBD health services research studies (CG). Besides descriptive statistics, regression and covariance analyses were carried out. RESULTS The OG differed from CG in a highly significant and partly clinically relevant way. One in 3 of the OG was younger than 30 years of age (CG: 19%); 45% had completed high school (CG: 36%). In the OG, fewer were in disease remission (OG 34%; CG 59%). Even controlling for these differences, the OG reported more often greater burden in 12 of 17 psychosocial problem areas and expressed a greater need for information on 5 of 9 disease-related topic areas. CONCLUSION The internet-based assessment of psychosocial problems is used primarily by younger, better educated, and physically as well as psychosocially more burdened IBD patients with comparatively high information needs. The assessment may help them to actively participate in their care. Our data sheds further light on the peculiarities of internet-based study groups.
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Affiliation(s)
- Angelika Hüppe
- Institut für Sozialmedizin und Epidemiologie,Universität zu Lübeck, Lübeck, Deutschland
| | - Nina Herzog
- Produktmanagement,EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Deutschland
| | - Nora Eisemann
- Institut für Sozialmedizin und Epidemiologie,Universität zu Lübeck, Lübeck, Deutschland
| | - Jana Langbrandtner
- Institut für Sozialmedizin und Epidemiologie,Universität zu Lübeck, Lübeck, Deutschland
| | - Heiner Raspe
- Institut für Ethik, Geschichte und Theorie der Medizin, University of Munster, Münster, Deutschland
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20
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Hadwiger M, Frielitz FS, Eisemann N, Elsner C, Dagres N, Hindricks G, Katalinic A. Cardiac Resynchronisation Therapy in Patients with Moderate to Severe Heart Failure in Germany: A Cost-Utility Analysis of the Additional Defibrillator. Appl Health Econ Health Policy 2021; 19:57-68. [PMID: 32215877 PMCID: PMC7790776 DOI: 10.1007/s40258-020-00571-y] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cardiac resynchronisation therapy (CRT) is a well-established form of treatment for patients with heart failure and cardiac dyssynchrony. There are two different types of CRT devices: the biventricular pacemaker (CRT-P) and the biventricular defibrillator (CRT-D). The latter is more complex but also more expensive. For the majority of patients who are eligible for CRT, both devices are appropriate according to current guidelines. The purpose of this study was to conduct a cost-utility analysis for CRT-D compared to CRT-P from a German payer's perspective. METHODS A cohort Markov-model was developed to assess average costs and quality-adjusted life-years (QALY) for CRT-D and CRT-P. The model consisted of six stages: one for the device implementation, one for the absorbing state death, and two stages ("Stable" and "Hospital") for either a CRT device or medical therapy. The time horizon was 20 years. Deterministic and probabilistic sensitivity analyses and scenario analyses were conducted. RESULTS The incremental cost-effectiveness ratio (ICER) of CRT-D compared with CRT-P was €24,659 per additional QALY gained. In deterministic sensitivity analysis, the survival advantage of CRT-D to CRT-P was the most influential input parameter. In the probabilistic sensitivity analysis 96% of the simulated cases were more effective but also more costly. CONCLUSIONS Therapy with CRT-D compared to CRT-P resulted in an additional gain of QALYs, but was more expensive. In addition, the ICER was subject to uncertainty, especially due to the uncertainty in the survival benefit. A randomised controlled trial and subgroup analyses would be desirable to further inform decision making.
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Affiliation(s)
- Moritz Hadwiger
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
| | - Fabian-Simon Frielitz
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Christian Elsner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Nikolaos Dagres
- Heart Center Leipzig, University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Gerhard Hindricks
- Heart Center Leipzig, University of Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
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21
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von Sengbusch S, Eisemann N, Mueller-Godeffroy E, Lange K, Doerdelmann J, Erdem A, Menrath I, Bokelmann J, Krasmann M, Kaczmarczyk P, Bertram B, Hiort O, Katalinic A, Frielitz FS. Outcomes of monthly video consultations as an add-on to regular care for children with type 1 diabetes: A 6-month quasi-randomized clinical trial followed by an extension phase. Pediatr Diabetes 2020; 21:1502-1515. [PMID: 33009690 DOI: 10.1111/pedi.13133] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 06/02/2020] [Revised: 09/05/2020] [Accepted: 09/24/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To explore the outcomes of monthly video consultations for children with diabetes. METHODS The Virtual Outpatient Diabetes Clinic for Children and Youth (VIDIKI) was a 6-month multicenter controlled clinical trial followed by an extension phase. The 240 participants (1-16 years), all using a CGM, were quasi-randomized by residence location to the intervention group (IG) or the waitlist-control group (WG). The IG started immediately after enrollment with monthly video consultations as an add-on to regular care, while the WG received regular care for 6 months before starting the intervention. The extension phase lasted between 12 months and 2 years, depending on the enrollment date. Linear regression was applied to model the primary outcome of HbA1c after 6 months and other metabolic and psychosocial outcomes. RESULTS After covariate adjustments, the HbA1c at 6 months-corresponding to the controlled treatment phase-was 0.11% lower in the IG than that in the WG (95% CI -0.31 to 0.09, P = .277). For the total study sample, a significant HbA1c improvement was found after 12 months of video consultations, which increased further until month 15. The diabetes burden of the main caregivers was lower, and parental treatment satisfaction was significantly higher in the IG than that in the WG. CONCLUSIONS The VIDIKI study found no significant HbA1c difference between IG and WG after 6 months in the controlled phase, but there was a decreased diabetes burden and increased treatment satisfaction for the parents. In the longitudinal perspective, a significant HbA1c improvement was found after 12 and 15 months.
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Affiliation(s)
- Simone von Sengbusch
- Division of Pediatric Endocrinology and Diabetology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Nora Eisemann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Esther Mueller-Godeffroy
- Division of Pediatric Endocrinology and Diabetology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Karin Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | - Jana Doerdelmann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Alev Erdem
- Division of Pediatric Endocrinology and Diabetology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Ingo Menrath
- Division of Pediatric Endocrinology and Diabetology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Jessica Bokelmann
- Department of Pediatrics Kiel, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Miriam Krasmann
- Department of Pediatrics Kiel, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | | | - Bettina Bertram
- Department of Pediatrics, General Hospital Kiel, Kiel, Germany
| | - Olaf Hiort
- Division of Pediatric Endocrinology and Diabetology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Fabian S Frielitz
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
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Sonntag B, Eisemann N, Elsner S, Ludwig AK, Katalinic A, Ludwig M. Pubertätsentwicklung und reproduktiv-endokrines Profil der nach einer Therapie mit intrazytoplasmatischer Spermieninjektion geborenen Jugendlichen. Gynäkologische Endokrinologie 2020. [DOI: 10.1007/s10304-020-00336-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Elsner S, Katalinic A, Ludwig AK, Sonntag B, Martensen MJ, Kixmüller D, Eisemann N, Ludwig M. A comparison of metabolic health parameters in ICSI-conceived and naturally conceived adolescents. Reprod Biomed Online 2020; 41:686-697. [PMID: 32807658 DOI: 10.1016/j.rbmo.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/15/2022]
Abstract
RESEARCH QUESTION Are there differences in the cardiometabolic health of ICSI-conceived adolescents compared with a control group, taking parental risk factors into account? DESIGN ICSI-conceived adolescents (n = 272), their mothers (n = 273) and naturally conceived control adolescents (n = 273) and their mothers (n = 273) provided a blood test and answered a health-related questionnaire. The adolescents also attended a physical examination. RESULTS ICSI-conceived males showed significantly higher mean weight (72.6 ± 15.1 versus 67.7 ± 12.6 kg, P = 0.005), body mass index (BMI) (22.2 ± 3.7 versus 21.0 ± 3.2 kg/m2, P = 0.007) and waist circumference (79.1 ± 11.6 versus 74.5 ± 8.7 cm, P < 0.001). The mean values for weight and BMI were also significantly higher in the ICSI parents. In the ICSI-conceived females significant differences in high-density lipoprotein cholesterol (1.5 ± 0.3 versus 1.6 ± 0.3 mmol/l, P = 0.033) and triglyceride values (1.1 ± 0.5 versus 1.0 ± 0.4 mmol/l, P = 0.013) were observed. ICSI mothers also had significantly higher triglycerides (P = 0.002), higher glutamate pyruvate transaminase/alanine aminotransferase (P < 0.001) and higher alkaline phosphatase values (P < 0.001). CONCLUSIONS Increased values for weight were found in the male and differences in lipid parameters in the female ICSI-conceived adolescents, which were reflected in the values of their parents. Adjustment for parental risk factors generally attenuated the differences between the ICSI and the control groups, but did not completely remove them. Whether these observed differences are clinically relevant for the future health of the participants requires further study. To increase knowledge in this area, future studies should also include parental data.
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Affiliation(s)
- Susanne Elsner
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck 23562, Germany
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck 23562, Germany
| | - Annika K Ludwig
- Praxis für Frauengesundheit und Pränatalmedizin, Prof. Dr. med. Annika Ludwig and Kollegen, Hamburg 22763, Germany
| | | | - Max Johannes Martensen
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck 23562, Germany
| | - Dorthe Kixmüller
- Institute for Clinical Chemistry, University of Kiel, Kiel 24105, Germany
| | - Nora Eisemann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck 23562, Germany
| | - Michael Ludwig
- SYNLAB Holding Deutschland GmbH, Augsburg 86156, Germany.
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Wienbergen H, Fach A, Erdmann J, Katalinic A, Eisemann N, Krawitz P, Maj C, Borisov O, Munz M, Noethen M, Meyer-Saraei R, Osteresch R, Schmucker J, Linke A, Eitel I, Hambrecht R, Langer H. New technologies for intensive prevention programs after myocardial infarction: rationale and design of the NET-IPP trial. Clin Res Cardiol 2020; 110:153-161. [DOI: 10.1007/s00392-020-01695-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/19/2020] [Indexed: 12/15/2022]
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Sonntag B, Eisemann N, Elsner S, Ludwig AK, Katalinic A, Kixmüller D, Ludwig M. Pubertal development and reproductive hormone levels of singleton ICSI offspring in adolescence: results of a prospective controlled study. Hum Reprod 2020; 35:968-976. [DOI: 10.1093/humrep/deaa021] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/04/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
STUDY QUESTION
Are there any differences in the pubertal development and reproductive hormone status during adolescence between singletons following ICSI therapy or spontaneous conception (SC)?
SUMMARY ANSWER
Pubertal development and reproductive hormone levels are largely similar between ICSI and SC adolescents, except for a tendency towards lower inhibin B levels as well as significantly higher estradiol levels and a lower testosterone-to-estradiol-ratio in male adolescents.
WHAT IS KNOWN ALREADY
Previous data are scarce and partly inconclusive regarding pubertal development in female ICSI adolescents as well as demonstrating a tendency towards lower inhibin B serum levels in male ICSI offspring.
STUDY DESIGN, SIZE, DURATION
Prospective controlled study including 274 singleton ICSI-conceived adolescents (141 girls, 133 boys) followed up for the third time, and 273 SC controls (142 girls, 131 boys) from seven German registration offices (Aachen, Eichstätt, Erfurt, Lübeck, Hamburg, Heidelberg and Schwerin).
PARTICIPANTS/MATERIALS, SETTING, METHODS
Pubertal development assessed by Tanner staging (breast, genital and pubic hair development), age at menarche and reproductive hormone levels were analyzed in ICSI and SC adolescents at the mean age of 16.5 years. Differences were analyzed by multinomial regression (Tanner stages) or t test and linear regression for hormonal assessments.
MAIN RESULTS AND THE ROLE OF CHANCE
Both female and male ICSI and SC adolescents showed adequate pubertal maturation according to their age, and the mean age at menarche (at 12.7 versus 12.8 years) was similar. Tanner stages as well did not display any relevant or significant differences between the groups. Reproductive hormone levels in female adolescents not using hormonal contraception were largely similar before and after adjustment for several factors such as preterm birth, Tanner stages, BMI or physical activity. In male ICSI adolescents, a tendency towards lower inhibin B (−14.8 pg/ml, 95% CI: −34.2 to 4.6 pg/ml), significantly higher estradiol (2.6 ng/l, 95% CI: 0.0 to 5.2 ng/l) and a significantly lower testosterone-to estradiol ratio (−0.047, 95% CI: −0.089 to −0.004) was found.
LIMITATIONS, REASONS FOR CAUTION
The all-over response rate and the willingness to participate in the blood test and medical examination were very low in the control group. Participating control families may have greater health awareness, and selection bias cannot be ruled out. Hormonal data in the females were measured irrespective of the cycle day and restricted to those not using hormonal contraception. Some parameters from the questionnaire data such as usage of hormonal contraception might suffer from reporting bias. As this is an observational study, we can draw only limited causal conclusions from the findings.
WIDER IMPLICATIONS OF THE FINDINGS
Differences in male reproductive hormones may indicate altered testicular function. However, at this time possible consequences for later reproductive success are unknown.
STUDY FUNDING/COMPETING INTEREST(S)
DFG research grant KA 1643/4-1. The authors declare no conflict of interest.
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Affiliation(s)
- B Sonntag
- Facharztzentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie, amedes experts Hamburg, 20095 Hamburg, Germany
| | - N Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, 23538 Lübeck, Germany
| | - S Elsner
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, 23538 Lübeck, Germany
| | - A K Ludwig
- Praxis für Frauengesundheit und Pränatalmedizin, 22763 Hamburg, Germany
| | - A Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, 23538 Lübeck, Germany
| | - D Kixmüller
- Institute of Clinical Chemistry, University Medical Centre Schleswig-Holstein, 23538 Lübeck, Germany
| | - M Ludwig
- SYNLAB Holding Deutschland GmbH, 86156 Augsburg, Germany
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26
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Frielitz FS, Müller-Godeffroy E, Hübner J, Eisemann N, Dördelmann J, Menrath I, Katalinic A, Hiort O, von Sengbusch S. Monthly Video-Consultation for Children With Type 1 Diabetes Using a Continuous Glucose Monitoring System: Design of ViDiKi, a Multimethod Intervention Study to Evaluate the Benefit of Telemedicine. J Diabetes Sci Technol 2020; 14:105-111. [PMID: 31315446 PMCID: PMC7189148 DOI: 10.1177/1932296819861991] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The introduction of continuous glucose monitoring (CGM) implies new challenges for diabetes care. As CGM systems are often directly linked to a web-based software solution, structured telemedicine care using a video-consultation may be a new option for families who care for children with type 1 diabetes mellitus (T1DM). METHODS "ViDiKi" (Virtual Diabetes Outpatient Clinic for Children and Youth) is a multicenter controlled trial carried out in Northern Germany. ViDiKi will examine if monthly telemedical consultations, in addition to regular care, will improve glycemic control and psychosocial outcomes. The primary outcome is glycemic control as measured by a change in glycated hemoglobin (HbA1c). A total of 240 participants aged between one year and 16 years using a CGM with multiple daily injections (MDI) or insulin pump therapy were recruited and assigned to a starter group or a six-month waiting control group. The sample size is designed to detect a between-group difference of 0.5% in HbA1c change at six months. Secondary outcomes are variability of blood glucose, health-related quality of life, self-efficacy, and satisfaction with telemedicine. To gain deeper insight into the experience of using telemedicine, qualitative interviews will be conducted. In a health-economic analysis, the costs of telemedicine and a cost-of-care analysis will be calculated. CONCLUSIONS The results from the ViDiKi study shall give important information on the feasibility and putative benefits of telemedicine in children with T1DM and their caregivers. GERMAN CLINICAL TRAILS REGISTER (DRKS) DRKS00012645.
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Affiliation(s)
- Fabian-Simon Frielitz
- Institute of Social Medicine and
Epidemiology, University of Luebeck, Germany
- Fabian-Simon Frielitz, Institute for Social
Medicine and Epidemiology, University of Luebeck, Ratzeburger Allee 160, Luebeck
23562, Germany.
| | - Esther Müller-Godeffroy
- Department of Pediatric Endocrinology
and Diabetology, University Medical Center, Campus Luebeck, Germany
| | - Joachim Hübner
- Institute of Social Medicine and
Epidemiology, University of Luebeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and
Epidemiology, University of Luebeck, Germany
| | - Jana Dördelmann
- Institute of Social Medicine and
Epidemiology, University of Luebeck, Germany
| | - Ingo Menrath
- Department of Pediatric Endocrinology
and Diabetology, University Medical Center, Campus Luebeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and
Epidemiology, University of Luebeck, Germany
| | - Olaf Hiort
- Department of Pediatric Endocrinology
and Diabetology, University Medical Center, Campus Luebeck, Germany
| | - Simone von Sengbusch
- Department of Pediatric Endocrinology
and Diabetology, University Medical Center, Campus Luebeck, Germany
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Katalinic A, Eisemann N, Kraywinkel K, Noftz MR, Hübner J. Breast cancer incidence and mortality before and after implementation of the German mammography screening program. Int J Cancer 2019; 147:709-718. [DOI: 10.1002/ijc.32767] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/04/2019] [Accepted: 10/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Alexander Katalinic
- Institute for Social Medicine and EpidemiologyUniversity of Lübeck Lübeck Germany
- Institute for Cancer EpidemiologyUniversity of Lübeck Lübeck Germany
| | - Nora Eisemann
- Institute for Social Medicine and EpidemiologyUniversity of Lübeck Lübeck Germany
| | - Klaus Kraywinkel
- Department for Epidemiology and Health ReportingGerman Centre for Cancer Registry Data, Robert Koch‐Institute Berlin Germany
| | - Maria R. Noftz
- Institute for Social Medicine and EpidemiologyUniversity of Lübeck Lübeck Germany
| | - Joachim Hübner
- Institute for Social Medicine and EpidemiologyUniversity of Lübeck Lübeck Germany
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Hübner J, Eisemann N, Brunßen A, Katalinic A. [Skin cancer screening in Germany: review after ten years]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:1536-1543. [PMID: 30411137 DOI: 10.1007/s00103-018-2836-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/27/2022]
Abstract
In 2008, a nationwide population-based skin cancer screening program was introduced in Germany. Its potential to reduce the skin cancer-related burden of disease is the subject of a controversial debate. This article gives an overview on the epidemiology of cutaneous melanoma of the skin and nonmelanoma skin cancer, on the history and practice of the current program, and appraises the evidence of screening for skin cancer based on a selective search for literature and data.The incidence of skin cancer has increased markedly throughout the last decades. The available evidence indicates efficacy of screening for skin cancer, but on a low level. Randomized controlled trials are lacking and the available evidence is based largely on the pilot study SCREEN which was conducted in 2003/2004 in Schleswig-Holstein, Germany. Following this pilot study, a marked decline of melanoma mortality was observed. After implementation of nationwide skin cancer screening, a mortality reduction has not appeared so far.A comparison of nationwide skin cancer screening and the SCREEN project suggests a lower intensity of the current screening program. Its process and outcome quality requires further investigations. Improved documentation allowing for a linkage between screening procedures conducted by nondermatologists and dermatologists is desirable. Personal invitations could help to reach individuals who currently make little or no use of skin cancer screening but might benefit from it.
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Affiliation(s)
- Joachim Hübner
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland.
| | - Nora Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland
| | - Alicia Brunßen
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland
| | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland
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29
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Hübner J, Lewin P, Pritzkuleit R, Eisemann N, Maier W, Katalinic A. Colorectal cancer screening by colonoscopy and trends in disease-specific mortality: a population-based ecological study of 358 German districts. Int J Colorectal Dis 2019; 34:599-605. [PMID: 30627848 DOI: 10.1007/s00384-018-03226-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Accepted: 12/21/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE Screening for colorectal cancer (CRC) by colonoscopy was implemented in Germany in 2002. Although the procedure has proven to be effective in reducing disease-specific mortality in numerous clinical studies, its effect at the population level is unclear. We performed an ecological study at the level of 358 German districts, testing the hypothesis that a higher participation rate in screening colonoscopy is associated with a stronger decline in CRC mortality from 2001 to 2012. METHODS Information on the use of colonoscopy in each district was extracted from settlement data, used for the remuneration of physicians of the ambulant sector from 2008 to 2011. Yearly mortality rates for each district from 2001 to 2012 were derived from the official mortality statistics. A spatial model was fitted, considering other factors which might influence early detection of CRC (fecal occult blood test (FOBT), diagnostic colonoscopy, material and social area deprivation, and rural-urban disparities). RESULTS The population-weighted mean annual participation rate during 2008-2011 in screening colonoscopy was 2.0% (range 0.6 to 3.9%). The weighted mean annual percentage change (APC) of CRC mortality was - 2.9% (range - 7.8 to 1.2%). According to the fully adjusted model, a 1% higher annual participation rate in colonoscopy screening was associated with an additional annual change in CRC mortality rate of - 0.34% (p = 0.015). Given an annual 2.0% participation rate, colonoscopy screening attributed 23% to the observed decline. CONCLUSIONS Our real-world data from Germany provide first evidence that colonoscopy screening for CRC is effective in reducing disease-specific mortality at the population level.
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Affiliation(s)
- Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Philip Lewin
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Ron Pritzkuleit
- Institute of Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Werner Maier
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.,Institute of Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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30
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Menrath I, Ernst G, Lange K, Eisemann N, Szczepanski R, Staab D, Degner M, Thyen U. Evaluation of a generic patient education program in children with different chronic conditions. Health Educ Res 2019; 34:50-61. [PMID: 30535075 DOI: 10.1093/her/cyy045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/13/2018] [Indexed: 06/09/2023]
Abstract
For frequent pediatric chronic conditions, especially less common chronic conditions patient education programs are missing. A recently developed modular patient education approach (ModuS) combines disease-specific modules with generic psychosocial topics. ModuS was associated with increased disease-specific knowledge and improvements in families' well-being in children with asthma. In this study we tested if new developed ModuS programs for seven, mostly less common, chronic conditions show comparable program-associated effects. ModuS education programs were offered to the affected child and its parents. Disease-specific knowledge, children's health-related quality of life, life satisfaction and condition-specific burden were measured before, directly following and 6 weeks after participation in the program. The results were compared with families who received a ModuS asthma program. One hundred and sixty-eight children participated. Families were highly satisfied with the programs. Program participation was associated with increased families' knowledge, children`s self-reported health-related quality of life and reduced condition-specific burden. The results were comparable with the results of 230 families who participated in a ModuS asthma program. The ModuS approach allowed the development of patient education programs for children with a variety of chronic conditions. Therefore, ModuS closed an important healthcare gap.
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Affiliation(s)
- Ingo Menrath
- Department of Pediatrics, Luebeck University, Luebeck, Germany
| | - Gundula Ernst
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Karin Lange
- Department of Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, Luebeck University, Luebeck, Germany
| | | | - Doris Staab
- Department of Pediatric Pulmonology and Immunology, Charité, Berlin, Germany
| | - Mareike Degner
- Department of Pediatrics, Luebeck University, Luebeck, Germany
| | - Ute Thyen
- Department of Pediatrics, Luebeck University, Luebeck, Germany
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Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, Allemani C, Bouzbid S, Hamdi-Chérif M, Zaidi Z, Bah E, Swaminathan R, Nortje S, El Mistiri M, Bayo S, Malle B, Manraj S, Sewpaul-Sungkur R, Fabowale A, Ogunbiyi O, Bradshaw D, Somdyala N, Stefan D, Abdel-Rahman M, Jaidane L, Mokni M, Kumcher I, Moreno F, González M, Laura E, Espinola S, Calabrano G, Carballo Quintero B, Fita R, Garcilazo D, Giacciani P, Diumenjo M, Laspada W, Green M, Lanza M, Ibañez S, Lima C, Lobo de Oliveira E, Daniel C, Scandiuzzi C, De Souza P, Melo C, Del Pino K, Laporte C, Curado M, de Oliveira J, Veneziano C, Veneziano D, Latorre M, Tanaka L, Azevedo e Silva G, Galaz J, Moya J, Herrmann D, Vargas S, Herrera V, Uribe C, Bravo L, Arias-Ortiz N, Jurado D, Yépez M, Galán Y, Torres P, Martínez-Reyes F, Pérez-Meza M, Jaramillo L, Quinto R, Cueva P, Yépez J, Torres-Cintrón C, Tortolero-Luna G, Alonso R, Barrios E, Nikiforuk C, Shack L, Coldman A, Woods R, Noonan G, Turner D, Kumar E, Zhang B, McCrate F, Ryan S, Hannah H, Dewar R, MacIntyre M, Lalany A, Ruta M, Marrett L, Nishri D, McClure C, Vriends K, Bertrand C, Louchini R, Robb K, Stuart-Panko H, Demers S, Wright S, George J, Shen X, Brockhouse J, O'Brien D, Ward K, Almon L, Bates J, Rycroft R, Mueller L, Phillips C, Brown H, Cromartie B, Schwartz A, Vigneau F, MacKinnon J, Wohler B, Bayakly A, Clarke C, Glaser S, West D, Green M, Hernandez B, Johnson C, Jozwik D, Charlton M, Lynch C, Huang B, Tucker T, Deapen D, Liu L, Hsieh M, Wu X, Stern K, Gershman S, Knowlton R, Alverson J, Copeland G, Rogers D, Lemons D, Williamson L, Hood M, Hosain G, Rees J, Pawlish K, Stroup A, Key C, Wiggins C, Kahn A, Schymura M, Leung G, Rao C, Giljahn L, Warther B, Pate A, Patil M, Schubert S, Rubertone J, Slack S, Fulton J, Rousseau D, Janes T, Schwartz S, Bolick S, Hurley D, Richards J, Whiteside M, Nogueira L, Herget K, Sweeney C, Martin J, Wang S, Harrelson D, Keitheri Cheteri M, Farley S, Hudson A, Borchers R, Stephenson L, Espinoza J, Weir H, Edwards B, Wang N, Yang L, Chen J, Song G, Gu X, Zhang P, Ge H, Zhao D, Zhang J, Zhu F, Tang J, Shen Y, Wang J, Li Q, Yang X, Dong J, Li W, Cheng L, Chen J, Huang Q, Huang S, Guo G, Wei K, Chen W, Zeng H, Demetriou A, Pavlou P, Mang W, Ngan K, Swaminathan R, Kataki A, Krishnatreya M, Jayalekshmi P, Sebastian P, Sapkota S, Verma Y, Nandakumar A, Suzanna E, Keinan-Boker L, Silverman B, Ito H, Nakagawa H, Hattori M, Kaizaki Y, Sugiyama H, Utada M, Katayama K, Narimatsu H, Kanemura S, Koike T, Miyashiro I, Yoshii M, Oki I, Shibata A, Matsuda T, Nimri O, Ab Manan A, Bhoo-Pathy N, Tuvshingerel S, Chimedsuren O, Al Khater A, El Mistiri M, Al-Eid H, Jung K, Won Y, Chiang C, Lai M, Suwanrungruang K, Wiangnon S, Daoprasert K, Pongnikorn D, Geater S, Sriplung H, Eser S, Yakut C, Hackl M, Mühlböck H, Oberaigner W, Zborovskaya A, Aleinikova O, Henau K, Van Eycken L, Dimitrova N, Valerianova Z, Šekerija M, Zvolský M, Engholm G, Storm H, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier A, Faivre J, Guizard A, Bouvier V, Launoy G, Arveux P, Maynadié M, Mounier M, Fournier E, Woronoff A, Daoulas M, Clavel J, Le Guyader-Peyrou S, Monnereau A, Trétarre B, Colonna M, Cowppli-Bony A, Molinié F, Bara S, Degré D, Ganry O, Lapôtre-Ledoux B, Grosclaude P, Estève J, Bray F, Piñeros M, Sassi F, Stabenow R, Eberle A, Erb C, Nennecke A, Kieschke J, Sirri E, Kajueter H, Emrich K, Zeissig S, Holleczek B, Eisemann N, Katalinic A, Brenner H, Asquez R, Kumar V, Ólafsdóttir E, Tryggvadóttir L, Comber H, Walsh P, Sundseth H, Devigili E, Mazzoleni G, Giacomin A, Bella F, Castaing M, Sutera A, Gola G, Ferretti S, Serraino D, Zucchetto A, Lillini R, Vercelli M, Busco S, Pannozzo F, Vitarelli S, Ricci P, Pascucci C, Autelitano M, Cirilli C, Federico M, Fusco M, Vitale M, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Maule M, Sacerdote C, Tumino R, Di Felice E, Vicentini M, Falcini F, Cremone L, Budroni M, Cesaraccio R, Contrino M, Tisano F, Fanetti A, Maspero S, Candela G, Scuderi T, Gentilini M, Piffer S, Rosso S, Sacchetto L, Caldarella A, La Rosa F, Stracci F, Contiero P, Tagliabue G, Dei Tos A, Zorzi M, Zanetti R, Baili P, Berrino F, Gatta G, Sant M, Capocaccia R, De Angelis R, Liepina E, Maurina A, Smailyte G, Agius D, Calleja N, Siesling S, Visser O, Larønningen S, Møller B, Dyzmann-Sroka A, Trojanowski M, Góźdż S, Mężyk R, Grądalska-Lampart M, Radziszewska A, Didkowska J, Wojciechowska U, Błaszczyk J, Kępska K, Bielska-Lasota M, Kwiatkowska K, Forjaz G, Rego R, Bastos J, Silva M, Antunes L, Bento M, Mayer-da-Silva A, Miranda A, Coza D, Todescu A, Valkov M, Adamcik J, Safaei Diba C, Primic-Žakelj M, Žagar T, Stare J, Almar E, Mateos A, Quirós J, Bidaurrazaga J, Larrañaga N, Díaz García J, Marcos A, Marcos-Gragera R, Vilardell Gil M, Molina E, Sánchez M, Franch Sureda P, Ramos Montserrat M, Chirlaque M, Navarro C, Ardanaz E, Moreno-Iribas C, Fernández-Delgado R, Peris-Bonet R, Galceran J, Khan S, Lambe M, Camey B, Bouchardy C, Usel M, Ess S, Herrmann C, Bulliard J, Maspoli-Conconi M, Frick H, Kuehni C, Schindler M, Bordoni A, Spitale A, Chiolero A, Konzelmann I, Dehler S, Matthes K, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Bannon F, Black R, Brewster D, Huws D, White C, Finan P, Allemani C, Bonaventure A, Carreira H, Coleman M, Di Carlo V, Harewood R, Liu K, Matz M, Montel L, Nikšić M, Rachet B, Sanz N, Spika D, Stephens R, Peake M, Chalker E, Newman L, Baker D, Soeberg M, Aitken J, Scott C, Stokes B, Venn A, Farrugia H, Giles G, Threlfall T, Currow D, You H, Hendrix J, Lewis C. Erratum to “The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)” [Gynecol. Oncol. 144 (2017) 405–413]. Gynecol Oncol 2017; 147:726. [DOI: 10.1016/j.ygyno.2017.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Eisemann N, Waldmann A, Holleczek B, Katalinic A. Observed and expected mortality in the German skin cancer screening pilot project SCREEN. J Med Screen 2017; 25:166-168. [DOI: 10.1177/0969141317734003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective The main purpose of skin cancer screening is melanoma mortality reduction. Before the implementation of nationwide German skin cancer screening, the pilot project SCREEN was conducted in Schleswig-Holstein in 2003–2004. We aimed to determine whether the pilot project had achieved a mortality reduction. Methods Using an incidence-based approach (patients with both melanoma diagnosis and death in 2003–2008), we compared the observed melanoma mortality of the SCREEN cohort to the melanoma mortality expected without screening in the general population of Saarland. Results The age- and sex-standardized melanoma mortality ratio (SMR) for 5.5 years of follow-up was 0.59 (95% confidence interval, 0.40–0.83). Conclusion Our results indicate reduced mortality in the SCREEN cohort. Several potential biases cannot be excluded, but most of them tend to inflate the SMR.
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Affiliation(s)
- Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Annika Waldmann
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Hamburg Cancer Registry, Authority for Health and Consumer Protection, Hamburg, Germany
| | | | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany
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Pulte D, Weberpals J, Jansen L, Luttmann S, Holleczek B, Nennecke A, Ressing M, Katalinic A, Brenner H, Geiss K, Meyer M, Eberle A, Luttmann S, Stabenow R, Hentschel S, Nennecke A, Kieschke J, Sirri E, Holleczek B, Emrich K, Kajüter H, Mattauch V, Katalinic A, Eisemann N, Barnes B, Kraywinkel K, Brenner H, Jansen L, Weberpals J. Survival for patients with rare haematologic malignancies: Changes in the early 21st century. Eur J Cancer 2017; 84:81-87. [DOI: 10.1016/j.ejca.2017.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 11/15/2022]
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Brunßen A, Jansen L, Eisemann N, Weberpals J, Katalinic A. Recent trends in relative survival from melanoma in Germany stratified by age group, T-stage, and histological subtype. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Brunßen
- University of Luebeck, Institute for Social Medicine and Epidemiology, Luebeck
| | - L Jansen
- German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Heidelberg
| | - N Eisemann
- University of Luebeck, Institute for Social Medicine and Epidemiology, Luebeck
| | - J Weberpals
- German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research, Heidelberg
| | - A Katalinic
- University of Luebeck, Institute for Cancer Epidemiology, Luebeck
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Eisemann N, Katalinic A. Heilung und konkurrierende Todesursachen – Überlebenszeitanalysen in der Krebsepidemiologie. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- N Eisemann
- Universität zu Lübeck, Institut für Sozialmedizin und Epidemiologie, Lübeck
| | - A Katalinic
- Universität zu Lübeck, Institut für Sozialmedizin und Epidemiologie, Lübeck
- Universität zu Lübeck, Institut für Krebsepidemiologie, Lübeck
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Ernst G, Menrath I, Lange K, Eisemann N, Staab D, Thyen U, Szczepanski R. Development and evaluation of a generic education program for chronic diseases in childhood. Patient Educ Couns 2017; 100:1153-1160. [PMID: 28109650 DOI: 10.1016/j.pec.2017.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To support families with a chronically ill child, a modular curriculum and new healthcare structures (trainer education, quality management) for a group self-management program (ModuS) were developed. ModuS focuses on common psychosocial aspects of chronic conditions and comprises generic and disease-specific modules. A pilot test was conducted for asthma by comparing ModuS with an established asthma-specific education program (CAE). METHODS Under routine care conditions, 491 children (6-17 years) with asthma and their parents participated in a multi-center prospective study (265 ModuS; 226 CAE). Families' program satisfaction, disease-specific knowledge, health-related quality of life (HRQoL), life satisfaction, and burden of disease were assessed before, directly following and six weeks after participation. RESULTS The families were highly satisfied with the program. CAE and ModuS were associated with improved disease-specific knowledge, childreńs HRQoL and life satisfaction and decreased the families' burden. This demonstrates comparability of existing care with the modular approach. CONCLUSION The ModuS approach offers a structure for effective patient education programs aiming to improve self-management. As it focused on the similarities of chronic conditions, it provides the opportunity to establish education programs for a wide range of chronic childhood diseases. PRACTICE IMPLICATIONS ModuS facilitates the development of new patient education programs.
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Affiliation(s)
- Gundula Ernst
- Dept. Medical Psychology, Hannover Medical School, Hannover, Germany.
| | - Ingo Menrath
- Dept. of Pediatrics, Luebeck University, Luebeck, Germany
| | - Karin Lange
- Dept. Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, Luebeck University, Luebeck, Germany
| | - Doris Staab
- Dept. of Pediatric Pulmonology and Immunology, Charité, Berlin, Germany
| | - Ute Thyen
- Dept. of Pediatrics, Luebeck University, Luebeck, Germany
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Rapp M, Eisemann N, Arnaud C, Ehlinger V, Fauconnier J, Marcelli M, Michelsen SI, Nystrand M, Colver A, Thyen U. Predictors of parent-reported quality of life of adolescents with cerebral palsy: A longitudinal study. Res Dev Disabil 2017; 62:259-270. [PMID: 28110883 DOI: 10.1016/j.ridd.2016.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/14/2016] [Accepted: 12/18/2016] [Indexed: 06/06/2023]
Abstract
AIM Parent-reporting is needed to examine Quality of Life (QoL) of children with cerebral palsy (CP) across all severities. This study examines whether QoL changes between childhood and adolescence, and what predicts adolescent QoL. METHOD SPARCLE is a European cohort study of children with CP, randomly sampled from population databases. Of 818 8-12-year-olds joining the study, 594 (73%) were revisited as 13-17-year-olds. The subject of this report is the 551 (316 boys, 235 girls) where the same parent reported QoL on both occasions using KIDSCREEN-52 (transformed Rasch scale, mean 50, SD 10 per domain). Associations were assessed using linear regression. RESULTS Between childhood and adolescence, average QoL reduced in six domains (1.3-3.8 points, p<0.01) and was stable in three (Physical wellbeing, Autonomy, Social acceptance). Socio-demographic factors had little predictive value. Childhood QoL was a strong predictor of all domains of adolescent QoL. Severe impairments of motor function, IQ or communication predicted higher adolescent QoL on some domains; except that severe motor impairment predicted lower adolescent QoL on the Autonomy domain. More psychological problems and higher parenting stress in childhood and their worsening by adolescence predicted lower QoL in five and eight domains respectively; contemporaneous pain in seven domains. The final model explained 30%-40% of variance in QoL, depending on domain. INTERPRETATION In general, impairment severity and socio-demographic factors were not predictors of lower adolescent QoL. However, pain, psychological problems and parenting stress were predictors of lower adolescent QoL in most domains. These are modifiable factors and addressing them may improve adolescent QoL.
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Affiliation(s)
- Marion Rapp
- Department of Pediatrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - Catherine Arnaud
- INSERM, UMR 1027, Paul Sabatier University, Purpan, Clinical Epidemiology Unit, Toulouse, France.
| | | | - Jérôme Fauconnier
- UJF-Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France.
| | | | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Malin Nystrand
- Gothenburg University, The Queen Silvia Children's Hospital, S-41685 Gothenburg, Sweden.
| | - Allan Colver
- Institute of Health and Society, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Ute Thyen
- Department of Pediatrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
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Hübner J, Waldmann A, Geller AC, Weinstock MA, Eisemann N, Noftz M, Bertram S, Nolte S, Volkmer B, Greinert R, Breitbart E, Katalinic A. Interval cancers after skin cancer screening: incidence, tumour characteristics and risk factors for cutaneous melanoma. Br J Cancer 2017; 116:253-259. [PMID: 27898656 PMCID: PMC5243984 DOI: 10.1038/bjc.2016.390] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 07/18/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The rate of interval cancers is an established indicator for the performance of a cancer-screening programme. METHODS We examined the incidence, tumour characteristics and risk factors of melanoma interval cancers that occurred in participants of the SCREEN project, which was carried out 2003/2004 in Schleswig-Holstein, Germany. Data from 350 306 SCREEN participants, who had been screened negative for melanoma, were linked to data of the state cancer registry. Melanoma interval cancers were defined as melanomas diagnosed within 4-24 months after SCREEN examination. Results were compared with melanomas of the pre-SCREEN era (1999-2002), extracted from the cancer registry. RESULTS The overall relative incidence of melanoma interval cancers in terms of observed/expected ratio was 0.93 (95% CI: 0.82-1.05; in situ: 1.61 (1.32-1.95), invasive: 0.71 (0.60-0.84)). Compared with melanomas of the pre-SCREEN era, the interval melanomas were thinner and had a slightly greater proportion of lentigo maligna melanomas whereas nodular melanomas were less frequent. INTERPRETATION The results indicate a moderate performance of the SCREEN intervention with an excess of in situ melanomas. In part, the findings might be due to specifics of the SCREEN project, in particular a short-term follow-up of patients at high risk for melanoma.
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Affiliation(s)
- J Hübner
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - A Waldmann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - A C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - M A Weinstock
- Center for Dermatoepidemiology, VA Medical Center—111D, 830 Chalkstone Avenue, Providence, RI 02908, USA
- Department of Dermatology, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA
- Departments of Dermatology and Epidemiology, Brown University, 593 Eddy Street, Providence, RI 02903, USA
| | - N Eisemann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - M Noftz
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - S Bertram
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - S Nolte
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany
- Population Health Strategic Research Centre, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia
| | - B Volkmer
- Division of Molecular Cell Biology, Dermatology Center, Elbe Clinics Stade-Buxtehude, Am Krankenhaus 1, Buxtehude 21614, Germany
| | - R Greinert
- Division of Molecular Cell Biology, Dermatology Center, Elbe Clinics Stade-Buxtehude, Am Krankenhaus 1, Buxtehude 21614, Germany
| | - E Breitbart
- Association of Dermatological Prevention e.V., Cremon 11, Hamburg 20457, Germany
| | - A Katalinic
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
- Cancer Registry of Schleswig-Holstein, Ratzeburger Allee 160, Lübeck 23562, Germany
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Brunssen A, Waldmann A, Eisemann N, Katalinic A. Impact of skin cancer screening and secondary prevention campaigns on skin cancer incidence and mortality: A systematic review. J Am Acad Dermatol 2017; 76:129-139.e10. [DOI: 10.1016/j.jaad.2016.07.045] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/20/2016] [Accepted: 07/24/2016] [Indexed: 11/26/2022]
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Katalinic A, Eisemann N, Waldmann A. Skin Cancer Screening in Germany. Documenting Melanoma Incidence and Mortality From 2008 to 2013. Dtsch Arztebl Int 2016; 112:629-34. [PMID: 26429634 DOI: 10.3238/arztebl.2015.0629] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/15/2015] [Accepted: 06/15/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Nationwide skin cancer screening was introduced in Germany in 2008. The positive results of a pilot project carried out in 2003-4 in the federal state of Schleswig-Holstein had implied that screening would lower the mortality from melanoma. METHODS Data on the incidence of invasive malignant melanoma of the skin (MM; ICD-10: C43) were extracted from the databases of the Association of Population-based Cancer Registries in Germany (GEKID) and from the Schleswig-Holstein cancer registry. Mortality rates were extracted from the official cause-of-death statistics. RESULTS With the beginning of nationwide screening in 2008, the age-standardized incidence rate in Germany increased by approximately 28% to 18.2 cases per 100 000 persons in 2010. In Schleswig-Holstein, the incidence fell after the pilot project ended and has been comparable to the nationwide incidence since 2008. For Germany overall, there has been no downward trend in MM mortality since the introduction of nationwide screening; in 2013, the mortality rate was 2.3 deaths per 100 000 persons per year. In the area of the pilot study, mortality declined to a level of 1.0/100 000/year until 2008 and then began to rise again. At present, the mortality due to MM in Schleswig- Holstein is once again the same as that in Germany overall (2.4/100 000/year). CONCLUSION The introduction of nationwide skin cancer screening in 2008 has not yet led to any measurable decline in mortality due to melanoma. The current method of screening seems to be less thorough than that used in the pilot project; this may explain the absence of a decline in MM-related mortality in Germany overall up to the year 2013, as well as the rising mortality in Schleswig-Holstein since the end of the pilot program. The generation of a robust set of data on how skin cancer screening can be optimized now seems urgently necessary.
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Affiliation(s)
- Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University Medical Center, Lübeck, Institute for Cancer Epidemiology e.V., University of L¨beck
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Stahlmann N, Eisemann N, Thyen U, Herting E, Rapp M. Long-Term Health Outcomes and Health-Related Quality of Life in Adolescents from a Cohort of Extremely Premature Infants Born at Less Than 27 Weeks of Gestation in Northern Germany. Neuropediatrics 2016; 47:388-398. [PMID: 27701681 DOI: 10.1055/s-0036-1593373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Little is known about the psychosocial development and health-related quality of life (HRQOL) of extremely preterm infants once they are adolescents. Methods The regional population-based study cohort included 90 extremely premature infants (< 27+0 gestational weeks) born between January 1997 and December 1999 in the German state of Schleswig-Holstein. In addition to a neurological and cognitive Wechsler Intelligence Scale for Children, 4th edition assessment, self- and parent-reported psychological problems (Strengths and Difficulties Questionnaire), and health-related quality of life (KINDLR) were obtained and compared with a general population of 3,737 adolescents using data from a German Health Interview and Examination Survey for Children and Adolescents (KiGGS survey 2003-2006, Robert Koch Institute, Germany). Results Overall, 72 of the 90 surviving adolescents and their families (80.0%) participated in this study (mean age: 15.7 years; range: 14.2-17.2). A total of 22 adolescents (30.6%) did not have any neurosensory or cognitive limitations, whereas 31 adolescents (43.1%) were affected by multiple impairments. Parent-reported psychological problems were more common in the study cohort for the total difficulties score (11.3 points [standard deviation, SD: 5.9] vs. 7.7 points [SD: 5.0], p < 0.001) and for three of the five domains (emotional symptoms, hyperactivity-inattention, peer relationship problems) compared with the KiGGS reference population. In contrast, the rate of self-reported "abnormal" psychological problems was similar to the reference population. Parent-reported HRQOL was significantly lower in the study cohort for the total score (-3.7 points, p < 0.05) and for three of six subscales (emotional wellbeing, p < 0.05; self-esteem, p < 0.001, and wellbeing with regard to friends/friendship, p < 0.001). The adolescents themselves reported an HRQOL similar to that of the KiGGS reference population, though they rated their HRQOL higher for wellbeing with regard to families (p < 0.001) and wellbeing with regard to school/all-day function (p < 0.001). Overall, the parent- and self-reported HRQOL results were not associated with maternal education or disability status but were associated with adolescents' psychological problems. Conclusion Concordant with the high rate of functional and cognitive limitations, parents of adolescents who were born extremely prematurely faced more psychological problems in their children and reported a lower HRQOL compared with the KiGGS reference population. The adolescents themselves did not recognize these differences. However, having psychological problems was associated with lower self- and parent-reported HRQOL results.
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Affiliation(s)
- Nele Stahlmann
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Nora Eisemann
- Institut für Krebsepidemiologie, Universität zu Lübeck, Lübeck, Germany
| | - Ute Thyen
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
| | - Marion Rapp
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Lübeck, Germany
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Affiliation(s)
- N. Eisemann
- Institute of Social Medicine and Epidemiology; Ratzeburger Allee 160 23562 Lübeck Germany
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Hüppe A, Steimann G, Janotta M, Langbrandtner J, Eisemann N, Bokemeyer B, Raspe H. [Put to Test: Medical Inpatient Rehabilitation of Inflammatory Bowel Diseases]. REHABILITATION 2016; 55:248-55. [PMID: 27529302 DOI: 10.1055/s-0042-109590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Many CED-patients struggle with complex problem profiles and may be offered and profit from multidisciplinary multimodal rehabilitation. It is still unclear by whom and with what effects this option is used. METHODS We compared the results of an observational cohort study of 199 CED-inpatients of a single rehab clinic with those of 310 gastroenterological outpatients using propensity score matching. RESULTS Rehabilitands show more complex problem profiles than CED-outpatients. After 6 months of follow up direct and indirect change measures show generally small positive changes - however comparable in quality and size with that of matched outpatients. CONCLUSION Complex rehab is mainly used by CED-patients with several bio-psycho-social problems. Our preliminary data do not suggest a marked additional benefit of inpatient rehab compared to specialised outpatient care. Stricter controlled trials are urgently needed.
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Affiliation(s)
- A Hüppe
- Institut für Sozialmedizin und Epidemiologie der Universität Lübeck
| | | | - M Janotta
- Institut für Sozialmedizin und Epidemiologie der Universität Lübeck
| | - J Langbrandtner
- Institut für Sozialmedizin und Epidemiologie der Universität Lübeck
| | - N Eisemann
- Institut für Sozialmedizin und Epidemiologie der Universität Lübeck
| | - B Bokemeyer
- Gastroenterologische Gemeinschaftspraxis Minden
| | - H Raspe
- Zentrum für Bevölkerungsmedizin und Versorgungsforschung an der Universität Lübeck
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Abstract
BACKGROUND AND OBJECTIVES Nonmelanoma skin cancer (NMSC) is the most common malignant neoplasm in Germany. However, little is known about incidence trends of NMSC and its main subtypes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in Germany. MATERIAL AND METHODS Cancer registry data from fourteen German federal states was used to estimate age-standardized incidence rates by histologic subtype. Annual percentage changes (APC) were estimated in joinpoint regression models, in order to assess trend shifts in the years from 1998 to 2010. RESULTS In Germany, incidence rates of NMSC showed a significant increase from 43.1 cases/100 000 in 1998 to 105.2 cases/100 000 in 2010. Incidence rates and incidence increases revealed large regional variations. Basal cell carcinoma was the most common tumor followed by SCC. Men were more frequently affected than women, but incidence increases were steeper in women. CONCLUSIONS Results are consistent with national and international observations. The heterogeneity of incidence rates and their changes among federal states indicate that incidence changes are most likely related to improved case registration practices in German cancer registries.
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Affiliation(s)
- Christiane Rudolph
- Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
| | - Maike Schnoor
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Alexander Katalinic
- Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany.,Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
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Eisemann N, Jansen L, Castro F, Chen T, Eberle A, Nennecke A, Zeissig S, Brenner H, Katalinic A. Survival with nonmelanoma skin cancer in Germany. Br J Dermatol 2016; 174:778-85. [DOI: 10.1111/bjd.14352] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2015] [Indexed: 11/27/2022]
Affiliation(s)
- N. Eisemann
- Institute of Social Medicine and Epidemiology; University of Lübeck; Ratzeburger Allee 160 23562 Lübeck Germany
| | - L. Jansen
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); 69120 Heidelberg Germany
| | - F.A. Castro
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); 69120 Heidelberg Germany
| | - T. Chen
- Division of Molecular Genetic Epidemiology (C050); German Cancer Research Center (DKFZ); 69120 Heidelberg Germany
| | - A. Eberle
- Cancer Registry of Bremen; Achterstraße 30 28359 Bremen Germany
| | - A. Nennecke
- Cancer Registry of Hamburg; Billstraße 80 20539 Hamburg Germany
| | - S.R. Zeissig
- Cancer Registry of Rhineland-Palatinate; Obere Zahlbacher Straße 69 55131 Mainz Germany
| | - H. Brenner
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); 69120 Heidelberg Germany
- Division of Preventive Oncology; German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT); INF 460 69120 Heidelberg Germany
- German Cancer Consortium (DKTK); German Cancer Research Center (DKFZ); 69120 Heidelberg Germany
| | - A. Katalinic
- Institute of Social Medicine and Epidemiology; University of Lübeck; Ratzeburger Allee 160 23562 Lübeck Germany
- Institute of Cancer Epidemiology; University of Lübeck; Ratzeburger Allee 160 23562 Lübeck Germany
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Crocetti E, Mallone S, Robsahm TE, Gavin A, Agius D, Ardanaz E, Lopez MDC, Innos K, Minicozzi P, Borgognoni L, Pierannunzio D, Eisemann N. Survival of patients with skin melanoma in Europe increases further: Results of the EUROCARE-5 study. Eur J Cancer 2015; 51:2179-2190. [PMID: 26421821 DOI: 10.1016/j.ejca.2015.07.039] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [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: 03/13/2015] [Revised: 07/08/2015] [Accepted: 07/20/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND In Europe skin melanoma (SM) survival has increased over time. The aims were to evaluate recent trends and differences between countries and regions of Europe. METHODS Relative survival (RS) estimates and geographical comparisons were based on 241,485 patients aged 15years and over with a diagnosis of invasive SM in Europe (2000-2007). Survival time trends during 1999-2007 were estimated using the period approach, for 213,101 patients. Age, gender, sub-sites and morphology subgroups were considered. RESULTS In European patients, estimated 5-year RS was 83% (95% confidence interval, CI 83-84%). The highest values were found for patients resident in Northern (88%; 87-88%) and Central (88%; 87-88%) Europe, followed by Ireland and United Kingdom (UK) (86%; 85-86%) and Southern Europe (83%; 82-83%). The lowest survival was in Eastern Europe (74%; 74-75%). Within regions the intercountry absolute difference in percentage points of RS varied from 4% (North) to 34% (East). RS decreased markedly with patients' age and was higher in women than men. Differences according to SM morphology and skin sub-sites also emerged. Survival has slightly increased from 1999 to 2007, with a small improvement in Northern and the most pronounced improvement in Eastern Europe. DISCUSSION SM survival is high and still increasing in European patients. The gap between Northern and Southern and especially Eastern European countries, although still present, diminished over time. Differences in stage distribution at diagnosis may explain most of the geographical differences. However, part of the improvement in survival may be attributed to overdiagnosis from early diagnosis practices.
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Affiliation(s)
- Emanuele Crocetti
- UO Epidemiologia Clinica, Descrittiva e Registri - ISPO, Firenze, Italy.
| | - Sandra Mallone
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Trude Eid Robsahm
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queens University, Belfast, Northern Ireland, UK
| | - Domenic Agius
- Malta National Cancer Registry, Department of Health Information and Research, Pieta, Malta
| | - Eva Ardanaz
- Navarra Cancer Registry, Navarra Public Health Institute, Pamplona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria-Dolores Chirlaque Lopez
- Servicio de Epidemiología, Department of Epidemiology, Consejería de Sanidad, Murcia Health Authority, Murcia, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Kaire Innos
- Department of Epidemiology and Biostatistics National, Institute for Health Development, Tallinn, Estonia
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lorenzo Borgognoni
- SC Chirurgia Plastica e Ricostruttiva, Ospedale S.M. Annunziata - Azienda Sanitaria di Firenze Centro di Riferimento Regionale per il Melanoma, Istituto Toscano Tumori, Firenze, Italy
| | - Daniela Pierannunzio
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
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Holleczek B, Rossi S, Domenic A, Innos K, Minicozzi P, Francisci S, Hackl M, Eisemann N, Brenner H. On-going improvement and persistent differences in the survival for patients with colon and rectum cancer across Europe 1999-2007 - Results from the EUROCARE-5 study. Eur J Cancer 2015; 51:2158-2168. [PMID: 26421819 DOI: 10.1016/j.ejca.2015.07.024] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/09/2015] [Accepted: 07/19/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previous population-based studies revealed major variation in survival for patients with colorectal cancer (CRC) in Europe by age and between different countries and regions, but also a sustained improvement in survival for patients with CRC in recent years. This EUROCARE-5 paper aims to update available knowledge from previous studies and to provide the latest survival estimates for CRC patients from Europe. METHODS The study analysed data of patients diagnosed with CRC from population-based cancer registries diagnosed in 29 European countries. Estimates of 1-year and 5-year relative survival (RS) were derived for patients diagnosed in 2000-2007 by European region, country and age at diagnosis. Additionally to these cohort estimates, time trends in 5-year RS were obtained for the calendar periods 1999-2001 and 2005-2007, using the period analysis methodology. RESULTS European average 5-year RS for patients diagnosed with colon and rectum cancer was 57% and 56%, respectively. The analyses showed persistent differences in cancer survival across Europe with lowest survival for CRC patients observed in Eastern Europe. The analyses further showed a strong gradient in age-specific survival. Even though the study revealed sustained improvement in patient survival between 1999-2001 and 2005-2007 (absolute increase of 4 and 6 percentage points for colon and rectum, respectively), the differences in the survival for CRC patients observed at the beginning of the millennium persisted over time. CONCLUSION Although survival for CRC patients in Europe improved markedly in the study period, significant geographic variations and a strong age gradient still persisted. Enhanced access to effective diagnostic procedures and treatment options might be the keys to reducing the existing disparities in the survival of CRC patients across Europe.
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Affiliation(s)
- Bernd Holleczek
- Saarland Cancer Registry, Präsident Baltz Straße 5, 66119 Saarbrücken, Germany.
| | - Silvia Rossi
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena, 299, 00161 Rome, Italy
| | - Agius Domenic
- Malta National Cancer Registry, DHIR, 95, G'Mangia Hill, G'Mangia, Malta
| | - Kaire Innos
- National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine Fondazione IRCCS, Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Silvia Francisci
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena, 299, 00161 Rome, Italy
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Vienna, Austria
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), INF 581, 69120 Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ), INF 581, 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, INF 280, 69120 Heidelberg, Germany
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Wilfling D, Junghans A, Marshall L, Eisemann N, Meyer G, Möhler R, Köpke S. Non-pharmacological interventions for sleep disturbances in people with dementia. Cochrane Database of Systematic Reviews 2015. [DOI: 10.1002/14651858.cd011881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Denise Wilfling
- University of Lübeck; Nursing Research Group, Institute of Social Medicine and Epidemiology; Ratzeburger Allee 160 Lübeck Germany 23583
| | - Anne Junghans
- University of Lübeck; Nursing Research Group, Institute of Social Medicine and Epidemiology; Ratzeburger Allee 160 Lübeck Germany 23583
| | - Lisa Marshall
- University of Lübeck; Institute of Experimental and Clinical Pharmacology and Toxicology; Ratzeburger Allee 160 Lübeck Germany 23538
| | - Nora Eisemann
- University of Lübeck; Institute of Social Medicine and Epidemiology; Ratzeburger Allee 160 Lübeck Germany 23583
| | - Gabriele Meyer
- Martin-Luther-University Halle-Wittenberg; Institute of Health and Nursing Sciences; Magdeburger Straße 8 Halle (Saale) Germany 06112
| | - Ralph Möhler
- Witten/Herdecke University; School of Nursing Science, Faculty of Health; Stockumer Straße 12 Witten Germany 58453
| | - Sascha Köpke
- University of Lübeck; Nursing Research Group, Institute of Social Medicine and Epidemiology; Ratzeburger Allee 160 Lübeck Germany 23583
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Rudolph C, Schnoor M, Eisemann N, Katalinic A. Inzidenztrends bei nicht-melanozytärem Hautkrebs in Deutschland von 1998 bis 2010. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.40_12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Maike Schnoor
- Institut für Sozialmedizin und Epidemiologie; Universität Lübeck; Lübeck Deutschland
| | - Nora Eisemann
- Institut für Krebsepidemiologie; Universität Lübeck; Lübeck Deutschland
| | - Alexander Katalinic
- Institut für Krebsepidemiologie; Universität Lübeck; Lübeck Deutschland
- Institut für Sozialmedizin und Epidemiologie; Universität Lübeck; Lübeck Deutschland
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Kötter T, Obst KU, Brüheim L, Eisemann N, Voltmer E, Katalinic A. [Can Psychometric Tests Predict Success in the Selection Interview for Medical School? A Cross-Sectional Study at One German Medical School]. Gesundheitswesen 2015; 79:e40-e47. [PMID: 26154257 DOI: 10.1055/s-0035-1554705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background The final exam grade is the main selection criterion for medical school application in Germany. For academic success, it seems to be a reliable predictor. Its use as the only selection criterion is, however, criticised. At some universities, personal interviews are part of the selection process. However, these are very time consuming and are of doubtful validity. The (additional) use of appropriate psychometric instruments could reduce the cost and increase the validity. This study investigates the extent to which psychometric instruments can predict the outcome of a personal selection interview. Methods This is a cross-sectional study on the correlation of the results of psychometric instruments with those of the personal selection interview as part of the application process. As the outcome, the score of the selection interview was used. The NEO - Five Factor Inventory, the Hospital Anxiety and Depression Scale (HADS) and the questionnaire to identify work-related behaviour and experience patterns (AVEM) were used as psychometric interviews. Results There was a statistically significant correlation with the results of the personal selection interview for the sum score of the depression scale from the HADS and the sum score for the dimension of life satisfaction of the AVEM. In addition, those participants who did not previously complete an application training achieved a better result in the selection interview. Conclusion The instruments used measure different aspects than the interviews and cannot replace them. It remains to be seen whether the selected parameters are able to predict academic success.
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Affiliation(s)
- T Kötter
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
| | - K U Obst
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
| | - L Brüheim
- Sektion Medizin, Bereich Studium und Lehre, Universität zu Lübeck, Lübeck
| | - N Eisemann
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
| | - E Voltmer
- Lehrstuhl für Gesundheitswissenschaften, Theologische Hochschule Friedensau, Möckern-Friedensau
| | - A Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck
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