A method for determining weights for excess relative risk and excess absolute risk when applied in the calculation of lifetime risk of cancer from radiation exposure

2012 ◽  
Vol 52 (1) ◽  
pp. 135-145 ◽  
Author(s):  
Linda Walsh ◽  
Uwe Schneider
Keyword(s):  
Relative Risk ◽  
Radiation Exposure ◽  
Absolute Risk ◽  
Lifetime Risk ◽  
Excess Relative Risk ◽  
Excess Absolute Risk ◽  
Risk Of Cancer

scholarly journals Quantifying Donor Effects on Transplant Outcomes Using Kidney Pairs from Deceased Donors

2019 ◽  
Vol 14 (12) ◽  
pp. 1781-1787
Author(s):  
Kathleen F. Kerr ◽  
Eric R. Morenz ◽  
Heather Thiessen-Philbrook ◽  
Steven G. Coca ◽  
F. Perry Wilson ◽  
...  
Keyword(s):  
Relative Risk ◽  
Clinical Outcomes ◽  
Graft Failure ◽  
Absolute Risk ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Kidney Donor ◽  
Excess Absolute Risk ◽  
Deceased Donors ◽  
Concordance Measures

Background and objectivesIn kidney transplantation, the relative contribution of donor versus other factors on clinical outcomes is unknown. We sought to quantify overall donor effects on transplant outcomes for kidney donations from deceased donors.Design, setting, participants, & measurementsFor paired donations from deceased donors resulting in transplants to different recipients, the magnitude of donor effects can be quantified by examining the excess of concordant outcomes within kidney pairs beyond chance concordance. Using data from the Organ Procurement and Transplantation Network between the years 2013 and 2017, we examined concordance measures for delayed graft function, death-censored 1-year graft failure, and death-censored 3-year graft failure. The concordance measures were excess relative risk, excess absolute risk, and the fixation index (where zero is no concordance and one is perfect concordance). We further examined concordance in strata of kidneys with similar values of the Kidney Donor Profile Index, a common metric of organ quality.ResultsIf the transplant of the kidney mate resulted in delayed graft function, risk for delayed graft function was 19% higher (95% confidence interval [95% CI], 18% to 20%), or 1.76-fold higher (95% CI, 1.73- to 1.80-fold), than baseline. If a kidney graft failed within 1 year, then the kidney mate’s risk of failure was 6% higher (95% CI, 4% to 9%), or 2.85-fold higher (95% CI, 2.25- to 3.48-fold), than baseline. For 3-year graft failure, the excess absolute risk was 7% (95% CI, 4% to 10%) but excess relative risk was smaller, 1.91-fold (95% CI, 1.56- to 2.28-fold). Fixation indices were 0.25 for delayed graft function (95% CI, 0.24 to 0.27), 0.07 for 1-year graft failure (95% CI, 0.04 to 0.09), and 0.07 for 3-year graft failure (95% CI, 0.04 to 0.10). Results were similar in strata of kidneys with a similar Kidney Donor Profile Index.ConclusionsOverall results indicated that the donor constitution has small or moderate effect on post-transplant clinical outcomes.

Pediatric neurointervention: collimation on radiation exposure-associated lifetime excess tumor risk

2016 ◽  
Vol 9 (9) ◽  
pp. 895-898 ◽  
Author(s):  
Karen Chen ◽  
Srinivasan Paramasivam ◽  
Alejandro Berenstein
Keyword(s):  
Relative Risk ◽  
Radiation Exposure ◽  
Vascular Malformations ◽  
Pediatric Population ◽  
Tumor Development ◽  
Population Based ◽  
Excess Relative Risk ◽  
External Beam Radiation ◽  
Treatment Modalities ◽  
Beam Radiation

BackgroundIntracranial vascular malformations in children are being addressed through a variety of treatment modalities including open surgery, external beam radiation, and image-guided neuroendovascular procedures. These patients often receive multiple treatments and incur serial exposures to ionizing radiation which has been linked to tumor development in population-based data.ObjectiveThis study quantifies the effect of collimation on exposures from single procedures and over patient lifetimes to estimate excess risk of lifetime tumor development.Methods215 patients aged 0–21 years from a single center took part in the study. Radiation exposure from neuroendovascular procedures was tabulated and converted to brain doses using modeled data and extrapolated to risk ratios using results of population-based estimates found in the literature.ResultsLifetime and per procedure risk was highest in patients with brain arteriovenous malformations, brain arteriovenous fistulas, and vein of Galen malformations, a reflection of our institutional referral patterns. Across all pathologies the per procedure excess relative risk decreased from 13.4 to 2.3 when full collimation was employed. Lifetime excess relative risk decreased from 49.0 to 7.7 for full collimation.ConclusionsThis is the first study to quantify the effect of collimation on lifetime and per procedure risk of tumor development in a pediatric population. In addition to collimation, technical and operator-based aspects of the neurointerventional suite are discussed to further reduce patient exposure without sacrificing image quality.

Kinetic Aspects of the Interplay of Cancer and the Immune System

2019 ◽  
Vol 14 (02) ◽  
pp. 101-114 ◽  
Author(s):  
Vladimir P. Zhdanov
Keyword(s):  
Stem Cells ◽  
Immune System ◽  
Kinetic Model ◽  
Human Population ◽  
Lifetime Risk ◽  
Risk Of Cancer

The understanding of the interplay between cancer and the immune system is still limited. Herein, I focus on two aspects of this interplay. First, I propose a kinetic model describing the likely role of the immune system in the lifetime risk of cancer at the level of the whole human population. For each tissue, the risk is predicted to be influenced by the heterogeneity of the population and to depend exponentially on time. The expression for the risk does not, however, depend explicitly on the total number of divisions of the corresponding stem cells. For this reason, the correlation with the latter number can only be indirect. Second, using another kinetic framework, I describe how the growth of a few tumors can depend on their interaction via the immune system. The analysis shows that depending on specific details, the tumors of different sizes tend either to reach the same size or remain to be of different sizes.

scholarly journals Repeated Pelvic Radiographs in Infants, After Harness Treatment for Developmental Dysplasia of the Hip, Carry Very Low Radiation Risk

2021 ◽  
Author(s):  
Elizabeth Vogel ◽  
Thomas Leaver ◽  
Fiona Wall ◽  
Ben Johnson ◽  
Michael Uglow ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Radiation Risk ◽  
Low Risk ◽  
Lifetime Risk ◽  
Body Region ◽  
Pavlik Harness ◽  
Pelvic Radiographs ◽  
Risk Of Malignancy ◽  
The Mean

Abstract Objective There are no data on the effect of X-Ray irradiation to the vulnerable pelvic organs of babies during DDH follow-up. This study aims to calculate, for the first time, the radiation exposure to infants during follow-up for DDH harness treatment, and thus quantify the lifetime risk of malignancy. Methods Patients who had completed 5 years’ follow-up following successful Pavlik harness treatment were identified from the hospital DDH database. The radiation dose was extracted from the Computerised Radiology Information System database for every radiograph of every patient. The effective dose (ED) was calculated using conversion coefficients for age, sex and body region irradiated. Cumulative ED was compared to Health Protection Agency standards to calculate lifetime risk of malignancy from the radiographs. Results All radiographs of 40 infants, successfully treated in Pavlik harness for DDH, were assessed. The mean number of AP pelvis radiographs was 7.00 (range: 6–9, mode: 7). The mean cumulative ED was 0.25 mSv (Range: 0.11–0.46, SD: 0.07). This is far lower than the annual ‘safe’ limit for healthcare workers of 20 mSv and is categorised as “Very Low Risk”. Conclusion Clinicians involved in the treatment DDH can be re-assured that the cumulative radiation exposure from pelvic radiographs following Pavlik harness treatment is “Very Low Risk”. Whilst being mindful of any radiation exposure in children, this study provides a scientific answer that help addresses parental concerns.

scholarly journals Risk of cancer associated with low-dose radiation exposure: comparison of results between the INWORKS nuclear workers study and the A-bomb survivors study

2021 ◽  
Vol 60 (1) ◽  
pp. 23-39
Author(s):  
Klervi Leuraud ◽  
David B. Richardson ◽  
Elisabeth Cardis ◽  
Robert D. Daniels ◽  
Michael Gillies ◽  
...  
Keyword(s):  
Low Dose ◽  
Atomic Bomb ◽  
Absolute Risk ◽  
Joint Analysis ◽  
Solid Cancer ◽  
Atomic Bomb Survivors ◽  
Nuclear Workers ◽  
Long Term Follow Up ◽  
Primary Basis ◽  
Risk Of Cancer

AbstractThe Life Span Study (LSS) of Japanese atomic bomb survivors has served as the primary basis for estimates of radiation-related disease risks that inform radiation protection standards. The long-term follow-up of radiation-monitored nuclear workers provides estimates of radiation-cancer associations that complement findings from the LSS. Here, a comparison of radiation-cancer mortality risk estimates derived from the LSS and INWORKS, a large international nuclear worker study, is presented. Restrictions were made, so that the two study populations were similar with respect to ages and periods of exposure, leading to selection of 45,625 A-bomb survivors and 259,350 nuclear workers. For solid cancer, excess relative rates (ERR) per gray (Gy) were 0.28 (90% CI 0.18; 0.38) in the LSS, and 0.29 (90% CI 0.07; 0.53) in INWORKS. A joint analysis of the data allowed for a formal assessment of heterogeneity of the ERR per Gy across the two studies (P = 0.909), with minimal evidence of curvature or of a modifying effect of attained age, age at exposure, or sex in either study. There was evidence in both cohorts of modification of the excess absolute risk (EAR) of solid cancer by attained age, with a trend of increasing EAR per Gy with attained age. For leukemia, under a simple linear model, the ERR per Gy was 2.75 (90% CI 1.73; 4.21) in the LSS and 3.15 (90% CI 1.12; 5.72) in INWORKS, with evidence of curvature in the association across the range of dose observed in the LSS but not in INWORKS; the EAR per Gy was 3.54 (90% CI 2.30; 5.05) in the LSS and 2.03 (90% CI 0.36; 4.07) in INWORKS. These findings from different study populations may help understanding of radiation risks, with INWORKS contributing information derived from cohorts of workers with protracted low dose-rate exposures.

scholarly journals Impact of Proteinuria and Low eGFR on Lifetime Risk of Cardiovascular Disease Death: A Pooled Analysis of Data From the Evidence for Cardiovascular Prevention From Observational Cohorts in Japan Study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
Y Imai ◽  
M Sakurai ◽  
H Nakagawa ◽  
A Hirata ◽  
Y Murakami ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lifestyle Modification ◽  
Absolute Risk ◽  
Cardiovascular Prevention ◽  
Asian Population ◽  
Cardiovascular Death ◽  
Pooled Analysis ◽  
Lifetime Risk ◽  
National Budget ◽  
Public Grant

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): H20–Junkankitou [Seishuu]–Ippan–013; H23–Junkankitou [Seishuu]–Ippan–005; H26-Junkankitou [Seisaku]-Ippan-001; H29–Junkankitou–Ippan–003 and 20FA1002 OnBehalf EPOCH-JAPAN Introduction Absolute risk of Lifetime risk (LTR) is useful estimate for risk communication compared with short term risk or relative risk especially for young people. Proteinuria is leading cause of end-stage kidney disease (ESKD) and independent risk factor for cardiovascular disease (CVD). Although nonproteinuric renal disease is global burden of ESKD, it has been poorly focused. To date, there have been no reports of impact of proteinuria and low eGFR on LTR with the outcome of CVD death in Asian population. Purpose We aimed to estimate LTR of CVD death stratified by the status of proteinuria and low eGFR. Methods We used modified Kaplan-Meier approach to estimate the remaining lifetime risk of cardiovascular death based on EPOCH-JAPAN(Evidence for Cardiovascular Prevention From Observational Cohorts in Japan) database. LTR was estimated at each index age starting from 40 years for those with proteinuria and without proteinuria stratified by low eGFR, which is defined as eGFR <60 ml/min/1.73 m². Participants were classified into three groups, which were those with proteinuria (Proteinuria (+)), those without proteinuria with low eGFR (Proteinuria (-)/Low eGFR (+)), those without proteinuria without low eGFR (Proteinuria (-)/Low eGFR (-)). Results A total of 47,292 participants from 9 cohorts was included in the analysis. Mean follow-up period was 14.6 years with 690,463 person years and total CVD death was 1,075 in men and 1,193 in women. The LTRs at the index age of 40 years were as follows: 17.7% (95% confidence interval: 15.4 – 19.0%) in Proteinuria (-)/Low eGFR (-) group, 26.2% (20.2 – 31.1%) in Proteinuria (-)/low eGFR (+) group, 24.5% (15.1 – 29.3%) in Proteinuria (+) group for men; 15.3%(13.7 – 16.5%), 29.9%(14.7 – 46.8%) , 28.3%(19.4 – 34.7%) for women. Conclusions We observed that those without proteinuria with low eGFR have equivalently high LTR with those with proteinuria. These results indicate that even in the absence of proteinuria, low eGFR has high impact on LTR. Lifestyle modification from young age is necessary to prevent from renal dysfunction.

scholarly journals Risk of cancer development in patients with keloids

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ying-Yi Lu ◽  
Hung-Pin Tu ◽  
Chieh-Hsin Wu ◽  
Chien-Hui Hong ◽  
Kuo-Chia Yang ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Relative Risk ◽  
Skin Cancer ◽  
Cancer Risk ◽  
Population Based ◽  
Abdominal Ultrasonography ◽  
Cancer Risk Factors ◽  
Oral Cancers ◽  
Cox Proportional Hazard Regression ◽  
Risk Of Cancer

AbstractKeloid is a skin disease characterized by exaggerated scar formation, excessive fibroblast proliferation, and excessive collagen deposition. Cancers commonly arise from a fibrotic microenvironment; e.g., hepatoma arises from liver cirrhosis, and oral cancers arise from submucosal fibrosis. As keloids are a prototypic fibroproliferative disease, this study investigated whether patients with keloids have an increased cancer risk. In a matched, population-based study, first 17,401 patients treated for keloids during 1998–2010 with 69,604 controls without keloids at a ratio of 1:4 were evaluated. The association between keloids and risk of cancer was estimated by logistic regression or Cox proportional hazard regression models after adjustment of covariates. In total, 893 first-time cases of cancer were identified in the 17,401 patients with keloids. The overall cancer risk was 1.49-fold higher in the keloids group compared to controls. Regarding specific cancers, the keloids group, had a significantly higher risk of skin cancer compared to controls (Relative risk = 1.73). The relative risk for skin cancer was even higher for males with keloids (Relative risk = 2.16). Further stratified analyses also revealed a significantly higher risk of developing pancreatic cancer in female patients with keloids compared to controls (Relative risk = 2.19) after adjustment for known pancreatic cancer risk factors. This study indicates that patients with keloids have a higher than normal risk for several cancer types, especially skin cancers (both genders) and pancreatic cancer (females). Therefore, patients with keloids should undergo regular skin examinations, and females with keloids should regularly undergo abdominal ultrasonography.

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