scholarly journals The Nordic Twin Study on Cancer — NorTwinCan

2019 ◽  
Vol 22 (6) ◽  
pp. 817-823
Author(s):  
Jennifer R. Harris ◽  
Jacob Hjelmborg ◽  
Hans-Olov Adami ◽  
Kamila Czene ◽  
Lorelei Mucci ◽  
...  
Keyword(s):  
Critical Role ◽  
Familial Risk ◽  
Twin Studies ◽  
Population Based ◽  
Cancer Etiology ◽  
Incident Cancer ◽  
Incidence And Mortality ◽  
Analytical Approaches ◽  
Country Specific

AbstractNordic twin studies have played a critical role in understanding cancer etiology and elucidating the nature of familial effects on site-specific cancers. The NorTwinCan consortium is a collaborative effort that capitalizes on unique research advantages made possible through the Nordic system of registries. It was constructed by linking the population-based twin registries of Denmark, Finland, Norway and Sweden to their country-specific national cancer and cause-of-death registries. These linkages enable the twins to be followed many decades for cancer incidence and mortality. To date, two major linkages have been conducted: NorTwinCan I in 2011–2012 and NorTwinCan II in 2018. Overall, there are 315,413 eligible twins, 57,236 incident cancer cases and 58 years of follow-up, on average. In the initial phases of our work, NorTwinCan established the world’s most comprehensive twin database for studying cancer, developed novel analytical approaches tailored to address specific research considerations within the context of the Nordic data and leveraged these models and data in research publications that provide the most accurate estimates of heritability and familial risk of cancers reported in the literature to date. Our findings indicate an excess familial risk for nearly all cancers and demonstrate that the incidence of cancer among twins mirrors the rate in the general population. They also revealed that twin concordance for cancer most often manifests across, rather than within, cancer sites, and we are currently focusing on the analysis of these cross-cancer associations.

Cerebrovascular disease after placental abruption

Neurology ◽  
2019 ◽  
Vol 93 (12) ◽  
pp. e1148-e1158
Author(s):  
Cande V. Ananth ◽  
Anne Vinkel Hansen ◽  
Mitchell S.V. Elkind ◽  
Michelle A. Williams ◽  
Janet W. Rich-Edwards ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Birth Registry ◽  
Cerebrovascular Complications ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
National Patient

ObjectiveTo test whether abruption during pregnancy is associated with long-term cerebrovascular disease by assessing the incidence and mortality from stroke among women with abruption.MethodsWe designed a population-based prospective cohort study of women who delivered in Denmark from 1978 to 2010. We used data from the National Patient Registry, Causes of Death Registry, and Danish Birth Registry to identify women with abruption, cerebrovascular events, and deaths. The outcomes included deaths resulting from stroke and nonfatal ischemic and hemorrhagic strokes. We fit Cox proportional hazards regression models for stroke outcomes, adjusting for the delivery year, parity, education, and smoking.ResultsThe median (interquartile range) follow-up in the nonabruption and abruption groups was 15.9 (7.8–23.8) and 16.2 (9.6–23.1) years, respectively, among 828,289 women with 13,231,559 person-years of follow-up. Cerebrovascular mortality rates were 0.8 and 0.5 per 10,000 person-years among women with and without abruption, respectively (hazard ratio [HR] 1.6, 95% confidence interval [CI] 0.9–3.0). Abruption was associated with increased rates of nonfatal ischemic stroke (HR 1.4, 95% CI 1.1–1.7) and hemorrhagic stroke (HR 1.4, 95% CI 1.1–1.9). The association of abruption and stroke was increased with delivery at <34 weeks, when accompanied by ischemic placental disease, and among women with ≥2 abruptions. These associations are less likely to have been affected by unmeasured confounding.ConclusionAbruption is associated with increased risk of cerebrovascular morbidity and mortality. Disruption of the hemostatic system manifesting as ischemia and hemorrhage may indicate shared etiologies between abruption and cerebrovascular complications.

Chronic kidney disease and the risk of incident renal and urothelial cancer in a population-based cohort of 1.2 million adults.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 351-351
Author(s):  
William Thomas Lowrance ◽  
Natalia Udaltsova ◽  
Juan Ordoñez ◽  
Paul Russo ◽  
Alan S. Go
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cancer Risk ◽  
Urothelial Cancer ◽  
Population Based ◽  
Incident Cancer ◽  
Increased Risk ◽  
Lower Egfr ◽  
Risk Of Cancer

351 Background: Prior studies have observed an increased risk of cancer in patients with end stage renal disease, but whether less severe chronic kidney disease influences the risk of cancer is uncertain. Methods: Among 1,190,538 adults at least 40 years of age and no prior dialysis, renal transplant or known cancer who received care within Kaiser Permanente Northern California, we examined the independent association between estimated glomerular filtration rate (eGFR) and the risk of cancer, overall and by type, between 2000 and 2008. Incident cancers were identified from a comprehensive regional cancer registry and potential confounders were ascertained using validated algorithms based on health plan electronic medical records. The impact of time-varying eGFR on incident cancer risk was examined using multivariable extended Cox regression, after excluding any cancers detected during the first two years of follow-up and any eGFR values within 3 months before a cancer diagnosis to reduce potential biases. Results: During 6,000,420 person-years of follow-up, 76,809 incident cancer diagnoses were identified among 72,875 patients (38,744 M, 34,131 F). After adjustment for possible confounding factors, the risk of renal cancer increased with lower eGFR (ml/min/1.73 m2): the adjusted hazard ratio [HR] for renal cancer was 1.35 (95% CI: 1.18–1.55) for eGFR 45–59, HR 1.65 (1.37 to 1.97) for eGFR 30–44, and HR 2.09 (1.62 to 2.70) for eGFR <30. There was a similar association between eGFR and urothelial cancer. However, there was not a significant multivariable association between eGFR and prostate, colorectal, lung, breast, or any cancer. Conclusions: We observed a graded, independent increased risk of renal and urothelial cancer risk with lower eGFR in a large, population-based cohort. However, lower eGFR was not significantly associated with other major cancer types. Additional research is needed to understand potential contributing mechanisms between reduced renal function and renal or urothelial malignancies, as well as whether differential cancer screening strategies are effective in patients with chronic kidney disease.

scholarly journals Mortality Risk Among Older People Who Did Versus Did Not Sustain a Fracture: Baseline Prefracture Strength and Gait Speed as Predictors in a 15-Year Follow-Up

2019 ◽  
Vol 75 (10) ◽  
pp. 1996-2002
Author(s):  
Kaisa Koivunen ◽  
Elina Sillanpää ◽  
Mikaela von Bonsdorff ◽  
Ritva Sakari ◽  
Timo Törmäkangas ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Mortality Risk ◽  
Gait Speed ◽  
Cox Regression ◽  
Population Based ◽  
Knee Extension ◽  
Cox Regression Analysis ◽  
Knee Extension Strength ◽  
Incidence And Mortality

Abstract Background Physiological reserve, as indicated by muscle strength and gait speed, may be especially determinant of survival in people who are exposed to a health stressor. We studied whether the association between strength/speed and mortality risk would be stronger in the time period after a fracture compared to other time periods. Methods Participants were population-based sample of 157 men and 325 women aged 75 and 80 years at baseline. Maximal 10-m gait speed and maximal isometric grip and knee extension strength were tested at the baseline before the fracture. Subsequent fracture incidence and mortality were followed up for 15 years. Cox regression analysis was used to estimate fracture time-stratified effects of gait speed and muscle strength on mortality risk in three states: (i) nonfracture state, (ii) the first postfracture year, and (iii) after the first postfracture year until death/end of follow-up. Results During the follow-up, 20% of the men and 44% of the women sustained a fracture. In both sexes, lower gait speed and in women lower knee extension strength was associated with increased mortality risk in the nonfracture state. During the first postfracture year, the mortality risk associated with slower gait and lower strength was increased and higher than in the nonfracture state. After the first postfracture year, mortality risk associated with lower gait speed and muscle strength attenuated. Conclusions Lower gait speed and muscle strength were more strongly associated with mortality risk after fracture than during nonfracture time, which may indicate decreased likelihood of recovery.

scholarly journals Reduction of Colorectal Cancer Mortality and Advanced Stage Cancer Incidence After 10 Years of Fecal Immunochemical Test Screening

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 206s-206s
Author(s):  
R.-C. Chen ◽  
H.-M. Chiu ◽  
Y.-W. Wang ◽  
J.C.-Y. Fann ◽  
A.M.-F. Yen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Advanced Cancer ◽  
Cancer Incidence ◽  
Screening Program ◽  
Population Based ◽  
Study Cohort ◽  
Adjusted Relative Risk ◽  
Advanced Stage ◽  
Incidence And Mortality

Background and aims: Colorectal cancer (CRC) is a leading cause of cancer deaths worldwide, and fecal immunochemical testing (FIT) is most widely used for population-based screening. Reduced long-term CRC mortality has been reported only scarcely in response to early detection with FIT screening. We aimed to elucidate whether and how FIT screening led to overall and site-specific reduction of advanced stage CRC incidence and mortality after the first decade of Taiwan's screening program, which offers biennial FIT screening for people aged 50-69 years. Method: The study cohort comprised eligible subjects who did (screened group) and did not (unscreened group) participate in FIT screening during the inaugural 5 years (2004-2009) with follow up until 2014. FIT-positive subjects were offered colonoscopy as a confirmatory exam. The primary outcome was incidence of advanced stage CRC and CRC mortality. Results: Among 5,417,699 eligible subjects, 3,072,164 (56.6%) had at least once FIT screening, and 1,605,200 (52.3%) received 2 or more screenings during the study period. During mean follow-up of 9.78 years, 5716 screened and 20,962 unscreened subjects developed incident advanced stage cancers [adjusted relative risk (aRR) = 0.76; 95% CI, 0.72-0.79] after controlling for self-selection to attend screening and increasing CRC incidence. CRC deaths during follow-up included 3077 screened and 15,550 unscreened subjects (aRR = 0.56, 95% CI, 0.53-0.59). Effectiveness was greater for distal cancers (advanced cancer incidence aRR = 0.68, 95% CI, 0.65-0.71); mortality aRR = 0.52 95% CI, 0.49-0.55) than for proximal cancers (advanced cancer incidence aRR = 0.99 95% CI, 0.92-1.07; mortality aRR = 0.69 95% CI, 0.63-0.75). Conclusion: FIT screening effectively reduces risk of advanced stage CRC and CRC mortality, with effectiveness consistently stronger for distal CRC than proximal CRC.

scholarly journals Low rate of follow-up colonoscopy after positive results of colorectal cancer screening in a Chinese urban core district

2019 ◽  
Author(s):  
Yawen Guo ◽  
Qingwu Jiang ◽  
Tetsuya Tanimoto ◽  
Masahiro Kami ◽  
Peng Peng ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rural Areas ◽  
Municipal Government ◽  
Precancerous Lesions ◽  
Population Based ◽  
Registry Data ◽  
Crc Screening ◽  
Incidence And Mortality ◽  
The Status

AbstractColorectal cancer (CRC) is one of the most common cancers in China. In 2003, a systematic CRC registry that enables the determination of CRC incidence and mortality and a CRC screening project were introduced in the Jing’an district of Shanghai by the municipal government. This study assessed the registry data to determine the status of CRC and CRC screening rates in the core district of an urban area of China. Data were retrieved from the Official registry information systems of Jing’an district Shanghai Cance. The incidence and mortality of CRC, as well as population-based CRC screening rates, were analysed. Individuals who screened positive for CRC based upon results of a high-risk factor questionnaire (HRFQ) and a faecal immunochemical test (FIT) were selected for follow-up colonoscopy (CSPY). From the registry data collected between 2003 and 2013, the standardized incidence rate was 26.44/105, with a significant gender difference. The CRC standardized mortality rate was 10.08/105. In 2013, 17,866 individuals (21.6%) enrolled for CRC screening among the 82,602 candidate residents. The positive screening rate was 16.28% (2909/17866). Among the 2909 positives, 508 (17.5%) underwent follow-up CSPY. In 41.3% of these individuals (210/508), abnormal lesions were detected. Of these, 8 (1.57%) lesions were diagnosed as CRC, and 142 (28.0%) were identified as precancerous lesions. During the assessment period, both the incidence and mortality of CRC in the Jing’an district were determined in the area of high CRC prevalence in Chin. Nevertheless, the rate of participation in CRC screening was low (21.6%), and the rate of participation in follow-up CSPY for individuals who screened positive was only 17.5%. Improved participation in CRC screening and follow-up CSPY is expected to lower the incidence and mortality of CRC significantly in the rural areas of China. (288)

Breast Cancer Trend, Incidence, and Mortality in Kerman, Iran: A 14-Year Follow-up

2018 ◽  
pp. 122-128 ◽  
Author(s):  
Leila Tavakkoli ◽  
Behjat Kalantari-Khandani ◽  
Moghaddameh Mirzaei ◽  
Narges Khanjani ◽  
Vahid Moazed
Keyword(s):  
Breast Cancer ◽  
Population Based ◽  
Medical Sciences ◽  
Cancer Symptoms ◽  
Screening Programs ◽  
Total Incidence ◽  
Incidence And Mortality ◽  
Increasing Trend ◽  
The Mean

Background: The present study aimed to investigate breast cancer trend, incidence, and mortality among Iranian women and was one of the first provincial and population-based studies to investigate breast cancer changes during 14 years in the largest province of Iran, Kerman. Methods: This was a population-based longitudinal study. Information about women diagnosed with breast cancer from 2001 to 2014 was obtained from the Cancer Registry of Kerman University of Medical Sciences. Independent-samples t test, one-way analysis of variance, linear regression, time series graphs, and fitted line plots were performed using SPSS 22 and Minitab 17.Results: A total of 2771 women were diagnosed with breast cancer in Kerman province from 2001 to 2014. The mean age of female patients was 49.52±12.88 years. The total incidence rate was 13.5 per 100,000 women and there was an increasing trend for incidence and age at diagnosis. Also, 254 women died from breast cancer during these 14 years and the mean mortality age was 54.16±14.33 years. There was also an increasing trend for mortality and age of death.Conclusion: There is an increasing trend for incidence and mortality from breast cancer in Kerman province and this requires interventions such as appropriate screening programs. Also, enabling physicians and increasing patient awareness to identify breast cancer symptoms is necessary.

Abstract MP089: Cardiovascular Protection Profile and All-cause and CVD Mortality among U.S. Adults

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Quanhe Yang ◽  
Mary Cogswell ◽  
W. Dana Flanders ◽  
Yuling Hong ◽  
Zefeng Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Disease Incidence ◽  
Population Attributable Fraction ◽  
Population Based ◽  
Normal Blood ◽  
Cvd Risk ◽  
Incidence And Mortality ◽  
Reduced Risk ◽  
Cvd Mortality

Introduction: Epidemiologic studies suggest that multiple cardiovascular (CVD) protection-factors (i.e., non-smoking, physically active, normal blood pressure, normal blood glucose, normal total cholesterol, non-obese, and healthy diet) are associated with significantly reduced risk of cardiovascular disease incidence and mortality. Hypothesis: We assessed the hypothesis that the increased number of CVD protection-factors is associated with reduced risk for all-cause and CVD mortality and adherence to low CVD risk profile could result in significant lower rates of all-cause and CVD mortality. Methods: We used the Third National Health and Nutrition Examination Survey (NHANES III 1988-1994) Linked Mortality File (through 2006), a prospective cohort study of a nationally representative sample of 12,861 U.S. adults to examine the prevalence, associations, and population attributable fraction (PAF) of seven CVD protection-factors in relation to risk of all-cause and CVD mortality. Results: Only 3.1% of U.S. adults had all seven CVD protection-factors. The average follow-up was 14.5 years. After multivariable adjustment for potential confounders, hazard ratios (HR) were: 0.30 (95% CI 0.22-0.40), 0.21 (0.12-0.34), and 0.17 (0.09-0.32), comparing individuals with ≥six protection-factors to those with ≤one protection-factors for all-cause, CVD, and IHD mortality respectively. Elevated blood pressure was responsible for the largest number of all-cause and CVD death followed by smoking and poor diet. Overall, 59% (95% CI 27-78) of total deaths and 66% (95% CI 22-88) CVD death would have been avoided during the average of 14.5 years follow-up if the population were changed to the high CVD protection-factors status (with ≥six protection-factors). Conclusions: Few adults in this U.S.-based study population had all seven desirable CVD protection-factors. The presence of an increasing number of CVD protection-factors was associated with a progressively lower risk of total and CVD mortality. Comprehensive population-based initiatives are needed to improve modifiable CVD risk factors, resulting in substantial reductions of all-cause and CVD mortality in the U.S. population.

scholarly journals A new colorectal cancer risk prediction model incorporating family history, personal and environmental factors

2019 ◽  
Author(s):  
Yingye Zheng ◽  
Xinwei Hua ◽  
Aung K. Win ◽  
Robert J. MacInnis ◽  
Steven Gallinger ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Family History ◽  
Prediction Model ◽  
Risk Prediction ◽  
Prediction Models ◽  
Familial Risk ◽  
Population Based ◽  
Risk Prediction Model ◽  
Incidence And Mortality

AbstractPurposeReducing colorectal cancer (CRC) incidence and mortality through early detection would improve efficacy if targeted. A CRC risk-prediction model incorporating personal, family, genetic and environmental risk factors could enhance prediction.MethodsWe developed risk-prediction models using population-based CRC cases (N=4,445) and controls (N=3,967) recruited by the Colon Cancer Family Registry Cohort (CCFRC). A familial risk profile (FRP) was calculated to summarize individuals’ risk based on their CRC family history, family structure, germline mutation probability in major susceptibility genes, and a polygenic component. Using logistic regression, we developed risk models including individuals’ FRP or a binary CRC family-history (FH), and risk factors collected at recruitment. Model validation used follow-up data for population-(N=12,052) and clinic-based (N=5,584) relatives with no cancer history at recruitment, assessing calibration (E/O) and discrimination (AUC).ResultsThe E/O (95% confidence interval [CI]) for FRP models for population-based relatives were 1.04 (0.74-1.45) and 0.86 (0.64-1.20) for men and women, and for clinic-based relatives 1.15 (0.87-1.58) and 1.04 (0.76-1.45). The age-adjusted AUC (95% CI) for FRP models in population-based relatives were 0.69 (0.60-0.78) and 0.70 (0.62-0.77), and for clinic-based relatives 0.77 (0.69-0.84) and 0.68 (0.60-0.76). The incremental values of AUC (95% CI) for FRP over FH models for population-based relatives were 0.08 (0.01-0.15) and 0.10 (0.04-0.16), and for clinic-based relatives 0.11 (0.05-0.17) and 0.11 (0.06-0.17).ConclusionThe FRP-based model and FH-based model calibrate well in both settings. The FRP-based model provided better risk-prediction and discrimination than the FH-based model. A detailed family history may be useful for targeted risk-based screening and clinical management.

scholarly journals Hypertensive Disorders of Pregnancy (HDP) and the Risk of Common Cancers in Women: Evidence from the European Prospective Investigation into Cancer (EPIC)-Norfolk Prospective Population-Based Study

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3100
Author(s):  
Zahra Pasdar ◽  
David T. Gamble ◽  
Phyo K. Myint ◽  
Robert N. Luben ◽  
Nicholas J. Wareham ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Reproductive Factors ◽  
Population Based ◽  
Population Based Study ◽  
Incident Cancer ◽  
History Of ◽  
Multivariable Analyses ◽  
Baseline Health ◽  
Prospective Investigation

Purpose: The purpose was to determine the association between HDP and cancer in a UK cohort. Methods: Between 1993 and 1997, participants from the EPIC-Norfolk cohort attended baseline health-checks and completed questionnaires, where a history of HDP was collected. Incident cancer cases were identified through NHS record linkage until March 2016. Univariable and multivariable logistic regression analyses were employed to determine the association between HDP and odds of cancer, with adjustment for potential confounders including co-morbidities, sociodemographic, lifestyle and reproductive factors. Results: 13,562 women were included after excluding prevalent cancer cases and women with no pregnancies. 2919 (21.5%) reported HDP and 2615 incident cancers occurred during mean follow up of 19 years. Median age (IQR) at baseline for incident cancer was 60.8 (±14.8) years. Among incident cancer cases, 578 (22.1%) had HDP. In multivariable analyses, HDP had odds ratio (OR) 1.06; 95% CI 0.95–1.18 for incident cancer. The ORs (95% CIs) for common site-specific cancers including breast, colorectal, lung, ovarian and endometrial cancers were 1.06 (0.88–1.28), 1.15 (0.92–1.45), 0.96 (0.68–1.35), 1.30 (0.93–1.83) and 1.16 (0.80–1.67). Conclusion: We found no association between HDP and cancer risk. Further studies are required to confirm and account for any underlying genetic factors involved in pregnancy-related exposures and cancer risk.

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