scholarly journals Prevalence of hypertension and diabetes in Finland by different data sources

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Koponen ◽  
J Reinikainen ◽  
H Tolonen ◽  
T Laatikainen ◽  
P Jousilahti ◽  
...  
Keyword(s):  
Survey Data ◽  
Population Level ◽  
Population Based ◽  
Register Data ◽  
Data Sources ◽  
Health Examination ◽  
Antihypertensive Medications ◽  
Prevalence Estimates ◽  
Icd 10 ◽  
Level Information

Abstract Background Population level information on the prevalence of hypertension and diabetes is needed to support planning and evaluation of preventive activities and care. Population based health examination surveys (HES) can provide valid information, but they are time consuming and expensive. Administrative registers on hospitalizations and out-patient visits could provide information faster and at less cost. The aim of this study is to estimate how comparable prevalence estimates of type 2 diabetes (T2D), hypertension and their combination are based on data from the Finnish national health examination survey (FinHealth 2017) and data from administrative hospital and primary care registers in Finland. Methods Survey data were linked to care registers using personal identity codes. Survey based hypertension was defined as SBP≥140 mmHg or DBP≥90 mmHg or self-reported use of antihypertensive medications; and T2D as HbA1c ≥48 mmol/mol or self-reported us of diabetes medications. Corresponding indicators from care registers were: hypertension and T2D as a reason for care or visit or having received prescription for diabetes medication (using ICD-10, ICPC and ATC codes). Results For hypertension, survey data provided the prevalence of 43 % while only 12 % of individuals were identified as hypertensives in the register data. The prevalence of T2D was 9 % in both data sources. The prevalence of having both hypertension and T2D was 7 % based on survey data and 3 % based on register data. Agreement between survey and register data was lower for hypertension (Cohen’s kappa 0.23) than for T2D (0.84). Conclusions Register data provided lower prevalence for hypertension than the survey data. For diabetes, similar prevalences were observed. As there are limitations in the coverage of register data more reliable population level information can be obtained from HES. Key messages Health examination surveys cover persons with undiagnosed problems and conditions omitted in national registers. Hypertension and T2D should be monitored with both register and survey data.

Vulvar cancer in Germany: Increase of incidence and change of tumor-biological characteristics in the period 1974-2013.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17031-e17031
Author(s):  
Jana Barinoff ◽  
Jalid Sehouli ◽  
Bernd Holleczek
Keyword(s):  
Squamous Cell ◽  
Vulvar Cancer ◽  
Advanced Disease ◽  
Population Level ◽  
Population Based ◽  
Tumor Characteristics ◽  
Incidence Data ◽  
Incidence Trends ◽  
The Past ◽  
Icd 10

e17031 Background: Incidence of vulvar cancer in Germany is increasing. Gynecological oncologists reported to observe increasing numbers of women presenting with small tumors. The aim of the presented study is to validate this observation on a population level and to extend available incidence data. Methods: Data from the population-based Saarland Cancer Registry (CR) were used and included 1,136 female patients diagnosed with invasive vulvar cancer (ICD-10 code: C51) between 1974 and 2013. Multiple imputation methodology was used to overcome loss of precision and potential bias. Incidence trends were investigated with regard to patient and tumor characteristics. Results: During the study period, the age standardized rate of incidence increased from 1.6 to 7.9 cases per 100,000 women per year (+390%). Since 1989, the incidence of squamous cell carcinoma increased from 1.7 to 7.1 (+320%), whereas no increase was observed in other morphologic types. Simultaneously, the incidence of small vulvar tumors <= 2 cm (T1) increased from 0.8 in 1989-93 to 6.6 in 2009-13 (the proportion of T1 tumors increased from 34% to 79%, respectively). Patients aged >= 75 years suffered from more advanced disease at the time of diagnosis. Conclusions: The detailed analyses revealed that the observed increase in vulvar cancer in the past 15 years mainly resulted from newly incident squamous cell carcinomas. Furthermore, the analyses showed an almost exclusive increase of T1 tumors. An increase in vulvar cancer incidence as shown for Germany could not be observed for any other European country.

scholarly journals Association between height and the risk of primary brain malignancy in adults: A nationwide population-based cohort study

2021 ◽  
Author(s):  
Stephen Ahn ◽  
Kyungdo Han ◽  
Jung Eun Lee ◽  
Sin-Soo Jeun ◽  
Yong Moon Park ◽  
...  
Keyword(s):  
National Health ◽  
Asian Population ◽  
Population Based ◽  
Health Examination ◽  
National Health Insurance System ◽  
Increased Risk ◽  
Icd 10 ◽  
Korean National Health Insurance ◽  
Using Data ◽  
Brain Malignancy

Abstract Purpose The association between height and the risk of developing primary brain malignancy remains unclear. We evaluated the association between height and risk of primary brain malignancy based on a nationwide population-based database of Koreans. Methods Using data from the Korean National Health Insurance System cohort, 6,833,744 people over 20 years of age that underwent regular national health examination were followed from January 2009 until the end of 2017. We documented 4,771 cases of primary brain malignancy based on an ICD-10 code of C71 during the median follow-up period of 7.30 years and 49,877,983 person-years. Results When dividing the population into quartiles of height for each age group and sex, people within the highest height quartile had a significantly higher risk of brain malignancy, compared to those within the lowest height quartile (HR 1.21 CI 1.18–1.32) after adjusting for potential confounders. We also found that the risk of primary brain malignancy increased in proportion with the quartile increase in height. After analyzing subgroups based on older age (≥ 65) and sex, we found positive relationships between height and primary brain malignancy in all subgroups. Conclusions This study is the first to suggest that height is associated with increased risk of primary brain malignancy in the East-Asian population. Further prospective and larger studies with precise designs are needed to validate our findings.

scholarly journals Experiences from the harmonization of Finnish national population-based health survey data

2021 ◽  
pp. 140349482110521
Author(s):  
Laura Paalanen ◽  
Hanna Tolonen
Keyword(s):  
Survey Data ◽  
Survey Methods ◽  
Blood Pressure Measurement ◽  
Population Based ◽  
Health Examination ◽  
Response Options ◽  
National Population ◽  
Objective Health ◽  
Research Guidelines ◽  
Time Period

Aims: There are several advantages to pooling survey data from individual studies over time or across different countries. Our aim is to share our experiences on harmonizing data from 13 Finnish health examination surveys covering the years 1972–2017 and to describe the challenges related to harmonizing different variable types using two questionnaire variables – blood pressure measurement and total cholesterol assessment – as examples. Methods: Data from Finnish national population-based health surveys were harmonized as part of the research project ‘Projections of the Burden of Disease and Disability in Finland – Health Policy Prospects’, including variables from questionnaires, objective health measurements and results from the laboratory analysis of biological samples. The process presented in the Maelstrom Research guidelines for data harmonization was followed with minor adjustments. Results: The harmonization of data from objective measurements and biomarkers was reasonably straightforward, but questionnaire items proved more challenging. Some questions and response options had changed during the covered time period. This concerned, for example, questionnaire items on the availability and use of medication and diet. Conclusions: The long time period – 45 years – made harmonization more complicated. The survey questions or response options had changed for some topics due to changes in society. However, common core variables for topics that were especially relevant for the project, such as lifestyle factors and certain diseases or conditions, could be harmonized with sufficient comparability. For future surveys, the use of standardized survey methods and the proper documentation of data collection are recommended to facilitate harmonization.

Screening Rates for Primary Aldosteronism Among Individuals With Hypertension Plus Hypokalemia: A Population-Based Retrospective Cohort Study

Hypertension ◽  
2021 ◽  
Author(s):  
Gregory L. Hundemer ◽  
Haris Imsirovic ◽  
Anand Vaidya ◽  
Nicholas Yozamp ◽  
Rémi Goupil ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Primary Aldosteronism ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Time Window ◽  
Population Level ◽  
Population Based ◽  
Clinical Predictors ◽  
Antihypertensive Medications

Primary aldosteronism is a common, yet highly underdiagnosed, cause of hypertension that leads to disproportionately high rates of cardiovascular disease. Hypertension plus hypokalemia is a guideline-recommended indication to screen for primary aldosteronism, yet the uptake of this recommendation at the population level remains unknown. We performed a population-based retrospective cohort study of adults ≥18 years old in Ontario, Canada, with hypertension plus hypokalemia (potassium <3.5 mEq/L) from 2009 to 2015 with follow-up through 2017. We measured the proportion of individuals who underwent primary aldosteronism screening via the aldosterone-to-renin ratio based upon hypokalemia frequency and severity along with concurrent antihypertensive medication use. We assessed clinical predictors associated with screening via Cox regression. The cohort included 26 533 adults of which only 422 (1.6%) underwent primary aldosteronism screening. When assessed by number of instances of hypokalemia over a 2-year time window, the proportion of eligible patients who were screened increased only modestly from 1.0% (158/15 983) with one instance to 4.8% (71/1494) with ≥5 instances. Among individuals with severe hypokalemia (potassium <3.0 mEq/L), only 3.9% (58/1422) were screened. Among older adults prescribed ≥4 antihypertensive medications, only 1.0% were screened. Subspecialty care with endocrinology (hazard ratio [HR], 1.52 [95% CI, 1.10–2.09]), nephrology (HR, 1.43 [95% CI, 1.07–1.91]), and cardiology (HR, 1.39 [95% CI, 1.14–1.70]) were associated with an increased likelihood of screening, whereas age (HR, 0.95 [95% CI, 0.94–0.96]) and diabetes (HR, 0.66 [95% CI, 0.50–0.89]) were inversely associated with screening. In conclusion, population-level uptake of guideline recommendations for primary aldosteronism screening is exceedingly low. Increased education and awareness are critical to bridge this gap.

scholarly journals Associations of General and Abdominal Obesity with the Risk of Glioma Development

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2859
Author(s):  
Stephen Ahn ◽  
Kyungdo Han ◽  
Jung-Eun Lee ◽  
Sin-Soo Jeun ◽  
Yong-Moon Park ◽  
...  
Keyword(s):  
Abdominal Obesity ◽  
National Health ◽  
Asian Population ◽  
Population Based ◽  
Health Examination ◽  
Obese People ◽  
National Health Insurance System ◽  
Potential Association ◽  
Icd 10 ◽  
Using Data

The association between obesity and the risk of glioma remains unclear. We sought to evaluate the potential association between general and abdominal obesity and the risk of glioma based on a nationwide population-based cohort study of Koreans. Using data from the Korean National Health Insurance System cohort, 6,833,744 people older than 20 years who underwent regular national health examination in both 2009 and 2011 were followed until the end of 2017. We documented 4771 glioma cases based on an ICD-10 code of C71 during the median follow-up period of 7.30 years. Individuals with a body mass index (BMI) ≥ 25.0 kg/m2 were at significantly higher risk of developing glioma than those with a BMI < 25.0 kg/m2 (HR 1.08 CI 1.02–1.15). Individuals with a waist circumference (WC) ≥ 90 cm (males)/85 cm (females) also had a significantly higher risk of glioma than those with a WC < 90 cm (males)/85 cm (females) (HR 1.16 CI 1.09–1.24). In the group with a BMI ≥ 25.0 kg/m2, individuals with abdominal obesity were at significantly higher risk of developing glioma (HR 1.18 CI 1.09–1.27) than those without abdominal obesity. The role of abdominal obesity in this association was stronger in women than in men. To the best of our knowledge, this is the first demonstration that obese people may be at higher risk of glioma, especially centrally obese people from an Asian population with a BMI ≥ 25.0 kg/m2. Loss of visceral fat in people with abdominal obesity may reduce their risk of developing glioma.

scholarly journals Risk of Suicide After a Cancer Diagnosis in England: A Population-Based Study

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 228s-228s
Author(s):  
K. Henson ◽  
R. Brock ◽  
J. Charnock ◽  
B. Wickramasinghe ◽  
O. Will ◽  
...  
Keyword(s):  
At Risk ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Suicide Risk ◽  
Population Level ◽  
Population Based ◽  
Psychological Support ◽  
Cancer Type ◽  
Increased Risk ◽  
Icd 10

Background: Previous research has identified an increased risk of suicide among cancer patients, however this has not been investigated at a population level in England. Those subgroups of patients most at risk need to be identified to ensure appropriate access to psychological support. Aim: To examine the variation in suicide risk among individuals diagnosed with cancer in England. Methods: We identified 4,453,547 individuals (21 million person-years at risk) aged 18 to 99 years at diagnosis of cancer during 1995 to 2015 from the national cancer registry, and followed them up until 31 August 2017. The outcomes of interest were both suicide and open verdicts (ICD-10 X60-X84, Y87.0, Y10-Y34 [excluding Y33.9, Y87.2]). Population-based expected deaths were as published by ONS [2]. We calculated standardized mortality ratios (SMRs) and absolute excess risks (AERs), and explored variation in suicide risk by cancer type, age at death, sex, deprivation, ethnicity, and years since cancer diagnosis. Results: 2352 cancer patients died by suicide. This was 0.08% of all deaths. The overall SMR for suicide was 1.19 (95% CI 1.14-1.24) and AER per 10,000 person-years was 0.18 (0.13-0.22). The risk was highest among individuals diagnosed with mesothelioma, with a 4.34-fold risk corresponding to 4.00 extra deaths per 10,000 person-years. This was followed by pancreatic (3.94-fold), esophageal (2.53-fold), lung (2.52-fold), and stomach (2.14-fold) cancer (all significantly elevated). Suicide risk was highest in the first 6 months following cancer diagnosis (SMR: 2.64 [2.42-2.89]), but a significantly increased risk persisted for 2 years (SMR: 1.21 [1.08-1.35]). Conclusion: Despite low numbers, the elevated risk of suicide in patients with certain cancers is a concern, representing potentially preventable deaths. The increased risk in the first 6 months after diagnosis, which is consistent with previous studies, highlights unmet needs for psychological support delivered alongside cancer diagnosis and treatment. Our findings suggest a need for improved risk stratification across cancer services, followed by targeted psychological support.

Systemic Sclerosis and Associated Interstitial Lung Disease in Ontario, Canada: An Examination of Prevalence and Survival Over 10 Years

2021 ◽  
pp. jrheum.201049
Author(s):  
Janet E. Pope ◽  
Kobina Quansah ◽  
Shazia Hassan ◽  
Soo Jin Seung ◽  
Jason Flavin ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Survival Rates ◽  
Population Based ◽  
Pulmonary Complications ◽  
Administrative Databases ◽  
Fiscal Year ◽  
Discharge Abstract Database ◽  
Kaplan Meier ◽  
Prevalence Estimates ◽  
Icd 10

Objective Systemic sclerosis (SSc) is a rare autoimmune disease. Pulmonary complications of SSc are one of the leading causes of morbidity and mortality. The objective of this study was to determine prevalence and survival estimates of SSc and SSc-ILD in a Canadian province (Ontario) using administrative data over 10 years. Methods Using ICD-10-CA codes, adult patients diagnosed with SSc and SSc-ILD between April 1, 2008 and March 31, 2018 were identified from the National Ambulatory Care Reporting System (NACRS) and Discharge Abstract Database (DAD) administrative databases. SSc was identified first and ILD if present occurred after the SSc diagnosis. Prevalence estimates were determined for both SSc and SSc-ILD. For survival, Kaplan Meier survival curves were generated. Results At the start of fiscal year 2017/18 (final year of the cohort), there were 2,114 prevalent SSc cases for a cumulative prevalence of 19.1 per 100,000 persons and 257 prevalent cases of SSc-ILD, generating a prevalence of 2.32 cases per 100,000 persons. Mean age was 57 and 58 years with 84% and 80% females for SSc and SSc- ILD patients, respectively. One, 5 and 10 year survival rates respectively for the SSc group were 85.0%, 64.5% and 44.9%, and 77.1%, 44.4% and 22.0% for the SSc-ILD. Conclusion This study provides the first population-based estimates of SSc and SSc- ILD in Canada for prevalence and survival. Results confirm that the prevalence estimates of SSc-ILD falls within the Canadian threshold of rare disease. It also demonstrates the poor survival in SSc especially when ILD is also present.

scholarly journals Combining self-reported and objectively measured survey data to improve hypertension prevalence estimates: Portuguese experience

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Irina Kislaya ◽  
Andreia Leite ◽  
Julian Perelman ◽  
Ausenda Machado ◽  
Ana Rita Torres ◽  
...  
Keyword(s):  
Multiple Imputation ◽  
Survey Data ◽  
Multivariate Analyses ◽  
Health Examination ◽  
Age Group ◽  
Hypertension Prevalence ◽  
Misclassification Bias ◽  
Prevalence Estimates ◽  
Objectively Measured ◽  
Prevalence Ratios

Abstract Background Accurate data on hypertension is essential to inform decision-making. Hypertension prevalence may be underestimated by population-based surveys due to misclassification of health status by participants. Therefore, adjustment for misclassification bias is required when relying on self-reports. This study aims to quantify misclassification bias in self-reported hypertension prevalence and prevalence ratios in the Portuguese component of the European Health Interview Survey (INS2014), and illustrate application of multiple imputation (MIME) for bias correction using measured high blood pressure data from the first Portuguese health examination survey (INSEF). Methods We assumed that objectively measured hypertension status was missing for INS2014 participants (n = 13,937) and imputed it using INSEF (n = 4910) as auxiliary data. Self-reported, objectively measured and MIME-corrected hypertension prevalence and prevalence ratios (PR) by sex, age group and education were estimated. Bias in self-reported and MIME-corrected estimates were computed using objectively measured INSEF data as a gold-standard. Results Self-reported INS2014 data underestimated hypertension prevalence in all population subgroups, with misclassification bias ranging from 5.2 to 18.6 percentage points (pp). After MIME-correction, prevalence estimates increased and became closer to objectively measured ones, with bias reduction to 0 pp - 5.7 pp. Compared to objectively measured INSEF, self-reported INS2014 data considerably underestimated prevalence ratio by sex (PR = 0.8, 95CI = [0.7, 0.9] vs. PR = 1.2, 95CI = [1.1, 1.4]). MIME successfully corrected direction of association with sex in bivariate (PR = 1.1, 95CI = [1.0, 1.3]) and multivariate analyses (PR = 1.2, 95CI = [1.0, 1.3]). Misclassification bias in hypertension prevalence ratios by education and age group were less pronounced and did not require correction in multivariate analyses. Conclusions Our results highlight the importance of misclassification bias analysis in self-reported hypertension. Multiple imputation is a feasible approach to adjust for misclassification bias in prevalence estimates and exposure-outcomes associations in survey data.

scholarly journals POS0138 ALTERED RISK OF GOUT ACCORDING TO CHANGE OF METABOLIC PARAMETERS IN YOUNG ADULTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 281.1-281
Author(s):  
Y. Eun ◽  
I. Y. Kim ◽  
K. D. Han ◽  
S. Y. Kang ◽  
S. Lee ◽  
...  
Keyword(s):  
Young Adults ◽  
Population Based ◽  
Metabolic Parameters ◽  
Claim Database ◽  
Metabolic Parameter ◽  
Health Examination ◽  
Lifestyle Modifications ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Icd 10

Background:Many studies have shown a link between gout and metabolic syndrome (MetS). It is well known that lifestyle modifications such as weight reduction and abstinence from alcohol are effective in the treatment of gout, but data are lacking on how exactly the change of metabolic parameters affects gout.Objectives:The purpose of this study was to investigate the relationship between gout risk and metabolic parameters in a nationwide population based young adult cohort, and to determine whether changes in metabolic parameters affect gout risk changes.Methods:Among adults aged 20-39 years who participated in national health check-up programs from 2009 to 2012, a total of 6,290,914 subjects were included in the study, excluding subjects who were previously diagnosed with gout. To determine the effect of changes in metabolic parameters on gout incidence, 2,701,138 subjects who participated in the health examination once more 2 years later were used for the analysis. Outcome was defined as the occurrence of gout, when the ICD-10 code (M10) was registered twice in the claim database. The Cox proportional hazard model and Kaplan Meier curve were used for the analysis.Results:The incidence rate of gout was higher in those with MetS compared to those without (10.1 vs. 3.6 per 1,000 person-years). The risk of gout in people with MetS was 85% higher (adjusted HR 1.85, 95% CI 1.83-1.87) and was more significant in men than in women (adjusted HR 1.88 in male and 1.56 in female). Each component of MetS was also associated with increased gout risk, and hypertriglyceridemia showed the highest adjusted HR. The greater the number of MetS components, the higher the gout risk. The risk of gout was 70% higher in those who had MetS consistently (adjusted HR 1.71, 95% CI 1.67-1.75) and 44% higher in those with newly developed MetS (adjusted HR 1.47, 95% CI 1.40-1.48) than those who did not have MetS at the two health examinations. Similar risk patterns were observed according to the change of each metabolic parameter. Among the metabolic parameters, the change in hypertriglyceridemia was associated with the greatest difference in the change in gout risk.Conclusion:In young adults, MetS was associated with a higher risk of gout, especially with more components, the higher the risk. Since the occurrence of MetS is associated with an increased risk of gout, prevention of MetS would be important to reduce gout incidence.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document