Pregnancy-associated cancers: frequency and temporal trends in Italy

ObjectiveLimited data are available on the frequency and time trends of pregnancy-associated cancers, particularly from Southern European countries. The aim of this study was to analyze the frequency and time trends of pregnancy-associated cancer in Italy.MethodsThis was a population-based linkage study using the regional hospital discharge forms database of four Italian regions with more than 17 million inhabitants. All resident women with a hospital discharge form reporting a birth or abortion in the time period under consideration were identified. The time period of the study was 2003–2015 for the Piemonte and Puglia region, 2006–2015 for the Tuscany region, and 2005–2015 for the Veneto region. Risk of developing a pregnancy-associated cancer was calculated as the ratio of the number of pregnancy-related cancers to the total number of pregnancies.ResultsA total of 2 297 648 pregnancies were identified. Overall, the pregnancy-associated cancer frequency was 134.8 per 100 000 pregnancies: the frequency ranged from 127.1 in Puglia to 157.3 in Tuscany. The frequency for 100 000 pregnancies was 66.4 in women aged <30 years; the risk increased with age, with a frequency of 275.6 among women aged 40+ years. Approximately two-thirds of cancers were associated with pregnancies resulting in a delivery and one-third with pregnancies resulting in a termination of pregnancy or spontaneous pregnancy loss. No clear trend emerged in the risk of pregnancy-associated cancer per 100 000 pregnancies and calendar year.ConclusionNo clear time trend was observed in the frequency of pregnancy-associated cancers in Italy during the last 10 years, the rates being 104, 164, and 130 per 100 000 pregnancies, respectively, in 2003, 2010, and 2015.

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Abstract 12069: Long-Term Trends in the Incidence and Outcome of Refractory and Non-Refractory Ventricular Fibrillation Cardiac Arrest

Circulation ◽

10.1161/circ.144.suppl_2.12069 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Ziad Nehme ◽

Emily Andrew ◽

Jocasta Ball ◽

Karen L Smith

Keyword(s):

Cardiac Arrest ◽

Ventricular Fibrillation ◽

Hospital Discharge ◽

Temporal Trends ◽

Developed Countries ◽

Population Based ◽

Logistic Regression Models ◽

Shockable Rhythm ◽

Adjusted Logistic Regression ◽

Population Based Registry

Introduction: Although many developed countries are reporting temporal improvements in out-of-hospital cardiac arrest (OHCA) outcomes from initial shockable rhythms, trends in the incidence and outcome of refractory ventricular fibrillation are not well understood. Methods: Between 2010 and 2019, we performed a retrospective observational study of OHCA from a population-based registry in Victoria, Australia. We included all adult, non-traumatic OHCA with an initial shockable rhythm. Temporal trends in incidence and survival to hospital discharge were compared across non-refractory and refractory OHCA, defined as cases receiving 3 or more consecutive shocks for a persistent shockable rhythm. Risk-adjusted logistic regression models were used to describe the year-on-year change in the likelihood of refractory OHCA and survival to hospital discharge. Results: Of the 7,267 initial shockable OHCA with an attempted resuscitation, 4168 (57.4%) and 3,099 (42.6%) were non-refractory and refractory OHCA, respectively. The proportion of cases with refractory OHCA declined over the study period from 48.4% in 2010 to 40.2% in 2019 (p trend <0.001). Unadjusted survival to hospital discharge was higher in non-refractory OHCA (46.3% vs. 25.8%, p<0.001), although both populations experienced increases in survival over time (p trend <0.05 for both). After adjustment for arrest confounders, the likelihood of refractory VF decreased by 4.4% every year (adjusted odds ratio [AOR]: 0.96, 95% CI: 0.94, 0.97; p<0.001). Factors reducing the likelihood of refractory OHCA were female sex, bystander CPR, arrest witnessed by emergency medical services, and public location. In the survival model, refractory OHCA was independently associated with a reduction in survival to hospital discharge (AOR 0.50, 95% CI: 0.45, 0.56; p<0.001). Temporal improvements in survival were observed year-on-year (AOR 1.03, 95% CI: 1.02, 1.05; p<0.001) and this did not differ between non-refractory and refractory OHCA (group interaction, p = 0.51). Conclusions: The incidence of refractory OHCA is declining in our region and survival outcomes are improving. Further research identifying factors contributing to the decline in refractory OHCA may help to improve outcomes further.

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Incidence and prevalence of psoriatic arthritis in Denmark: a nationwide register linkage study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-210963 ◽

2017 ◽

Vol 76 (9) ◽

pp. 1591-1597 ◽

Cited By ~ 24

Author(s):

Alexander Egeberg ◽

Lars Erik Kristensen ◽

Jacob P Thyssen ◽

Gunnar Hilmar Gislason ◽

Alice B Gottlieb ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Certolizumab Pegol ◽

National Level ◽

Temporal Trends ◽

Linkage Study ◽

Incidence Rates ◽

Biologic Agents ◽

Clear Trend ◽

Number Of Patients ◽

Gender And Age

ObjectivesTo examine the incidence and temporal trends of psoriatic arthritis (PsA) in the general population in Denmark.MethodsUsing nationwide registry data, we estimated the number of patients with incident PsA within each 1-year period between 1997 and 2011 and calculated the rate of PsA cases within gender and age subgroups. Incidence rates were presented per 100 000 person-years.ResultsThere was a female predominance ranging from 50.3% (1998) to 59.2% (2010), and the mean age at time of diagnosis was 47–50 years. We identified a total of 12 719 patients with PsA (prevalence=0.22%), including 9034 patients where the PsA diagnosis was made by a rheumatologist (prevalence=0.16%). Incidence rates of PsA (per 100 000 person-years) increased from 7.3 in 1997 to a peak incidence of 27.3 in 2010. Incidence rates were highest for women and patients aged 50–59 years, respectively. The use of systemic non-biologic agents, that is, methotrexate, leflunomide, ciclosporin or sulfasalazine increased over the 15-year study course and were used in 66.3% of all patients. Biologic agents (etanercept, infliximab, adalimumab, certolizumab pegol, golimumab or ustekinumab) were used in 17.7% of patients with PsA.ConclusionsWe found a clear trend of rising PsA incidence on a national level. While the cause remains unclear, our findings might be explained by increased attention by patients and physicians.

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Time trends in survival in young women with breast cancer in a population-based study: Are there estrogen receptor status differentials?

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.85 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 85-85

Author(s):

Foluso Olabisi Ademuyiwa ◽

Adrienne Groman ◽

Chi-Chen Hong ◽

Shicha Kumar ◽

Ellis Glenn Levine ◽

...

Keyword(s):

Breast Cancer ◽

Time Trends ◽

Advanced Disease ◽

Age Groups ◽

Population Based ◽

Time Period ◽

Breast Cancer Outcome ◽

Er Positive ◽

Time Periods ◽

Cancer Outcome

85 Background: As mammography is not generally recommended to women under 40, it is reasonable to conclude that documented outcome improvements over time are attributable to treatment advances with screening playing a less important role. In order to determine the contribution of screening and treatment to improvements, we evaluated the odds of presenting with more advanced disease by time-period and examined the time-trends in outcome in a population-based cohort ≤50. We evaluated whether any outcomes differentials existed by ER status. Methods: Patients in SEER diagnosed with breast cancer were divided into 4 by year of diagnosis (1990-1994, 1995-1999, 2000-2004, 2005-2008). Patients were categorized into 2 age-groups: <40 and 40-50 years. Odds ratios for presenting with more advanced disease over the 4 time-periods were calculated for the 2 age-groups. Multivariate analysis was done to investigate the association of survival with time-period for the 2 age-groups by ER status. Results: 110,629 patient records were included. Patients 40-50 who were diagnosed in the 3 later time-periods (1995-1999, 2000-2004, 2005-2008) were more likely to have small tumors (≤2cm) compared with patients diagnosed in 1990-1994. Similarly, these patients were less likely to have larger tumors (≥3cm) comparing the 3 time-periods relative to 1990-1994. Conversely, patients <40 years had a higher odds of presenting with larger tumors (≥3cm) when the 3 later time-periods were compared to 1990-1994. In the ER positive patients, multivariate analysis showed that being diagnosed in the 3 later time-periods relative to 1990-1994 was associated with improved survival irrespective of age. In the ER negative cohort, those 40-50 years had a higher risk of death in the 3 later time-periods relative to 1990-1994; while there was a no effect of time-period on mortality for the younger age group of <40. Conclusions: Patients who are ER positive and between 40-50 years have had time-trend changes with improvements in breast cancer outcome and smaller tumors likely attributable to both screening and hormonal therapies. Patients who are <40 years and/or ER negative have not had improvements in breast cancer outcome.

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Simultaneous temporal trends in dementia incidence and prevalence, 2005–2013: a population-based retrospective cohort study in Saskatchewan, Canada

International Psychogeriatrics ◽

10.1017/s1041610216000818 ◽

2016 ◽

Vol 28 (10) ◽

pp. 1643-1658 ◽

Cited By ~ 20

Author(s):

Julie G. Kosteniuk ◽

Debra G. Morgan ◽

Megan E. O'Connell ◽

Andrew Kirk ◽

Margaret Crossley ◽

...

Keyword(s):

Cohort Study ◽

Incidence Rate ◽

Retrospective Cohort Study ◽

Time Trends ◽

Retrospective Cohort ◽

Temporal Trends ◽

Population Based ◽

Dementia Incidence ◽

Administrative Health Databases ◽

Incident Cases

ABSTRACTBackground:Original studies published over the last decade regarding time trends in dementia report mixed results. The aims of the present study were to use linked administrative health data for the province of Saskatchewan for the period 2005/2006 to 2012/2013 to: (1) examine simultaneous temporal trends in annual age- and sex-specific dementia incidence and prevalence among individuals aged 45 and older, and (2) stratify the changes in incidence over time by database of identification.Methods:Using a population-based retrospective cohort study design, data were extracted from seven provincial administrative health databases linked by a unique anonymized identification number. Individuals 45 years and older at first identification of dementia between April 1, 2005 and March 31, 2013 were included, based on case definition criteria met within any one of four administrative health databases (hospital, physician, prescription drug, and long-term care).Results:Between 2005/2006 and 2012/2013, the 12-month age-standardized incidence rate of dementia declined significantly by 11.07% and the 12-month age-standardized prevalence increased significantly by 30.54%. The number of incident cases decreased from 3,389 to 3,270 and the number of prevalent cases increased from 8,795 to 13,012. Incidence rate reductions were observed in every database of identification.Conclusions:We observed a simultaneous trend of decreasing incidence and increasing prevalence of dementia over a relatively short 8-year time period from 2005/2006 to 2012/2013. These trends indicate that the average survival time of dementia is lengthening. Continued observation of these time trends is warranted given the short study period.

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Risk of Myocarditis from COVID-19 Infection in People Under Age 20: A Population-Based Analysis

10.1101/2021.07.23.21260998 ◽

2021 ◽

Author(s):

Mendel E Singer ◽

Ira B. Taub ◽

David C. Kaelber

Keyword(s):

Age Groups ◽

Population Based ◽

Research Network ◽

Limited Data ◽

Healthcare Organizations ◽

Data Set ◽

Young Males ◽

Time Period ◽

Male Cohort ◽

Adjusted Rate

Background There have been recent reports of myocarditis (including myocarditis, pericarditis or myopericarditis) as a side-effect of mRNA-based COVID-19 vaccines, particularly in young males. Less information is available regarding the risk of myocarditis from COVID-19 infection itself. Such data would be helpful in developing a complete risk-benefit analysis for this population. Methods A de-identified, limited data set was created from the TriNetX Research Network, aggregating electronic health records from 48 mostly large U.S. Healthcare Organizations (HCOs). Inclusion criteria were a first COVID-19 diagnosis during the April 1, 2020 - March 31, 2021 time period, with an outpatient visit 1 month to 2 years before, and another 6 months to 2 years before that. Analysis was stratified by sex and age (12-17, 12-15, 16-19). Patients were excluded for any prior cardiovascular condition. Primary outcome was an encounter diagnosis of myocarditis within 90 days following the index date. Rates of COVID-19 cases and myocarditis not identified in the system were estimated and the results adjusted accordingly. Wilson score intervals were used for 95% confidence intervals due to the very low probability outcome. Results For the 12-17-year-old male cohort, 6/6,846 (0.09%) patients developed myocarditis overall, with an adjusted rate per million of 876 cases (Wilson score interval 402 - 1,911). For the 12-15 and 16-19 male age groups, the adjusted rates per million were 601 (257 - 1,406) and 561 (240 - 1,313). For 12-17-year-old females, there were 3 (0.04%) cases of myocarditis of 7,361 patients. The adjusted rate was 213 (73 - 627) per million cases. For the 12-15- and 16-19-year-old female cohorts the adjusted rates per million cases were 235 (64 - 857) and 708 (359 - 1,397). The outcomes occurred either within 5 days (40.0%) or from 19-82 days (~60.0%). Conclusions Myocarditis (or pericarditis or myopericarditis) from primary COVID19 infection occurred at a rate as high as 450 per million in young males. Young males infected with the virus are up 6 times more likely to develop myocarditis as those who have received the vaccine.

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The Association Between Hysterectomy and Ovarian Cancer Risk: A Population-Based Record-Linkage Study

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz015 ◽

2019 ◽

Vol 111 (10) ◽

pp. 1097-1103

Author(s):

Suzanne C Dixon-Suen ◽

Penelope M Webb ◽

Louise F Wilson ◽

Karen Tuesley ◽

Louise M Stewart ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Risk ◽

Record Linkage ◽

Cox Regression ◽

Population Based ◽

Linkage Study ◽

Ovarian Cancer Risk ◽

Hazard Ratios ◽

Time Period ◽

Hospital Births

Abstract Background Recent studies have called into question the long-held belief that hysterectomy without oophorectomy protects against ovarian cancer. This population-based longitudinal record-linkage study aimed to explore this relationship, overall and by age at hysterectomy, time period, surgery type, and indication for hysterectomy. Methods We followed the female adult Western Australian population (837 942 women) across a 27-year period using linked electoral, hospital, births, deaths, and cancer records. Surgery dates were determined from hospital records, and ovarian cancer diagnoses (n = 1640) were ascertained from cancer registry records. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between hysterectomy and ovarian cancer incidence. Results Hysterectomy without oophorectomy (n = 78 594) was not associated with risk of invasive ovarian cancer overall (HR = 0.98, 95% CI = 0.85 to 1.11) or with the most common serous subtype (HR = 1.05, 95% CI = 0.89 to 1.23). Estimates did not vary statistically significantly by age at procedure, time period, or surgical approach. However, among women with endometriosis (5.8%) or with fibroids (5.7%), hysterectomy was associated with substantially decreased ovarian cancer risk overall (HR = 0.17, 95% CI = 0.12 to 0.24, and HR = 0.27, 95% CI = 0.20 to 0.36, respectively) and across all subtypes. Conclusions Our results suggest that for most women, having a hysterectomy with ovarian conservation is not likely to substantially alter their risk of developing ovarian cancer. However, our results, if confirmed, suggest that ovarian cancer risk reduction could be considered as a possible benefit of hysterectomy when making decisions about surgical management of endometriosis or fibroids.

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Characteristics and changes in characteristics of women and babies admitted to residential parenting services in New South Wales, Australia in the first year following birth: a population-based data linkage study 2000–2012

BMJ Open ◽

10.1136/bmjopen-2019-030133 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030133 ◽

Cited By ~ 1

Author(s):

Hannah G Dahlen ◽

Charlene Thornton ◽

Cathrine Fowler ◽

Robert Mills ◽

Grainne O'Loughlin ◽

...

Keyword(s):

New South ◽

New South Wales ◽

Population Data ◽

Male Infant ◽

Population Based ◽

Linkage Study ◽

First Year ◽

Private Patient ◽

South Wales ◽

Time Period

ObjectiveTo examine the characteristics of women and babies admitted to the residential parenting services (RPS) of Tresillian and Karitane in the first year following birth.DesignA linked population data cohort study was undertaken for the years 2000–2012.SettingNew South Wales (NSW), Australia.ParticipantsAll women giving birth and babies born in NSW were compared with those admitted to RPS.ResultsDuring the time period there were a total of 1 097 762 births (2000–2012) in NSW and 32 991 admissions to RPS. Women in cohort 1: (those admitted to RPS) were older at the time of birth, more likely to be admitted as a private patient at the time of birth, be born in Australia and be having their first baby compared with women in cohort 2 (those not admitted to an RPS). Women admitted to RPS experienced more birth intervention (induction, instrumental birth, caesarean section), had more multiple births and were more likely to have a male infant. Their babies were also more likely to be resuscitated and have experienced birth trauma to the scalp. Between 2000 and 2012 the average age of women in the RPS increased by nearly 2 years; their infants were older on admission and women were less likely to smoke. Over the time period there was a drop in the numbers of women admitted to RPS having a normal vaginal birth and an increase in women having an instrumental birth.ConclusionWomen who access RPS in the first year after birth are more socially advantaged and have higher birth intervention than those who do not, due in part to higher numbers birthing in the private sector where intervention rates are high. The rise in women admitted to RPS (2000–2012) who have had instrumental births is intriguing as overall rates did not increase.

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DOP41 Temporal Trends in the epidemiology of Inflammatory Bowel Diseases in the public healthcare system in Brazil: A large population-based study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab073.080 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S079-S080

Author(s):

A B Quaresma ◽

A O M C Damiao ◽

C S R Coy ◽

D O Magro ◽

D A Valverde ◽

...

Keyword(s):

Temporal Trends ◽

Population Based ◽

Incidence Rates ◽

Public Healthcare ◽

Prevalence Rates ◽

Industrialized Countries ◽

Newly Industrialized Countries ◽

Time Period ◽

Binomial Regression ◽

Bowel Diseases

Abstract Background Background: Population-based data on incidence and prevalence of Inflammatory Bowel Diseases (IBD) in newly industrialized countries such as Brazil are scarce. This study aims to define temporal trends of estimated incidence and prevalence rates of Crohn’s disease (CD) and ulcerative colitis (UC) in Brazil using unique public healthcare datasets. Methods Methods: All IBD patients (UC and CD) from the unique public healthcare national system (DATASUS) were included from January 2012 to December 2020 and identified according to ICD codes, medication use or IBD-relates procedures. Data extraction was performed with the platform “TT Disease Explorer” (Techtrials Healthcare Data Science, Brazil) and checked by 2 independent reviewers. The platform collects publicly available data from the ministry of health via electronic algorithms (ETLs and Webcrawlers) with automatic updates. The population of Brazil was calculated according to the national Brazilian Geographics and Statistics Institute (IBGE). Average Annual Percent Change (AAPC) and 95% confidence intervals (CI) were calculated using poisson (or negative binomial) regression for incidence and log binomial regression for prevalence. Results Results: A total of 212,026 IBD patients (UC: n=140,705; CD: n=92,326) were included, There was a higher proportion of females as opposed to males, and age at health system entry was similar to developed countries (figure 1). Estimated incidence rates of IBD were 9.41 per 100,000 in 2012 and 9.57 per 100,000 in 2020 (AAPC=0.80%; CI -0.37–1.99; p=0.18); for UC, incidence increased from 5.69 per 100,000 to 6.89 per 100,000 (AAPC=3.04; CI 1.51–4.58; p<0.001) and for CD incidence dropped from 3.71 per 100,000 to 2.68 per 100,000 (AAPC=-3.24%; CI -4.45- -2.02; p<0.001) in the same time period (figure 2). Estimated prevalence rates of IBD increased significantly from 30.01 per 100,000 in 2012 to 100.13 per 100,000 in 2020 (AAPC=14.87%; CI 14.78–14.95; p<0.001); For UC, from 17.4 per 100,000 to 66.45 per 100,000 (AAPC=16.51%; CI 16.41–16.62; p<0.001) and for CD from 14.24 per 100,000 to 43.6 per 100,000 (AAPC=13.49%; CI13.37-13.61; p<0.001) in the same time period (figure 3). Conclusion Conclusions: Estimated incidence rates of IBD have remained stable from 2012–2020. Incidence of CD is significantly decreasing whereas of UC is significantly increasing. There was a significant increase in estimated prevalence rates of CD and UC. This massive rise in prevalence can support planning for future strategies for public healthcare providers in our country towards better IBD care. This is the largest IBD epidemiological study from newly industrialized countries to date.

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