scholarly journals Impact of changes to cervical screening guidelines on age and interval at which women are tested: Population-based study

2020 ◽  
pp. 096914132095344
Author(s):  
Alejandra Castanon ◽  
Shama Sheikh ◽  
Philippa Pearmain ◽  
Peter Sasieni
Keyword(s):  
Case Control Study ◽  
Screening Programme ◽  
Cervical Screening ◽  
Population Based ◽  
Birth Cohorts ◽  
Population Based Study ◽  
Screening Guidelines ◽  
Kaplan Meier ◽  
The Impact ◽  
Control Study

Background English cervical screening programme guidelines changed between 2009 and 2012. We explore the impact on the age and intervals at which women receive a cytology test. Methods Eligible women were controls from a population-based case–control study in England. Tests taken between 1980 and 2017 were extracted from the call/recall database. Using the Kaplan–Meier estimator by birth cohort and age at (or time since) last test, we explore proportions tested since or prior to a given age, years since previous test, and interval following a negative test. Results Screening histories from 46,037 women were included. Proportion tested by age 26 has increased from 55% among birth cohorts 1978–1979 to 67% among those born 1990–1991, despite more recent cohorts only having received one invitation (instead of two) prior to age 26. The proportion of women tested at aged 28 with a test three years earlier increased by 20% (from 36% in 1997–2006 to 56% in 2012–2017) whereas the proportion tested at ages 23–27 without a prior test increased from 34% to 80%. The age at last test prior to exiting the programme has decreased: among those born 1928–1931 86% had a test aged 60–65, but only 71% of those born 1947–1951. Conclusion Clear programme guidance alongside quality assurance has improved the cervical screening programme by standardising the age and intervals at which women are screened.

scholarly journals Utilization of Health Services Among Adults With RecurrentClostridium difficileInfection: A 12-Year Population-Based Study

2016 ◽  
Vol 38 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Jennifer L. Kuntz ◽  
Jennifer M. Baker ◽  
Patricia Kipnis ◽  
Sherian Xu Li ◽  
Vincent Liu ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Case Control Study ◽  
Population Based ◽  
Severe Illness ◽  
Population Based Study ◽  
Utilization Of Health Services ◽  
Nested Case Control ◽  
The Impact ◽  
Test Result ◽  
Control Study

BACKGROUNDConsiderable efforts have been dedicated to developing strategies to prevent and treat recurrentClostridium difficileinfection (rCDI); however, evidence of the impact of rCDI on patient healthcare utilization and outcomes is limited.OBJECTIVETo compare healthcare utilization and 1-year mortality among adults who had rCDI, nonrecurrent CDI, or no CDI.METHODSWe performed a nested case-control study among adult Kaiser Foundation Health Plan members from September 1, 2001, through December 31, 2013. We identified CDI through the presence of a positive laboratory test result and divided patients into 3 groups: patients with rCDI, defined as CDI in the 14–57 days after initial CDI; patients with nonrecurrent CDI; and patients who never had CDI. We conducted 3 matched comparisons: (1) rCDI vs no CDI; (2) rCDI vs nonrecurrent CDI; (3) nonrecurrent CDI vs no CDI. We followed patients for 1 year and compared healthcare utilization between groups, after matching patients on age, sex, and comorbidity.RESULTSWe found that patients with rCDI consistently have substantially higher levels of healthcare utilization in various settings and greater 1-year mortality risk than both patients who had nonrecurrent CDI and patients who never had CDI.CONCLUSIONSPatients who develop an initial CDI are generally characterized by excess underlying, severe illness and utilization. However, patients with rCDI experience even greater adverse consequences of their disease than patients who do not experience rCDI. Our results further support the need for continued emphasis on identifying and using novel approaches to prevent and treat rCDI.Infect Control Hosp Epidemiol.2016;1–8

scholarly journals Environmental asbestos exposure and clustering of malignant mesothelioma in community: a spatial analysis in a population-based case–control study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
C. Airoldi ◽  
C. Magnani ◽  
F. Lazzarato ◽  
D. Mirabelli ◽  
S. Tunesi ◽  
...  
Keyword(s):  
Spatial Variation ◽  
Malignant Mesothelioma ◽  
Case Control Study ◽  
Disease Risk ◽  
Population Based ◽  
Case Control ◽  
Contour Plot ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

Abstract Background Neighborhood exposure to asbestos increases the risk of developing malignant mesothelioma (MM) in residents who live near asbestos mines and asbestos product plants. The area of Casale Monferrato (Northwest Italy) was impacted by several sources of asbestos environmental pollution, due to the presence of the largest Italian asbestos cement (AC) plant. In the present study, we examined the spatial variation of MM risk in an area with high levels of asbestos pollution and secondly, and we explored the pattern of clustering. Methods A population-based case–control study conducted between 2001 and 2006 included 200 cases and 348 controls. Demographic and occupational data along with residential information were recorded. Bivariate Kernel density estimation was used to map spatial variation in disease risk while an adjusted logistic model was applied to estimate the impact of residential distance from the AC plant. Kulldorf test and Cuzick Edward test were then performed. Results One hundred ninety-six cases and 322 controls were included in the analyses. The contour plot of the cases to controls ratio showed a well-defined peak of MM incidence near the AC factory, and the risk decreased monotonically in all directions when large bandwidths were used. However, considering narrower smoothing parameters, several peaks of increased risk were reported. A constant trend of decreasing OR with increasing distance was observed, with estimates of 10.9 (95% CI 5.32–22.38) and 10.48 (95%CI 4.54–24.2) for 0–5 km and 5–10 km, respectively (reference > 15 km). Finally, a significant (p < 0.0001) excess of cases near the pollution source was identified and cases are spatially clustered relative to the controls until 13 nearest neighbors. Conclusions In this study, we found an increasing pattern of mesothelioma risk in the area around a big AC factory and we detected secondary clusters of cases due to local exposure points, possibly associated to the use of asbestos materials.

The impact of meningococcal disease in adolescence: Longitudinal prospective population-based case-control study

2005 ◽  
Vol 36 (2) ◽  
pp. 106-107 ◽  
Author(s):  
Jennie Borg ◽  
Deborah Christie ◽  
Pietro Coen ◽  
Robert Booy ◽  
Russell Viner
Keyword(s):  
Meningococcal Disease ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
The Impact ◽  
Control Study

Critical appraisal of a large population-based case–control study

2017 ◽  
Author(s):  
Mark Elwood
Keyword(s):  
Dose Response ◽  
Case Control Study ◽  
Large Population ◽  
Quantitative Relationship ◽  
Population Based ◽  
Case Control ◽  
Critical Assessment ◽  
Response Consistency ◽  
The Impact ◽  
Control Study

This chapter shows a large population-based case-control study, to address the quantitative relationship between alcohol consumption and breast cancer. It shows the logistic and design issues, and the assessment of dose-response, consistency and specificity. The critical assessment follows the scheme set out in chapter 10: describing the study, assessing the non-causal explanations of observation bias, confounding, and chance variation; assessing time relationships, strength, dose-response, consistency and specificity, and applying the results to the eligible, source, and target populations; and then comparing the results with evidence from other studies, considering consistency and specificity, biological mechanisms, and coherence with the distribution of exposures and outcomes. The chapter gives a summary and table of the critical assessment and its conclusions; and comments on the impact of the study and research carried out since.

The Impact of Cataract on Time-use: Results from a Population Based Case-Control Study in Kenya, the Philippines and Bangladesh

2008 ◽  
Vol 15 (6) ◽  
pp. 372-382 ◽  
Author(s):  
Sarah Polack ◽  
Hannah Kuper ◽  
Cristina Eusebio ◽  
Wanjiku Mathenge ◽  
Zakia Wadud ◽  
...  
Keyword(s):  
Time Use ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
The Philippines ◽  
The Impact ◽  
Control Study

Implications of pancreatic cancer with diabetes mellitus on patient outcomes and care: A matched case-control study.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 239-239
Author(s):  
Nina J. Karlin ◽  
Shailja Amin ◽  
Matthew Buras ◽  
Heidi E. Kosiorek ◽  
Patricia M. Verona ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Glycemic Control ◽  
Cancer Diagnosis ◽  
Case Control Study ◽  
Case Control ◽  
Kaplan Meier ◽  
The Impact ◽  
Control Study ◽  
Over Time

239 Background: The aim of this case-control study was to determine the impact of DM on survival in pancreatic cancer patients, and to examine the impact of pancreatic cancer on glycemic control in DM. Methods: Ninety-two patients with newly diagnosed pancreatic cancer from 2007 to 2015 with DM were identified from the institutional Cancer Registry and matched to ninety-two pancreatic cancer patients without DM according to age, gender, and year of pancreatic cancer diagnosis. The file was linked to the electronic medical record to obtain information on DM and pancreatic cancer therapies, and laboratory results. Overall survival (OS) was estimated with the Kaplan-Meier method and compared by Cox regression analysis. Mixed models were used to compare hemoglobin A1c (HbA1c) and glucose over time. Results: Mean age of the entire pancreatic cancer cohort was 70 years, most (92%) were white, most common (88%) histology was adenocarcinoma, and majority (41%) were stage IV. No differences in age, race/ethnicity, histology, or tumor stage were detected between patients with and without DM, although DM patients had higher body mass index (P = 0.014). Mean ca 19-9 (U/ml) was 804 for diabetics, and 395 for non-diabetics. Among those with DM the mean HbA1c during the year following cancer diagnosis was 7.3%. Time (days since diagnosis) was significant in DM patients (p = 0.014) as HbA1c decreased over time. Mean glucose during the year following diagnosis among DM patients was significantly higher compared to non-DM patients [160.6 (SD = 38.0) versus 117.2 (SD = 19.0); p < 0.001]. Both groups had a decline in glucose over time (p = 0.008). In Kaplan-Meier survival analysis (median follow-up time of 11.9 months), 2 year overall survival was estimated at 15% [95% CI: 8-24%] for DM patients versus 26% [95% CI: 17-36%] in non-DM patients. Hazard ratio (for matched pairs) was 1.15 (95% CI: 0.75-1.77; p = 0.51). Conclusions: DM did not adversely impact survival in patients with pancreatic cancer. Pancreatic cancer did not affect glycemic control. Elevated ca 19-9 in diabetic patients may be an unreliable marker for gauging disease progression.

scholarly journals Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment

2021 ◽  
Vol 11 ◽  
Author(s):  
Bo Fan ◽  
Alradhi Mohammed ◽  
Yuanbin Huang ◽  
Hong Luo ◽  
Hongxian Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Case Control Study ◽  
Meta Analysis ◽  
Case Control ◽  
Female Patients ◽  
Kaplan Meier ◽  
History Of ◽  
The Impact ◽  
Control Study

Aspirin, widely used to prevent cardiovascular disease, had been linked to the incidence of bladder cancer (BCa). Existing studies focusing on Chinese populations are relatively rare, especially for Northeast China. Meanwhile, relevant studies on the effects of aspirin on the occurrence or prognosis of BCa are inconsistent or even controversial. First, in the case control study, logistic regression analysis was used to investigate the association between aspirin intake and risk of BCa including 1121 patients with BCa and the 2242 controls. Subsequently, Kaplan-Meier curve and Cox regression analyses were applied to explore the association between aspirin intake and clinicopathological factors which may predict overall survival (OS) and recurrence-free survival (RFS) of BCa patients. Finally, we quantificationally combined the results with those from the published literature evaluating aspirin intake and its effects on the occurrence, outcome of surgery and prognosis of BCa by meta-analysis up to May 1, 2021.Our case-control study demonstrated that the regular use of aspirin was not associated with a reduced incidence of BCa (P=0.175). Stratified analyses of sex showed that aspirin intake did not lead to a lower risk of BCa in female patients (P=0.063). However, the male population who regularly took aspirin had a lower incidence of BCa (OR=0.748, 95% CI= 0.584-0.958, P=0.021). Subgroup analyses stratified by smoking found a significant reduction in the risk of BCa in current smokers with aspirin intake (OR=0.522, 95% CI=0.342-0.797, P=0.002). In terms of prognosis of BCa, patients with a history of aspirin intake did not had a markedly longer OS or RFS than those with no history of aspirin intake by Kaplan-Meier curves. Stratified analysis by sex showed no correlation between aspirin intake and the recurrence or survival of BCa for either male or female patients. However, in people younger than 68, aspirin intake seemed to have prolonged effects for overall survival (HR=3.876; 95% CI=1.326-11.325, P=0.019). Then, we performed a meta-analysis and the combined results from 19 articles and our study involving more than 39524 BCa cases indicated that aspirin intake was not associated with the occurrence of BCa (P=0.671). Subgroup analysis by whether regular use of aspirin, by the mean duration of use of aspirin, by sex, by smoking exposure, by research region and by study type also supported the above results. In terms of the impact of aspirin intake on the prognosis of patients with BCa, 11 articles and our study involving 8825 BCa cases were eligible. The combined results showed that patients with aspirin intake did not have significantly influence on survival, recurrence, progression and metastasis than those without aspirin intake. On the whole, both our retrospective study and literature meta-analysis suggested a lack of a strong relevant association between the use of aspirin and the incidence or prognosis of BCa. Thus, additional long-term follow-up prospective research is warranted to clarify the association of aspirin with BCa incidence and prognosis.

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