scholarly journals Risk of Synchronous and Metachronous Colorectal Cancer: Population-Based Estimates in Denmark with Focus on Non-Hereditary Cases Diagnosed After Age 50

2018 ◽  
Vol 108 (2) ◽  
pp. 152-158 ◽  
Author(s):  
L. J. Lindberg ◽  
S. Ladelund ◽  
I. Bernstein ◽  
C. Therkildsen ◽  
M. Nilbert
Keyword(s):  
Colorectal Cancer ◽  
Environmental Factors ◽  
Absolute Risk ◽  
Tumor Location ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Synchronous Colorectal Cancer ◽  
Metachronous Colorectal Cancer ◽  
Rate Ratios

Background and Aims: The risk of synchronous and metachronous colorectal cancer is influenced by heritable and environmental factors. As a basis for comparative studies, we provide population-based estimates of synchronous and metachronous colorectal cancer with a focus on non-heritable cases. Material and Methods: Based on data from national Danish cancer registers, we estimated the proportion of synchronous colorectal cancer and the incidence rates and risks for metachronous colorectal cancer in 28,504 individuals, who developed 577 metachronous colorectal cancer above age 50. Results: Synchronous colorectal cancer was diagnosed in 1.3% of the cases. The risk of metachronous colorectal cancer was associated with sex, tumor location, and age with the strongest influence from the latter. The incidence rate ratios for metachronous colorectal cancer ranged from above 6 in patients below age 65 to <1–3.2 in patients above age 65. The absolute risk of metachronous colorectal cancer was ⩾10% in patients below age 65 and 1.0%–8.0% in patients above age 65. Conclusion: Individuals who develop sporadic, non-inherited colorectal cancer above age 50 are at a significantly increased risk of metachronous colorectal cancer with risk estimates that are strongly affected by age. This observation underscores the need for development of targeted surveillance in the most common clinical subset of colorectal cancer.

Methimazole Treatment and Risk of Acute Pancreatitis: A Population-based Cohort Study

2020 ◽  
Vol 105 (12) ◽  
pp. e4527-e4530
Author(s):  
Alessandro Pecere ◽  
Marina Caputo ◽  
Andrea Sarro ◽  
Andrealuna Ucciero ◽  
Angelica Zibetti ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Absolute Risk ◽  
Population Based ◽  
Age Classes ◽  
Population Based Study ◽  
Increased Risk ◽  
Hospital Discharge Records ◽  
Adjusted Rate ◽  
Administrative Health Databases ◽  
Rate Ratios

Abstract Context A warning has been recently issued by the European Medicine Agency (EMA) regarding a potential increased risk of acute pancreatitis (AP) in methimazole (MMI) users. Objective To investigate the association between MMI and the diagnosis of AP in a population-based study. Materials and Methods A retrospective analysis of administrative health databases was conducted (2013–2018). Relevant data were obtained from: (1) inhabitants registry, (2) hospital discharge records (ICD-9-CM 577.0), and (3) drug claims registry (ATC H03BB02). We evaluated AP risk in MMI users in 18 months of treatment, stratifying results by trimester. Poisson regression was used to estimate the age- and sex-adjusted rate ratios (RR), and the relative 95% confidence intervals (CI), comparing rates of AP between MMI users and nonusers. The absolute risk of AP in MMI users was also calculated. Results A total of 23 087 new users of MMI were identified. Among them, 61 hospitalizations occurred during the study period. An increase in AP risk was evident during the first 3 trimesters of therapy (RR 3.40 [95% CI: 2.12–5.48]; RR 2.40 [95% CI: 1.36–4.23]; RR 2.80 [95% CI: 1.66–4.73]), but disappeared thereafter. The AP absolute risk in MMI users during the first 18 months of treatment was less than 0.4% in all sex and age classes. Conclusions Our results support the EMA warning, suggesting an increased risk of AP associated with MMI use. However, such an increase seems limited to the first months of MMI treatment. Moreover, in absolute terms, the probability of AP is low among patients, well below 1%.

scholarly journals Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

2018 ◽  
Vol 103 (6) ◽  
pp. 2182-2188 ◽  
Author(s):  
Jakob Dal ◽  
Michelle Z Leisner ◽  
Kasper Hermansen ◽  
Dóra Körmendiné Farkas ◽  
Mads Bengtsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cohort Study ◽  
Cancer Incidence ◽  
Meta Analysis ◽  
Population Based ◽  
Incidence Rates ◽  
Tract Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Context Acromegaly has been associated with increased risk of cancer morbidity and mortality, but research findings remain conflicting and population-based data are scarce. We therefore examined whether patients with acromegaly are at higher risk of cancer. Design A nationwide cohort study (1978 to 2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared with national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed. Results The cohort study identified 81 cases of cancer after exclusion of cases diagnosed within the first year [SIR 1.1; 95% confidence interval (CI), 0.9 to 1.4]. SIRs were 1.4 (95% CI, 0.7 to 2.6) for colorectal cancer, 1.1 (95% CI, 0.5 to 2.1) for breast cancer, and 1.4 (95% CI, 0.6 to 2.6) for prostate cancer. Whereas overall mortality was elevated in acromegaly (SIR 1.3; 95% CI, 1.1 to 1.6), cancer-specific mortality was not. The meta-analysis yielded an SIR of overall cancer of 1.5 (95% CI, 1.2 to 1.8). SIRs were elevated for colorectal cancer, 2.6 (95% CI, 1.7 to 4.0); thyroid cancer, 9.2 (95% CI, 4.2 to 19.9); breast cancer, 1.6 (1.1 to 2.3); gastric cancer, 2.0 (95% CI, 1.4 to 2.9); and urinary tract cancer, 1.5 (95% CI, 1.0 to 2.3). In general, cancer SIR was higher in single-center studies and in studies with &lt;10 cancer cases. Conclusions Cancer incidence rates were slightly elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.

Risk of Colorectal Cancer After Diagnosis of Endometrial Cancer: A Population-Based Study

2013 ◽  
Vol 31 (16) ◽  
pp. 2010-2015 ◽  
Author(s):  
Harminder Singh ◽  
Zoann Nugent ◽  
Alain Demers ◽  
Piotr M. Czaykowski ◽  
Salaheddin M. Mahmud
Keyword(s):  
Colorectal Cancer ◽  
Endometrial Cancer ◽  
Proportional Hazards ◽  
Population Based ◽  
Incidence Rates ◽  
Administrative Databases ◽  
Historical Cohort ◽  
Population Based Study ◽  
Increased Risk ◽  
History Of

Purpose Site-specific risk of colorectal cancer (CRC) among survivors of endometrial cancer (EC) is not known. The objective of the present study was to assess the risk of CRC (overall and subsite specific) among EC survivors. Methods A historical cohort study was performed by linking the Manitoba Cancer Registry and the Manitoba Health administrative databases. Each subject diagnosed with EC as her first cancer between 1987 and 2008 was age matched with up to five women with no history of invasive cancer on the index date (date of EC diagnosis). All subjects were followed up to the date of diagnosis of CRC or another cancer, death, migration, or study end point (December 31, 2009). Competing-risk proportional hazards models were used to compare the CRC incidence rates with adjustment for age, history of lower gastrointestinal endoscopy, and socioeconomic status. There were three mutually exclusive (and competing) outcomes: CRC, another primary cancer, and death. Results A total of 3,115 women with EC and 15,084 without EC were followed up for a total of 145,502 person-years. Women diagnosed with EC at age ≤ 50 years had an increased risk of being diagnosed with CRC (all CRC: hazard ratio [HR] = 4.41; 95% CI, 1.47 to 13.26; right-sided CRC: HR = 7.48; 95% CI, 1.29 to 43.28). There was no increased risk of all CRC among women 51 to 65 years of age or those older than 65 years at the time of EC diagnosis. However, women 51 to 65 years of age at EC diagnosis had an increased risk of right-sided CRC (HR = 2.30; 95% CI, 1.05 to 5.01). Conclusion This study suggests young women (age ≤ 50 years) with EC are at increased risk of CRC; risk of right-sided CRC is also increased in women 51 to 65 years old at EC diagnosis.

scholarly journals The incidence of first stroke in and around pregnancy: A population-based cohort study from Sweden

2017 ◽  
Vol 2 (3) ◽  
pp. 250-256 ◽  
Author(s):  
Lu Ban ◽  
Alyshah Abdul Sultan ◽  
Olof Stephansson ◽  
Laila J Tata ◽  
Nikola Sprigg ◽  
...  
Keyword(s):  
Population Based ◽  
Incidence Rates ◽  
Baseline Risk ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Calendar Time ◽  
Birth Registry ◽  
Early Postpartum ◽  
Increased Risk ◽  
Rate Ratios

Introduction Research has suggested that delivery is associated with an increased risk of stroke in women; however, there is a lack of contemporary estimates on the incidence of stroke in and after pregnancy compared with the baseline risk in women of childbearing age in Sweden. Patients and methods All women aged 15–49 years with live births/stillbirths in 1992–2011 were identified from the Swedish Medical Birth Registry linked with the National Patient Registry. First stroke during the study period was identified. Incidence rates per 100,000 person-years and adjusted incidence rate ratios (IRRs) were calculated for antepartum, peripartum and early and late postpartum periods, compared with all other available follow-up time (time before pregnancy and after postpartum) using Poisson regression adjusted for maternal age, education attainment and calendar time. Results Of 1,124,541 women, 3094 had a first incident stroke (331 occurred during pregnancy or first 12 weeks postpartum), about half having ischaemic stroke. The incidence was 15.0 per 100,000 person-years (95% confidence interval 14.5–15.6) in non-pregnant time. The incidence was lower antepartum (7.3/100,000 person-years, 6.0–8.9; adjusted IRR = 0.7, 0.5–0.8) but higher peripartum (314.4/100,000 person-years, 247.5–399.5; adjusted IRR = 27.3, 21.4–34.9) and early postpartum (64.0/100,000 person-years, 54.1–75.7; adjusted IRR = 5.5, 4.6–6.6). The increased risk in peripartum was more evident for intracerebral haemorrhage than other types of stroke. Conclusion Overall risk of stroke was low in women of childbearing age, but stroke risk peaks in the peripartum and early postpartum periods. Future work should address factors that contribute to this increased risk in order to develop approaches to attenuate risk.

scholarly journals Urban–rural differences in incidence rates of psychiatric disorders in Denmark

2016 ◽  
Vol 208 (5) ◽  
pp. 435-440 ◽  
Author(s):  
Evangelos Vassos ◽  
Esben Agerbo ◽  
Ole Mors ◽  
Carsten Bøcker Pedersen
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Icd 10 ◽  
Urban Rural ◽  
Rate Ratios

BackgroundPeople born in densely populated areas have a higher risk of developing schizophrenia, bipolar disorder and autism.AimsThe purpose of this study was to investigate whether urban–rural differences in place of birth influence a broad range of mental disorders.MethodPopulation-based cohort study of everyone born in Denmark between 1955 and 2006 (n = 2 894 640). Main outcome measures were incidence rate ratios for five levels of urbanisation and summary estimates contrasting birth in the capital with birth in rural areas.ResultsFor all psychiatric disorders, except intellectual disability (ICD-10 ‘mental retardation’) and behavioural and emotional disorders with onset in childhood, people born in the capital had a higher incidence than people born in rural areas.ConclusionsBirth in an urban environment is associated with an increased risk for mental illness in general and for a broad range of specific psychiatric disorders. Given this new evidence that urban–rural differences in incidence are not confined to the well-studied psychotic disorders, further work is needed to identify the underlying aetiopathogenic mechanisms.

scholarly journals The absolute risk of gout by clusters of gout-associated comorbidities and lifestyle factors—30 years follow-up of the Malmö Preventive Project

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Tahzeeb Fatima ◽  
Peter M. Nilsson ◽  
Carl Turesson ◽  
Mats Dehlin ◽  
Nicola Dalbeth ◽  
...  
Keyword(s):  
Absolute Risk ◽  
Population Based ◽  
Lifestyle Factors ◽  
Incidence Rates ◽  
Kidney Dysfunction ◽  
Swedish Population ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Close Proximity

Abstract Background Gout is predicted by a number of comorbidities and lifestyle factors. We aimed to identify discrete phenotype clusters of these factors in a Swedish population-based health survey. In these clusters, we calculated and compared the incidence and relative risk of gout. Methods Cluster analyses were performed to group variables with close proximity and to obtain homogenous clusters of individuals (n = 22,057) in the Malmö Preventive Project (MPP) cohort. Variables clustered included obesity, kidney dysfunction, diabetes mellitus (DM), hypertension, cardiovascular disease (CVD), dyslipidemia, pulmonary dysfunction (PD), smoking, and the use of diuretics. Incidence rates and hazard ratios (HRs) for gout, adjusted for age and sex, were computed for each cluster. Results Five clusters (C1–C5) were identified. Cluster C1 (n = 16,063) was characterized by few comorbidities. All participants in C2 (n = 750) had kidney dysfunction (100%), and none had CVD. In C3 (n = 528), 100% had CVD and most participants were smokers (74%). C4 (n = 3673) had the greatest fractions of obesity (34%) and dyslipidemia (74%). In C5 (n = 1043), proportions with DM (51%), hypertension (54%), and diuretics (52%) were highest. C1 was by far the most common in the population (73%), followed by C4 (17%). These two pathways included 86% of incident gout cases. The four smaller clusters (C2–C5) had higher incidence rates and a 2- to 3-fold increased risk for incident gout. Conclusions Five distinct clusters based on gout-related comorbidities and lifestyle factors were identified. Most incident gout cases occurred in the cluster of few comorbidities, and the four comorbidity pathways had overall a modest influence on the incidence of gout.

scholarly journals Su1228 Increased Risk of Colorectal Cancer in Patients With Prior Ovarian Cancer Diagnosis: A Population Based US Study

2014 ◽  
Vol 146 (5) ◽  
pp. S-408
Author(s):  
Yezaz A. Ghouri ◽  
Sachin Batra ◽  
Nirav C. Thosani ◽  
Sushovan Guha
Keyword(s):  
Colorectal Cancer ◽  
Ovarian Cancer ◽  
Cancer Diagnosis ◽  
Population Based ◽  
Increased Risk

scholarly journals Early postoperative pain as a marker of anastomotic leakage in colorectal cancer surgery

2021 ◽  
Author(s):  
Petrus Boström ◽  
Johan Svensson ◽  
Camilla Brorsson ◽  
Martin Rutegård
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Pain ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Population Based ◽  
Colorectal Cancer Surgery ◽  
Increased Risk ◽  
Independent Marker

Abstract Purpose Even though anastomotic leakage after colorectal surgery is a major clinical problem in need of a timely diagnosis, early indicators of leakage have been insufficiently studied. We therefore conducted a population-based observational study to determine whether the patient’s early postoperative pain is an independent marker of anastomotic leakage. Methods By combining the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry, we retrieved prospectively collected data on 3084 patients who underwent anastomotic colorectal surgery for cancer in 2014–2017. Postoperative pain, measured with the numerical rating scale (NRS), was considered exposure, while anastomotic leakage and reoperation due to leakage were outcomes. We performed logistic regression to evaluate associations, estimating odds ratios (ORs) and 95% confidence intervals (CIs), while multiple imputation was used to handle missing data. Results In total, 189 patients suffered from anastomotic leakage, of whom 121 patients also needed a reoperation due to leakage. Moderate or severe postoperative pain (NRS 4–10) was associated with an increased risk of anastomotic leakage (OR 1.69, 95% CI 1.21–2.38), as well as reoperation (OR 2.17, 95% CI 1.41–3.32). Severe pain (NRS 8–10) was more strongly related to leakage (OR 2.38, 95% CI 1.44–3.93). These associations were confirmed in multivariable analyses and when reoperation due to leakage was used as an outcome. Conclusion In this population-based retrospective study on prospectively collected data, increased pain in the post-anaesthesia care unit is an independent marker of anastomotic leakage, possibly indicating a need for further diagnostic measures.

scholarly journals Osteoarthritis and risk of hospitalization for ambulatory care sensitive conditions: A general population-based cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Ali Kiadaliri ◽  
Martin Englund
Keyword(s):  
Ambulatory Care ◽  
Hazard Model ◽  
Population Based ◽  
Incidence Rates ◽  
Ambulatory Care Sensitive Conditions ◽  
Chronic Obstructive ◽  
Main Diagnosis ◽  
Increased Risk ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Objective To determine the association between osteoarthritis (OA) and risk of hospitalization for ambulatory care sensitive conditions (HACSCs). Methods We included all individuals aged 40–85 years who resided in Skåne, Sweden on 31st December 2005 with at least one healthcare consultation during 1998–2005 (n = 515 256). We identified those with a main diagnosis of OA between January 1, 1998 and December 31, 2016. People were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016 (whichever occurred first). OA status was treated as a time-varying covariate (those diagnosed before January 1, 2006 considered as exposed for whole study period). We assessed relative (hazard ratios (HRs) using Cox proportional hazard model) and absolute (hazard difference using additive hazard model) effects of OA on HACSCs adjusted for potential confounders. Results Crude incidence rates of HACSCs were 239 (95% CI 235, 242) and 151 (150, 152) per 10 000 person-years among OA and non-OA persons, respectively. The OA persons had an increased risk of HACSCs (HR [95% CI] 1.11 [1.09, 1.13]) and its subcategories of medical conditions except chronic obstructive pulmonary disease (HR [95% CI] 0.86 [0.81, 0.90]). There were 20 (95% CI 16, 24) more HACSCs per 10 000 person-years in OA compared with non-OA persons. While HRs for knee and hip OA were generally comparable, only knee OA was associated with increased risk of hospitalization for diabetes. Conclusion OA is associated with an increased risk of HACSCs, highlighting the urgent need to improve outpatient care for OA patients.

Abstract P259: Smoking Increases Risks of Death and Stroke in Both Men and Women. Absolute Risk Difference of Stroke is Likely to be Larger in Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Masaki Ohsawa ◽  
Kuniaki Ogasawara ◽  
Shinichi Omama ◽  
Kozo Tanno ◽  
Kazuyoshi Itai ◽  
...  
Keyword(s):  
Smoking Status ◽  
Absolute Risk ◽  
Incidence Rates ◽  
Risk Difference ◽  
Current Smoker ◽  
Men And Women ◽  
Risk Of Death ◽  
Adjusted Rate ◽  
Never Smokers ◽  
Rate Ratios

Background: Smoking is an important risk factor for cardiovascular disease, however, to what extent smoking increases excessive deaths and strokes in a general population has not been sufficiently examined especially in women. Methods: A total of 10,382 female and male participants aged 65 years or older were divided into two groups according to smoking status (current smoker; never smoker). Past smokers were excluded. Main outcomes were all-cause death and incident stroke. Age-adjusted mortality and incidence rates were estimated in the groups using Poisson’s regression analysis. Age-adjusted rate ratios (RR) and excess events (EE per 1000 person-years) attributable to smoking were determined using the rate in never smokers as a reference. Results: There were 1410 deaths and 735 strokes during the 9.0-year observation period (90,099 person-years). Smoking contributed to a 2.3-fold higher risk of death in women and 1.8-fold higher risk in men. It contributed to 12 excess deaths per 1000 person-years in both men and women. The rate ratio and excessive events of stroke were likely to be higher in women than those in men (RR: 2.6 vs. 1.6; EE: 9.3 vs 5.0, see table). Conclusion: Smoking significantly increases risks of death and stroke not only in men but also in women. Absolute risk difference of stroke attributable to smoking is likely to be larger in women than in men.

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