Epidemiology of Myeloproliferative Neoplasms in Norway

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1858-1858
Author(s):  
Christina Roaldsnes ◽  
Anders Waage ◽  
Mette Nørgaard ◽  
Waleed Ghanima
Keyword(s):  
Incidence Rate ◽  
Cancer Registry ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
Relative Survival ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Jak2 Mutation ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background: Polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF) are clonal hematological disorders collectively named as myeloproliferative neoplasms (MPN). Discovery of JAK2 mutation in 2005, altered WHO classification for MPN diagnosis in 2008 and availability of new treatment of MPN may have substantial effect on epidemiology of MPN. Published data on epidemiology of MPN after the discovery of JAK2 mutation and the introduction of 2008 WHO classifications for MPN, in particular on the prevalence of MPN, are scarce. We aimed to study the epidemiology of MPN in Norway and to explore the impact of JAK-2 mutation and new guidelines on the incidence of MPN using data from the Norwegian cancer registry. Method: We identified 2344 persons diagnosed with MPN from the Norwegian Cancer Registry diagnosed between 1995 and 2012. Registration of cancer in the Norwegian Cancer Registry is mandatory according to the law. We report age-adjusted incidence, prevalence and relative survival of MPN. Age adjusted incidence was reported for 2 years periods from 1995 to 2012. The prevalence was calculated according to the Norwegian population per 31.12.2011. Results: A total of 945 cases of PV was identified with a median age at diagnosis of 70 years; 471 males (50%) and 474 females (50%). The overall age-adjusted incidence rate both genders was 0.4/10⁵ in 1995-1997, 0.5/10⁵ in 1998-2000, 0.7/10⁵ in 2001-2003, 0.8/10⁵ in 2004-2007, 2008-2009 and 0.7/10⁵ in 2010-12. We identified a total of 762 cases of ET with a median age at diagnosis of 65 years, 297 males (39%) and 465 females (61%). The overall age adjusted incidence rate both genders being 0.3/10⁵ in 1995-1997 and 1998-2000, 0.5/10⁵ in 2001-2003 and 2004-2006, 0.9/10⁵ in 2007-2009 and 2010-2012. A total of 418 cases of MF was identified with a median age at diagnosis of 71 years; 243 males (58%) and 175 females (42%). Age adjusted incidence rates of both genders were 0.2/10⁵ from 1995-2006, 0.3/10⁵ in 2007-2009 and 0.5/10⁵ in 2010-2012. There were a total of 219 persons with unclassified MPN both genders,119 males (54%) and 100 females (46%) and age adjusted incidence rate varied from 0.1-0.2 to 0.1/10⁵ 1995-2012. Per 31.12.2011 the prevalence of PV, ET and MF was 9.2, 8.6 and 3.0 per 10⁵ inhabitants respectively. The survival curves for males and females for the three conditions are shown in the figure. Conclusions: This population-based study shows that the incidence of ET and MF almost doubled during the years 2007-2012 as compared to 1995-2006 as shown in the table. This increment in the incidence may possibly be related to improved diagnostics including the JAK2 mutation and the introduction of 2008 WHO-guidelines for MPN. Surprisingly, the discovery of JAK2 does not seem to have had impact on the incidence of PV as indicated by steady incidence rates since 2001. The relative survival was only slightly reduced for PV and ET, but substantially reduced for MF. Only 50% of patients with MF survive for more than 5 years. Table Incidence of MPN per 105 inhabitants during the period 1995 to 2012 in Norway 1995-97 1998-2000 2001-03 2004-06 2007-09 2010-12 PV 0.4 0.5 0.7 0.8 0.8 0.7 ET 0.3 0.3 0.5 0.5 0.9 0.9 MF 0.2 0.2 0.2 0.2 0.3 0.5 Figure showing the relative survival of PV, ET and MF Figure. showing the relative survival of PV, ET and MF Disclosures Roaldsnes: Novartis Norge AS: Research Funding. Ghanima:Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals Dengue Fever in Italy: The “Eternal Return” of an Emerging Arboviral Disease

2022 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Matteo Riccò ◽  
Simona Peruzzi ◽  
Federica Balzarini ◽  
Alessandro Zaniboni ◽  
Silvia Ranzieri
Keyword(s):  
Incidence Rate ◽  
Central Italy ◽  
Denv Infection ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Annual Reports ◽  
Foreign Born ◽  
Time Period ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Enhanced surveillance for dengue virus (DENV) infections in Italy has been implemented since 2012, with annual reports from the National Health Institute. In this study, we summarize available evidence on the epidemiology of officially notified DENV infections from 2010–2021. In total, 1043 DENV infection cases were diagnosed, and most of them occurred in travelers, with only 11 autochthonous cases. The annual incidence rates of DENV infections peaked during 2019 with 0.277 cases per 100,000 (95% confidence interval [95% CI] 0.187–0.267), (age-adjusted incidence rate: 0.328, 95% CI 0.314–0.314). Cases of DENV were clustered during the summer months of July (11.4%), August (19.3%), and September (12.7%). The areas characterized by higher notification rates were north-western (29.0%), and mostly north-eastern Italy (41.3%). The risk for DENV infection in travelers increased in the time period 2015–2019 (risk ratio [RR] 1.808, 95% CI 1.594–2.051) and even during 2020–2021 (RR 1.771, 95% CI 1.238–2.543). Higher risk for DENV was additionally reported in male subjects compared with females subjects, and aged 25 to 44 years, and in individuals from northern and central Italy compared to southern regions and islands. In a multivariable Poisson regression model, the increased number of travelers per 100 inhabitants (incidence rate ratio [IRR] 1.065, 95% CI 1.036–1.096), the incidence in other countries (IRR 1.323, 95% CI 1.165–1.481), the share of individuals aged 25 to 44 years (IRR 1.622, 95% CI 1.338–1.968), and foreign-born residents (IRR 2.717, 95% CI 1.555–3.881), were identified as effectors of annual incidence. In summary, although the circulation of DENV remains clustered among travelers, enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.

Higher Incidence of Chronic Myeloid Leukemia (CML) Among Blacks Compared to Whites in the Post-Imatinib Period (2002–2009) Corresponds with Worse Survival Observed within the Surveillance, Epidemiology and End Results 18 Registries

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3773-3773
Author(s):  
Adam Mendizabal ◽  
Paul H Levine
Keyword(s):  
Tyrosine Kinase ◽  
Incidence Rate ◽  
Kinase Inhibitors ◽  
Age Groups ◽  
Incidence Rates ◽  
Age At Diagnosis ◽  
Age Group ◽  
Risk Of Death ◽  
Younger Age ◽  
Adjusted Incidence

Abstract Abstract 3773 Background: Age at diagnosis of CML varies by race in the United States with median occurring around ages 54 and 63 among Black and White patients, respectively. The treatment paradigm shifted when Imatinib was approved in 2001 for treatment of CML. More recently, second generation tyrosine kinase inhibitors (TKI) have also been used for treatment of CML. Differences in outcomes by race have been previously reported prior to the TKI treatment period. We aimed to assess whether the earlier age at diagnosis resulted in differential trends in age-adjusted incidence rates and survival outcomes by race in the post-Imatinib treatment period. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries were extracted for diagnoses between 2002 and 2009 based on the assumption that cases diagnosed after 2002 would be treated with TKI's. CML was defined according to the International Classification of Diseases for Oncology 3rd edition code 9863 (CML-NOS) and 9875 (CML-Philadelphia Chromosome Positive). Cases diagnosed by autopsy or death certificate only were excluded. Incidence rates are expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population. Black/White incidence rate ratios (IRRBW) are shown with corresponding 95% confidence intervals (CI). Kaplan-Meier estimates of CML-specific survival (CPS) and overall survival (OS) were estimated at 5-years post-diagnosis with the event being time to CML-specific death or any death, respectively. Stratified Cox proportional hazards models were constructed to assess the impact of age and race on the risk of death expressed as a hazard ratio (HR). Results: Since 2002, 6,632 patients diagnosed with CML were reported to the SEER 18 registries including 5,829 White patients (87.9%) and 803 Black patients (12.1%) with 57% being male. The age-adjusted incidence rate for Blacks was 1.18 (95% CI, 1.10–1.27) per 100,000 and 1.12 (95% CI, 1.09–1.27) per 100,000 for Whites. The corresponding IRRBW was 1.06 (95% CI, 0.98– 1.14). When considering 20-year age-groups, Blacks had higher incidence rates in the 20–39 and 40–59 age groups; IRRBW of 1.26 (95% CI, 1.06–1.49; p=0.0073) and 1.23 (95% CI, 1.09–1.39; p=0.0007), respectively. No statistically significant differences in IRRBW were seen within the 0–19, 60–79 and 80+ age-groupings although Whites have higher non-significant incidence rates in the latter 2 age-groups. Differences in IRRBW prompted an assessment of survival to determine if the excess incidence observed in the younger age groups corresponded with a worse survival. CPS at 5-years was 85.5% (95% CI, 84.3–86.6). In univariate analysis, age was an important predictor of outcome (p<0.0001) with patients diagnosed after age 80 having the worse outcomes (OS: 58.3%), followed by patients diagnosed between 60 and 79 years (OS 84.7%), 0–19 years (OS: 87.1%), 40–59 years (OS: 90.2%), and 20–39 years (OS: 92.6%). When considering all age-groups, race was not a significant predictor of death (HR 0.91; 95% CI, 0.72–1.15). However, in a stratified analysis with 20-year age groups, Blacks had an increased risk of death as compared to Whites (Figure 1) in the 20–39 age group (HR: 2.94; 95% CI, 1.72–5.26; p<0.0001) and the 40–59 age group (HR: 1.67; 95% CI, 1.22–2.27; p=0.0069) while no differences were seen within the 0–19, 60–79 and 80+ age groups. Conclusions from OS models were similar to that of the CPS models. Conclusions: Through this analysis of population-based cancer registry data collected in the US between 2002 and 2009, we show that Blacks have a younger age at diagnosis with higher incidence rates observed in the 20–39 and 40–59 age-groups as compared to Whites. Both CPS and OS outcomes differed by race and age. Similar to the differences observed with the incidence rates, survival was worse in Blacks diagnosed within the 20–39 and 40–59 age-groups as compared to Whites. Although outcomes have globally improved in patients with CML since the advent of tyrosine kinase inhibitors, the persistence of incidence heterogeneity and poorer survival among Blacks warrants further attention. Access to care may be a possible reason for the differences observed but further studies are warranted to rule out biological differences which may be causing an earlier age at onset and poorer survival. Disclosures: No relevant conflicts of interest to declare.

A Population-Based Study of Incidence of Myeloproliferative Neoplasms in Sweden Between 2000 and 2012

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1605-1605
Author(s):  
Malin Hultcrantz ◽  
Therese M-L Andersson ◽  
Ola Landgren ◽  
Paul W Dickman ◽  
Bjorn Andreasson ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Confidence Intervals ◽  
Research Funding ◽  
Myeloproliferative Neoplasms ◽  
Population Based ◽  
Incidence Rates ◽  
Annual Incidence Rate ◽  
Swedish Population ◽  
Population Based Study ◽  
Cancer Register

Abstract Background The Myeloproliferative neoplasms (MPNs) consists of the subtypes polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF), and MPN unclassifiable (MPN-U). The incidence rates of these diseases vary substantially between different reports, ranging from 1.15 to 4.99/100,000 person-years. However, in a recent metaanalysis, there was no significant difference in MPN incidence between Europe and North America and the variations in incidence may therefore reflect the quality of the cancer registers and reporting of MPNs. In addition, there is a limited number of reports on MPN incidence during more recent years. Therefore, we assessed the incidence of MPN based on the Swedish Cancer Register, a high-quality population-based cancer register between 2000 and 2012. Patients and Methods The Swedish Cancer Register was used to identify all patients diagnosed with an MPN between January 1st 2000 and December 31st 2012. These Swedish Cancer Registers have very high levels of quality and completeness. Between 2008 and 2012, the reporting of newly diagnosed MPN to the cancer register was >92%. Information on the Swedish population was obtained from the Human Mortality Database (www.mortality.org). Based on information from these registers, incidence rates of MPNs with 95% confidence intervals (CIs) were calculated. Confidence intervals were estimated on the log scale. In addition, the incidence rate in relation to MPN subtype, age group (18-39, 40-49, 50-59, 60-69, 70-79, and ³80 years), as well as calendar year of diagnosis was assessed. Results A total of 5,442 MPN patients were reported to the cancer register between 2000 and 2012. During these years, there were 1,810 incident cases of PV, 1,862 of ET, 636 of PMF, and 1,134 with MPN-U. Between January 1st 2000 and December 31st 2012, the population in Sweden increased from 8,861,426 to 9,555,893 inhabitants. The overall annual incidence rate of MPN was 5.83 (95% CI 5.68-5.99)/100,000 persons. The incidence rate of PV was 1.94 (1.85-2.03), ET 2.00 (1.91-2.09), PMF 0.68 (0.63-0.74), and MPN-U 1.22 (1.15-1.29) per 100,000 person-years. In addition, there was a strong correlation between age and incidence of MPN with incidence rates being substantially higher among the older age groups (Table). The overall incidence rate of MPNs increased during the study period, from 5.06 (4.55-5.62)/100,000 person-years in the year 2000 to 5.98 (5.45-6.55)/100,000 person-years in 2012. The incidence rate of PV was similar throughout the study period, the incidence was 2.05 (1.74-2.42)/100,000 person-years in 2000 and 2.12 (1.81-2.47)/100,000 person-years in 2012. The annual incidence rate of ET and PMF increased, from 1.62 (1.34-1.95) to 2.49 (2.15-2.87) per 100,000 persons for ET and from 0.36 (0.24-0.53) to 0.86 (0.67-1.10) per 100,000 persons for PMF between 2000 and 2012. Conversely, the incidence of MPN-U decreased, 1.03 (0.81-1.29) to 0.52 (0.38-0.71)/100,000 person-years between 2000 and 2012. Summary and Conclusions In this large population-based study, the incidence of MPN was higher than previously reported in both European and North American studies. As earlier lower incidence rates likely are an effect of limited coverage of cancer registers, there may be an underreporting of MPNs in many European and American countries. The increase in MPN incidence rates during the study period may reflect increasing life expectancy of the Swedish population, improved reporting to the cancer register as well as changes in the classification and diagnostic systems. Similarly, the decrease in incidence of MPN-U is also likely a result of improved diagnostics during more recent years. In conclusion, the MPN incidences rates reported here are presumably more accurate compared to earlier reports due to the high level of coverage and accuracy of the Swedish registers. Table 1. Incidence rates of MPNs overall and in relation to subtype and age at diagnosis Total number MPN diagnosed 2000-2012 Incidence/100 000 person-years (95% confidence interval) All MPN 5,442 5.83 (5.68-5.99) Subtype PV 1,810 1.94 (1.85-2.03) ET 1,862 2.00 (1.91-2.09) PMF 636 0.68 (0.63-0.74) MPN-U 1,134 1.22 (1.15-1.29) Age at diagnosis (years) 18-39 226 0.67 (0.59-0.76) 40-49 361 2.26 (2.04-2.51) 50-59 769 4.92 (4.58-5.28) 60-69 1,228 9.54 (9.02-10.1) 70-79 1,680 18.99 (18.1-19.9) >80 1,178 18.92 (17.87-20.03) Disclosures Landgren: BMJ Publishing: Honoraria; Bristol-Myers Squibb: Honoraria; Medscape: Honoraria; Onyx: Honoraria; Celgene: Honoraria; International Myeloma Foundation: Research Funding; Medscape: Consultancy; BMJ Publishing: Consultancy; Onyx: Research Funding; Bristol-Myers Squibb: Consultancy; Onyx: Consultancy; Celgene: Consultancy.

Differences in colon cancer incidence rates by latitude.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14627-e14627
Author(s):  
Binay Kumar Shah ◽  
Krishna Bilas Ghimire ◽  
Barsha Nepal
Keyword(s):  
Colon Cancer ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Southern Region ◽  
Southern Latitude ◽  
Northern Latitude ◽  
The North ◽  
Northern Regions ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

e14627 Background: There is significant decrease in the ultraviolet B photons reaching the earth’s surface during November to February (Holick MF Am J Clin Nutr. 2004 Dec; 80(6 Suppl):1678S-88S). This results in little if any vitamin D3 production in the skin during this period. This study was conducted to evaluate difference in colon cancer age adjusted incidence rates in the northern (latitude ≥37o N) and the southern (latitude < 37oN) regions in the contiguous United States during 1973-2008. Methods: Patients, aged 20 years and older, who had been diagnosed with colong cancer during January 1973 and December 2008, were selected from the Surveillance, Epidemiology, and End Results (SEER) 13 database. Based on the counties’ centroid, northern (latitude ≥37o N) and southern (latitude < 37oN) regions were determined. We compared age adjusted incidence rates (AAIR) of colon cancer in the southern and northern regions among cohorts of patients categorized by age (≥20, 20-64, ≥65 years), gender (Men, Women) and Race (Caucasians, Blacks, Others). The AAIR was calculated per 100,000 population. We used SEER*Stat software to calculate age adjusted incidence rate, incidence ratio, confidence interval (CI, 95%) and P value. Results: There were 314,975 cases of colon cancer diagnosed among 608,245,557 US population during 1973-2008. The overall colon cancer AAIR was 57.1 per 100,000 population studied. The incidence rates were 49.1 in the south and 58.7 in the north of 37oN latitude, (95% CI 1.18-1.20, p<0.05). The AAIRs for patients in the age group 20-64 years were 17.9 and 18.8 in the southern and northern regions, (CI 95%, 1.0346-1.0697), p<0.0005 respectively. The incidence rates for patients aged ≥65 years were 194.3 and 243.9 in the southern and northern regions, (CI 95%, 1.0346-1.0697) p<0.0005. Similarly, the AAIRs were significantly higher in the northern region compared to southern region for both sexes and all ethnic groups. Conclusions: Colon cancer age-adjusted incidence rate is significantly higher in the Northern compared to the Southern region of the US. The higher incidence of colon cancer in the North may be related to lack of sunlight exposure and relative vitamin D deficiency.

Trends in Incidence and Survival of Myeloid Malignancies Since 1980, in the Côte D'or Department, Burgundy, France.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3122-3122
Author(s):  
Marc Maynadié ◽  
Ines Manivet ◽  
Morgane Mounier ◽  
Francine Mugneret ◽  
François Bailly ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Conflicts Of Interest ◽  
Myeloproliferative Neoplasms ◽  
Relative Survival ◽  
Incidence Rates ◽  
Good Survival ◽  
World Population ◽  
Myeloid Malignancies ◽  
Urban Rural ◽  
Definition Of

Abstract Abstract 3122 Poster Board III-59 Objective The Registry of Haematological Malignancies (HM) has been established on January 1st, 1980 in the department of Côte d'Or (pop 500 000 inhabitants). It was the first specialized registry in haematology in the world. During the course of 25 years (1980-2004), 5026 cases of HM were recorded including 1553 Myeloid malignancies (MM) in which entities not initially considered as malignant were taken in account such as Myelodysplastic syndrome (MDS) and some Myeloproliferative neoplasms (MPN). This allow us to present trends in incidence and survival of myeloid malignancies by entities since 1980. Method MM diagnosed in the population between 01/01/1980 and 31/12/2004 were registered. They were coded according to ICD-O-3 and following the principles of the 2001 WHO classification i.e. new threshold of definition of acute myeloid leukaemia (AML). World population standardized incidence rate were calculated by sex, age, by urban /rural repartition and by period of time. Five-year, 10-y, 15-y and 20-y relative survival was calculated using Estève's method and based on vital status updated at the end of 2007. Results Incidence rate for whole MM were 3.73/100 000/y in men and 2.74 in women. They were 2.82 for AML, 3.73 in MPN and 2.83 in MDS. Sex ratio was 1.5/1 as a whole and urban/ratio was always close to 2, data being statistically significant for numerous entities. Incidence rates increase with age until 75y-o for AML and 80y-o for MPN and then decreased except for MDS in which incidence continue to increase. Along the period, only incidence of MDS increases significantly with an annual medium rate of 3% (2.7 in men and 3.3 in women). In MPN, a significant increase was observed only for women (2%). Within AML, surprisingly a significant increase was found for AML with recurrent cytogenetic abnormality in men (8.03%). 15-years relative survival was the best for MPN (46%), being significantly better in women (59% vs 31%), in which Essential Thrombocythemia was the best (74%). On the contrary, the worst 15-y survival was for was for MDS (9%). Within AML, the best survival was found for AML recurrent cytogenetic abnormalities (15-y: 54%) compare to other categories (4-8%). Survival has not increased along the period, has increased significantly in MPN. In AML, 10-y survival has increased until 1999 to reach 39% but has decreased for the 2000-2004 period (8-y: 11%). Conclusion Analysis of the largest epidemiologic database on HM allow to produce information such as a significant increase of incidence of MDS in which survival remained very poor in both sex, a good survival of MPN compared to other categories and a worrying decreased of survival of AML in the more recent period. Disclosures No relevant conflicts of interest to declare.

scholarly journals Temporal Trends in Incidence and Case Fatality of Intracerebral Hemorrhage: The Tromsø Study 1995-2012

2016 ◽  
Vol 6 (2) ◽  
pp. 40-49 ◽  
Author(s):  
Maria Carlsson ◽  
Tom Wilsgaard ◽  
Stein Harald Johnsen ◽  
Anne Merete Vangen-Lønne ◽  
Maja-Lisa Løchen ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Incidence Rate ◽  
Temporal Trends ◽  
Case Fatality ◽  
Incidence Rates ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Incident Cases ◽  
Over Time ◽  
Age And Sex

Background: The aim of this study was to explore temporal trends in incidence and case fatality rates of intracerebral hemorrhage (ICH) over the last two decades in a Norwegian municipality. Methods: Incident cases of primary ICH were registered in the period from 1995 through 2012 in 32,530 participants of the longitudinal population-based Tromsø Study. Poisson regression models were used to obtain incidence rates over time in age- and sex-adjusted and age- and sex-specific models. Case fatality rates were calculated and age- and sex-adjusted trends over time were estimated using logistic regression. Results: A total of 226 ICHs were registered. The age- and sex-adjusted incidence rate [95% confidence interval (CI)] in the overall population was 0.42 (0.37-0.48) per 1,000 person-years. Age-adjusted incidence rates were 0.53 (0.43-0.62) in men and 0.33 (0.26-0.39) in women. In individuals aged <75 years, the age- and sex-adjusted incidence rate was 0.27 (0.22-0.32) and in individuals aged ≥75 years, it was 2.42 (1.95-2.89) per 1,000 person-years. There was no significant change in incidence rates over time. The incidence rate ratio (95% CI) in the overall population was 0.73 (0.47-1.12) in 2012 compared with 1995. The overall 30-day case fatality (95% CI) was 23.9% (18.3-29.5) and did not change substantially over time [odds ratio in 2012 vs. 1995 = 0.83 (95% CI 0.27-2.52)]. Conclusion: No significant changes in incidence and case fatality rates of ICH were observed during the last two decades.

MO514CARDIORENAL OUTCOMES AND MORTALITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A MULTINATIONAL PROSPECTIVE COHORT STUDY (PROVALID)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Stefanie Thöni ◽  
Felix Keller ◽  
Sara Denicolo ◽  
Susanne Eder ◽  
Laszlo Rosivall ◽  
...  
Keyword(s):  
Risk Factors ◽  
The Netherlands ◽  
Incidence Rate ◽  
Composite Endpoint ◽  
Incidence Rates ◽  
European Countries ◽  
All Cause Mortality ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background and Aims PROVALID is a prospective, observational, multinational cohort study in 4000 patients with type 2 diabetes mellitus. Our aim was to determine the incidence rate of renal and cardiovascular endpoints, as well as all-cause-mortality in different European countries and to identify risk factors associated with the investigated outcomes. Method Potential risk factors associated with the investigated outcomes were identified by calculation of the incidence rate ratio. Crude and adjusted incidence rates for every country were estimated using generalized linear (poisson) regression models and corresponding 95 % confidence intervals were computed. Incidence rates were adjusted for different risk factors including age, sex, estimated GFR, albuminuria, HbA1c, LDL, HDL, total cholesterol, systolic blood pressure, BMI and cardiovascular and renal comorbidities; among these several show significant impact on outcomes. The renal outcome was a composite of a sustained decline in the estimated GFR of at least 40%, a sustained increase in albuminuria of at least 30 % including the progression from normo- to micro- or macroalbuminuria, end-stage kidney disease, or death from renal causes. The cardiovascular composite endpoint was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Results 3461 participants of four European countries (Austria 18 %, Hungary 41 %, Netherlands 26 % and Scotland 15 %) with a mean follow up time of 3.9 years were included into this study. Participants from Poland were excluded due to missing follow-up data. In total, 9.2 % and 6.4 % participants reached the renal and cardiovascular composite endpoint, respectively. 7.0 % of the participants died within this timeframe. The adjusted incidence rate for the renal endpoint ranged from 14.5 to 25.3 (per 1000 patient-years) with no significant differences between countries. On average, the incidence rate was lower in Scotland (IR, 14.5; 95 % CI, 8.7 to 22.5) and in the Netherlands (IR, 15.7; 95 % CI, 10.9 to 21.8) compared to Hungary (IR, 25.3; 95 % CI, 20.7 to 30.6) and Austria (IR 21.3; 95 % CI, 16.2 to 27.5). The adjusted incidence rate for the cardiovascular endpoint ranged from 7.0 to 20.3 and was significantly lower in Hungary (IR, 7.0; 95 % CI, 5.1 to 9.3) and the Netherlands (IR, 7.6; 95 % CI, 4.4 to 12.2) compared to Austria (IR, 16.7; 95 % CI, 12.4 to 22.1) and Scotland (IR, 20.3; 95 % CI, 13.8 to 28.9). The adjusted incidence rate for all-cause-mortality ranged from 4.2 to 15.9 and was significantly lower in the Netherlands (IR, 4.2; 95 % CI, 2.2 to 7.6) compared to Scotland (IR, 15.9; 95 % CI, 10.9 to 22.6). No significant difference in the incidence rates between Austria (IR, 9.8; 95 % CI, 7.0 to 13.4) and Hungary (IR, 9.3; 95 % CI, 6.8 to 12.4) was found. Conclusion After adjustment for known risk factors, incidence rates of cardiovascular endpoints, as well as all-cause-mortality still vary significantly between four European countries. This may be due to manifold reasons. Further analysis of the national therapeutic practice pattern within the PROVALID cohort may provide additional information.

Incidence and Geographic Distribution of Adult Acute Lymphoblastic Leukemia in the State of Georgia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4309-4309
Author(s):  
Fuad El Rassi ◽  
Martha Arellano ◽  
Leonard T Heffner ◽  
Edmund K. Waller ◽  
Elliott F. Winton ◽  
...  
Keyword(s):  
Public Health ◽  
Acute Lymphoblastic Leukemia ◽  
Incidence Rate ◽  
Cancer Registry ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
The State ◽  
South Central ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Abstract 4309 We investigated an apparent increase in acute lymphoblastic leukemia (ALL) referral from north Georgia to Emory University Hospital, a tertiary care center located in Atlanta, Georgia. Cases reported between 1999 and 2008 to the Georgia Comprehensive Cancer Registry (GCCR) and the national Surveillance Epidemiology and End Results (SEER) cancer registry were analyzed. Age-adjusted incidence rates were calculated for all counties and public health regions within the state of Georgia and compared to national rates calculated using SEER 17 data for those ages 20 and above. Cases of adult acute myeloid leukemia (AML) served as control for health referral patterns, completeness of data collection and healthcare availability. The associations between geographic residence and acute leukemia were analyzed using Poisson regression analysis, and additional models were created to control for the effects of race and ethnicity. The age-adjusted incidence rate of adult ALL (0.8/100,000) and AML (4.6/100,000) for the state of Georgia were comparable to the national rates (0.9/100,000 and 5.2/100,000 respectively). Overall, the rate of ALL observed in parts of the North Georgia region (1.1 (95% CI 0.8, 1.5) were similar when compared to the rest of the state; and not affected after adjusting for race. We conclude that the higher number of cases of ALL cases referred from North Georgia is likely related to a physician-related referral pattern rather than an increased incidence. Age-adjusted incidence rate of ALL by state and public health region and rate ratios comparing the rate of ALL within each region to the pooled rates demonstrated in all other Georgia public health regions. Region of Georgia (GA) Rate SE Lower CI Upper CI Count Pop GA: Clayton (Jonesboro) 1.1 0.3 0.6 1.8 17 1,715,865 GA: DeKalb 0.8 0.1 0.5 1.1 37 5,111,685 GA: Fulton 0.6 0.1 0.4 0.8 37 6,565,834 GA: Northwest (Rome) 0.9 0.1 0.6 1.2 35 3,962,399 GA: North Georgia (Dalton) 0.9 0.2 0.6 1.4 23 2,632,276 GA: North (Gainesville) 1.1 0.2 0.8 1.5 41 3,723,276 GA: Cobb-Douglas 0.8 0.1 0.5 1.1 38 5,357,377 GA: Gwinnett 0.7 0.1 0.5 1 38 5,712,772 GA: LaGrange 0.8 0.1 0.5 1.1 37 4,818,090 GA: South Central (Dublin) 0.3 0.2 0.1 0.9 4 1,009,356 GA: North Central (Macon) 0.7 0.1 0.4 1 24 3,476,472 GA: East Central (Augusta) 0.7 0.2 0.4 1.1 20 3,017,677 GA: West Central (Columbus) 0.6 0.2 0.3 1 14 2,492,172 GA: South (Valdosta) 0.3 0.1 0.1 0.8 5 1,638,741 GA: Southwest (Albany) 0.9 0.2 0.5 1.3 22 2,500,405 GA: Coastal (Savannah) 0.8 0.2 0.6 1.2 29 3,568,163 GA: Northeast (Athens) 0.9 0.2 0.6 1.3 26 2,903,745 GA: All Georgia 0.8 0 0.7 0.8 463 62,540,286 Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P25–1130) standard; Confidence intervals (Tiwari mod) are 95% for rates. Disclosures: Waller: Outsuka: Research Funding.

scholarly journals Patients With MEN1 Are at an Increased Risk for Venous Thromboembolism

2020 ◽  
Author(s):  
Maya E Lee ◽  
Yashira M Ortega-Sustache ◽  
Sunita K Agarwal ◽  
Aisha Tepede ◽  
James Welch ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Incidence Rates ◽  
Natural History Study ◽  
Search Terms ◽  
Increased Risk ◽  
Mechanistic Investigation ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence

Abstract Background Multiple endocrine neoplasia type 1 (MEN1) is a rare inherited disorder predisposing the development of multiple functional and nonfunctional neuroendocrine tumors (NETs). Only uncommon MEN1-associated functional NETs such as glucagonomas (&lt;1%) and adenocorticotropic hormone-producing tumors (&lt;5%) are known to be associated with hypercoagulability. It is unknown if patients with MEN1 generally have an increased risk of venous thromboembolism (VTE). Methods We queried a prospective natural history study of germline mutation-positive MEN1 patients (n = 286) between 1991 and 2019 for all lifetime events of VTE. The search terms were: DVT, thromb, embol, PE, pulmonary embolism, clot, hematology consult, anticoagulant, coumadin, lovenox, xarelto, warfarin, aspirin, rivaroxaban, and apixaban. Incidence rates were calculated, accounting for age and sex. Comparisons were made to published incidence rates in healthy populations, different types of cancer, and Cushing’s syndrome. Results Thirty-six subjects (median age 45 years, range 16–75) experienced a VTE event, yielding a prevalence rate of 12.9%. The age–sex adjusted incidence rate of VTE is 9.11 per 1000 patient-years, with a sex-adjusted lifetime incidence rate of 2.81 per 1000 patient-years. MEN1-associated lifetime incidence rates are ~2-fold higher than the estimated annual incidence rate in the general population and are comparable to the known risk in the setting of various types of cancer. Approximately 80% of patients who had a VTE were diagnosed with pancreatic NETs, of which 24% were insulinomas. Fourteen patients (42%) experienced perioperative VTE events. Conclusions MEN1 patients have an increased risk of VTE. Further mechanistic investigation and validation from other MEN1 cohorts are needed to confirm the increased prevalence of VTE in MEN1.

Incidence and prevalence of intracranial aneurysms and hemorrhage in Olmsted County, Minnesota, 1965 to 1995

Neurology ◽  
1998 ◽  
Vol 51 (2) ◽  
pp. 405-411 ◽  
Author(s):  
V. V. Menghini ◽  
R. D. Brown ◽  
J. D. Sicks ◽  
W. M. O'Fallon ◽  
D. O. Wiebers
Keyword(s):  
Incidence Rate ◽  
Medical Records ◽  
Population Based ◽  
Incidence Rates ◽  
Olmsted County ◽  
Anterior Circulation ◽  
Unique Data ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Age And Sex

Background: There are no previous reports of the incidence rate of intracranial saccular aneurysms in a defined population.Methods: Medical records of all residents of Olmsted County, MN, with a possible intracranial saccular aneurysm (IA) were reviewed. Incidence rates and prevalence of symptomatic and asymptomatic IAs, aneurysmal intracranial hemorrhage (ICH), and frequency of IA detection based on size and site were determined.Results: A total of 348 IAs were detected among 270 persons during the 31-year period from 1965 to 1995, including 188 symptomatic patients at presentation(166 with ICH). The age- and sex-adjusted incidence rate for IAs excluding asymptomatic autopsy cases was 9.0/100,000 person-years (P-Y; 95% CI, 7.8 to 10.2). The rate of detection in women (10.7/100,000 P-Y; 95% CI, 8.9 to 12.4) was higher than in men. The highest incidence of IA was among those age 55 to 64 years in men, and 65 to 74 years in women. The incidence rate of aneurysmal ICH was 6.9/100,000 P-Y (95% CI, 5.9 to 8.0). Aneurysms were seven times more likely to be detected in the anterior circulation, and this ratio was not altered significantly by age or gender. On January 1, 1990, the age- and sex-adjusted prevalence rate of identified IAs was 83.4/100,000 population (95% CI, 64.1 to 102.7).Conclusions: This study provides unique data on the population-based incidence and prevalence rates of IAs.

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