scholarly journals A prospective study on cancer risk after total hip replacements for 41,402 patients linked to the Cancer registry of Norway

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Risk ◽  
Cancer Registry ◽  
Cox Regression ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Increased Risk ◽  
Hip Replacements ◽  
Joint Prostheses

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to increased cancer risk. Several different materials, metals and fixation techniques are used in joint prostheses and different types of articulation can cause an increased invasion of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987–2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular components). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender and if the patient had additional THR-surgery in the same or the opposite hip. The study follows the STROBE guidelines. Results Comparing patients with THR to the general population in Norway we found no differences in cancer risk. The overall SIR for the THR-patients after 10 years follow-up was 1.02 (95% CI: 0.97–1.07). For cemented THR, the SIR after 10 years follow-up was 0.99 (95% CI: 0.94–1.05), for uncemented, 1.16 (95% CI: 1.02–1.30), and for hybrid 1.12 (95% CI: 0.91–1.33). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk for cancer (hazard ratio: HR = 1.24, 95% CI: 1.05–1.46, p = 0.009) when compared to patients with cemented THRs after 10 years follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR = 1.07, 95% CI: 0.85–1.35, p = 0.55) compared to patients with cemented THRs. Conclusions THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk for cancer compared to cemented THR in males, but that this may be prone to unmeasured confounding.

scholarly journals Cancer risk after total hip replacements. A prospective study of 41,402 patients in the Norwegian Arthroplasty Register linked to the Cancer Registry of Norway

2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Risk ◽  
Cancer Registry ◽  
Arthroplasty Register ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Increased Risk ◽  
Hip Replacements ◽  
Norwegian Arthroplasty Register

Abstract Background: Concerns have been raised that implants used in total hip replacements (THR) could lead to increased cancer risk. Several different materials, metals and fixation techniques are used in joint prostheses and different types of articulation can cause an increased invasion of particles or ions into the human body. Methods: Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular components). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender and if the patient had additional THR-surgery in the same or the opposite hip. The study follows the STROBE guidelines.Results: Comparing patients with THR to the general population in Norway we found no differences in cancer risk. The overall SIR for the THR-patients after 10 years follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years follow-up was 0.99 (95% CI: 0.94-1.05), for uncemented, 1.16 (95% CI: 1.02-1.30), and for hybrid 1.12 (95% CI: 0.91-1.33). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk for cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs.Conclusions: THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk for cancer compared to cemented THR in males, but that this may be prone to unmeasured confounding.

scholarly journals Cancer risk after total hip replacements. A prospective study of 41,402 patients in the Norwegian Arthroplasty Register linked to the Cancer Registry of Norway

2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Risk ◽  
Cancer Registry ◽  
Arthroplasty Register ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Increased Risk ◽  
Hip Replacements ◽  
Norwegian Arthroplasty Register

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to increased cancer risk. Several different materials, metals and fixation techniques are used in joint prostheses and different types of articulation can cause an increased invasion of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular components). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender and if the patient had additional THR-surgery in the same or the opposite hip. The study follows the STROBE guidelines.Results Comparing patients with THR to the general population in Norway we found no differences in cancer risk. The overall SIR for the THR-patients after 10 years follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years follow-up was 0.99 (95% CI: 0.94-1.05), for uncemented, 1.16 (95% CI: 1.02-1.30), and for hybrid 1.12 (95% CI: 0.91-1.33). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk for cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs.Conclusions THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk for cancer compared to cemented THR in males, but that this may be prone to unmeasured confounding.

scholarly journals Cancer risk after total hip replacements. A prospective study of 41,402 patients in the Norwegian Arthroplasty Register linked to the Cancer Registry of Norway

2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Risk ◽  
Cancer Registry ◽  
Arthroplasty Register ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Risk Of Cancer ◽  
Norwegian Arthroplasty Register

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to a future increased cancer risk. Several different materials and metals are used in joint prosthesis, as well as different fixation techniques and types of articulation for the surface of the joint can lead to an increased escape of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular component). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender, and if the patient had additional THR-surgery in the same or the opposite hip. The study is according to the STROBE guidelines.Results When comparing patients with THR to the general population in Norway we found no differences in the risk. The overall SIR for the THR-patients after 10 years of follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years of follow-up was 0.99 (95% CI: 0.94-1.05), while it was 1.16 (95% CI: 1.02-1.30) for uncemented THRs, and 1.12 (95% CI: 0.91-1.33) for hybrid THRs. Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk of cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years of follow-up. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs. Conclusions We found that receiving an uncemented THR was associated with a small increased risk of cancer, in particular prostate cancer for younger men.

scholarly journals Cancer risk after total hip replacements. A prospective study of 41,402 patients in the Norwegian Arthroplasty Register linked to the Cancer Registry of Norway

2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Risk ◽  
Cancer Registry ◽  
Arthroplasty Register ◽  
Total Hip Replacements ◽  
Increased Risk ◽  
Hip Replacements ◽  
Fixation Techniques ◽  
Norwegian Arthroplasty Register

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to a future increased cancer risk. Several different materials and, metals and fixation techniques are used in joint prosthesis, as well as prostheses and different fixation techniques and types of articulation for the surface of the joint can lead to cause an increased escapeinvasion of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular componentcomponents). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender, and if the patient had additional THR-surgery in the same or the opposite hip. The study is according tofollows the STROBE guidelines.Results When comparingComparing patients with THR to the general population in Norway we found no differences in thecancer risk. The overall SIR for the THR-patients after 10 years of follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years of follow-up was 0.99 (95% CI: 0.94-1.05), while it wasfor uncemented, 1.16 (95% CI: 1.02-1.30) for uncemented THRs,), and for hybrid 1.12 (95% CI: 0.91-1.33) for hybrid THRs.). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk offor cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years of follow-up.follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs. Conclusions THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk of cancer, in particular prostatefor cancer for younger mencompared to cemented THR in males, but that this may be prone to unmeasured confounding.

Ten-Year Follow-up Study of Charnley and Charnley-Mueller Total Hip Replacements.

1992 ◽  
Vol 41 (2) ◽  
pp. 604-607
Author(s):  
Kiyotaka Okuyama ◽  
Kenichiro Shibata ◽  
Masahiro Kina ◽  
Shinji Tomari ◽  
Shinichi Motomatsu ◽  
...  
Keyword(s):  
Total Hip ◽  
Follow Up Study ◽  
Total Hip Replacements ◽  
Hip Replacements

Do We Need to Follow up Primary Total Hip Replacements?

2009 ◽  
Vol 19 (2) ◽  
pp. 99-102 ◽  
Author(s):  
Cronan Kerin ◽  
G. Cheung ◽  
N. Graham ◽  
P. Cool
Keyword(s):  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Ceramic-on-ceramic versus ceramic-on-polyethylene bearings in total hip arthroplasty: Results of a multicenter prospective randomized study and update of modern ceramic total hip trials in the United States

2005 ◽  
Vol 15 (3) ◽  
pp. 129-135 ◽  
Author(s):  
B. Sonny Bal ◽  
T.J. Aleto ◽  
J.P. Garino ◽  
A. Toni ◽  
K.J. Hendricks
Keyword(s):  
Aseptic Loosening ◽  
Randomized Study ◽  
The United States ◽  
Control Group ◽  
Time Interval ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Ceramic On Ceramic

One reason why otherwise well-functioning total hip replacements have a finite service life is eventual aseptic loosening of the implants because of osteolysis induced by wear particles from the artificial bearing. Pain and osteolysis from wear debris can manifest even in the absence of aseptic loosening. Total hip replacements with ceramic-on-ceramic articulations have shown less wear both in vitro and in vivo. A randomized prospective clinical trial was conducted to compare the outcomes of ceramic-on-ceramic articulations to ceramic-on-polyethylene articulations. Two-year data are of interest because premature failures of ceramic femoral heads usually occur by this time interval. Of 500 patients enrolled in this trial, half received total hip replacements with alumina-on-alumina bearings, while the other half had ceramic-on-polyethylene bearings. At the two-year follow-up, 444 patients (217 study group and 227 control group) were available for review. The clinical and radiographic outcomes between the groups were comparable, and reflected the typical results of primary total hip replacements. No complications related to spontaneous failures of the ceramic bearings were observed at this early follow-up period. Further follow-up is needed to confirm these findings over the long-term, but the short-term safety of alumina ceramic bearings in hip replacements reported in other recent reports is further validated by our findings.

scholarly journals Endometrial Cancer Risk in Women with Germline BRCA1 or BRCA2 Mutations: Multicenter Cohort Study

2021 ◽  
Author(s):  
Marthe M de Jonge ◽  
Cornelis D de Kroon ◽  
Denise J Jenner ◽  
Jan Oosting ◽  
Joanne A de Hullu ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cohort Study ◽  
General Population ◽  
Cox Regression ◽  
Statistical Tests ◽  
Brca1 Mutation ◽  
Brca2 Mutation ◽  
Mutation Carriers ◽  
Increased Risk

Abstract Background Endometrial cancer (EC) risk in BReast CAncer gene 1/2 (BRCA1/2) mutation carriers is uncertain, therefore we assessed this in a large Dutch nationwide cohort study. Methods 5,980 BRCA1/2 (3,788 BRCA1, 2,151 gBRCA2, 41 both BRCA1/BRCA2) and 8,451 non-BRCA1/2 mutation carriers were selected from the HEBON-cohort. Follow-up started at date of nationwide PALGA coverage (January 1, 1989) or at the age of 25 years (whichever came last), and ended at date of EC diagnosis, last follow-up or death (whichever came first). EC risk in BRCA1/2 mutation carriers was compared to: 1) general population, estimating standardized incidence ratios (SIRs) based on Dutch population-based incidence rates; and 2) non-BRCA1/2 mutation carriers, using Cox-regression analyses, expressed as hazard ratio (HR). Statistical tests were two-sided. Results Fifty-eight BRCA1/2 and 33 non-BRCA1/2 mutation carriers developed EC over 119,296 and 160,841 person-years, respectively (SIR = 2.83, 95% confidence interval (CI) = 2.18–3.65; and HR = 2.37, 95% CI = 1.53–3.69, respectively). gBRCA1 mutation carriers showed increased risks for EC overall (SIR = 3.51, 95% CI = 2.61–4.72; HR = 2.91, 95% CI = 1.83–4.66), serous-like EC (SIR: 12.64, 95% CI = 7.62–20.96; HR = 10.48, 95% CI = 2.95–37.20), endometrioid EC (SIR = 2.63, 95% CI = 1.80–3.83; HR = 2.01, 95% CI = 1.18–3.45) and TP53-mutated EC (HR = 15.71, 95% CI = 4.62–53.40). For BRCA2 mutation carriers, overall (SIR = 1.70, 95% CI = 1.01–2.87), and serous-like EC risks (SIR = 5.11, 95% CI = 1.92–13.63) were increased when compared to the general population. Absolute risks by 75 years remained low (overall EC = 3.0%; serous-like EC = 1.1%). Conclusions BRCA1/2 mutation carriers have a 2- to 3-fold increased risk for EC, with highest risk observed for the rare subgroups of serous-like and p53-abnormal EC in BRCA1 mutation carriers.

Cancer Risk in Patients with Autoimmune Hepatitis: A Nationwide Population-Based Cohort Study with Histopathology

2021 ◽  
Author(s):  
Rajani Sharma ◽  
Elizabeth C Verna ◽  
Tracey G Simon ◽  
Jonas Söderling ◽  
Hannes Hagström ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Cancer Risk ◽  
Autoimmune Hepatitis ◽  
Cox Regression ◽  
Population Based ◽  
Swedish Population ◽  
Non Melanoma Skin Cancer ◽  
Incident Cancer ◽  
Increased Risk

Abstract We aimed to determine the risk of incident cancer in autoimmune hepatitis (AIH) compared to the general population and siblings. AIH was defined by the presence of a medical diagnosis of AIH and a liver biopsy in a nationwide Swedish population-based cohort study. We identified 5,268 adults with AIH diagnosed 1969-2016 and 22,996 matched general population reference individuals and 4,170 sibling comparators. Using Cox regression, hazard ratios (HRs) were determined for any incident cancer and sub-types determined from the Swedish Cancer Register. During follow-up, a cancer diagnosis was made in 1,119 individuals with AIH (17.2/1000 person-years) and 4,450 reference individuals (12.0/1000 person-years). This corresponded to an HR of 1.53 (95%CI: 1.42,1.66). Cancer risk was highest in those with cirrhosis. There was a 29.18-fold increased risk of hepatocellular carcinoma (HCC) (95%CI, 17.52,48.61). The annual incidence risk of HCC in individuals with AIH who had cirrhosis was 1.1% per year. AIH was also linked to non-melanoma skin cancer (HR=2.69) and lymphoma (HR=1.89). Sibling analyses yielded similar risk estimates for any cancer (HR=1.84) and HCC (HR=23.10). AIH is associated with an increased risk of any cancer, in particular, HCC and extra-hepatic malignancies. The highest risk for cancer, especially HCC, is in patients with cirrhosis.

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