Longitudinal Cohort Study of Risk Factors in Cancer Patients of Bisphosphonate-Related Osteonecrosis of the Jaw

2009 ◽  
Vol 27 (32) ◽  
pp. 5356-5362 ◽  
Author(s):  
Konstantinos Vahtsevanos ◽  
Athanassios Kyrgidis ◽  
Evgenia Verrou ◽  
Eirini Katodritou ◽  
Stefanos Triaridis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cohort Study ◽  
Smoking Status ◽  
Underlying Disease ◽  
Osteonecrosis Of The Jaw ◽  
Relative Risks ◽  
Increased Risk ◽  
Increase Risk ◽  
History Of

Purpose The reported incidence of osteonecrosis of the jaw (ONJ) ranges from 0.94% to 18.6%. This cohort study aimed to calculate the incidence of and identify the risk factors for ONJ in patients with cancer treated with intravenous zoledronate, ibandronate, and pamidronate. Patients and Methods Data analyzed included age, sex, smoking status, underlying disease, medical and dental history, bisphosphonates (BP) type, and doses administered. Relative risks, crude and adjusted odds ratios (aORs), and cumulative hazard ratios for ONJ development were calculated. Results We included 1,621 patients who received 29,006 intravenous doses of BP, given monthly. Crude ONJ incidence was 8.5%, 3.1%, and 4.9% in patients with multiple myeloma, breast cancer, and prostate cancer, respectively. Patients with breast cancer demonstrated a reduced risk for ONJ development, which turned out to be nonsignificant after adjustment for other variables. Multivariate analysis demonstrated that use of dentures (aOR = 2.02; 95% CI, 1.03 to 3.96), history of dental extraction (aOR = 32.97; 95% CI, 18.02 to 60.31), having ever received zoledronate (aOR = 28.09; 95% CI, 5.74 to 137.43), and each zoledronate dose (aOR = 2.02; 95% CI, 1.15 to 3.56) were associated with increased risk for ONJ development. Smoking, periodontitis, and root canal treatment did not increase risk for ONJ in patients receiving BP. Conclusion The conclusions of this study validated dental extractions and use of dentures as risk factors for ONJ development. Ibandronate and pamidronate at the dosages and frequency used in this study seem to exhibit a safer drug profile concerning ONJ complication; however, randomized controlled trials are needed to validate these results. Before initiation of a bisphosphonate, patients should have a comprehensive dental examination. Patients with a challenging dental situation should have dental care attended to before initiation of these drugs.

P126 EPIDEMIOLOGY AND RISK FACTORS OF BREAST CANCER IN INFLAMMATORY BOWEL DISEASE IN THE UNITED STATES BETWEEN 2014 AND 2019: A POPULATION-BASED STUDY

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S24-S25
Author(s):  
Emad Mansoor ◽  
Mohannad Abou-Saleh ◽  
Muhammad Talal Sarmini ◽  
Vijit Chouhan ◽  
Miguel Regueiro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Tobacco Use ◽  
Ileoanal Anastomosis ◽  
Malignant Neoplasm ◽  
The United States ◽  
Intestinal Surgery ◽  
Electronic Health Record Data ◽  
Increased Risk ◽  
History Of

Abstract Background The risk of extra-colonic cancer in IBD is unclear. While thiopurines and tumour necrosis factor-α antagonists (anti-TNFs) are associated with increased risk of skin cancer and lymphoma in IBD, there is scant data on breast cancer in IBD. We evaluated the prevalence of breast cancer in IBD and investigated the role of biologics, immunomodulators, and clinical characteristics of IBD in patients with IBD and breast cancer. Methods We queried a commercial database (Explorys Inc), an aggregate of Electronic Health Record data from 26 major integrated healthcare systems in the US from 1999 to 2019. We identified a cohort of eligible patients with a diagnosis of “Crohn’s disease” (CD) and “Ulcerative Colitis” (UC) between June 2014 and 2019, based on Systemized Nomenclature Of Medicine – Clinical Terms. We calculated the prevalence of “primary malignant neoplasm of breast” in IBD overall, and among different sub-groups and identified risk factors for breast cancer in IBD utilizing linear regression. Results Of the 35,521,930 individuals in the database from October 2014–2019, we identified 165,750 and 140,640 individuals with a diagnosis of CD and UC with an overall prevalence rate of 0.47% and 0.4% respectively. Out of these, 3,160 individuals with CD and 3,340 individuals with UC had a co-diagnosis of breast cancer. The prevalence of breast cancer in individuals without IBD was 1.1%. Compared to individuals with breast cancer without IBD, the prevalence of breast cancer in CD was increased at 1.9% [OR: 1.79, 95% CI: 1.73–1.85, p<0.0001] and in UC was 2.3% [OR: 2.24, 95% CI: 2.17–2.32, p<0.0001]. Compared to individuals with IBD and no malignancy, individuals with IBD and breast cancer were predominantly females, elderly (>65yo), Caucasians, had history of tobacco use and appendectomy (Table 1). Anti-TNFs and vedolizumab were associated with increased risk of breast cancer in CD (ORs 1.82 and 1.38) but not in UC. Azathioprine was associated with increased risk of breast cancer in both CD and UC (ORs 1.9 and 1.29). For UC, history of colectomy was associated with an increased risk of breast cancer with OR 1.51. For CD, history of total abdominal colectomy (TAC) with ileostomy or with ileoanal anastomosis, partial resection of the colon and small intestinal surgery were all associated increased risk of breast cancer. However, fistulizing disease, peri-anal disease, and incision and drainage of perineal or perirectal abscess were not associated with increased risk of breast cancer (Table 1). Conclusion We found a two-fold higher prevalence of breast cancer in patients with IBD compared to individuals without IBD. We identified tobacco use, appendectomy and surrogate markers of luminal inflammation (use of immunomodulators, biologic agents and history of intestinal surgery) to increase risk of breast cancer. Further prospective studies are needed to confirm these findings which have implications on agressive screening of breast cancer in females with IBD.

scholarly journals Cancer and the risk of COVID-19 diagnosis, hospitalisation, and death: a population-based multi-state cohort study including 4,618,377 adults in Catalonia, Spain

2021 ◽  
Author(s):  
Elena Roel ◽  
Andrea Pistillo ◽  
Martina Recalde ◽  
Sergio Fernandez-Bertolin ◽  
Maria Aragon ◽  
...  
Keyword(s):  
Cohort Study ◽  
Smoking Status ◽  
Population Based ◽  
High Risk Population ◽  
Cancer Type ◽  
Non Melanoma Skin Cancer ◽  
Hazard Ratios ◽  
Increased Risk ◽  
History Of ◽  
One Year

Objectives: To investigate the associations between cancer and risk of outpatient COVID-19 diagnosis, hospitalisation, and COVID-19-related death, overall and by years since cancer diagnosis (<1-year, 1-5-years, >5-years), sex, age, and cancer type. Design: Population-based cohort study Setting: Primary care electronic health records including ~80% of the population in Catalonia, Spain, linked to hospital and mortality records between 1 March and 6 May 2020. Participants: Individuals aged ≥18 years with at least one year of prior medical history available from the general population. Cancer was defined as any prior diagnosis of a primary invasive malignancy excluding non-melanoma skin cancer. Main outcome measures: Cause-specific hazard ratios (aHR) with 95% confidence intervals for each outcome. Estimates were adjusted by age, sex, deprivation, smoking status, and comorbidities. Results: We included 4,618,377 adults, of which 260,667 (5.6%) had a history of cancer. Patients with cancer were older and had more comorbidities than cancer-free patients. A total of 98,951 individuals (5.5% with cancer) were diagnosed and 6,355 (16.4% with cancer) were directly hospitalised (no prior diagnosis) with COVID-19. Of those diagnosed, 6,851 were subsequently hospitalised (10.7% with cancer) and 3,227 died without being hospitalised (18.5% with cancer). Among those hospitalised, 1,963 (22.5% with cancer) died. Cancer was associated with an increased risk of COVID-19 diagnosis (aHR: 1.08; 95% confidence interval [1.05-1.11]); direct COVID-19 hospitalisation (1.33 [1.24-1.43]); and death following a COVID-19 hospitalisation (1.12 [1.01-1.25]). These associations were stronger for patients recently diagnosed with cancer, aged <70 years, and with haematological cancers. Conclusions: Patients recently diagnosed with cancer, aged <70 years, or with haematological cancers are a high-risk population for COVID-19 diagnosis and severity. These patients should be prioritised in COVID-19 vaccination campaigns and continued non-pharmaceutical interventions.

scholarly journals Risk of coronary heart disease in patients with periodontitis among the middled-aged and elderly in China: a cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaikai Gao ◽  
Zhiyuan Wu ◽  
Yue Liu ◽  
Lixin Tao ◽  
Yanxia Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Convincing Evidence ◽  
Multiple Mediation ◽  
Chinese Populations ◽  
Increased Risk ◽  
History Of ◽  
Shared Risk

Abstract Background Convincing evidence of the periodontitis as a risk factor for coronary heart disease (CHD) is lacking due to shared risk factors, and no cohort study has investigated the association between CHD and periodontitis in Chinese populations. Methods This study used a prospective cohort study design. The analysis included 4591 participants aged 40 years and older (3146 men and 1445 women). The association between CHD and periodontitis was estimated using relative risk (RR) calculated using modified Poisson regression. Multiple mediation analysis was used to differentiate the relative effects (RE) from different risk factors on the effect of periodontitis on CHD. Results In the analysis using the imputed dataset and fully adjusted model, participants with periodontitis at baseline had 37% increased risk of CHD overall compared to those without periodontitis at baseline (RR 1.37; 95% CI 0.96–1.95). Most of the association can be explained by age, sex, history of diabetes, history of hypertension, uric acid and education (RE 0.76; 95% CI 0.41–1.02). Conclusion Periodontitis was weakly associated with an increased risk of CHD among the middled-aged and elderly in China. Further studies are required to identify more mediators and elucidate the mechanisms of how periodontitis increases the risk of CHD.

scholarly journals Examining the Etiology of Early-Onset Breast Cancer in the Canadian Partnership for Tomorrow’s Health (CanPath)

2021 ◽  
Author(s):  
Joy Pader ◽  
Robert B. Basmadjian ◽  
Dylan E. O’Sullivan ◽  
Nicole E. Mealey ◽  
Yibing Ruan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Early Onset ◽  
Vegetable Consumption ◽  
Conditional Logistic Regression ◽  
Breast Cancer Incidence ◽  
Health Study ◽  
Early Onset Breast Cancer ◽  
Increased Risk ◽  
History Of

Abstract Purpose: Breast cancer incidence among younger women (under age 50) has increased over the past 25 years, yet little is known about the etiology among this age group. The objective of this study was to investigate relationships between modifiable and non-modifiable risk factors and early-onset breast cancer among three prospective Canadian cohorts.Methods: A matched case-control study was conducted using data from Alberta’s Tomorrow Project, BC Generations Project, and the Ontario Health Study. Participants diagnosed with breast cancer before age 50 were identified through provincial registries and matched to three control participants of similar age and follow-up. Conditional logistic regression was used to examine the association between factors and risk of early-onset breast cancer. Results: In total, 609 cases and 1,827 controls were included. A body mass index ≥30kg/m2 was associated with a lower risk of early-onset breast cancer (OR=0.65; 95% CI: 0.47-0.90), while a waist circumference ≥88 cm was associated with an increased risk (OR=1.40; 95% CI: 1.06-1.84). A reduced risk was found for women with ≥2 pregnancies (OR=0.80; 95% CI: 0.64-1.00) and a first-degree family history of breast cancer was associated with an increased risk (OR=2.06; 95% CI: 1.54-2.75).Conclusions: In this study, measures of adiposity, pregnancy history, and familial history of breast cancer are important risk factors for early-onset breast cancer. Evidence was insufficient to conclude if smoking, alcohol intake, fruit and vegetable consumption, and physical activity are meaningful risk factors. The results of this study could inform targeted primary and secondary prevention for early-onset breast cancer.

scholarly journals Increased non-typhoidal Salmonella hospitalizations in transfusion-naïve thalassemia children: a nationwide population-based cohort study

2021 ◽  
Author(s):  
Fang-Ju Lin ◽  
Jiunn-Ming Sheen ◽  
Yao-Hsu Yang ◽  
Kuang-Che Kuo
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Population Based ◽  
List Type ◽  
Research Database ◽  
Thalassemia Patient ◽  
Urbanization Level ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
History Of

Abstract Introduction Although non-typhoidal Salmonella (NTS) infection usually causes self-limited enterocolitis, several risk factors have been found to predispose individuals to more severe NTS infections. However, few studies have discussed the association between NTS infection and pediatric thalassemia populations. Material and methods A nationwide population-based retrospective cohort study was conducted using medical records of the selected children from the Taiwan National Health Insurance Research Database. Immunocompromised individuals or patients with a history of transfusion or splenectomy were excluded. One thalassemia patient was matched with four non-thalassemia patients based on their year of birth, sex, and urbanization level. Results In this cohort, 912 patients with thalassemia and 3648 comparison cohort were analyzed. The mean age of NTS hospitalization was 2.0 ± 1.4 in thalassemia cohort and 2.6 ± 2.4 in non-thalassemia cohort. Transfusion-naïve thalassemia children were proved to have a higher rate of NTS hospitalization (6.90 vs 4.11 per 1000 person-year; p = 0.0004) than the non-thalassemia cohort, with an adjusted hazard ratio (HR) of 1.68 (95% confidence interval [CI] = 1.26–2.24). Conclusion Our research shows that transfusion-naïve thalassemia is associated with an increased risk of NTS hospitalization. Further prospective study comparing the incidence and severity of NTS infection among children with and without thalassemia is needed. Impact Pediatric transfusion-naïve thalassemia patients have an 1.68-fold increased risk for hospitalization due to non-typhoidal Salmonella (NTS) infection. This is the first nationwide population-based cohort study based on an extremely large database that shows pediatric transfusion-naïve thalassemia patients have an increased risk for NTS hospitalizations. Besides the previously known risk factors such as extremes of age, sickle cell disease, or immunosuppressing conditions, clinicians must also take thalassemia as a possible risk factor for more severe NTS disease.

Epilepsy as a Risk Factor for Submersion Injury in Children

PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 612-616 ◽  
Author(s):  
Douglas S. Diekema ◽  
Linda Quan ◽  
Victoria L. Holt
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Confidence Interval ◽  
Retrospective Cohort ◽  
Population Based ◽  
King County ◽  
Relative Risks ◽  
Increased Risk

The purpose of this study was to determine the risk of submersion injury and drowning among children with epilepsy and to define further specific risk factors. In a population-based retrospective cohort study the authors identified and reviewed records of all 0- through 19-year-old residents of King County Washington, who suffered a submersion incident between 1974 and 1990. Children with epilepsy were compared with those without epilepsy with regard to age, sex, site of incident, supervision, outcome, and presence of preexisting handicap. Relative risks were determined using population-based estimates of epilepsy prevalence. Of 336 submersions, 21 (6%) occurred among children with epilepsy. Children with epilepsy were more likely to be greater than 5 years old (86% vs 47%) and more likely to submerge in a bathtub (38% vs 11%). The relative risk of submersion for children with epilepsy was 47 (95% confidence interval [CI] 22 to 100) in the bathtub and 18.7 (95% CI 9.8 to 35.6) in the pool. The relative risk of drowning for children with epilepsy was 96 (95% CI 33 to 275) in the bathtub and 23.4 (95% CI 7.1 to 77.1) in the pool. These data support an increased risk of submersion and drowning among children with epilepsy.

scholarly journals Risk Factors Among Breast Cancer Patients Being Treated in Tertiary Level Hospital of Nepal: A Case Control Study

2020 ◽  
Vol 42 (1) ◽  
pp. 79
Author(s):  
Asmita Rana ◽  
Anup Ghimire ◽  
Ram B Sah ◽  
Prajjwal Pyakurel ◽  
Nirmal P Shah
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Benign Breast Disease ◽  
Case Control Study ◽  
Breast Disease ◽  
Case Control ◽  
P Value ◽  
Increased Risk ◽  
History Of ◽  
Control Study

Introduction Breast cancer is the leading cause of cancer death among females worldwide. Its incidence is on the rise in Nepal. However, the risk factors have not been studied in context of Nepal. The aim of this study is to identify and quantify the association of various risk factors with breast cancer in Nepal. MethodsHospital-based age-matched case-control study was conducted among 50 cases and 150 controls visiting BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal. Semi-structured questionnaire was used to collect information on demographic characters, socio-economic parameters, reproductive history, dietary and personal habits, family history, history of contraception and history of benign breast disease. Height, weight, hip circumference and waist circumference were measured. ResultsMajority of the cases (52%) belonged to the age group of 46-55 years. The significant risk factors were ethnicity of Dalit/Madhesi (AOR 8.222, 95% CI 2.377-28.441, p-value 0.001), parity of 3 to 5 (AOR 5.614, 95% CI 1.140-27.639, p-value 0.03) and previous history of benign breast disease (OR 13.614, 95% CI 3.229-57.391, p-value 0.001). Hysterectomy was found to reduce the risk of breast cancer (OR 0.122, 95% CI 0.017-0.826, p-value 0.03). Knowledge of breast self-examination was significantly higher among cases than controls (AOR 36.29, 95% CI 5.788-227.555, p-value < 0.001). Knowledge of mammography was significantly lower among cases than control (AOR=0.133, 95% CI=0.028-0.647, p-value=0.01). ConclusionThis study showed a number of factors to be associated with the increased risk of breast cancer. It was observed that the mean age at diagnosis is a decade earlier than in Western countries. Genetic component was not significant in context of Nepal. It is hoped that the findings of this study will facilitate further exploration and evidenced-based preventive measures for Nepalese women.

Persistent Incisional Pain after Noncardiac Surgery: An International Prospective Cohort Study

2021 ◽  
Vol 135 (4) ◽  
pp. 711-723
Author(s):  
James S. Khan ◽  
Daniel I. Sessler ◽  
Matthew T. V. Chan ◽  
C. Y. Wang ◽  
Ignacio Garutti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Rating Scale ◽  
Noncardiac Surgery ◽  
Persistent Pain ◽  
Increased Risk ◽  
History Of ◽  
Incisional Pain

Background The purpose of this study was to determine the incidence, characteristics, impact, and risk factors associated with persistent incisional pain. The hypothesis was that patient demographics and perioperative interventions are associated with persistent pain. Methods This was a secondary analysis of an international prospective cohort study from 2012 to 2014. This study included patients who were 45 yr of age or older who underwent major inpatient noncardiac surgery. Data were collected perioperatively and at 1 yr after surgery to assess for the development of persistent incisional pain (pain present around incision at 1 yr after surgery). Results Among 14,831 patients, 495 (3.3%; 95% CI, 3.1 to 3.6) reported persistent incisional pain at 1 yr, with an average pain intensity of 3.6 ± 2.5 (0 to 10 numeric rating scale), with 35% and 14% reporting moderate and severe pain intensities, respectively. More than half of patients with persistent pain reported needing analgesic medications, and 85% reported interference with daily activities (denominator = 495 in the above proportions). Risk factors for persistent pain included female sex (P = 0.007), Asian ethnicity (P &lt; 0.001), surgery for fracture (P &lt; 0.001), history of chronic pain (P &lt; 0.001), coronary artery disease (P &lt; 0.001), history of tobacco use (P = 0.048), postoperative patient-controlled analgesia (P &lt; 0.001), postoperative continuous nerve block (P = 0.010), insulin initiation within 24 h of surgery (P &lt; 0.001), and withholding nonsteroidal anti-inflammatory medication or cyclooxygenase-2 inhibitors on the day of surgery (P = 0.029 and P &lt; 0.001, respectively). Older age (P &lt; 0.001), endoscopic surgery (P = 0.005), and South Asian (P &lt; 0.001), Native American/Australian (P = 0.004), and Latin/Hispanic ethnicities (P &lt; 0.001) were associated with a lower risk of persistent pain. Conclusions Persistent incisional pain is a common complication of inpatient noncardiac surgery, occurring in approximately 1 in 30 adults. It results in significant morbidity, interferes with daily living, and is associated with persistent analgesic consumption. Certain demographics, ethnicities, and perioperative practices are associated with increased risk of persistent pain. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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