Incidence of sepsis and associated mortality within the first year after cancer diagnosis in middle aged adults: A US population based study

Background The incidence of sepsis has been rising overall but updated data in cancer patients are lacking. After a cancer diagnosis, incidence of sepsis and overall mortality peak within the first year. However, how much sepsis contributes to mortality remains unclear. We used a multistate model approach to analyze the incidence, risk factors and associated mortality of sepsis within 1 year of cancer diagnosis in middle aged adults. Methods Analysis of a large US health insurance claims database (Marketscan) between 2005 and 2014. Patients with a new diagnosis of cancer who received chemotherapy were included. Within a year of diagnosis, we assessed inpatient admissions for sepsis based on ICD-9 codes and survival using hospitalizations, outpatient visits and prescriptions filled. Competing risk and multistate models were used to assess the incidence of sepsis and transition probabilities between cancer, sepsis and death. Results 119,379 patients (38.9% males), aged 55 (50–60) years, were included; 2,560 developed isolated sepsis, 477 severe sepsis and 1331 septic shock within 1 year, with associated hospital mortality of 14.8%, 30% and 46% respectively. The probability of sepsis increased between 2005 and 2014; at 1 year, its cumulative incidence was 3.7% with a probability of mortality after sepsis of 35.5% (95% CI 21.6%-50.9%). Age, male gender, Charlson comorbidity index, hematological malignancies and metastases at diagnosis were associated with sepsis and mortality. Conclusions Incidence and mortality of sepsis were 3.7% and 35.5% at 1 year after cancer diagnosis and were both associated with baseline patient and cancer characteristics.

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Factors associated with sarcopenia screened by finger-circle test among middle-aged and older adults: a population-based multisite cross-sectional survey in Japan

BMC Public Health ◽

10.1186/s12889-021-10844-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daiki Watanabe ◽

Tsukasa Yoshida ◽

Takashi Nakagata ◽

Naomi Sawada ◽

Yosuke Yamada ◽

...

Keyword(s):

Older Adults ◽

Smoking Status ◽

Multiple Logistic Regression Analysis ◽

Population Based ◽

Middle Aged ◽

Cross Sectional ◽

Factors Associated ◽

Mail Surveys ◽

Osaka Prefecture ◽

Middle Aged Adults

AbstractBackgroundPrevious epidemiological studies have demonstrated the prevalence and relationship of various factors associated with sarcopenia in older adults; however, few have examined the status of sarcopenia in middle-aged adults. In this study, we aimed to, 1) evaluate the validity of the finger-circle test, which is potentially a useful screening tool for sarcopenia, and 2) determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.MethodsWe conducted face-to-face surveys of 525 adults, who were aged 40–91 years and resided in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test evaluated calf circumference by referring to an illustration printed on the survey form. The area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test for screening sarcopenia and compared to that evaluated by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted multisite population-based cross-sectional anonymous mail surveys of 9337 adults, who were aged 40–97 years and resided in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.ResultsSarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, < 65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia screened by finger-circle test was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8–9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.ConclusionsSarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results may provide useful indications for developing public health programs, not only for the prevention, but especially for the management of sarcopenia.Trial registrationUMIN000036880, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027

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The Working After Cancer Study (WACS): a population-based study of middle-aged workers diagnosed with colorectal cancer and their return to work experiences

BMC Public Health ◽

10.1186/1471-2458-11-604 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 12

Author(s):

Louisa G Gordon ◽

Brigid M Lynch ◽

Vanessa L Beesley ◽

Nicholas Graves ◽

Catherine McGrath ◽

...

Keyword(s):

Colorectal Cancer ◽

Return To Work ◽

Population Based ◽

Work Experiences ◽

Middle Aged ◽

Population Based Study ◽

Cancer Study ◽

After Cancer

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Incidence and risk of major heart diseases in middle-aged adults with moderate to severe vision impairment: a population-based cohort study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312471 ◽

2018 ◽

Vol 103 (8) ◽

pp. 1054-1059 ◽

Cited By ~ 1

Author(s):

Chun-Mei Hsueh ◽

Jing-Hwa Wey ◽

Jong-Shiuan Yeh ◽

Chien-Hua Wu ◽

Tsan-Hon Liou ◽

...

Keyword(s):

Cohort Study ◽

Heart Diseases ◽

Population Based ◽

Vision Impairment ◽

Major Adverse Cardiovascular Events ◽

Research Database ◽

Middle Aged ◽

Visual Disability ◽

Aged People ◽

Middle Aged Adults

Background/aimTo estimate the incidence and risk of major adverse cardiovascular events (MACEs), including heart failure and ischaemic heart disease, among middle-aged people with a visual disability (VD).MethodsWe used a national health insurance research database to conduct a population-based cohort study from 1 January 2000 to 31 December 2013. Patients with VD aged 35~65 years were recruited. For each VD patient, five age-matched, sex-matched and comorbidity-matched patients were randomly selected and recruited as controls. Control patients had no documented disability.ResultsThis study recruited 978 patients with VD (mean age±SD, 55.1±7.8 years; 48.9% male) and 4677 controls. Compared with the same sex of the controls, women with VD had higher incidence of MACE 1 (7.9 vs 2.8/1000 person-years, p<0.001), MACE 2 (27.5 vs 16.9/1000 person-years, p<0.001), MACE 3 (3.7 vs 1.4/1000 person-years, p<0.005) and MACE 4 (4.5 vs 2.5/1000 person-years, p<0.05), and men with VD had higher incidence of MACE 1 (4.6 vs 2.0/1000 person-years, p<0.005). Compared with the controls, patients with VD had lower cumulative MACE 1~MACE 4-free probabilities and had an independently higher risk of MACE 1~MACE 4 during the 13-year study, yielding an adjusted hazard ratio range of 1.31~2.75. Those persons with VD who had diabetes and hypertension had greater risks of MACE 1~MACE 4.ConclusionsMiddle-aged adults with VD were at risk of MACEs. A programme for MACE prevention is important for middle-aged people with VD. This is especially true for women and for those who also have diabetes and hypertension.

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Increased Overall Mortality Even after Risk Reducing Surgery for BRCA-Positive Women in Western Sweden

Genes ◽

10.3390/genes10121046 ◽

2019 ◽

Vol 10 (12) ◽

pp. 1046

Author(s):

Anna Öfverholm ◽

Zakaria Einbeigi ◽

Antonia Wigermo ◽

Erik Holmberg ◽

Per Karsson

Keyword(s):

Ovarian Cancer ◽

General Population ◽

Cancer Incidence ◽

Population Based ◽

Pathology Report ◽

Breast And Ovarian Cancer ◽

Incidence And Mortality ◽

Incidence Risk ◽

Risk Reducing ◽

Overall Mortality

Women with BRCA variants have a high lifetime risk of developing breast and ovarian cancer. The aim of this study was to investigate the standard incidence ratios (SIR) for breast and ovarian cancer and standard mortality ratios (SMR) in a population-based cohort of women in Western Sweden, under surveillance and after risk reducing surgery. Women who tested positive for a BRCA variant between 1995–2016 (n = 489) were prospectively registered and followed up for cancer incidence, risk reducing surgery and mortality. The Swedish Cancer Register was used to compare breast and ovarian cancer incidence and mortality with and without risk reducing surgery for women with BRCA variants in comparison to women in the general population. SIR for breast cancer under surveillance until risk-reducing mastectomy (RRM) was 14.0 (95% CI 9.42–20.7) and decreased to 1.93 (95% CI 0.48–7.7) after RRM. The SIR for ovarian cancer was 124.6 (95% CI 59.4–261.3) under surveillance until risk reducing salpingo-oophorectomy (RRSO) and decreased to 13.5 (95% CI 4.34–41.8) after RRSO. The SMR under surveillance before any risk reducing surgery was 5.56 (95% 2.09–14.8) and after both RRM and RRSO 4.32 (95% CI 1.62–11.5). Women with cancer diagnoses from the pathology report after risk reducing surgery were excluded from the analyses. Risk reducing surgery reduced the incidence of breast and ovarian cancer in women with BRCA variants. However, overall mortality was significantly increased in comparison to the women in the general population and remained elevated even after risk reducing surgery. These findings warrant further research regarding additional measures for these women.

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Long-Term Incidence of Venous Thromboembolism in Cancer: The Scandinavian Thrombosis and Cancer Cohort

TH Open ◽

10.1055/s-0038-1641678 ◽

2018 ◽

Vol 02 (02) ◽

pp. e131-e138 ◽

Cited By ~ 2

Author(s):

Inger Lise Gade ◽

Sigrid Brækkan ◽

Inger Anne Næss ◽

John-Bjarne Hansen ◽

Suzanne Cannegieter ◽

...

Keyword(s):

Venous Thromboembolism ◽

Cancer Diagnosis ◽

Population Based ◽

Incidence Rates ◽

Solid Cancer ◽

Background Population ◽

Hematological Cancers ◽

Cancer Types ◽

After Cancer ◽

Rate Ratios

AbstractThe risk of venous thromboembolism (VTE) in patients who survive the first years after a cancer diagnosis after the acute effects of disease and treatment in comparison to a similar background population has been sparsely investigated. The aim of the study was to investigate if incidence rates (IRs) of VTE differed in patients who were alive at least 2 years after a cancer diagnosis without VTE compared with cancer-free references in a population-based cohort study. The study entry was 2 years after a first cancer diagnosis. For each cancer-exposed subject, five reference subjects were identified within the cohort. The IRs were calculated as number of VTEs per 1,000 person years (×10−3 p-y) in total and in distinct cancer types and corresponding reference subjects. Incidence rate ratios (IRRs) were calculated by Poisson's regression. During a mean follow-up of 5.3 years, 110 VTEs occurred among the 7,288 cancer-exposed subjects and 321 VTEs occurred among the 36,297 identified reference subjects. The IR of VTE was higher for cancer-exposed subjects compared with reference subjects, IRs 3.7 × 10−3 p-y, 95% CI: 3.1 to 4.5 and 1.9 × 10−3 p-y, 95% CI: 1.7 to 2.2, respectively. IRs of VTE in most solid cancer types declined to almost the same level as in the reference subjects 2 years after cancer diagnosis, but remained higher in hematological cancers, IRR 4.0, 95% CI: 2.0 to 7.8.

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Impact of Body Mass Index on the Risk of Total Cancer Incidence and Mortality Among Middle-Aged Japanese: Data from a Large-Scale Population-Based Cohort Study – The JPHC Study

Cancer Causes & Control ◽

10.1023/b:caco.0000036177.77953.47 ◽

2004 ◽

Vol 15 (7) ◽

pp. 671-680 ◽

Cited By ~ 46

Author(s):

Manami Inoue ◽

Tomotaka Sobue ◽

Shoichiro Tsugane

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Body Mass ◽

Cancer Incidence ◽

Large Scale ◽

Population Based ◽

Middle Aged ◽

Incidence And Mortality ◽

Scale Population ◽

Total Cancer

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Genitourinary disease risks among 5-year ovarian cancer survivors in a population-based cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.10073 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 10073-10073

Author(s):

Mia Hashibe ◽

Yuji Chen ◽

Brenna Blackburn ◽

Yuan Wan ◽

Kerry G. Rowe ◽

...

Keyword(s):

Ovarian Cancer ◽

Renal Failure ◽

Acute Renal Failure ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Population Based ◽

General Population Cohort ◽

Disease Risks ◽

After Cancer

10073 Background: In the US, there are approximately 235,200 ovarian cancer survivors today. Five-year survival for ovarian cancer has increased from 36% for women who were diagnosed in 1975-1977 to 46% for women diagnosed between 2005-2011. Long term follow-up studies among ovarian cancer survivors are uncommon and late effects have not been well characterized in a population-based cohort. Although genitourinary complications during treatment are well known, long term impacts need to be investigated. Methods: A total of 602 first primary invasive ovarian cancer cases diagnosed between 1996-2012 who survived for > 5 years were identified in the Utah Population Database and compared to a general population cohort of women. Genitourinary disease diagnoses were identified through ICD codes from hospital electronic medical records and statewide ambulatory surgery and inpatient data. Cox regression models were used to estimate hazard ratios for disease risks by time since cancer diagnosis with adjustments on matching factors, baseline BMI, baseline Charlson Comorbidity Index (CCI), and race. Results: The overall risk of genitourinary diseases for ovarian cancer patients in comparison to the general population cohort was 1.51 (95%CI = 1.30-1.74) 5-10 years after cancer diagnosis. Approximately 54.6% of ovarian cancer survivors were diagnosed with a genitourinary disease 5-10 years after cancer diagnosis. The most common genitourinary diseases among the ovarian cancer survivors were urinary tract infections (10.1%), acute renal failure (5.5%), and chronic kidney disease (4.4%). The greatest risks were observed for hydronephrosis (HR = 10.65, 95%CI = 3.68-30.80), pelvic peritoneal adhesions (HR = 5.81, 95%CI = 1.11-30.39), cystitis and urethritis (HR = 2.67, 95%CI = 1.21-6.38), and acute renal failure (HR = 2.30, 95%CI = 1.36-3.88). Conclusions: Ovarian cancer survivors experience increased risks of various genitourinary diseases in the 5-10 year period following cancer diagnosis. Understanding the multimorbidity trajectory among ovarian cancer survivors is of vital importance to improve their clinical care after cancer diagnosis and allow for increased attention to these potential late effects.

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Incidence and mortality trends for four major cancers in the elderly and middle-aged adults: An international comparison

Surgical Oncology ◽

10.1016/j.suronc.2013.02.010 ◽

2013 ◽

Vol 22 (2) ◽

pp. e31-e38 ◽

Cited By ~ 10

Author(s):

Alberto Quaglia ◽

Roberto Lillini ◽

Emanuele Crocetti ◽

Carlotta Buzzoni ◽

Marina Vercelli

Keyword(s):

International Comparison ◽

The Elderly ◽

Middle Aged ◽

Mortality Trends ◽

Incidence And Mortality ◽

Middle Aged Adults

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Executive dysfunction following SARS-CoV-2 infection: A cross-sectional examination in a population-representative sample

10.1101/2022.01.01.22268614 ◽

2022 ◽

Author(s):

Peter A Hall ◽

Gang Meng ◽

Anna Hudson ◽

Mohammad Nazmus Sakib ◽

Sara C Hitchman ◽

...

Keyword(s):

Symptom Severity ◽

Executive Dysfunction ◽

Population Based ◽

Community Dwelling ◽

Middle Aged ◽

Observation Study ◽

Cross Sectional ◽

French Speaking ◽

National Cohort ◽

Middle Aged Adults

Objective: To determine whether SRS-CoV-2 infection and COVID-19 symptom severity are associated with executive dysfunction among members of the general population, including those not hospitalized or exposed to intubation. Design: Cross-sectional observation study with data from an ongoing national cohort study of young and middle-aged adults. The Canadian COVID-19 Experiences Project (CCEP) survey involves 1,958 adults with equal representation of vaccinated and vaccine hesitant adults between the ages of 18 and 54 years. Setting: Population-based survey of community dwelling adults, representative of the broader Canadian population. Participants: Men and women between 18 and 54 years of age from English and French speaking provinces. The sample comprised 1,958 adults with a mean age of 37 years (SD=10.4); 60.8% were female. Exposures: SARS-CoV-2 infection with COVID-19 symptoms of any severity, ranging from negligeable to life-threatening infection requiring hospitalization. Primary Outcome: Symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS). Results: Those who reported a prior SARS-CoV-2 infection regardless of COVID-19 symptom severity (Madj=1.89, SE=0.08, CI: 1.74, 2.04; n=175) reported a significantly higher number of symptoms of executive dysfunction than their non-infected counterparts (Madj=1.63, SE=0.08, CI: 1.47,1.80; n=1,599; β=0.26, p=.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of executive dysfunction, with moderate (β=0.23, CI: 0.003-0.46) and very/extremely severe (β= 0.69, CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater dysfunction, compared to asymptomatic. These effects remained reliable and of similar magnitude after removing those who had been received intubation and when controlling for vaccination status. Conclusions: Positive SARS-CoV-2 infection history and COVID-19 symptom severity are associated with executive dysfunction among young and middle-aged adults with no history of medically induced coma.

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