scholarly journals Prevalence and factors associated with the performance of prostate cancer screening in the elderly: a population-based study

2018 ◽  
Vol 21 (1) ◽  
pp. 53-59
Author(s):  
Alisson Padilha de Lima ◽  
Ezequiel Vitório Lini ◽  
Rodrigo Britto Giacomazzi ◽  
Marcos Paulo Dellani ◽  
Marilene Rodrigues Portella ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Cancer Screening ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Population Based ◽  
Multiple Model ◽  
Population Based Study ◽  
Factors Associated ◽  
Independent Variables ◽  
Rectal Examination

Abstract Objective: to identify the prevalence and factors associated with preventive examinations for the screening of prostate cancer in the elderly. Methods: a cross-sectional population-based study of 181 men aged ≥60 years who were residents of a small city in the state of Rio Grande do Sul, Brazil, was carried out. The dependent variable was considered to be the performance of preventive prostate cancer tests in the past two years and the independent variables were those related to health and sociodemographic characteristics. To test the association between the outcome and the independent variables, gross and multivariable analysis using Poisson regression was performed, estimating the gross and adjusted prevalence ratios, calculating the confidence intervals of 95%. All variables with p≤0.20 were included in the multiple model. Results: the prevalence of preventive examinations for prostate cancer was 89%. The tests used were the Prostate Specific Antigen (PSA) (85.7%), followed by tests performed in combination: rectal examination and PSA (9.3%), rectal examination, ultrasound and PSA (3.1%), rectal examination and ultrasound (1.3%) and ultrasound and PSA (0.6%). In multivariate analysis, the variables retirement and marital status were the independent factors associated with the carrying out of at least one preventive examination of the prostate. Conclusions: The findings demonstrate that being retired increases the likelihood of carrying out preventive examinations and having a partner, being married or cohabiting increases the likelihood of undergoing tests.

scholarly journals Factors associated with lower gait speed among the elderly living in a developing country: a cross-sectional population-based study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Telma de Almeida Busch ◽  
Yeda Aparecida Duarte ◽  
Daniella Pires Nunes ◽  
Maria Lucia Lebrão ◽  
Michel Satya Naslavsky ◽  
...  
Keyword(s):  
Developing Country ◽  
Gait Speed ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional ◽  
Population Based Study ◽  
Factors Associated ◽  
Elderly Living

scholarly journals Falls among the elderly: risk factors in a population-based study

2014 ◽  
Vol 17 (3) ◽  
pp. 705-718 ◽  
Author(s):  
Iara Guimarães Rodrigues ◽  
Gustavo Pereira Fraga ◽  
Marilisa Berti de Azevedo Barros
Keyword(s):  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Elderly Adults ◽  
Cross Sectional ◽  
Population Based Study ◽  
Factors Associated ◽  
Gender And Age ◽  
Policies And Programs

Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95%CI 1.61 - 3.88), widowed (PR = 1.74; 95%CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74), headache (PR = 1.59; 95%CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64), dizziness (PR = 2.82; 95%CI 1.98 - 4.02), insomnia (PR = 1.75; 95%CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95%CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93). Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

Atherogenic dyslipidemia, but not hyperglycemia, is an independent factor associated with liver fibrosis in subjects with type 2 diabetes and NAFLD: A population –based study

2021 ◽  
Author(s):  
María Teresa Julián ◽  
Guillem Pera ◽  
Berta Soldevila ◽  
Llorenç Caballería ◽  
Josep Julve ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Fibrosis ◽  
Multivariable Analysis ◽  
Liver Stiffness ◽  
Population Based ◽  
Atherogenic Dyslipidemia ◽  
Population Based Study ◽  
Factors Associated ◽  
Advanced Liver Fibrosis

Objective: To investigate the prevalence and risks factors associated with the presence of significant liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD) with and without type 2 diabetes mellitus (T2D). Design and methods: This study was part of a population-based study conducted in the Barcelona metropolitan area among subjects aged 18-75 years old. Secondary causes of steatosis were excluded. Moderate-to-advanced liver fibrosis was defined as a liver stiffness measurement (LSM) ≥ 8.0 kPa assessed by transient elastography. Results: Among 930 subjects with NAFLD, the prevalence of moderate-to-advanced liver fibrosis was higher in subjects with T2D compared those without (30.8% vs. 8.7%). By multivariable analysis, one of the main factors independently associated with increased LSM in subjects with NAFLD was atherogenic dyslipidemia, but only in those with T2D. The percentage of subjects with LSM ≥ 8.0 kPa was higher in subjects with T2D and atherogenic dyslipidemia than in those with T2D without atherogenic dyslipidemia, both for the cut-off point of LSM ≥8.0 kPa (45% vs 24%, p=0.002) and 13 kPa (13% vs 4%, p=0.020). No differences were observed in the prevalence of LSM ≥8.0 kPa regarding glycemic control among NAFLD-diabetic subjects. Conclusions: Factors associated with moderate-to-advanced liver fibrosis in NAFLD are different in subjects with and without T2D. Atherogenic dyslipidemia was associated with the presence of moderate-to-advanced liver fibrosis in T2D with NAFLD but not in non-diabetic subjects. These findings highlight the need for an active search for liver fibrosis in subjects with T2D, NAFLD and atherogenic dyslipidemia.

Digital rectal examination is barrier to population-based prostate cancer screening

Urology ◽  
2005 ◽  
Vol 65 (6) ◽  
pp. 1137-1140 ◽  
Author(s):  
Harris M. Nagler ◽  
Eric W. Gerber ◽  
Peter Homel ◽  
Joseph R. Wagner ◽  
Jennifer Norton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Digital Rectal Examination ◽  
Population Based ◽  
Rectal Examination

scholarly journals Determinants for choosing and adhering to active surveillance for localised prostate cancer: a nationwide population-based study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033944
Author(s):  
Oskar Bergengren ◽  
Hans Garmo ◽  
Ola Bratt ◽  
Lars Holmberg ◽  
Eva Johansson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Healthcare Providers ◽  
Population Based ◽  
Low Risk ◽  
Population Based Study ◽  
Factors Associated ◽  
Comorbidity Index ◽  
Main Factor

ObjectiveKnowledge about factors influencing choice of and adherence to active surveillance (AS) for prostate cancer (PC) is scarce. We aim to identify which factors most affected choosing and adhering to AS and to quantify their relative importance.Design, setting and participantsIn 2015, we sent a questionnaire to all Swedish men aged ≤70 years registered in the National Prostate Cancer Register of Sweden who were diagnosed in 2008 with low-risk PC and had undergone prostatectomy, radiotherapy or started on AS.Outcome measurements and statistical analysisLogistic regression was used to calculate ORs with 95% CIs for factors potentially affecting choice and adherence to AS.Results1288 out of 1720 men (75%) responded, 451 (35%) chose AS and 837 (65%) underwent curative treatment. Of those starting on AS, 238 (53%) diverted to treatment within 7 years. Most men (83%) choose AS because ‘My doctor recommended AS’. Factors associated with choosing AS over treatment were older age (OR 1.81, 95% CI 1.29 to 2.54), a Charlson Comorbidity Index >2 (OR 1.50, 95% CI 1.06 to 2.13), being unaccompanied when notified of the cancer diagnosis (OR 1.45, 95% CI 1.11 to 1.89). Men with a higher prostate-specific antigen (PSA) at the time of diagnosis were less likely to adhere to AS (OR 0.26, 95% CI 0.10 to 0.63). The reason for having treatment after initial AS was ‘the PSA level was rising’ in 55% and biopsy findings in 36%.ConclusionsA doctor’s recommendation strongly affects which treatment is chosen for men with low-risk PC. Rising PSA values were the main factor for initiating treatment for men on AS. These findings need be considered by healthcare providers who wish to increase the uptake of and adherence to AS.

PSA-detected prostate cancer in the United States: A population-based study of 70,345 men with AJCC stage T1cN0M0 disease.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 50-50
Author(s):  
Hong Zhang ◽  
Lois B. Travis ◽  
Edward M. Messing ◽  
Ollivier Hyrien ◽  
Rui Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Gleason Score ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
The United States ◽  
Population Based ◽  
Population Based Study ◽  
Ajcc Stage ◽  
High Risk Disease

50 Background: The U.S. Preventive Services Task Force (USPSTF) recently recommended against prostate-specific antigen (PSA)-based screening for prostate cancer. This recommendation has heightened the debate about risks and benefits of prostate cancer screening, and underscored our limited understanding of PSA-detected prostate cancer. The purpose of this study was to determine the frequency of various risks of prostate cancer based on patient characteristics and PSA levels. Methods: This population-based study used the Surveillance, Epidemiology, and End Results (SEER) program to identify men with AJCC stage T1cN0M0 disease diagnosed between 1/2004 and 12/2008. Multivariate logistic regression was conducted to model the probability of developing low (PSA <10 mg/L and Gleason score ≤6), intermediate (PSA between 10 mg/L to 20 mg/L and/or Gleason score 7), and high risk diseases (PSA ≥20 mg/L, and/or Gleason score ≥8). Results: A total of 70,345 men with PSA-detected T1cN0M0 prostate cancer were evaluated. Among them, 47.6%, 35.9% and16.5% had low, intermediate, or high risk disease, respectively. Odds ratios (OR) of having intermediate or high risk disease in patients ≥75 years old were 4.47 (95% confidence interval (CI) 3.81 to 5.26, p<0.01) and 9.39 (95% CI 7.25 to 12.16, p<0.01), respectively, when compared with patients aged <50. Also, black men had increased ORs for intermediate and high risk disease compared with white men (OR 1.50, 95% CI 1.42 to 1.58, p<0.01 for intermediate risk disease; OR 1.84, 95% CI 1.72 to 19.97, p<0.01 for high risk disease). While men aged >75 accounted for 11.8% of the population at risk, they accounted for 24.3% of intermediate and 26.1% of high risk disease. Conclusions: A substantial number of PSA-detected prostate cancer patients have either intermediate or high risk disease at diagnosis. Men age >75 or of black race have the highest risk of presenting with intermediate or high risk disease.

Impact of putative chemopreventative agents on prostate cancer diagnosis.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 40-40
Author(s):  
Hanan Goldberg ◽  
Faizan Moshin ◽  
Zachary William Abraham Klaassen ◽  
Thenappan Chandrasekar ◽  
Christopher Wallis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cox Regression ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cumulative Exposure ◽  
Population Based Study ◽  
Diagnosis Rate ◽  
The Impact

40 Background: Prostate cancer (PC) is the most common non-cutaneous cancer in Canadian men and the third most common cause of cancer death in Canada. Several studies have shown that use of commonly prescribed medications, including those used for diabetes and hypercholesterolemia, is associated with improved survival in various malignancies, including PC. There has not been any large population-based study, examining the effects of these and other commonly prescribed medications, on the rate of PC diagnosis, over a 20 years follow-up period. Methods: A retrospective population-based study using data from the institute of clinical evaluative sciences, including all male patients aged 65 and above in Ontario who have had a negative first prostate biopsy between 1994 and 2016. We assessed the impact of commonly prescribed medications on PC diagnosis. The medications included Statins (hydrophilic and hydrophobic), diabetes drugs (metformin, insulins, sulfonylureas, and thizolidinedions), proton pump inhibitors, 5 alpha reductase inhibitors, and alpha blockers. Time dependent Cox regression proportional hazards models were performed determine predictors of PC diagnosis. Medication exposure was time varying and modeled as “ever” vs. “never” use or as cumulative exposure for 6 months of usage. A priori variables included in the model included age, ADG comorbidity score, rurality index, index year, and all medications. Results: A total of 51,415 men were analyzed over a mean (SD) follow-up time of 8.06 (5.44) years. Overall, 10,466 patients (20.4%) were diagnosed with PC, 16,726 (32.5%) had died, and 1,460 (2.8%) patients died of PC. On multivariable analysis increasing age and rurality index were associated with higher PC diagnosis rate, while a more recent index year, and usage of hydrophilic statins was associated with a lower diagnosis rate in both “ever” vs. “never” and cumulative models (HR 0.832, 95% CI 0.732-0.946, p = 0.005, HR 0.973 95% CI 0.951-0.995, p = 0.016, respectively). Conclusions: Hydrophilic statins are associated with a clinically significant lower PC diagnosis. To our knowledge this is the first study demonstrating a clear advantage of one group of statins (hydrophilic) over another (hydrophobic) in PC prevention.

scholarly journals Sociodemographic, clinical, and lifestyle factors associated with prostate cancer aggressiveness in a population‐based study

2013 ◽  
Vol 27 (S1) ◽  
Author(s):  
Terrence M Vance ◽  
Ying Wang ◽  
L. Joseph Su ◽  
Elizabeth T. H. Fontham ◽  
Jeannette T. Bensen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Population Based ◽  
Lifestyle Factors ◽  
Population Based Study ◽  
Factors Associated ◽  
Cancer Aggressiveness

IMPACT of putative chemopreventative agents on prostate cancer diagnosis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16553-e16553
Author(s):  
Hanan Goldberg ◽  
Faizan Moshin ◽  
Zachary William Abraham Klaassen ◽  
Thenappan Chandrasekar ◽  
Christopher J.D. Wallis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Advanced Disease ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cumulative Exposure ◽  
Population Based Study ◽  
The Impact

e16553 Background: Prostate cancer (PC) is the most common non-cutaneous cancer in men and the third most common cause of cancer death in males. Several studies have shown that use of commonly prescribed medications, is associated with improved survival in various malignancies, including PC. There has not been any large population-based study, examining the effects of these and other commonly prescribed medications, such as proton pump inhibitors (PPI), on the rate of PC diagnosis, PC advanced disease and PC-specific death. Methods: A retrospective population-based study using data from the institute of clinical evaluative sciences, including all male patients aged 65 and above in Ontario who have had a negative first prostate biopsy between 1994 and 2016. We assessed the impact of commonly prescribed medications on PC outcomes. The analyzed medications included Statins (hydrophilic and hydrophobic), most commonly used diabetes drugs (metformin, insulins, sulfonylureas, and thizolidinedions), PPIs, 5 alpha reductase inhibitors, and alpha blockers. Time dependent Cox regression proportional hazards models were performed to determine predictors of PC diagnosis, PC advanced disease (defined as usage of hormonal therapy), and PC-specific death. Medication exposure was time varying and modelled as “ever” vs. “never” use or as cumulative exposure. Results: A total of 21,562 men were analyzed over a mean (SD) follow-up time of 8.06 (5.44) years. Overall, 5,187 patients (24%) were diagnosed with PC, 7861 (36.5%) had died, and 647 (3%) died of PC. On multivariable analysis usage of hydrophilic statins modelled as “ever vs. never” was associated with a lower diagnosis rate (OR 0.832, 95% CI 0.732-0.946, p = 0.005) and a significantly decreased PC-specific death (OR 0.676, 95% CI 0.528-0.871, p = 0.0024). In contrast, Pantoprazole was associated with a higher rate of advanced PC disease when modelled as cumulative exposure of 6 months (OR 1.03, 95% CI 1.003-1.06, P = 0.031), and PC-specific death, when modeled as “ever vs. never” (OR 1.26, 95% CI 1.02-1.576, p = 0.031). Conclusions: Hydrophilic statins were associated with a clinically and statistically significant lower PC diagnosis and PC-specific death, while pantoprazole was associated with a higher rate of advanced PC disease and PC-specific death.

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