scholarly journals Incidence trends in bladder and lung cancers between Denmark, Finland and Sweden may implicate oral tobacco (snuff/snus) as a possible risk factor

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Hemminki ◽  
Asta Försti ◽  
Akseli Hemminki ◽  
Börje Ljungberg ◽  
Otto Hemminki
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Risk Factor ◽  
Smoking Prevalence ◽  
Urinary Bladder Cancer ◽  
Lung Cancers ◽  
Cancer Data ◽  
Incidence Trends ◽  
The Difference ◽  
Tobacco Specific Nitrosamines

Abstract Background The dominant risk factor for urinary bladder cancer has been cigarette smoking, but, as smoking prevalence is decreasing in many populations, other risk factors may become uncovered. Such new risk factors could be responsible for halting the declining incidence of bladder cancer. We hypothesize that snuff use by Swedish men may increase the rate for bladder cancer, as snuff contains carcinogenic nitrosamines. Methods We carried out an ecological study by comparing incidence trends in lung and bladder cancers between Danish, Finnish and Swedish men in order to test if the Swedish bladder cancer rate deviates from the Danish and Finnish ones. We used the NORDCAN database for cancer data from 1960 through 2016 to test the hypothesis. Results In the three countries, the incidence of lung cancer started to decrease after a peak incidence, and this was later followed by declining incidence in bladder cancer in Denmark from 1990 to 2016 by 14.3%, in Finland by 8.3% but not in Sweden (the decline of 1.4% was not significant). The difference in trends can be partly explained by the increasing incidence in Swedish men aged 70 or more years. Sweden differs from the two other countries by low male smoking prevalence but increasing use of snuff recorded by various surveys. Conclusion The stable bladder cancer trend for Swedish men was opposite to the declining trends in Denmark, Finland and globally. We suggest that this unusual finding may be related to the increasing use of snuff by Swedish men. Average users of snuff are exposed to at least 3 times higher levels of carcinogenic tobacco-specific nitrosamines than a smoker of one daily pack of cigarettes.

scholarly journals Thromboembolism in Muscle-Invasive Bladder Cancer. A Population-based Nationwide Study

2021 ◽  
pp. 1-11
Author(s):  
Staffan Jahnson ◽  
Truls Gårdmark ◽  
Abolfazl Hosseini ◽  
Tomas Jerlström ◽  
Fredrik Liedberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Cumulative Incidence ◽  
Cox Regression ◽  
Clinical Stage ◽  
Urinary Bladder Cancer ◽  
Population Based ◽  
Vte Prophylaxis ◽  
Cancer Data ◽  
Muscle Invasive

BACKGROUND: Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking. OBJECTIVE: To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy. MATERIALS AND METHODS: We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE. RESULTS: In 9720 patients (71%males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patient’s and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease. CONCLUSIONS: VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken.

Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011990
Author(s):  
Liisa Karjalainen ◽  
Minna Tikkanen ◽  
Kirsi Rantanen ◽  
Karoliina Aarnio ◽  
Aino Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postpartum Period ◽  
First Trimester ◽  
Class Iii ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Factor Management ◽  
Incidence Trends ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

Abstract P115: How Many Coronary Heart Disease Deaths In Poland In 2020 Might Be Prevented By Further Reductions In Population Risk Factor Levels?

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Piotr Bandosz ◽  
Maria Guzman-Castillo ◽  
Simon Capewell ◽  
Tomasz Zdrojewski ◽  
Julia Critchley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Smoking Prevalence ◽  
Mortality Rates ◽  
Mortality Reduction ◽  
Scenario Reduction ◽  
Saturated Fats ◽  
Changes In Risk

Background: Poland has experienced one of the most dramatic declines in coronary heart disease (CHD) mortality rates in recent decades. This decline reflects the use of evidence based treatments and, crucially, population wide changes in diet. Our aim is to explore the potential for further gains in Poland by achieving population wide reductions in smoking, dietary salt and saturated fat intake and physical inactivity levels. Methods: A validated and updated policy model was used to forecast potential decreases in CHD deaths by 2020 as consequence of lifestyle and dietary changes in the population. Data from the most recent Polish risk factor survey was used for the baseline (2011). We modeled two different policy scenarios regarding possible future changes in risk factors: A) conservative scenario: reduction of smoking prevalence and physically inactivity rates by 5% between 2011 and 2020, and reduction of dietary consumption of energy from saturated fats by 1% and of salt by 10%. B) ideal scenario: reduction of smoking and physically inactivity prevalence by 15%, and dietary reduction of energy from saturated fats by 3% and of salt by 30%. We also conducted extensive sensitivity analysis using different counterfactual scenarios of future mortality trends. Results: Baseline scenarios. By assuming continuing declines in mortality and no future improvements in risk factors the predicted number of CHD deaths in 2020 would be approximately 13,600 (9,838-18,184) while if mortality rates remain stable, the predicted number of deaths would approximate 22,200 (17,792-26,688). Conservative scenario. Assuming continuing declines in mortality, small changes in risk factors could result in approximately 1,500 (688-2,940) fewer deaths. This corresponds to a 11% mortality reduction. Under the ideal scenario, our model predicted some 4,600 (2,048-8,701) fewer deaths (a 34% mortality reduction). Reduction in smoking prevalence by 5% (conservative scenario) or 15% (ideal scenario) could result in mortality reductions of 4.5% and 13.8% respectively. Decreases in salt intake by 10% or 30% might reduce CHD deaths by 3.0% and 8.6% respectively. Replacing 1% or 3% of dietary saturated fats by poly-unsaturates could reduce CHD deaths by 2.6% or 7.7% Lowering the prevalence of physically inactive people by 5%-15% could decrease CHD deaths by 1.2%-3.7%. Conclusion: Small and eminently feasible population reductions in lifestyle related risk factors could substantially decrease future number of CHD deaths in Poland, thus consolidating the earlier gains.

Donor Selection For Haploidentical Hematopoietic Stem Cell Transplantation: Who Is The Better – Donor-Recipient Risk Factor Analysis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 705-705
Author(s):  
Yu Wang ◽  
Xiao Jun Huang
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Stem Cell ◽  
Lower Incidence ◽  
Family Relationship ◽  
Donor Age ◽  
Sibling Donor ◽  
The Difference ◽  
Grade 3

Abstract Background many aspects should be considered when selecting an ideal donor. The progress made in haploidentical HSCT in recent years offers almost unlimited donor and availabilities of more than one donor at many occasions. To date, there have been no studies to answer the question of apart from HLA disparity, whether one donor should be preferred over another among various haploidentical donors available. The goal of the current study was to attempt to answer the question by analyzing the data on haploidentical HSCT without in-vitro T cell depletion modality. Methods Consecutive patients with leukemia or MDS who received HSCT from 3-5 of 6 HLA loci-matched family donors excluding collateral relatives between May 2002 and December 2010 were enrolled in this study (n=749). The stem cell source was G-CSF mobilized BM combined with PB. The conditioning regimen was modified BUCY plus ATG with 10mg/kg in total dosage. Patients receiving prophylactic DLI for prevention of leukemia relapse were excluded. Donor-recipient risk factors relevant to selection of optimal donor for haploidentical HCT were analyzed. Results (1)donor sex: male donor had lower incidence of both grade 2-4 (39% vs. 46%, p=.07) and grade 3-4 acute GVHD (aGVHD) (11% vs. 17%, p=.04), lower rate of NRM (16% vs. 24%, p=.006) and higher probabilities of OS (70% vs. 62%, p=.02) and LFS (67% vs. 60%, p=.03), compared with female donor. In multivariate analysis, donor sex was still a risk factor for GVHD, NRM and survival. However, if mother donor was excluded, all the difference became no longer significant. (2) Donor age: donor younger than 30 years old had lower incidence of both grade 2-4 (25% vs. 48%, p<.0001) and grade 3-4 aGVHD (5% vs. 16%, p=.0005), lower rate of NRM (12% vs. 22%, p=.007) and higher probabilities of OS (78% vs. 64%, p=.001) and LFS (76% vs. 64%, p=.002), compared with donor older than 30 years old. In multivariate analysis, donor age was a more prominent risk factor for GVHD, NRM and survival compared with donor sex. And if mother donor was excluded, all the difference remained significant both in univariate and multivariate analysis. (3)The rate of GVHD was not associated with the extent of HLA disparity or any individual allele disparity. (4) comparison between mother and father: father donor had lower incidence of both grade 2-4 (45% vs. 56%, p=.03) and grade 3-4 aGVHD (13% vs. 22%, p=.007), lower rate of NRM (14% vs. 26%, p=.003) and higher probabilities of OS (70% vs. 57%, p=.007) and LFS (67% vs. 57%, p=.03), compared with mother donor. In multivariate analysis, mother donor was still a risk factor for GVHD, NRM and survival. (5) comparison between offspring and sibling: offspring donor had significant lower incidence of grade 2-4 aGVHD (16% vs. 37%, p=.002), lower NRM and higher survival, although not reaching statistical significance, compared with sibling donor. In multivariate analysis, sibling donor was still a risk factor for GVHD. (6) comparison among sibling and father donors: donor older than 30 years old was the most important risk factor affecting GVHD, NRM and survival while the rates between father and sibling donor were comparable. Conclusions Not abiding by the rule of HLA disparity, this study was the first one to confirm that significant different outcomes were achieved among various haploidentical donors and proved once again that haploidentical HSCT overcame HLA barriers. Instead of HLA disparity, donor age and the family relationship were important risk factors under our treatment modality. The underlying mechanisms of crossing human leukocyte antigen barriers need further investigation and to be validated by other treatment modalities. Figure impact of donor age and family relationship on GVHD This work was partly supported by The Key Program of National Natural Science Foundation of China (Grant No. 81230013), Beijing Municipal Science & Technology Commission (No.Z121107002812033) and Beijing Municipal Science & Technology Commission(No. Z121107002612035). Disclosures: No relevant conflicts of interest to declare.

Risk Model Predictive of Severe Anemia Requiring RBC Transfusion After Chemotherapy in Pediatric Solid Tumor Patients

2003 ◽  
Vol 21 (22) ◽  
pp. 4235-4238 ◽  
Author(s):  
Perrine Marec-Berard ◽  
Jean Yves Blay ◽  
Matthias Schell ◽  
Murielle Buclon ◽  
Corrine Demaret ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Lymphocyte Count ◽  
Risk Model ◽  
Pediatric Population ◽  
Performance Status ◽  
Univariate Analysis ◽  
Absolute Lymphocyte Count ◽  
The Difference ◽  
Rbc Transfusion

Purpose: Severe anemias requiring RBC transfusions is a frequent complication of chemotherapy. A model elaborated by Ray-Coquard et al in adults pointed to three independent risk factors for RBC transfusion: performance status (PS) more than 1, hemoglobin less than 12 g/dL, and prechemotherapy absolute lymphocyte count (ALC) ≤ 700/μL. This model is tested on a pediatric population.Patients and Methods: One hundred nineteen children with solid tumors consecutively admitted for conventional chemotherapy throughout 1 year were included. The study end point was the RBC-transfusion risk in the month following chemotherapy. Only one course was considered for each patient. Age, sex, number of courses, platinum-containing regimens, PS, and hemoglobin and lymphocyte count at day 1 were tested in univariate and multivariate analyses.Results: Thirty-one (26%) of 119 children required RBC transfusion within 31 days of chemotherapy. Three factors correlated to transfusion risk in the univariate analysis: PS more than 1 (P < .001), hemoglobin less than 12 g/dL (P = .007), and pretreatment ALC ≤ 700/μL (P < .001). In the multivariate analysis, hemoglobin less than 12 g/dL, PS more than 1, and ALC ≤ 700/μL were identified as independent factors predicting RBC transfusion. The calculated probability of receiving RBC transfusion within 31 days of chemotherapy was high with three risk factors (96%), intermediate with two risk factors (53% to 77%), low with one risk factor (10% to 26%), and very low when no risk factor was present (2%). The difference of transfusion needs was significant (P < .001).Conclusion: The risk model elaborated for adults may also segregate children at high risk of postchemotherapy RBC transfusion, thus facilitating assessment of risk of transfusion and/or prophylactic erythropoietin support.

scholarly journals Survival of patients with urinary bladder cancer in Jordan, 2005–2014

2021 ◽  
Vol 27 (07) ◽  
pp. 648-655
Author(s):  
Nour Abdo ◽  
Majd Alsoukhni ◽  
Anwar Batieha ◽  
Kamal Arqoub
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Urinary Bladder ◽  
National Level ◽  
Urinary Bladder Cancer ◽  
Developed Countries ◽  
Cancer Data ◽  
Factors Associated ◽  
Survival Probabilities ◽  
Significant Difference

Background: Urinary bladder cancer is the fourth most common cancer in Jordan. No research on survival from bladder cancer at the national level has been conducted before. Aims: This study aimed to estimate the probability of survival in patients with bladder cancer in Jordan and identify factors associated with survival. Methods: Data were obtained from the database of the Jordan cancer registry. All cases of urinary bladder cancer in Jordanians registered during 2005–2014 were included in the study (n = 2139). Data collected for each case included: age, sex, date of diagnosis, and stage and grade at diagnosis. Actuarial life table survival analysis was used to determine the overall survival probabilities. Cox proportional hazard regression was used to identify independent factors associated with survival. Results: The overall 1-, 3-, 5- and 10-year survival probabilities for urinary bladder cancer were 85%, 73%, 69% and 59%, respectively (standard error = 0.01 for each). No significant difference in survival probabilities was found between males and females (P = 0.642). The overall survival probabilities decreased significantly as age at diagnosis increased (P < 0.005). Better survival was observed in patients with early stage and well differentiated tumours at diagnosis. Conclusions: The survival of patients with bladder cancer in Jordan is comparable to that reported from developed countries. A high percentage of data was missing and the reporting of some variables was inconsistent. To improve the quality of cancer data, regular training is needed for hospital focal points on recording complete data

Sign in / Sign up

Export Citation Format

Share Document