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Conisation as a marker of persistent human papilloma virus infection and risk of breast cancer.

https://arctichealth.org/en/permalink/ahliterature282676
Source
Br J Cancer. 2016 Aug 23;115(5):588-91
Publication Type
Article
Date
Aug-23-2016
Author
Mette Søgaard
Dora K Farkas
Anne G Ording
Henrik T Sørensen
Deirdre P Cronin-Fenton
Source
Br J Cancer. 2016 Aug 23;115(5):588-91
Date
Aug-23-2016
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - complications
Conization
Denmark
Female
Humans
Papillomavirus Infections - complications - epidemiology
Risk factors
Uterine Cervical Neoplasms - complications - therapy
Abstract
Human papillomavirus (HPV) infection may increase breast cancer (BC) risk.
To examine this, we used nationwide medical registries to identify all Danish women who underwent conisation to remove HPV-associated cervical precancerous lesions (n=87?782) from 1978 to 2013. We computed the absolute risk of BC and standardised incidence ratios (SIRs) and 95% confidence intervals (95% CIs) for breast cancer, based on national breast cancer incidence rates.
Conisation was associated with slightly increased BC incidence (SIR=1.1, 95% CI=1.0-1.1), and an absolute BC risk of 7.7% (95% CI=7.3-8.1%) in 35.9 years of follow-up. BC risk was elevated throughout follow-up, especially in the first 5 years (
Notes
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PubMed ID
27253173 View in PubMed
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Erosive reflux disease increases risk for esophageal adenocarcinoma, compared with nonerosive reflux.

https://arctichealth.org/en/permalink/ahliterature127986
Source
Clin Gastroenterol Hepatol. 2012 May;10(5):475-80.e1
Publication Type
Article
Date
May-2012
Author
Rune Erichsen
Douglas Robertson
Dora K Farkas
Lars Pedersen
Heiko Pohl
John A Baron
Henrik T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark. re@dce.au.dk
Source
Clin Gastroenterol Hepatol. 2012 May;10(5):475-80.e1
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - epidemiology
Adult
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Endoscopy, Digestive System
Esophageal Neoplasms - epidemiology
Female
Gastroesophageal Reflux - complications - pathology
Humans
Incidence
Male
Middle Aged
Risk assessment
Abstract
Gastroesophageal reflux disease is a strong risk factor for esophageal adenocarcinoma, but it is not clear whether the mucosal inflammation that develops in patients with reflux disease promotes this cancer. We determined the development of adenocarcinoma among patients who underwent esophagogastroduodenoscopy and were found to have erosive (with esophagitis) or nonerosive (without esophagitis) reflux.
We performed a nationwide cohort study using data from 33,849 patients with reflux disease (52% men; median age, 59.3 y) from population-based Danish medical registries, from 1996 through 2008. The observed incidences of adenocarcinoma were compared with the expected incidence for the general population, standardized by age, sex, and calendar time. Absolute risks were estimated using Kaplan-Meier methods.
In the study cohort, 26,194 of the patients (77%) had erosive reflux disease and 37 subsequently developed esophageal adenocarcinoma after a mean follow-up time of 7.4 years. Their absolute risk after 10 years was 0.24% (95% confidence interval [CI], 0.15%-0.32%). The incidence of cancer among patients with erosive reflux disease was significantly greater than that expected for the general population (standardized incidence ratio, 2.2; 95% CI, 1.6-3.0). In contrast, of the 7655 patients with nonerosive reflux disease, only 1 was diagnosed with esophageal adenocarcinoma after 4.5 years of follow-up evaluation (standardized incidence ratio, 0.3; 95% CI, 0.01-1.5).
Erosive reflux disease, but not nonerosive disease, increased the risk of esophageal adenocarcinoma, based on analysis of population-based Danish medical registries. Inflammation therefore might be an important factor in the progression from reflux to esophageal adenocarcinoma.
PubMed ID
22245963 View in PubMed
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Gram-negative bacteremia as a clinical marker of occult malignancy.

https://arctichealth.org/en/permalink/ahliterature286547
Source
J Infect. 2017 Feb;74(2):153-162
Publication Type
Article
Date
Feb-2017
Author
Kirstine K Søgaard
Dóra K Farkas
Mette Søgaard
Henrik C Schønheyder
Reimar W Thomsen
Henrik T Sørensen
Source
J Infect. 2017 Feb;74(2):153-162
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bacteremia - complications - epidemiology - microbiology
Cohort Studies
Denmark - epidemiology
Female
Gram-Negative Bacterial Infections - complications - epidemiology - microbiology
Hospitalization
Humans
Incidence
Male
Middle Aged
Neoplasms - complications - epidemiology
Risk assessment
Risk factors
Abstract
Gram-negative bacteremia may be a harbinger of occult cancer. We examined the risk of cancer following hospitalization with bacteremia.
Using medical databases, we conducted a nationwide population-based cohort study of all Danes with a discharge diagnosis of Gram-negative bacteremia during 1994-2013. We calculated absolute risks and standardized incidence ratios (SIRs) of cancer, comparing the observed risk to that expected in the general population.
We observed 1379 cancers vs. 988 expected among 11,753 patients with Gram-negative bacteremia, corresponding to an overall SIR of 1.40 (95% confidence interval (CI): 1.32-1.47). During the first 6 months following the bacteremia diagnosis, the SIR for cancer was 3.33-fold (95% CI: 2.99-3.69) increased, corresponding to an absolute risk of 3.05%. The increased risk stemmed mainly from higher than expected occurrence of gastrointestinal cancer (3- to 13-fold higher), genitourinary cancer (4- to 10-fold higher), non-Hodgkin lymphoma (5-fold higher), non-specified metastatic cancer (5-fold higher), and breast and lung cancer (2-fold higher). The 6-12 months SIR for any cancer was 1.46 (95% CI: 1.22-1.72), and beyond 1 year of follow-up, the SIR declined to 1.13 (95% CI: 1.05-1.20).
Gram-negative bacteremia is a clinical marker of occult cancer.
PubMed ID
27838520 View in PubMed
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Long-term clinical outcomes of patients with primary chronic immune thrombocytopenia: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature137638
Source
Blood. 2011 Mar 31;117(13):3514-20
Publication Type
Article
Date
Mar-31-2011
Author
Mette Nørgaard
Annette Ø Jensen
Malene C Engebjerg
Dóra K Farkas
Reimar W Thomsen
Steven Cha
Sean Zhao
Henrik T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Sdr Skovvej 15, Aalborg, Denmark. m.noergaard@rn.dk
Source
Blood. 2011 Mar 31;117(13):3514-20
Date
Mar-31-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Case-Control Studies
Chronic Disease
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Population
Prognosis
Purpura, Thrombocytopenic, Idiopathic - diagnosis - epidemiology - mortality
Time Factors
Young Adult
Abstract
Few data exist on the long-term prognosis of patients with chronic primary chronic immune thrombocytopenia (ITP). We examined the risk of infections, hemorrhage resulting in hospitalization, hematologic malignancies, and total and cause-specific mortality among patients with ITP compared with the general population. We used population-based medical databases to identify 407 patients with primary chronic ITP diagnosed during 1996 to 2007 and 4069 general population members individually matched on age, sex, and comorbidity level. We used Cox regression analysis to estimate rate ratios (RRs) adjusted for age (= 60 or > 60 years), sex, calendar year, and level of comorbidity. The adjusted 1-year RR of infection was 4.5 (95% confidence interval [CI], 3.3-6.1) for patients with chronic ITP compared with the general population cohort. The adjusted RR decreased to 1.8 (95% CI, 1.3-2.5) for the second to fifth year of follow-up. The adjusted 5-year RR was 3.2 (95% CI, 1.2-9.0) for hospitalized intracranial hemorrhage, 4.4 (95% CI, 2.3-8.3) for other hospitalized hemorrhages, and 4.7 (95% CI, 1.7-12.7) for hematologic malignancy. The 5-year all-cause mortality RR was 2.3 (95% CI, 1.8-3.0). In summary, primary chronic ITP was associated with substantially increased long-term risk of infections, hemorrhagic episodes requiring hospitalization, hematologic malignancies, and mortality.
PubMed ID
21263148 View in PubMed
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Long-term risk of gastrointestinal cancers in persons with gastric or duodenal ulcers.

https://arctichealth.org/en/permalink/ahliterature279403
Source
Cancer Med. 2016 06;5(6):1341-51
Publication Type
Article
Date
06-2016
Author
Kirstine K Søgaard
Dóra K Farkas
Lars Pedersen
Jennifer L Lund
Reimar W Thomsen
Henrik T Sørensen
Source
Cancer Med. 2016 06;5(6):1341-51
Date
06-2016
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Denmark - epidemiology
Duodenal Ulcer - complications
Female
Follow-Up Studies
Gastrointestinal Neoplasms - epidemiology - etiology
Humans
Incidence
Male
Middle Aged
Population Surveillance
Registries
Risk
Stomach Ulcer - complications
Abstract
Peptic ulcer predicts gastric cancer. It is controversial if peptic ulcers predict other gastrointestinal cancers, potentially related to Helicobacter pylori or shared lifestyle factors. We hypothesized that gastric and duodenal ulcers may have different impact on the risk of gastrointestinal cancers. In a nationwide cohort study using Danish medical databases 1994-2013, we quantified the risk of gastric and other gastrointestinal cancers among patients with duodenal ulcers (dominantly H. pylori-related) and gastric ulcers (dominantly lifestyle-related) compared with the general population. We started follow-up 1-year after ulcer diagnosis to avoid detection bias and calculated absolute risks of cancer and standardized incidence ratios (SIRs). We identified 54,565 patients with gastric ulcers and 38,576 patients with duodenal ulcers. Patient characteristics were similar in the two cohorts. The 1-5-year risk of any gastrointestinal cancer was slightly higher for gastric ulcers patients (2.1%) than for duodenal ulcers patients (2.0%), and SIRs were 1.38 (95% CI: 1.31-1.44) and 1.30 (95% CI: 1.23-1.37), respectively. The SIR of gastric cancer was higher among patients with gastric ulcer than duodenal ulcer (1.92 vs. 1.38), while the SIRs for other gastrointestinal cancers were similar (1.33 vs. 1.29). Compared with gastric ulcer patients, duodenal ulcer patients were at lower risk of smoking- and alcohol-related gastrointestinal cancers. The risk of nongastric gastrointestinal cancers is increased both for patients with gastric ulcers and with duodenal ulcers, but absolute risks are low. H. pylori may be less important for the development of nongastric gastrointestinal cancer than hypothesized.
PubMed ID
26923747 View in PubMed
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Lymph node enlargement and risk of haematological and solid cancer.

https://arctichealth.org/en/permalink/ahliterature117917
Source
Br J Haematol. 2013 Mar;160(5):599-607
Publication Type
Article
Date
Mar-2013
Author
Henrik Frederiksen
Claus Svaerke
Reimar W Thomsen
Dóra K Farkas
Lars Pedersen
Noel S Weiss
Henrik T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. hef@dadlnet.dk
Source
Br J Haematol. 2013 Mar;160(5):599-607
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Comorbidity
Denmark - epidemiology
Endocrine System Diseases - epidemiology
Female
Follow-Up Studies
Head and Neck Neoplasms - diagnosis - epidemiology - pathology
Humans
Incidence
Infection - epidemiology
Lymphatic Diseases - etiology
Lymphatic Metastasis - diagnosis - pathology
Lymphoma - diagnosis - epidemiology - pathology
Male
Middle Aged
Neoplasms, Unknown Primary - epidemiology
Organ Specificity
Registries - statistics & numerical data
Rheumatic Diseases - epidemiology
Risk
Young Adult
Abstract
Enlarged lymph nodes may be a marker of occult cancer, but accurate data on cancer risk are limited. We used population-based Danish medical registries to assess cancer risk in a cohort of patients with a first-time inpatient or outpatient hospital contact for enlarged lymph nodes during 1994-2008. Observed cancer incidences were compared with that expected in the general population. We observed 1750 cancers among 11284 patients with enlarged lymph nodes during median follow up of 4.7 years. Only 389 cases were expected. Cancer risk was 11.5% [95% confidence interval (CI): 10.9-12.1%] during the first year of follow up, corresponding to an age- and sex-standardized incidence ratio (SIR) of 21.1 (95% CI: 20.0-22.3). One-year SIRs were more than 100 times increased for head and neck cancer and lymphomas. Beyond one year of follow up, overall cancer risk remained 1.4-fold (95% CI: 1.3-1.5-fold) higher than expected, while risk of lymphoma remained six to 10 times higher. Cancer risk was also elevated among patients with other conditions known to be associated with enlarged lymph nodes, such as infections and rheumatic disorders. We conclude that enlarged lymph nodes are a marker of occult cancer and long-term risk of cancer.
PubMed ID
23252600 View in PubMed
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Mortality risk in splenectomised patients: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature98184
Source
Eur J Intern Med. 2010 Feb;21(1):12-6
Publication Type
Article
Date
Feb-2010
Author
Mellissa Yong
Reimar W Thomsen
W Marieke Schoonen
Dóra K Farkas
Anders Riis
Jon P Fryzek
Henrik Toft Sørensen
Author Affiliation
Global Epidemiology, Amgen Inc., Thousand Oaks, CA 91320, United States. myong@amgen.com
Source
Eur J Intern Med. 2010 Feb;21(1):12-6
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Cohort Studies
Confidence Intervals
Denmark - epidemiology
Female
Humans
Infection - etiology - mortality
Male
Middle Aged
Proportional Hazards Models
Risk
Risk factors
Sex Factors
Splenectomy - adverse effects - mortality
Abstract
BACKGROUND: The extent and magnitude of mortality risk among patients splenectomised for a variety of indications is not well-described in the literature. We assessed mortality risk among splenectomised patients compared to the general population and to un-splenectomised patients with similar underlying medical conditions. METHODS: We conducted a historical population-based cohort study in Denmark between January 1, 1996 and December 31, 2005. Mortality risk was evaluated within 90 days, 91-365 days, and >365 days post-splenectomy, controlling for age, sex, and comorbid conditions using Cox proportional hazards models for a splenectomised cohort compared to the general Danish population and a matched indication cohort. RESULTS: We identified a total of 3812 splenectomised patients, 38,120 population comparisons, and 8310 matched indication comparisons. Within 90 days post-splenectomy, the adjusted relative risk (RR) for death, regardless of indication, was highly elevated compared to the general population: RR 33.6 [95% confidence interval (CI): 6.9, 35.0]. This risk declined substantially after 90 days post-splenectomy but remained higher 365 days post-splenectomy for all indications compared to the general population. When compared to the matched indication cohort, short- and long-term mortality risk with splenectomy was not increased. CONCLUSION: Regardless of indication, the adjusted short- and long-term risk of death for splenectomised patients was higher than the general population. Most of this risk seems to be due to the underlying splenectomy indication and not to splenectomy alone.
PubMed ID
20122606 View in PubMed
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Risk of cancer in patients with inflammatory bowel diseases: a nationwide population-based cohort study with 30 years of follow-up evaluation.

https://arctichealth.org/en/permalink/ahliterature114587
Source
Clin Gastroenterol Hepatol. 2014 Feb;12(2):265-73.e1
Publication Type
Article
Date
Feb-2014
Author
Michael D Kappelman
Dora K Farkas
Millie D Long
Rune Erichsen
Robert S Sandler
Henrik T Sørensen
John A Baron
Author Affiliation
Department of Pediatrics, Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: michael_kappelman@med.unc.edu.
Source
Clin Gastroenterol Hepatol. 2014 Feb;12(2):265-73.e1
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Cohort Studies
Colitis, Ulcerative - epidemiology
Colorectal Neoplasms - epidemiology
Crohn Disease - epidemiology
Denmark - epidemiology
Gastrointestinal Neoplasms - epidemiology
Hematologic Neoplasms - epidemiology
Humans
Inflammatory Bowel Diseases
Neoplasms - epidemiology
Registries
Abstract
Data regarding the risk of gastrointestinal and extraintestinal cancers in Crohn's disease (CD) and ulcerative colitis (UC) are needed to understand the clinical course of inflammatory bowel diseases (IBDs) and their treatments.
We performed a nationwide historical cohort study using Danish health care databases. We identified patients with a diagnosis of CD or UC, recorded from 1978 through 2010, and followed them up until the first occurrence of cancer, death, or emigration. We used standardized incidence ratios (SIRs) to compare cancer incidence in CD and UC patients with that expected in the general population.
Excluding cancers diagnosed within 1 year of IBD diagnosis, 772 cases of invasive cancer occurred among 13,756 patients with CD (SIR, 1.3; 95% confidence interval [CI], 1.2-1.4) and 2331 occurred among 35,152 patients with UC (SIR, 1.1; 95% CI, 1.0-1.1). CD was associated weakly with gastrointestinal cancers (SIR, 1.2; 95% CI, 1.0-1.4) and extraintestinal cancers (SIR, 1.3; 95% CI, 1.2-1.4), with the strongest associations for hematologic malignancies (SIR, 1.9; 95% CI, 1.5-2.3), smoking-related cancers (SIR, 1.5; 95% CI, 1.3-1.8), and melanoma (SIR, 1.4; 95% CI, 1.0-1.9). Associations between UC and gastrointestinal and extraintestinal cancers were weaker (SIR, 1.1; 95% CI, 1.0-1.2; and SIR, 1.1; 95% CI, 1.0-1.1, respectively). The relative risk of extraintestinal cancers among patients with IBD was relatively stable over time, although the risk of gastrointestinal cancers decreased.
Patients with IBD, particularly CD, are at increased risk for gastrointestinal and extraintestinal malignancies. The relative risk of gastrointestinal malignancy has decreased since 1978, without a concomitant increase in the risk of nongastrointestinal malignancy.
Notes
Comment In: Clin Gastroenterol Hepatol. 2014 Feb;12(2):274-624183955
PubMed ID
23602821 View in PubMed
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Splanchnic venous thrombosis is a marker of cancer and a prognostic factor for cancer survival.

https://arctichealth.org/en/permalink/ahliterature267527
Source
Blood. 2015 Aug 20;126(8):957-63
Publication Type
Article
Date
Aug-20-2015
Author
Kirstine K Søgaard
Dóra K Farkas
Lars Pedersen
Henrik T Sørensen
Source
Blood. 2015 Aug 20;126(8):957-63
Date
Aug-20-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Denmark - epidemiology
Female
Hematologic Neoplasms - complications - mortality
Humans
Incidence
Kaplan-Meier Estimate
Liver Neoplasms - complications - mortality
Male
Middle Aged
Pancreatic Neoplasms - complications - mortality
Prognosis
Proportional Hazards Models
Registries
Risk factors
Splanchnic Circulation
Venous Thrombosis - epidemiology - etiology
Abstract
It is unknown if splanchnic venous thrombosis (SVT) is a marker of occult cancer and a prognostic factor for cancer survival. Using Danish medical registries, we conducted a nationwide cohort study including all patients with first-time SVT (n = 1191) between 1994 and 2011. We followed the patients for subsequent cancer diagnoses and calculated absolute risks and standardized incidence ratios (SIRs). We formed a matched comparison cohort of cancer patients without SVT, and assessed the prognostic impact of SVT on cancer survival by applying the Kaplan-Meier method and Cox regression. We followed the patients for a median of 1.6 years, and found that SVT was a marker of occult cancer. The 3-month cancer risk was 8.0% and the SIR was 33 (95% confidence interval, 27-40), compared with the general population. Increased risk was mainly found for liver cancer (risk = 3.5%; SIR = 1805), pancreatic cancer (risk = 1.5%; SIR = 256), and myeloproliferative neoplasms (risk = 0.7%; SIR = 764). The overall SIR remained increased twofold after 1 or more years of follow-up. SVT was also a prognostic factor for survival in patients with liver and pancreatic cancer. The clinical impact may be a more thorough diagnostic work-up in patients presenting with SVT.
Notes
Comment In: Blood. 2015 Aug 20;126(8):926-726294713
PubMed ID
26089394 View in PubMed
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