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A 25-year follow-up of a population screened with faecal occult blood test in Finland.

https://arctichealth.org/en/permalink/ahliterature161415
Source
Acta Oncol. 2007;46(8):1103-6
Publication Type
Article
Date
2007
Author
Nea Malila
Matti Hakama
Eero Pukkala
Author Affiliation
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu 21 B, FI-001 70 Helsinki, Finland. nea.malila@cancer.fi
Source
Acta Oncol. 2007;46(8):1103-6
Date
2007
Language
English
Publication Type
Article
Keywords
Cohort Studies
Colorectal Neoplasms - diagnosis - epidemiology - mortality
Feasibility Studies
Female
Finland
Follow-Up Studies
Humans
Incidence
Male
Mass Screening - methods
Occult Blood
Patient compliance
Reagent kits, diagnostic
Sensitivity and specificity
Abstract
The aim of the study was to assess the feasibility of and possible selection to attend in colorectal cancer screening.
During the years 1979-1980, 1 785 men and women (born in 1917-1929) were invited to a pilot screening project for colorectal cancer. The screening method used was a guaiac-based faecal occult blood test repeated once if the initial test was positive.
Compliance was 69% and the test was positive in 19% of those attending. In a record linkage with the Finnish Cancer Registry, 47 colorectal cancer cases and 24 deaths from colorectal cancer were observed by the end of 2004. In all, the particular test method was not regarded specific enough for population screening. There was, however, no difference in cancer incidence between those who complied and those who did not when compared to the general population of same age and gender.
Compliance was found high enough to make screening feasible and there was no self selection of persons with low cancer risk to attend screening.
PubMed ID
17851857 View in PubMed
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[A certain increase of skin cancer among pilots].

https://arctichealth.org/en/permalink/ahliterature184428
Source
Lakartidningen. 2003 Jun 26;100(26-27):2297-9
Publication Type
Article
Date
Jun-26-2003
Author
Niklas Hammar
Harald Eliasch
Anette Linnersjö
Bo-Göran Dammström
Maritha Johansson
Eero Pukkala
Author Affiliation
Enheten för epidemiologi, Institutet för miljömedicin, Karolinska institutet, Stockholm. niklas.hammar@imm.ki.se
Source
Lakartidningen. 2003 Jun 26;100(26-27):2297-9
Date
Jun-26-2003
Language
Swedish
Publication Type
Article
Keywords
Aerospace Medicine - manpower
Aircraft
Cosmic Radiation - adverse effects
Humans
Incidence
Male
Melanoma - epidemiology - etiology
Neoplasms, Radiation-Induced - epidemiology - etiology
Occupational Exposure - adverse effects
Registries
Risk factors
Scandinavia - epidemiology
Skin Neoplasms - epidemiology - etiology
Notes
Comment In: Lakartidningen. 2003 Jun 26;100(26-27):2278-912872371
PubMed ID
12872376 View in PubMed
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Acute myeloid leukemia following Hodgkin lymphoma: a population-based study of 35,511 patients.

https://arctichealth.org/en/permalink/ahliterature16487
Source
J Natl Cancer Inst. 2006 Feb 1;98(3):215-8
Publication Type
Article
Date
Feb-1-2006
Author
Sara J Schonfeld
Ethel S Gilbert
Graça M Dores
Charles F Lynch
David C Hodgson
Per Hall
Hans Storm
Aage Andersen
Eero Pukkala
Eric Holowaty
Magnus Kaijser
Michael Andersson
Heikki Joensuu
Sophie D Fosså
James M Allan
Lois B Travis
Author Affiliation
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-7238, USA.
Source
J Natl Cancer Inst. 2006 Feb 1;98(3):215-8
Date
Feb-1-2006
Language
English
Publication Type
Article
Keywords
Adult
Antineoplastic Agents - administration & dosage - adverse effects
Confounding Factors (Epidemiology)
Female
Finland - epidemiology
Hodgkin Disease - drug therapy - therapy
Humans
Incidence
Leukemia, Myelocytic, Acute - chemically induced - epidemiology
Male
Middle Aged
Neoplasms, Second Primary - chemically induced - epidemiology
North America - epidemiology
Ontario - epidemiology
Poisson Distribution
Registries
Research Design
Research Support, N.I.H., Intramural
Risk assessment
SEER Program
Scandinavia - epidemiology
Abstract
Treatments for Hodgkin lymphoma are associated with large relative risks of acute myeloid leukemia (AML), but there are few estimates of the excess absolute risk (EAR), a useful measure of disease burden. One-year Hodgkin lymphoma survivors (N = 35,511) were identified within 14 population-based cancer registries in Nordic countries and North America from January 1, 1970, through December 31, 2001. We used Poisson regression analysis to model the EAR of AML, per 10,000 person-years. A total of 217 Hodgkin lymphoma survivors were diagnosed with AML (10.8 expected; unadjusted EAR = 6.2; 95% confidence interval = 5.4 to 7.1). Excess absolute risk for AML was highest during the first 10 years after Hodgkin lymphoma diagnosis but remained elevated thereafter. In subsequent analyses, adjusted for time since Hodgkin lymphoma diagnosis and presented for the 5-9 year interval, the EAR was statistically significantly (P or = 35 age groups, respectively), which may be associated with modifications in chemotherapy.
PubMed ID
16449681 View in PubMed
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Age-time risk patterns of solid cancers in 60 901 non-Hodgkin lymphoma survivors from Finland, Norway and Sweden.

https://arctichealth.org/en/permalink/ahliterature102725
Source
Br J Haematol. 2014 Mar;164(5):675-83
Publication Type
Article
Date
Mar-2014
Author
Justo Lorenzo Bermejo
Eero Pukkala
Tom B Johannesen
Jan Sundquist
Kari Hemminki
Source
Br J Haematol. 2014 Mar;164(5):675-83
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Female
Finland - epidemiology
Follow-Up Studies
Humans
Incidence
Lymphoma, Non-Hodgkin - epidemiology - therapy
Male
Middle Aged
Neoplasms, Second Primary - epidemiology - etiology
Norway - epidemiology
Registries
Risk Assessment - methods
Sweden - epidemiology
Time Factors
Abstract
Survival after non-Hodgkin lymphoma (NHL) has increased thanks to improved treatment but NHL survivors have an increased risk of second neoplasms. The assessment of cancer risk patterns after NHL may help to quantify the late side-effects of therapy. Poisson regression was used to estimate relative risks (RRs) and absolute incidence rates for nine solid tumours based on a nationwide cohort of 60 901 NHL survivors from Finland, Norway and Sweden. Patients were diagnosed between 1980 and 2006 and developed 6815 s neoplasms. NHL patients showed an increased risk of each of the nine investigated cancer sites: prostate and pancreas (both RRs 1·28), breast (1·37), colorectum (1·48), urinary bladder (1·52), stomach and lung (both RRs 1·87), skin (melanoma 2·27) and kidney (2·56). The RRs showed a U-shaped relationship with time after NHL for all nine-second cancer types. NHL diagnosis early in life was a risk factor for the development of second cancers with the exception of melanoma, but a risk excess was even observed in patients diagnosed with NHL at age 80+ years. The present study provides accurate estimates on the adverse late effects of NHL therapy, which should guide the establishment of cancer prevention strategies in NHL survivors.
PubMed ID
24528128 View in PubMed
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Anticoagulants and Breast Cancer Survival: A Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature308486
Source
Cancer Epidemiol Biomarkers Prev. 2020 01; 29(1):208-215
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2020
Author
Pete T Kinnunen
Mika O Murto
Miia Artama
Eero Pukkala
Kala Visvanathan
Teemu J Murtola
Author Affiliation
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. pete.kinnunen@tuni.fi.
Source
Cancer Epidemiol Biomarkers Prev. 2020 01; 29(1):208-215
Date
01-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Anticoagulants - therapeutic use
Breast Neoplasms - complications - mortality
Drug Prescriptions - statistics & numerical data
Female
Finland - epidemiology
Follow-Up Studies
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Middle Aged
Registries - statistics & numerical data
Retrospective Studies
Risk factors
Survival Analysis
Venous Thromboembolism - drug therapy - epidemiology - etiology
Warfarin - therapeutic use
Abstract
Various components of the coagulation cascade have been linked to breast cancer progression. In vivo results suggest that anticoagulants possess anticancer properties, but there are virtually no studies in human populations. Our nationwide study explored the association between anticoagulant use and breast cancer survival.
All anticoagulants used from 1995 to 2015 in women (n = 73,170) diagnosed with invasive breast cancer in Finland between 1995 and 2013 were identified from the national prescription database; women were identified from the Finnish Cancer Registry. Cox regressions were performed to analyze breast cancer survival as a function of pre- and postdiagnostic anticoagulant use; analyses were conducted for different anticoagulant subtypes and overall. Models were adjusted for age, mammography screening, tumor clinical characteristics, comorbidities, statin use, antidiabetic use, and antihypertensive use. To control for immortal time bias, postdiagnostic anticoagulant use was analyzed as a time-dependent variable.
At a median of 5.8 years after breast cancer diagnosis, 10,900 (15%) women had died from breast cancer. In total, 25,622 (35%) women had used anticoagulants during the study period. Postdiagnostic anticoagulant use increased the risk of breast cancer death (HR = 1.41; 95% confidence interval, 1.33-1.49). The risk was especially high for low-molecular weight heparin, although the effect disappeared in long-term users.
Anticoagulant use provides no clinical benefit for breast cancer survival; however, the association between thrombosis and cancer might mask potential survival benefits.
Future pharmacoepidemiologic studies should adjust for anticoagulant use. Research should focus on the use of new oral anticoagulants because these are rarely studied and might be associated with improved breast cancer survival.
PubMed ID
31653681 View in PubMed
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Assessing the effect of treatment duration on the association between anti-diabetic medication and cancer risk.

https://arctichealth.org/en/permalink/ahliterature265055
Source
PLoS One. 2014;9(11):e113162
Publication Type
Article
Date
2014
Author
Anna But
Haining Wang
Satu Männistö
Eero Pukkala
Jari Haukka
Source
PLoS One. 2014;9(11):e113162
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Body mass index
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - drug therapy
Diabetes Mellitus, Type 2 - drug therapy
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys - methods - statistics & numerical data
Humans
Hypoglycemic agents - therapeutic use
Incidence
Male
Middle Aged
Neoplasms - epidemiology
Registries - statistics & numerical data
Risk Assessment - methods - statistics & numerical data
Risk factors
Smoking
Time Factors
Abstract
Most studies that have evaluated the association between anti-diabetic medication and cancer risk have suffered from methodological drawbacks. To avoid time-related biases, we evaluated the effect of treatment duration on the cancer risk among naive users of anti-diabetic medication as compared to non-users. In addition, we addressed the influence of common risk factors such as smoking and BMI. The study population comprised 23,394 participants of FINRISK surveys. Data on cancer and anti-diabetic medication were linked with the study cohorts. We applied Lexis tabulation to the data and analyzed split records by using Poisson regression. Changes in cancer incidence in relation to treatment duration were examined by modeling the rate ratio (RR). After a median follow-up of 9 years, 53 cancer cases among users of anti-diabetic medication and 1,028 among non-users were diagnosed. No significant difference in cancer risk between users and non-users was observed after adjustment. The RR for all medication regardless of its duration was 1.01 [95% CI 0.75-1.33], and 1.37 [0.94-1.94] for period of 1-4 years. The results were similar for metformin, sulfonylurea, and insulin. This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk.
Notes
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PubMed ID
25419576 View in PubMed
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Association between Epstein-Barr virus infection and risk for development of pregnancy-associated breast cancer: Joint effect with vitamin D?

https://arctichealth.org/en/permalink/ahliterature99290
Source
Eur J Cancer. 2010 Aug 4;
Publication Type
Article
Date
Aug-4-2010
Author
Calypse B Agborsangaya
Tuula Lehtinen
Adetunji T Toriola
Eero Pukkala
Helja-Marja Surcel
Rosamaria Tedeschi
Matti Lehtinen
Author Affiliation
Tampere School of Public Health, University of Tampere, Tampere, Finland; National Institute for Health and Welfare, Oulu, Finland.
Source
Eur J Cancer. 2010 Aug 4;
Date
Aug-4-2010
Language
English
Publication Type
Article
Abstract
BACKGROUND: Few studies have evaluated the role of the ubiquitous Epstein-Barr virus (EBV) infection, together with levels of the immunomodulator, vitamin D, in different breast cancer entities. We studied, prospectively, the association of EBV and vitamin D status with the risk of pregnancy-associated breast cancer (PABC), breast cancer diagnosed during pregnancy or 1year post-partum, using a nested case-control study. METHODS: Serum vitamin D and antibodies to EBV were measured for 108 PABC cases of the Finnish Maternity Cohort, and 208 controls matched for date of birth, date of sampling and parity. The joint effect of vitamin D and EBV on the risk of PABC was evaluated. RESULTS: EBV seropositivity was generally not associated with the risk of PABC. Among individuals with sufficient (75nmol/l) levels of vitamin D, we, however, found similar increased risk estimates for PABC associated with serum immunoglobulin G (IgG) antibodies to EBV early antigens [odds ratio (OR)=7.7, 95% (confidence interval) CI 1.4-42.3] and the viral reactivator protein, ZEBRA (OR=7.8, 95% CI 1.1-61.2). CONCLUSION: Immunological markers of EBV reactivation status among individuals with sufficient vitamin D levels were consistently associated with increased risk of the disease. This suggests that EBV reactivation may be an indicator of the progression of breast cancer occurring soon after pregnancy, while the virus probably is not the aetiological agent.
PubMed ID
20691583 View in PubMed
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Associations between three types of maternal bacterial infection and risk of leukemia in the offspring.

https://arctichealth.org/en/permalink/ahliterature16817
Source
Am J Epidemiol. 2005 Oct 1;162(7):662-7
Publication Type
Article
Date
Oct-1-2005
Author
Matti Lehtinen
Helga M Ogmundsdottir
Aini Bloigu
Timo Hakulinen
Elina Hemminki
Margret Gudnadottir
Anne Kjartansdottir
Jorma Paavonen
Eero Pukkala
Hrafn Tulinius
Tuula Lehtinen
Pentti Koskela
Author Affiliation
National Public Health Institute, Helsinki, Finland. llmale@uta.fi
Source
Am J Epidemiol. 2005 Oct 1;162(7):662-7
Date
Oct-1-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Case-Control Studies
Child
Child, Preschool
Chlamydia Infections - epidemiology
Enzyme-Linked Immunosorbent Assay
Female
Finland - epidemiology
Follow-Up Studies
Helicobacter Infections - epidemiology
Helicobacter pylori
Humans
Iceland - epidemiology
Immunoglobulin G - analysis
Immunoglobulin M - analysis
Infant
Infant, Newborn
Leukemia, Lymphocytic, Acute - epidemiology - microbiology
Logistic Models
Pneumonia, Mycoplasma - epidemiology
Population Surveillance
Pregnancy
Pregnancy Complications, Infectious - epidemiology - microbiology
Pregnancy Trimester, First
Registries
Research Support, Non-U.S. Gov't
Risk factors
Abstract
A case-control study was nested within two maternity cohorts with a total of 7 million years of follow-up for assessment of the role of bacterial infections in childhood leukemia. Offspring of 550,000 mothers in Finland and Iceland were combined to form a joint cohort that was followed for cancer up to age 15 years during 1975-1997 through national cancer registries. For each index mother-case pair, three or four matched control mother-control pairs were identified from population registers. First-trimester serum samples were retrieved from mothers of 341 acute lymphoblastic leukemia cases and 61 other leukemia cases and from 1,212 control mothers. Sera were tested for antibodies to the genus Chlamydia, Helicobacter pylori, and Mycoplasma pneumoniae. Odds ratios and 95% confidence intervals, adjusted for sibship size, were calculated as estimates of relative risk. M. pneumoniae immunoglobulin M appeared to be associated with increased risk (odds ratio (OR) = 1.6), but the association lost statistical significance when the specificity of the immunoglobulin M was considered (OR = 1.5, 95% confidence interval: 0.9, 2.4). In Iceland, H. pylori immunoglobulin G was associated with increased risk of childhood leukemia in offspring (OR = 2.8, 95% confidence interval: 1.1, 6.9). Since H. pylori immunoglobulin G indicates chronic carriage of the microorganism, early colonization of the offspring probably differs between Iceland and Finland, two affluent countries.
PubMed ID
16120707 View in PubMed
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Basal cell carcinoma of the eyelid in Finland during 1953-97.

https://arctichealth.org/en/permalink/ahliterature175502
Source
Acta Ophthalmol Scand. 2005 Apr;83(2):215-20
Publication Type
Article
Date
Apr-2005
Author
Ville Paavilainen
Juhani Tuominen
Eero Pukkala
K Matti Saari
Author Affiliation
Department of Ophthalmology, University of Turku, Turku, Finland.
Source
Acta Ophthalmol Scand. 2005 Apr;83(2):215-20
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Carcinoma, Basal Cell - epidemiology - pathology
Child
Child, Preschool
Eyelid Neoplasms - epidemiology - pathology
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Occupations
Registries - statistics & numerical data
Sex Distribution
Skin Neoplasms - epidemiology - pathology
Social Class
Abstract
To study the incidence of basal cell carcinoma (BCC) of the eyelid in Finland.
We studied 6241 cases of BCC of the eyelid reported to the nationwide Finnish Cancer Registry during 1953-97. We determined the age- and sex- specific incidence rates and overall rates adjusted for age to the world standard population, and social class- and occupation-specific standardized incidence ratios, with the total Finnish population as reference.
The incidence rates of BCC of the eyelid varied between 0.7 and 3.0 per 100 000 person-years in men and between 0.5 and 2.8 per 100 000 person-years in women during the study period. The age-adjusted incidence rates of BCC of the eyelid increased during 1953-87 (p
PubMed ID
15799736 View in PubMed
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Biobanks and registers in epidemiologic research on cancer.

https://arctichealth.org/en/permalink/ahliterature100277
Source
Methods Mol Biol. 2011;675:127-64
Publication Type
Article
Date
2011
Author
Eero Pukkala
Author Affiliation
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland. eero.pukkala@cancer.fi
Source
Methods Mol Biol. 2011;675:127-64
Date
2011
Language
English
Publication Type
Article
Abstract
The Nordic countries have a long tradition of register-based epidemiologic studies. Numerous population-based specialized registers offer high-quality data from individuals, and the extensive use of register data further improves the quality of the registers. Unique personal identity codes given to every resident and used in all registers guarantee easy and accurate record linkage. A legislation that makes the use of the existing data possible for purposes that benefit both registered individuals and the society - instead of forcing researchers to use their energy in repeated questionnaire studies, disturbing individuals' privacy and leading to response and recall biases - is a prerequisite for effective epidemiologic research. Biobanks can be considered an additional type of registers. They may offer data from individuals that cannot be reliably collected via questionnaire surveys. In turn, other types of registers are crucial in biobank-based studies (1) in defining for how long the persons in biobank cohorts are at risk of getting the diseases, (2) to get information on cofactors that may modify the relative risk measured by the biomarkers, and (3) to get information on the long-term outcome events. This chapter describes the possibilities of register use mainly in Finland - a typical representative of the Nordic "paradise of register-based epidemiological research" - in research of cancer etiology. The ongoing Nordic research project Changing work life and cancer risk in the Nordic countries (NOCCA) will be described as an example of a massive register use, including both direct linkages on an individual level and indirect group level linkages.
PubMed ID
20949386 View in PubMed
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214 records – page 1 of 22.