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Absolute and relative risk of cardiovascular disease in men with prostate cancer: results from the Population-Based PCBaSe Sweden.

https://arctichealth.org/en/permalink/ahliterature96622
Source
J Clin Oncol. 2010 Jul 20;28(21):3448-56
Publication Type
Article
Date
Jul-20-2010
Author
Mieke Van Hemelrijck
Hans Garmo
Lars Holmberg
Erik Ingelsson
Ola Bratt
Anna Bill-Axelson
Mats Lambe
Pär Stattin
Jan Adolfsson
Author Affiliation
King's College London, London, United Kingdom. mieke.vanhemelrijck@kcl.ac.uk
Source
J Clin Oncol. 2010 Jul 20;28(21):3448-56
Date
Jul-20-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Androgen Antagonists - adverse effects
Cardiovascular Diseases - etiology
Gonadotropin-Releasing Hormone - adverse effects - analogs & derivatives - therapeutic use
Humans
Male
Middle Aged
Prostatic Neoplasms - complications - drug therapy
Risk
Abstract
PURPOSE: Cardiovascular disease (CVD) is a potential adverse effect of endocrine treatment (ET) for prostate cancer (PC). We investigated absolute and relative CVD risk in 76,600 patients with PC undergoing ET, curative treatment, or surveillance. METHODS: PCBaSe Sweden is based on the National Prostate Cancer Register, which covers more than 96% of PC cases. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) of ischemic heart disease (IHD), acute myocardial infarction (MI), arrhythmia, heart failure, and stroke were calculated to compare observed and expected (using total Swedish population) numbers of CVD, taking into account age, calendar time, and previous CVD. RESULTS: Between 1997 and 2007, 30,642 patients with PC received primary ET, 26,432 curative treatment, and 19,527 surveillance. SIRs for CVD were elevated in all men with the highest for those undergoing ET, independent of circulatory disease history (SIR MI for men without circulatory disease history: 1.40 [95% CI, 1.31 to 1.49], 1.15 [95% CI, 1.01 to 1.31], and 1.20 [95% CI, 1.11 to 1.30] for men undergoing ET, curative treatment, and surveillance, respectively). Absolute risk differences (ARD) showed that two (arrhythmia) to eight (IHD) extra cases of CVD would occur per 1,000 person-years. SMRs showed similar patterns, with ARD of zero (arrhythmia) to three (IHD) per 1,000 person-years. CONCLUSION: Increased relative risks of nonfatal and fatal CVD were found among all men with PC, especially those treated with ET. Because ET is currently the only effective treatment for metastatic disease and the ARDs were rather small, our findings indicate that CVD risk should be considered when prescribing ET but should not constitute a contraindication when the expected gain is tangible.
PubMed ID
20567006 View in PubMed
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Adherence to guidelines for androgen deprivation therapy after radical prostatectomy: Swedish population-based study.

https://arctichealth.org/en/permalink/ahliterature311023
Source
Scand J Urol. 2020 Jun; 54(3):208-214
Publication Type
Journal Article
Observational Study
Date
Jun-2020
Author
Magdalena Lycken
Linda Drevin
Hans Garmo
Anders Larsson
Ove Andrén
Lars Holmberg
Anna Bill-Axelson
Author Affiliation
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Source
Scand J Urol. 2020 Jun; 54(3):208-214
Date
Jun-2020
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Aged
Aged, 80 and over
Androgen Antagonists - therapeutic use
Combined Modality Therapy
Guideline Adherence - statistics & numerical data
Humans
Male
Middle Aged
Orchiectomy
Postoperative Period
Prostatectomy
Prostatic Neoplasms - drug therapy - surgery
Sweden
Abstract
Background: Androgen deprivation therapy (ADT) is a non-curative but essential treatment of prostate cancer with severe side effects. Therefore, both over- and underuse should be avoided. We investigated adherence to guidelines for ADT following radical prostatectomy through Swedish population-based data.Material and methods: We used the database Uppsala/Örebro PSA cohort (UPSAC) to study men with localised or locally advanced prostate cancer at diagnosis (clinical stage T1-T3, N0-NX, M0-MX, and prostate-specific antigen (PSA)
PubMed ID
32338176 View in PubMed
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Anabolic steroids and cardiovascular risk: A national population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature269053
Source
Drug Alcohol Depend. 2015 Jul 1;152:87-92
Publication Type
Article
Date
Jul-1-2015
Author
Ingemar Thiblin
Hans Garmo
Mats Garle
Lars Holmberg
Liisa Byberg
Karl Michaëlsson
Rolf Gedeborg
Source
Drug Alcohol Depend. 2015 Jul 1;152:87-92
Date
Jul-1-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anabolic Agents - adverse effects
Cardiovascular Diseases - chemically induced - epidemiology - mortality
Cause of Death
Cohort Studies
Educational Status
Follow-Up Studies
Humans
Male
Middle Aged
Mortality, Premature
Registries
Socioeconomic Factors
Steroids - adverse effects
Sweden - epidemiology
Young Adult
Abstract
Non-therapeutic use of anabolic androgenic steroids (AAS) has been associated with various adverse effects; one of the most serious being direct cardiovascular effects with unknown long-term consequences. Therefore, large studies of the association between AAS and cardiovascular outcomes are warranted. We investigated cardiovascular morbidity and mortality in individuals who tested positive for AAS.
Between 2002 and 2009, a total of 2013 men were enrolled in a cohort on the date of their first AAS test. Mortality and morbidity after cohort entry was retrieved from national registries. Of the 2013 individuals, 409 (20%) tested positive for AAS. These men had twice the cardiovascular morbidity and mortality rate as those with negative tests (adjusted hazard ratio (aHR) 2.0; 95% confidence interval (CI) 1.2-3.3). Compared to the Swedish population, all tested men had an increased risk of premature death from all causes (standardized mortality ratio for AAS-positive: 19.3, 95% CI 12.4-30.0; for AAS-negative: 8.3, 95% CI 6.1-11.0).
Non-therapeutic exposure to AAS appears to be an independent risk factor for cardiovascular morbidity and premature death.
PubMed ID
26005042 View in PubMed
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Androgen Deprivation Therapies and Changes in Comorbidity: A Comparison of Gonadotropin-releasing Hormone Agonists and Antiandrogen Monotherapy as Primary Therapy in Men with High-risk Prostate Cancer.

https://arctichealth.org/en/permalink/ahliterature302621
Source
Eur Urol. 2019 04; 75(4):676-683
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
04-2019
Author
Kerri Beckmann
Hans Garmo
Jan Adolfsson
Cecilia Bosco
Eva Johansson
David Robinson
Lars Holmberg
Par Stattin
Mieke Van Hemelrijck
Author Affiliation
Australian Centre for Precision Health, University of South Australia, Adelaide, Australia; Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK. Electronic address: Kerri.beckmann@kcl.ac.uk.
Source
Eur Urol. 2019 04; 75(4):676-683
Date
04-2019
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Androgen Antagonists - adverse effects - therapeutic use
Antineoplastic Agents, Hormonal - adverse effects - therapeutic use
Comorbidity
Databases, Factual
Gonadotropin-Releasing Hormone - agonists
Humans
Male
Prostatic Neoplasms - drug therapy - mortality - pathology
Registries
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
Some studies suggest that gonadotropin-releasing hormone (GnRH) agonists are associated with higher risk of adverse events than antiandrogens (AAs) monotherapy. However, it has been unclear whether this is due to indication bias.
To investigate rates of change in comorbidity for men on GnRH agonists versus AA monotherapy in a population-based register study.
Men with advanced nonmetastatic prostate cancer (PCa) who received primary AA (n=2078) or GnRH agonists (n=4878) and age- and area-matched PCa-free men were selected from Prostate Cancer Database Sweden 3.0. Increases in comorbidity were measured using the Charlson Comorbidity Index (CCI), from 5yr before through to 5yr after starting androgen deprivation therapy (ADT).
Multivariable linear regression was used to determine differences in excess rate of CCI change before and after ADT initiation. Risk of any incremental change in CCI following ADT was assessed using multivariable Cox regression analyses.
Men on GnRH agonists experienced a greater difference in excess rate of CCI change after starting ADT than men on AA monotherapy (5.6% per yr, p
PubMed ID
30497883 View in PubMed
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Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories.

https://arctichealth.org/en/permalink/ahliterature279405
Source
Cancer Med. 2016 06;5(6):1307-18
Publication Type
Article
Date
06-2016
Author
Rhonda Arthur
Henrik Møller
Hans Garmo
Lars Holmberg
Pår Stattin
Håkan Malmstrom
Mats Lambe
Niklas Hammar
Göran Walldius
David Robinson
Ingmar Jungner
Mieke Van Hemelrijck
Source
Cancer Med. 2016 06;5(6):1307-18
Date
06-2016
Language
English
Publication Type
Article
Keywords
Aged
Blood glucose
Cholesterol - blood
Comorbidity
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Population Surveillance
Prostatic Neoplasms - blood - epidemiology - pathology
Registries
Risk
Sweden - epidemiology
Triglycerides - blood
Abstract
Lifestyle-related risk factors such as hyperglycemia and dyslipidemia have been associated with several cancers. However, studies exploring their link with prostate cancer (PCa) clinicopathological characteristics are sparse and inconclusive. Here, we investigated the associations between serum metabolic markers and PCa clinicopathological characteristics. The study comprised 14,294 men from the Swedish Apolipoprotein MOrtality RISk (AMORIS) cohort who were diagnosed with PCa between 1996 and 2011. Univariate and multivariable logistic regression were used to investigate the relation between glucose, triglycerides and total cholesterol and PCa risk categories, PSA, Gleason score, and T-stage. Mean age at time of PCa diagnosis was 69 years. Men with glucose levels >6.9 mmol/L tend to have PSA20 µg/L compared to PSA 4.0-9.9 µg/L. Hypertriglyceridemia was also positively associated with PSA>20 µg/L. Hyperglycemic men had a greater odds of intermediate- and high-grade PCa and advanced stage or metastatic PCa. Similarly, hypertriglyceridemia was positively associated with high-grade PCa. There was also a trend toward an increased odds of intermediate risk localized PCa and advanced stage PCa among men with hypertriglyceridemia. Total cholesterol did not have any statistically significant association with any of the outcomes studied. Our findings suggest that high serum levels of glucose and triglycerides may influence PCa aggressiveness and severity. Further investigation on the role of markers of glucose and lipid metabolism in influencing PCa aggressiveness and severity is needed as this may help define important targets for intervention.
PubMed ID
26923095 View in PubMed
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The association between individual metabolic syndrome components, primary liver cancer and cirrhosis: A study in the Swedish AMORIS cohort.

https://arctichealth.org/en/permalink/ahliterature285950
Source
Int J Cancer. 2017 Sep 15;141(6):1148-1160
Publication Type
Article
Date
Sep-15-2017
Author
Paul Nderitu
Cecilia Bosco
Hans Garmo
Lars Holmberg
Håkan Malmström
Niklas Hammar
Göran Walldius
Ingmar Jungner
Paul Ross
Mieke Van Hemelrijck
Source
Int J Cancer. 2017 Sep 15;141(6):1148-1160
Date
Sep-15-2017
Language
English
Publication Type
Article
Keywords
Adult
Blood Glucose - metabolism
Carcinoma, Hepatocellular - blood - epidemiology
Cohort Studies
Diabetes Mellitus - blood
Female
Humans
Lipids - blood
Liver Cirrhosis - blood - epidemiology
Liver Neoplasms - blood - epidemiology
Male
Metabolic Syndrome X - blood - epidemiology
Middle Aged
Obesity - blood - epidemiology
Sweden - epidemiology
Triglycerides - blood
Abstract
Metabolic syndrome (MetS) is associated with non-alcoholic fatty liver disease, which may progress to cirrhosis, a significant risk factor of hepatocellular carcinoma (HCC), the commonest malignant primary liver cancer (PLC). We investigated the association between the individual components of MetS (lipids, apolipoproteins, raised glucose, diabetes and obesity), PLC and cirrhosis. A total of 509,436 participants from the Swedish AMORIS cohort, recruited between January 1985 and December 1996 (end-date December 2011), aged =20 with baseline triglycerides (TG), total cholesterol (TC), glucose and liver enzymes were included. Those with baseline benign liver tumours, PLC or cirrhosis were excluded. Multivariate Cox regression, adjusted for age, gender, socio-economic status, liver disease (excluding cirrhosis) and MetS factors were used to estimate the association with PLC and cirrhosis. There were 766 PLC and 2,775 cirrhosis cases over 13 years. Raised TG, low TC, raised glucose, diabetes and low HDL were associated with an increased risk of developing PLC and cirrhosis. ApoB/ApoA-I ratio were also associated with PLC, whilst low LDL, raised TG/HDL, low ApoA-I and low ApoB were associated with cirrhosis. Obesity was significantly associated with PLC but not cirrhosis. Raised TG, low TC, raised glucose and diabetes showed stronger associations with PLC in participants with cirrhosis but many participants developed PLC without cirrhosis. Individual components of MetS (lipids, apolipoproteins, raised glucose, diabetes and obesity) were associated with an increased risk of developing PLC or cirrhosis. MetS components were more strongly associated with PLC with preceding cirrhosis history but many participants developed PLC without cirrhosis.
PubMed ID
28577304 View in PubMed
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Association between levels of C-reactive protein and leukocytes and cancer: three repeated measurements in the Swedish AMORIS study.

https://arctichealth.org/en/permalink/ahliterature137306
Source
Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):428-37
Publication Type
Article
Date
Mar-2011
Author
Mieke Van Hemelrijck
Lars Holmberg
Hans Garmo
Niklas Hammar
Göran Walldius
Elisa Binda
Mats Lambe
Ingmar Jungner
Author Affiliation
Cancer Epidemiology Group, Division of Cancer Studies, School of Medicine, King's College London, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, United Kingdom. mieke.vanhemelrijck@kcl.ac.uk
Source
Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):428-37
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Aged
C-Reactive Protein - metabolism
Cohort Studies
Female
Humans
Leukocytes - metabolism
Male
Middle Aged
Neoplasms - blood
Prospective Studies
Risk factors
Sweden
Tumor Markers, Biological - blood
Abstract
To study levels of C-reactive protein (CRP) and leukocytes, as inflammatory markers, in the context of cancer risk.
From the Apolipoprotein MOrtality RISk (AMORIS) study, we selected 102,749 persons with one measurement and 9,273 persons with three repeated measurements of CRP and leukocytes. Multivariate Cox proportional hazards regression was applied to categories of CRP (50 g/L) and quartiles of leukocytes. An inflammation-based predictive score (IPS) indicated whether someone had CRP levels of more than 10 mg/L combined with leukocytes of more than 10×10(9)/L. Reverse causality was assessed by excluding those with less than 3, 5, or 7 years of follow-up. To analyze repeated measurements of CRP and leukocytes, the repeated IPS (IPSr) was calculated by adding the IPS of each measurement.
In the cohort with one measurement, there was a positive trend between CRP and risk of developing cancer, with the lowest category being the 0.99 (0.92-1.06), 1.28 (1.11-1.47), 1.27 (1.09-1.49), and 1.22 (1.01-1.48) for the second to fifth categories, respectively. This association disappeared when excluding those with follow-up of less than 3, 5, or 7 years. The association between leukocytes and cancer was slightly stronger. In the cohort with repeated measurements, the IPSr was strongly associated with cancer risk: 1.87 (1.33-2.63), 1.51 (0.56-4.06), and 4.46 (1.43-13.87) for IPSr=1, 2, and 3 compared with IPSr=0. The association remained after excluding those with follow-up of less than 1 year.
Our large, prospective cohort study adds evidence for a link between inflammatory markers and cancer risk by using repeated measurements and ascertaining reverse causality.
Notes
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PubMed ID
21297038 View in PubMed
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Baseline serum folate, vitamin B12 and the risk of prostate and breast cancer using data from the Swedish AMORIS cohort.

https://arctichealth.org/en/permalink/ahliterature301732
Source
Cancer Causes Control. 2019 Jun; 30(6):603-615
Publication Type
Journal Article
Date
Jun-2019
Author
Anneli Essén
Aida Santaolalla
Hans Garmo
Niklas Hammar
Göran Walldius
Ingmar Jungner
Håkan Malmström
Lars Holmberg
Mieke Van Hemelrijck
Author Affiliation
Research Oncology, Translational Oncology & Urology Research (TOUR), Guy's Hospital, School of Cancer and Pharmaceutical Sciences, King's College London, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK.
Source
Cancer Causes Control. 2019 Jun; 30(6):603-615
Date
Jun-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
Breast Neoplasms - blood
Cohort Studies
Diet
Female
Folic Acid - blood
Humans
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Prostatic Neoplasms - blood
Risk
Sweden
Vitamin B 12 - blood
Abstract
The roles of folate and vitamin B12 in prostate cancer (PCa) or breast cancer (BC) development are unclear. We investigated their roles using the prospective Swedish Apolipoprotein MOrtality RISk (AMORIS) study.
8,783 men and 19,775 women with vitamin B12 and folate serum measurements were included. Their associations with PCa and BC risk categories were evaluated using Cox proportional hazards regression.
During mean follow-up of 13 years, 703 men developed PCa. There was an inverse association between folate?>?32 nmol/L and high-risk PCa [hazard ratio (HR) 0.12, 95% confidence interval (CI) 0.02-0.90], and a positive association between folate??32 nmol/L and BC (HR 1.47, 95% CI 1.06-2.04).
High folate levels may protect against PCa and low folate levels may increase risk of metastatic PCa. High fasting folate levels may be associated with an increased BC risk. Vitamin B12 was not found to be linked with risk of PCa or BC. Longitudinal studies with serum and dietary information could help define new prevention targets and add information on the role of folate fortification.
PubMed ID
31020446 View in PubMed
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Source
Acta Paediatr. 2009 Oct;98(10):1550-2
Publication Type
Article
Date
Oct-2009
Author
Lars Holmberg
Author Affiliation
Department of Paediatrics, Lund University, Lund, Sweden. lars.holmberg@med.lu.se
Source
Acta Paediatr. 2009 Oct;98(10):1550-2
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Brain Neoplasms - epidemiology - mortality - therapy
Child
Glioma - epidemiology - mortality - therapy
Health Status Disparities
Humans
Incidence
Prognosis
Registries
Risk factors
Survival Rate
Sweden - epidemiology
Notes
Comment On: Acta Paediatr. 2009 Oct;98(10):1620-719594464
PubMed ID
19650785 View in PubMed
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101 records – page 1 of 11.