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Cardiovascular Incidence in 6900 Patients with Differentiated Thyroid Cancer: a Swedish Nationwide Study.

https://arctichealth.org/en/permalink/ahliterature308466
Source
World J Surg. 2020 02; 44(2):436-441
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2020
Author
Maximilian Zoltek
Therese M-L Andersson
Christel Hedman
Catharina Ihre-Lundgren
Caroline Nordenvall
Author Affiliation
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. maximilian.zoltek@ki.se.
Source
World J Surg. 2020 02; 44(2):436-441
Date
02-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology
Cohort Studies
Female
Hospitalization
Humans
Incidence
Male
Middle Aged
Sweden - epidemiology
Thyroid Neoplasms - complications
Abstract
To minimize recurrence risk in differentiated thyroid cancer (DTC), TSH is usually lifelong suppressed with levothyroxine. A common consequence of this treatment is subclinical hyperthyroidism which can induce cardiovascular disease (CV). This study's aim was to compare CV incidence in DTC patients with the general population in Sweden.
All Swedish patients diagnosed with DTC in 1987-2013 were included in the cohort study. Lifelong TSH suppression treatment was assumed to be administered to patients in compliance with prevalent national guidelines. Patients were followed from 1 year after DTC diagnosis until December 31, 2014, death, or migration. The event of interest was hospitalization due to any of the following diseases: atrial fibrillation (AF), cerebrovascular disease, cerebral infarction, ischemic heart disease, ischemic heart attack, and heart failure. Standardized incidence ratios (SIRs) were calculated to compare CV incidence between DTC patients and the general population.
The cohort consisted of 6900 patients with DTC. Hospitalization was increased among DTC patients for AF (SIR 1.66, CI 95% 1.41-1.94), and women faced increased hospitalization for cerebrovascular disease (SIR 1.20 CI 95% 1.04-1.38). Regarding the remaining CV diseases, no consistent difference in SIR between the groups was observed.
Compared to the general population, DTC patients have a higher incidence in AF, and female face a slightly higher incidence in cerebrovascular disease. However, there was no difference in hospitalization for other studied CV diseases between DTC patients and the general population.
PubMed ID
31659412 View in PubMed
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Changes in inflammatory bowel disease subtype during follow-up and over time in 44,302 patients.

https://arctichealth.org/en/permalink/ahliterature300030
Source
Scand J Gastroenterol. 2019 Jan; 54(1):55-63
Publication Type
Journal Article
Date
Jan-2019
Author
Åsa H Everhov
Michael C Sachs
Petter Malmborg
Caroline Nordenvall
Pär Myrelid
Hamed Khalili
Maria Elmberg
Anders Ekbom
Johan Askling
Gustav Jakobsson
Jonas Halfvarson
Jonas F Ludvigsson
Ola Olén
Author Affiliation
a Department of Clinical Science and Education , Södersjukhuset, Karolinska Institutet , Stockholm , Sweden.
Source
Scand J Gastroenterol. 2019 Jan; 54(1):55-63
Date
Jan-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Algorithms
Child
Colitis, Ulcerative - epidemiology
Crohn Disease - epidemiology
Disease Progression
Follow-Up Studies
Humans
Inflammatory Bowel Diseases - classification
Prospective Studies
Registries - standards
Sweden - epidemiology
Abstract
To investigate inflammatory bowel disease (IBD) register-based subtype classifications over a patient's disease course and over time.
We examined International Classification of Diseases coding in patients with =2 IBD diagnostic listings in the National Patient Register 2002-2014 (n?=?44,302).
18% of the patients changed diagnosis (17% of adults, 29% of children) during a median follow-up of 3.8 years. Of visits with diagnoses of Crohn's disease (CD) or ulcerative colitis (UC), 97% were followed by the same diagnosis, whereas 67% of visits with diagnosis IBD-unclassified (IBD-U) were followed by another IBD-U diagnosis. Patients with any diagnostic change changed mostly once (47%) or twice (31%), 39% from UC to CD, 33% from CD to UC and 30% to or from IBD-U. Using a classification algorithm based on the first two diagnoses ('incident classification'), suited for prospective cohort studies, the proportion adult patients with CD, UC, and IBD-U 2002-2014 were 29%, 62%, and 10% (43%, 45%, and 12% in children). A classification model incorporating additional information from surgeries and giving weight to the last 5 years of visits ('prevalent classification'), suited for description of a study population at end of follow-up, classified 31% of adult cases as CD, 58% as UC and 11% as IBD-U (44%, 38%, and 18% in children).
IBD subtype changed in 18% during follow-up. The proportion with CD increased and UC decreased from definition at start to end of follow-up. IBD-U was more common in children.
PubMed ID
30700170 View in PubMed
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The Fate of Reconstructive Surgery Following Colectomy for Inflammatory Bowel Disease in Sweden: A Population-based Cohort Study.

https://arctichealth.org/en/permalink/ahliterature282691
Source
J Crohns Colitis. 2016 Oct;10(10):1165-71
Publication Type
Article
Date
Oct-2016
Author
Caroline Nordenvall
Ola Olén
Per J Nilsson
Anders Ekbom
Matteo Bottai
Pär Myrelid
Source
J Crohns Colitis. 2016 Oct;10(10):1165-71
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Inflammatory Bowel Diseases - surgery
Kaplan-Meier Estimate
Male
Middle Aged
Proctocolectomy, Restorative - methods
Proportional Hazards Models
Registries
Sweden
Treatment Failure
Young Adult
Abstract
Previous studies describing the cumulative failure rate after reconstructive surgery in patients with inflammatory bowel disease have been restricted to specific hospitals, and the generalizability of these results in a population-based setting is unknown. The aim of this study was to investigate the cumulative failure rate and risk factors for failure after reconstructive surgery in patients with inflammatory bowel disease.
The study cohort includes all patients with inflammatory bowel disease in Sweden who underwent colectomy in 2000 through 2013 who were later treated with reconstructive surgery with ileal pouch-anal anastomosis or ileorectal anastomosis. Each patient was followed from admission for reconstructive surgery until admission for failure (a diverting stoma or permanent stoma), date of death, migration or December 31, 2013. Cumulative failure distributions were obtained with the Kaplan-Meier method, and multivariable Cox regression models were used to calculate the risk of failure.
Of the 1809 patients with inflammatory bowel disease treated with colectomy and reconstructive surgery, 83% had ulcerative colitis. During follow-up, 270 patients failed, and the cumulative failure rate was 4.1%, 13.2%, and 15.3% after 1, 3, and 5 years, respectively. The risk of failure was lower after treatment with ileal pouch-anal anastomosis than with ileorectal anastomosis [hazard ratio (95% confidence interval): 0.72 (0.56-0.93)]. Gender, hospital volume, and timing of reconstruction were not significantly associated with the risk of failure.
The 5-year cumulative failure rate in a nationwide setting was 15.3%, and hospital volume was not associated with the risk of failure.
PubMed ID
26975385 View in PubMed
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Incidence and Treatment of Patients Diagnosed With Inflammatory Bowel Diseases at 60 Years or Older in Sweden.

https://arctichealth.org/en/permalink/ahliterature291560
Source
Gastroenterology. 2018 02; 154(3):518-528.e15
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Åsa H Everhov
Jonas Halfvarson
Pär Myrelid
Michael C Sachs
Caroline Nordenvall
Jonas Söderling
Anders Ekbom
Martin Neovius
Jonas F Ludvigsson
Johan Askling
Ola Olén
Author Affiliation
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: asa.hallqvist-everhov@ki.se.
Source
Gastroenterology. 2018 02; 154(3):518-528.e15
Date
02-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adrenal Cortex Hormones - adverse effects - therapeutic use
Adult
Age of Onset
Aged
Aged, 80 and over
Biological Products - adverse effects - therapeutic use
Child
Child, Preschool
Colectomy - adverse effects
Colitis, Ulcerative - diagnosis - epidemiology - therapy
Crohn Disease - diagnosis - epidemiology - therapy
Female
Gastrointestinal Agents - adverse effects - therapeutic use
Healthcare Disparities
Humans
Immunologic Factors - adverse effects - therapeutic use
Incidence
Infant
Infant, Newborn
Male
Middle Aged
Registries
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Young Adult
Abstract
Diagnosis of inflammatory bowel diseases (IBD) is increasing among elderly persons (60 years or older). We performed a nationwide population-based study to estimate incidence and treatment of IBD.
We identified all incident IBD cases in Sweden from 2006 through 2013 using national registers and up to 10 matched population comparator subjects. We collected data on the patients' health care contacts and estimated incidence rates, health service burden, pharmacologic treatments, extra-intestinal manifestations, and surgeries in relation to age of IBD onset (pediatric,
PubMed ID
29102619 View in PubMed
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Postmenopausal hormone replacement therapy and risk of cholecystectomy: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature256543
Source
Scand J Gastroenterol. 2014 Jan;49(1):109-13
Publication Type
Article
Date
Jan-2014
Author
Caroline Nordenvall
Viktor Oskarsson
Omid Sadr-Azodi
Nicola Orsini
Alicja Wolk
Author Affiliation
Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , Sweden.
Source
Scand J Gastroenterol. 2014 Jan;49(1):109-13
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cholecystectomy - statistics & numerical data
Cholecystitis - epidemiology - surgery
Cholelithiasis - epidemiology - surgery
Estrogen Replacement Therapy - adverse effects - statistics & numerical data
Female
Follow-Up Studies
Humans
Middle Aged
Postmenopause
Proportional Hazards Models
Prospective Studies
Risk assessment
Sweden - epidemiology
Abstract
Our aim of this study was to examine the association between the use of postmenopausal HRT and risk of cholecystectomy in Sweden, where the most common regimen of HRT (oral oestradiol in combination with testosterone-like progestin) has been different from those investigated in previous studies.
We performed a prospective study of 27 892 postmenopausal women (aged 48-83 years) from the population-based Swedish Mammography Cohort. Use of HRT was assessed by a self-reported questionnaire at baseline in 1997, and the cohort was followed up through 2011 for procedures of cholecystectomy by linkage to the Swedish Patient Register. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI).
During 362 728 person-years of follow-up (median 14 years), 995 cases of cholecystectomy were recorded. After adjustment for potential confounders, the HR of cholecystectomy was 1.52 (95% CI, 1.33-1.74) among ever users of HRT compared with never users. The risk did not differ by current or past use (p = 0.38) or duration of use (p = 0.65), but it did differ by indication of use (p = 0.006). Women who used HRT for systemic symptoms had a higher risk of cholecystectomy than those who used it for local symptoms (HR, 1.62; 95% CI, 1.41-1.87 vs HR, 1.21; 95% CI, 0.97-1.50).
This prospective study of postmenopausal women adds to the evidence that use of HRT may increase the risk of cholecystectomy.
PubMed ID
24256204 View in PubMed
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Sick Leave and Disability Pension in Prevalent Patients With Crohn's Disease.

https://arctichealth.org/en/permalink/ahliterature298938
Source
J Crohns Colitis. 2018 Nov 28; 12(12):1418-1428
Publication Type
Journal Article
Date
Nov-28-2018
Author
Åsa H Everhov
Hamed Khalili
Johan Askling
Pär Myrelid
Jonas F Ludvigsson
Jonas Halfvarson
Caroline Nordenvall
Jonas Söderling
Ola Olén
Martin Neovius
Author Affiliation
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Source
J Crohns Colitis. 2018 Nov 28; 12(12):1418-1428
Date
Nov-28-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Crohn Disease - diagnosis - economics - epidemiology - therapy
Disability Evaluation
Disabled persons - statistics & numerical data
Female
Humans
Insurance, Disability - economics - statistics & numerical data
Male
Patient Care Management - economics - methods
Registries - statistics & numerical data
Risk Assessment - methods
Sick Leave - economics - statistics & numerical data
Sweden - epidemiology
Work Performance
Abstract
Crohn's disease may affect the ability to work and lead to permanent disability. We aimed to investigate work loss in prevalent patients.
We identified patients with Crohn's disease and general population comparators matched by sex, birth year, healthcare region and education. We assessed days of sick leave and disability pension retrieved from the Swedish Social Insurance Agency and estimated the absolute and relative risk of receiving disability pension [minimum 25% work impairment].
In 2014, the 20638 Crohn's disease patients [median age 44 years] had more than twice as many mean lost workdays [disability pension: 44; sick leave: 19] as the 102038 comparators [disability pension: 20; sick leave: 8], mean difference 35 days [95% confidence interval 33-37]. However, the majority had no lost workdays [68% of patients and 85% of comparators]. The proportion of patients receiving disability pension was 15% (6.5% in the comparators, risk ratio 2.34 [2.25-2.43]) and was higher in all subgroups, especially in female patients [28% vs 13% in the comparators], in those with =9 years of education [41% vs 23%] and in ages 60-64 years [46% vs 25%]. The relative risk of disability pension within the patient cohort [adjusted for age, sex, region and education] was higher in patients with complicated disease behaviour, extraintestinal manifestations, need of surgery or treatment with biologics. The differences between patients and comparators remained when comparing other calendar years [2006-2013].
Work loss was found in approximately one-third of patients. The mean number of lost workdays was twice as high as in the comparators.
PubMed ID
30165593 View in PubMed
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Smoking, snus use and risk of right- and left-sided colon, rectal and anal cancer: a 37-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature100633
Source
Int J Cancer. 2011 Jan 1;128(1):157-65
Publication Type
Article
Date
Jan-1-2011
Author
Caroline Nordenvall
Per J Nilsson
Weimin Ye
Olof Nyrén
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden. caroline.nordenvall@ki.se
Source
Int J Cancer. 2011 Jan 1;128(1):157-65
Date
Jan-1-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anus Neoplasms - epidemiology - etiology
Colorectal Neoplasms - epidemiology - etiology
Facility Design and Construction
Follow-Up Studies
Humans
Male
Middle Aged
Occupational Health - statistics & numerical data
Proportional Hazards Models
Registries - statistics & numerical data
Retrospective Studies
Risk Assessment - methods - statistics & numerical data
Risk factors
Smoking - adverse effects
Sweden - epidemiology
Tobacco, Smokeless - adverse effects
Abstract
Although some authorities consider smoking to be an established risk factor for colorectal cancer, the international literature is not entirely consistent. Further, only 1 study has addressed the association with smokeless tobacco and none with Scandinavian moist snuff (snus). This retrospective cohort study included 336,381 male Swedish construction workers with detailed information on tobacco use at cohort entry in 1971-1992. Complete follow-up through 2007 was accomplished by means of linkage to population and health registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) derived from Cox proportional hazards regression models estimated relative risks, adjusted for age and body mass index. Subjects who were never-users of any tobacco served as reference. After up to 37 years of follow-up, pure smoking was associated with a marginally increased risk of colon cancer (HR 1.08, 95% CI 0.99-1.19), a modestly elevated risk of rectal cancer (HR 1.16, 95% CI 1.04-1.30) and a substantial excess risk of anal cancer (HR 2.41, 95% CI 1.06-5.48). Snus use was not significantly associated with an increased risk of colorectal or anal cancer, although the point estimate for colon cancer was similar to that observed among smokers. Swedish data provide meager support for the association between tobacco use and colorectal cancer. A general tendency among Swedish men to quit smoking in recent decades might have attenuated true associations. A link between smoking and anal cancer was confirmed.
PubMed ID
20209500 View in PubMed
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Smoking, use of moist snuff and risk of celiac disease: a prospective study.

https://arctichealth.org/en/permalink/ahliterature258807
Source
BMC Gastroenterol. 2014;14:120
Publication Type
Article
Date
2014
Author
Jonas F Ludvigsson
Caroline Nordenvall
Bengt Järvholm
Source
BMC Gastroenterol. 2014;14:120
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Celiac Disease - epidemiology
Female
Humans
Male
Middle Aged
Prospective Studies
Regression Analysis
Risk factors
Smoking - epidemiology
Sweden - epidemiology
Tobacco Use - epidemiology
Tobacco, Smokeless - utilization
Young Adult
Abstract
Smoking status has been linked to several chronic inflammatory conditions but earlier research on smoking and celiac disease (CD) is contradictive. There are little data on moist snuff use and CD. The purpose of this study was to investigate the association between smoking, moist snuff use and later CD.
We identified individuals with biopsy-verified CD (villous atrophy, histopathology stage Marsh III) through biopsy-reports from Sweden's 28 pathology departments. Data on smoking and moist snuff were collected from the Swedish construction worker database "Bygghälsan" that includes preventive health care check-up data. Through poisson regression we calculated relative risks (RRs) for later CD according to smoking status (n?=?305,722), and moist snuff status (n?=?199,200) adjusting for age, sex and decade.
During follow-up 488 individuals with smoking data, and 310 with moist snuff data had a diagnosis of CD. The risk of CD was independent of smoking status with all RRs being statistically insignificant and ranging between 0.9 and 1.0. Compared to non-smokers, neither current smokers (RR?=?0.93; 95%?CI?=?0.76-1.14) nor ex-smokers (RR?=?0.98; 95%?CI?=?0.75-1.28) were at increased or decreased risk of CD. Risk estimates were similar in moderate smokers (RR?=?0.92; 0.72-1.16) and heavy smokers (RR?=?0.95; 0.74-1.24), and did not change when we examined the risk more than ten years after health examination (RR-moderate: 0.90; and RR-heavy: 0.95; both p?>?0.05). Moist snuff use was not associated with later CD (RR?=?1.00; 0.78-1.28), or with CD after more than ten years of follow-up (RR?=?1.05; 0.80-1.38).
We found no association between smoking, moist snuff use and future CD.
Notes
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PubMed ID
24994113 View in PubMed
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Snus use, smoking and survival among prostate cancer patients.

https://arctichealth.org/en/permalink/ahliterature282296
Source
Int J Cancer. 2016 Dec 15;139(12):2753-2759
Publication Type
Article
Date
Dec-15-2016
Author
Kathryn M Wilson
Sarah C Markt
Fang Fang
Caroline Nordenvall
Jennifer R Rider
Weimin Ye
Hans-Olov Adami
Pär Stattin
Olof Nyrén
Lorelei A Mucci
Source
Int J Cancer. 2016 Dec 15;139(12):2753-2759
Date
Dec-15-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Follow-Up Studies
Humans
Male
Middle Aged
Mortality
Proportional Hazards Models
Prospective Studies
Prostatic Neoplasms - epidemiology - mortality - pathology
Registries
Smoking - adverse effects
Sweden - epidemiology
Tobacco, Smokeless - adverse effects
Abstract
Smoking is associated with prostate cancer mortality. The Scandinavian smokeless tobacco product snus is a source of nicotine but not the combustion products of smoke and has not been studied with respect to prostate cancer survival. The study is nested among 9,582 men with incident prostate cancer within a prospective cohort of 336,381 Swedish construction workers. Information on tobacco use was collected at study entry between 1971 and 1992, and categorized into (i) never users of any tobacco, (ii) exclusive snus: ever users of snus only, (iii) exclusive smokers: ever smokers (cigarette, cigar and/or pipe) only and (iv) ever users of both snus and smoking. Hazard ratios for prostate cancer-specific and total mortality for smoking and snus use based on Cox proportional hazards models adjusted for age, calendar period at diagnosis and body mass index at baseline. During 36 years of follow-up, 4,758 patients died-2,489 due to prostate cancer. Compared to never users of tobacco, exclusive smokers were at increased risk of prostate cancer mortality (HR 1.15, 95% CI: 1.05-1.27) and total mortality (HR 1.17, 95% CI: 1.09-1.26). Exclusive snus users also had increased risks for prostate cancer mortality (HR 1.24, 95% CI: 1.03-1.49) and total mortality (HR 1.19, 95% CI: 1.04-1.37). Among men diagnosed with nonmetastatic disease, the HR for prostate cancer death among exclusive snus users was 3.17 (95% CI: 1.66-6.06). The study is limited by a single assessment of tobacco use prior to diagnosis. Snus use was associated with increased risks of prostate cancer and total mortality among prostate cancer patients. This suggests that tobacco-related components such as nicotine or tobacco-specific carcinogens may promote cancer progression independent of tobacco's combustion products.
Notes
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PubMed ID
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