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Cancer and aging: Epidemiology and methodological challenges.

https://arctichealth.org/en/permalink/ahliterature276533
Source
Acta Oncol. 2016;55 Suppl 1:7-12
Publication Type
Article
Date
2016
Author
Jacob K Pedersen
Gerda Engholm
Axel Skytthe
Kaare Christensen
Source
Acta Oncol. 2016;55 Suppl 1:7-12
Date
2016
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Aging
Denmark - epidemiology
Epidemiologic Research Design
Female
Global health
Humans
Incidence
Male
Middle Aged
Neoplasms - epidemiology
Registries
Abstract
Epidemiological cancer data shed light on key questions within basic science, clinical medicine and public health. For decades, Denmark has had linkable health registers that contain individual level data on the entire population with virtually complete follow-up. This has enabled high quality studies of cancer epidemiology and minimized the challenges often faced in many countries, such as uncertain identification of the study base, age misreporting, and low validity of the cancer diagnoses. However, methodological challenges still remain to be addressed, especially in cancer epidemiology studies among the elderly and the oldest-old. For example, a characteristic pattern for many cancer types is that the incidence increases up to a maximum at about ages 75-90 years and is then followed by a decline or a leveling off at the oldest ages. It has been suggested that the oldest individuals may be asymptomatic, or even insusceptible to cancer. An alternative interpretation is that this pattern is an artifact due to lower diagnostic intensity among the elderly and oldest-old caused by higher levels of co-morbidities in this age group. Currently, the available cancer epidemiology data are not able to provide clear evidence for any of these hypotheses.
PubMed ID
26825001 View in PubMed
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Cancer Incidence and Mortality in Greenland 1983-2014 - Including Comparison With the Other Nordic Countries.

https://arctichealth.org/en/permalink/ahliterature300864
Source
EClinicalMedicine. 2018 Aug-Sep; 2-3:37-49
Publication Type
Journal Article
Nordic Countries Umbreen Yousaf a,⁎, Gerda Engholm b, Hans Storm c, Niels Christensen b, Elisabeth Zetlitz d, Henrik Trykker e, Frank Sejersen f, Peter Bjerregaard g,h, Lau Caspar Thygesen g a Oncological Outpatient Clinic, Haugesund Hospital, Helse Fonna, Postboks 2170, 5504 Haugesund, Norway b Dept
  1 document  
Author
Umbreen Yousaf
Gerda Engholm
Hans Storm
Niels Christensen
Elisabeth Zetlitz
Henrik Trykker
Frank Sejersen
Peter Bjerregaard
Lau Caspar Thygesen
Author Affiliation
Oncological Outpatient Clinic, Haugesund Hospital, Helse Fonna, Postboks 2170, 5504 Haugesund, Norway.
Source
EClinicalMedicine. 2018 Aug-Sep; 2-3:37-49
Language
English
Publication Type
Journal Article
File Size
4088775
Abstract
During the last decades, social and life-style changes in Greenland have led to an increase in the incidence of several non-communicable diseases. Our aim is to present the cancer incidence and mortality in Greenland and compare the results with the other Nordic countries.
The data stems from The Danish Cancer Registry and The Danish Register of Causes of Death. Comparable data on cancer incidence and mortality in Denmark, Finland, Iceland, Norway, Sweden, and Greenland are available through collaboration between Nordic Cancer Registries (NORDCAN). We included all individuals residing in Greenland and diagnosed with or died of a cancer from 1983 to 2014.
The total number of cancer cases in Greenland for the study period was 4716 and there were 3231 cancer deaths. Respiratory and gastrointestinal cancers had the highest incidence as well as mortality in Greenland for the entire time period and for both sexes. Compared to the other Nordic countries, Greenland had significantly higher incidence and mortality rates for several cancers. Cancer of the lip, oral cavity, and pharynx, respiratory cancer, and cancer of unknown sites had the highest incidence rate ratios (2.3-3.9) and mortality rate ratios (2.7-9.9) for both sexes. The time trend from 1983 to 2014 showed a significant increase in cancer incidence in Greenland with nearly the same incidence level as the other Nordic countries. While the cancer mortality decreased in the other Nordic countries during the time period studied, there was no change in the cancer-specific mortality in Greenland.
The trends in cancer incidence and mortality in Greenland compared to the other Nordic countries have not been reported earlier. These data underline a need to focus on cancer-specific mortality in Greenland and prevention of high-incidence cancers related to well-established risk factors.
PubMed ID
31193566 View in PubMed
Documents
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Cancer risks after solid organ transplantation and after long-term dialysis.

https://arctichealth.org/en/permalink/ahliterature282593
Source
Int J Cancer. 2017 Mar 01;140(5):1091-1101
Publication Type
Article
Date
Mar-01-2017
Author
Maria Hortlund
Laila Sara Arroyo Mühr
Hans Storm
Gerda Engholm
Joakim Dillner
Davit Bzhalava
Source
Int J Cancer. 2017 Mar 01;140(5):1091-1101
Date
Mar-01-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Denmark - epidemiology
Disease Susceptibility
Female
Follow-Up Studies
Humans
Immunocompromised Host
Incidence
Kidney Diseases - immunology - surgery - therapy
Male
Middle Aged
Neoplasms - epidemiology
Organ Specificity
Organ Transplantation - statistics & numerical data
Postoperative Complications - epidemiology - immunology
Registries
Renal Dialysis - statistics & numerical data
Risk
Sweden - epidemiology
Transplantation Immunology
Abstract
Immunosuppression involves an inability to control virus infections and increased incidence of virus-associated cancers. Some cancers without known viral etiology are also increased, but data on exactly which cancer forms are increased has been inconsistent. To provide a reliable and generalizable estimate, with high statistical power and long follow-up time, we assessed cancer risks using comprehensive, population-based registries in two different countries and from two different immunosuppressed patient groups (solid organ transplant recipients (OTRs) and long-term dialysis patients (LDPs)). National registries in Denmark and Sweden identified 20,804 OTRs and 31,140 LDPs that were followed up using national cancer registries. Standardized incidence ratios (SIR) compared to the general population were estimated. We found highly similar results, both for the two different countries and for the two different immunosuppressed cohorts, namely an increased incidence for the following specific cancer forms: Non-melanoma skin cancer (NMSC), non-Hodgkin's lymphoma and cancers of the lip, kidney, larynx and thyroid. The SIR for overall cancer among OTRs was 3.5 [n?=?2,142, 95% CI, 3.4-3.7] in Sweden, 2.9 [n?=?1,110, 95% CI, 2.8-3.1] in Denmark and 1.6 [n?=?1,713, 95% CI, 1.5-1.6] among LDP. The SIR for NMSC among OTRs was 44.7 [n?=?994, 95% CI, 42-47.5] in Sweden and 41.5 [n?=?445, 95% CI, 37.8-45.5] in Denmark. The increased SIR for NMSC among LDPs was 5.3 [n?=?304, 95% CI, 4.7-5.9]). In summary, an increased SIR for a specific, similar set of cancer forms is consistently found among the immunosuppressed. Conceivable explanations include surveillance bias and immunosuppression-related susceptibility to viral infections.
PubMed ID
27870055 View in PubMed
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A cluster randomised controlled trial of an adolescent smoking cessation intervention: short and long-term effects.

https://arctichealth.org/en/permalink/ahliterature127249
Source
Scand J Public Health. 2012 Mar;40(2):167-76
Publication Type
Article
Date
Mar-2012
Author
Peter Dalum
Georg Paludan-Müller
Gerda Engholm
Gerjo Kok
Author Affiliation
Department of Cancer Prevention & Documentation, Danish Cancer Society, Copenhagen, Denmark. pdal@si-folkesundhed.dk
Source
Scand J Public Health. 2012 Mar;40(2):167-76
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Cluster analysis
Denmark
Female
Follow-Up Studies
Humans
Male
Outcome Assessment (Health Care)
Program Evaluation
Self Efficacy
Smoking Cessation - methods - psychology - statistics & numerical data
Tobacco Use Cessation - methods - psychology - statistics & numerical data
Young Adult
Abstract
There is a lack of effective smoking cessation interventions which have a high reach among adolescent smokers.
We conducted a randomised controlled trial of an adolescent smoking cessation intervention for students aged 15-21 at 22 continuation schools in Denmark. The intervention was a minimal intervention based on events with short counselling and a range of self-help materials. Our 1-month follow up consisted of 514 baseline daily smokers and the 14-month follow up of 369 daily smokers.
We found positive short-term effects regarding smoking cessation (adjusted OR 4.50, 95% CI 1.20-16.86), self-efficacy (p=0.01), and intentions to quit (p=0.004). However, none of these effects were maintained at 1-year follow up. The intervention was successful in reaching more than half of all daily smokers in the target group with more than 30% receiving counselling at least once in the intervention period.
This trial shows that a "minimal" intervention can produce short-term effects but that this approach is insufficient in producing long-term effects.
PubMed ID
22312032 View in PubMed
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Costs of illness for melanoma and nonmelanoma skin cancer in Denmark.

https://arctichealth.org/en/permalink/ahliterature115105
Source
Eur J Cancer Prev. 2013 Nov;22(6):569-76
Publication Type
Article
Date
Nov-2013
Author
Joan Bentzen
Jakob Kjellberg
Camilla Thorgaard
Gerda Engholm
Anja Phillip
Hans H Storm
Author Affiliation
aDanish SunSmart Campaign, Department of Prevention and Documentation, Danish Cancer Society bKORA/DSI Danish Institute for Health Services Research cDepartment of Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark.
Source
Eur J Cancer Prev. 2013 Nov;22(6):569-76
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adult
Carcinoma, Basal Cell - economics - pathology
Carcinoma, Squamous Cell - economics - pathology
Cost of Illness
Denmark
Female
Follow-Up Studies
Health Care Costs
Humans
Male
Melanoma - economics - pathology
Middle Aged
Prognosis
Registries
Risk factors
Skin Neoplasms - economics - pathology
Abstract
Incidences of melanoma and nonmelanoma skin cancer are high and increasing in many countries including Denmark. The diseases are highly preventable. We have estimated the healthcare costs of these cancers by comparing costs for cohorts of patients and matched controls in a national register-based study in Denmark. All incident patients with a diagnosis of melanoma, basal cell carcinoma, or squamous cell carcinoma in the period 2004-2008 were included. Four control individuals for each case were matched in terms of sex, age, and area of residence. Healthcare costs and productivity loss for patients and controls were estimated using Danish health and social registries 3 years before and 3 years after diagnosis. The healthcare costs of melanoma and nonmelanoma skin cancer were &OV0556;33.3 million in the 3-year period after diagnosis, with male patients inducing the highest costs for all three cancers and costs increasing with age. The diagnoses of basal cell carcinoma and melanoma had almost the same healthcare costs, but per patient average healthcare costs were higher for melanoma. The costs of melanoma and nonmelanoma skin cancers, which can be prevented by sensible sun habits, exceed the costs of the preventive measures of the Danish SunSmart campaign manifold. Costs of melanoma and nonmelanoma skin cancer are expected to increase in the future with populations aging in the western world. The analyses provide a strong argument for the societal rationale of skin cancer prevention in Denmark.
PubMed ID
23542376 View in PubMed
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Development in sunburn 2007-2015 and skin cancer projections 2007-2040 of campaign results in the Danish population.

https://arctichealth.org/en/permalink/ahliterature295672
Source
Medicine (Baltimore). 2018 Oct; 97(41):e12738
Publication Type
Journal Article
Observational Study
Date
Oct-2018
Author
Brian Køster
Maria Meyer
Therese Andersson
Gerda Engholm
Peter Dalum
Author Affiliation
Department of Prevention and Information, Danish Cancer Society, Strandboulevarden Copenhagen Ø, Denmark.
Source
Medicine (Baltimore). 2018 Oct; 97(41):e12738
Date
Oct-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adolescent
Adult
Cross-Sectional Studies
Denmark - epidemiology
Female
Health Promotion - statistics & numerical data
Humans
Incidence
Male
Melanoma - epidemiology - prevention & control
Middle Aged
Prevalence
Skin Neoplasms - epidemiology - prevention & control
Socioeconomic Factors
Sunburn - epidemiology - prevention & control
Young Adult
Abstract
Exposure to ultraviolet radiation is the main risk factor for skin cancer. Denmark has one of the highest incidences of skin cancer in the world. In 2007, a long-term sun safety campaign was launched in Denmark. We have evaluated the effects on prevalence of sunburn and modeled the effects on future melanoma incidence.Sunburn was evaluated by annual cross-sectional surveys representative for the Danish population on age, gender, and region. During 2007-2015, survey data were collected for 33.315 Danes. Cutaneous Melanoma incidences were modeled in the Prevent program, using population projections, historic incidence, sunburn exposure, and relative risk of sunburn on melanoma.The prevalence of sunburn in Denmark was reduced with 1% annually during 2007 to 2015. The campaign is estimated to have reduced the number of skin cancer cases with 664 annually in 2040 and 14.326 totally during 2007 to 2040. If the campaign was terminated in 2015 and sunburn rates return to precampaign level there would be no annual reduction in 2040 while in total the reduction would be 4.024 cases for 2007 to 2040. A continuous campaign until 2040 would yield annual reductions of 2.121 cases by 2040 and a total of 29.729 cases for the entire period.We have showed the value of prevention and the value of long-term planning in prevention campaigning. Sunburn use was reduced significantly during 2007-2015 and further reductions are possible. Consequently, we predict significant fewer skin cancer cases as anticipated.
Notes
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PubMed ID
30313078 View in PubMed
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Differences in survival from prostate cancer in Denmark, Iceland and Sweden.

https://arctichealth.org/en/permalink/ahliterature115907
Source
Eur J Cancer. 2013 May;49(8):1984-92
Publication Type
Article
Date
May-2013
Author
Klaus Brasso
Inga Jóna Ingimarsdóttir
Ea Rusch
Gerda Engholm
Jan Adolfsson
Laufey Tryggvadóttir
Eiríkur Jónsson
Anna Bill-Axelson
Erik Holmberg
Hans Henrik Storm
Author Affiliation
Urological Research Unit, Department of Urology, Rigshospitalet, University of Copenhagen, Denmark. klausbrasso@hotmail.com
Source
Eur J Cancer. 2013 May;49(8):1984-92
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Prognosis
Prostate-Specific Antigen - analysis
Prostatic Neoplasms - epidemiology - mortality - pathology
Registries - statistics & numerical data
Survival Analysis
Survival Rate - trends
Sweden - epidemiology
Time Factors
Abstract
Register-based studies have shown large survival differences among prostate cancer patients in the Nordic countries. The aim of this study was to determine the background of such differences in Denmark, Iceland and Sweden.
Patients with prostate cancer were identified through population-based cancer registers in the three countries. Clinical findings at diagnosis were retrieved from hospital records. In Sweden, clinical information was gathered from regional population-based prostate cancer registers. Country-specific incidence and excess mortality rates were compared, with adjustment for prognostic factors.
The relative survival in the cohorts was comparable to that in previous population-based studies. Significant differences in excess mortality rates were found across countries, which diminished or disappeared after adjustment for patient characteristics, i.e. metastatic status, clinical T stage and prostate-specific antigen level. A difference in the proportion of patients with metastatic disease was the main explanation of the differences in survival among countries, while the incidence rates of metastatic cancer were similar.
Register-based studies of the relative survival of prostate cancer patients are influenced by national differences in clinical presentation at diagnosis. Differences in the proportion of patients with metastatic spread explained most of the difference in relative survival among patients in Denmark, Iceland and Sweden. Future country comparisons of relative survival should include adjustment for differences in patient characteristics, such as stage, prostate-specific antigen level and screening intensity.
PubMed ID
23453749 View in PubMed
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Does stage at diagnosis explain the difference in survival after breast cancer in Denmark and Sweden?

https://arctichealth.org/en/permalink/ahliterature17150
Source
Acta Oncol. 2004;43(8):719-26
Publication Type
Article
Date
2004
Author
Anni Ravnsbaek Jensen
Jens Peter Garne
Hans Henrik Storm
Gerda Engholm
Torgil Möller
Jens Overgaard
Author Affiliation
Centre for Cancer Documentation, Department of Experimental Clinical Oncology, Danish Cancer Society, Aarhus University Hospital, Denmark. anni@oncology.dk
Source
Acta Oncol. 2004;43(8):719-26
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Biopsy, Needle
Breast Neoplasms - mortality - pathology - therapy
Chemotherapy, Adjuvant
Cohort Studies
Combined Modality Therapy
Comparative Study
Denmark - epidemiology
Early Diagnosis
Female
Humans
Immunohistochemistry
Mammography - standards - trends
Mass Screening - organization & administration
Mastectomy - methods
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Radiotherapy, Adjuvant
Research Support, Non-U.S. Gov't
Risk assessment
Survival Analysis
Sweden - epidemiology
Abstract
Breast cancer survival differs 9 percentage points between the neighbouring countries of Denmark and Sweden. The authors' aim was to analyse whether this was caused by early detection in Sweden. The extent of disease and outcome was compared in two population-based breast cancer cohorts in 1983-1989. Breast cancer management was decentralized in Denmark without mammography screening whereas treatment in Sweden was centralized and the population partly screened. Ten- and 15-year relative survival was 15% and 6% higher in Sweden (p
PubMed ID
15764216 View in PubMed
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Impact of a smoking and alcohol intervention programme on lung and breast cancer incidence in Denmark: An example of dynamic modelling with Prevent.

https://arctichealth.org/en/permalink/ahliterature140785
Source
Eur J Cancer. 2010 Sep;46(14):2617-24
Publication Type
Article
Date
Sep-2010
Author
Isabelle Soerjomataram
Esther de Vries
Gerda Engholm
Georg Paludan-Müller
Henrik Brønnum-Hansen
Hans H Storm
Jan J Barendregt
Author Affiliation
Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands. i.soerjomataram@erasmusmc.nl
Source
Eur J Cancer. 2010 Sep;46(14):2617-24
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking - epidemiology - prevention & control
Breast Neoplasms - epidemiology - prevention & control
Computer simulation
Denmark - epidemiology
Female
Forecasting
Humans
Incidence
Lung Neoplasms - epidemiology - prevention & control
Male
Middle Aged
Models, Biological
Risk factors
Smoking - epidemiology - prevention & control
Young Adult
Abstract
Among the known risk factors, smoking is clearly related to the incidence of lung cancer and alcohol consumption is to breast cancer. In this manuscript we modelled the potential benefits of reductions in smoking or alcohol prevalence for the burden of these cancers.
We used Prevent v.3.01 to assess the changes in incidence as a result of risk factor changes. Incidence of lung and breast cancer until 2050 was predicted under two scenarios: ideal (total elimination of smoking and reduction of alcohol intake to maximum 1 units/d for women) and optimistic (decreasing prevalence of risk factors because of a 10% increase in cigarette and alcohol beverage price, repeated every 5 years). Danish data from the household surveys, cancer registration and Eurostat were used.
Up to 49% less new lung cancer cases can be expected in 2050 if smoking were to be completely eliminated. Five-yearly 10% price increases may prevent 521 new lung cancer cases in 2050 (21% less cases). An intervention that immediately reduces population alcohol consumption to the recommended level (below 12 g/d) may lower breast cancer by 7%, preventing 445 out of the 6060 expected new cases in 2050. Five-yearly 10% price increases in alcoholic beverages achieved a reduction of half as expected by the ideal scenario, i.e. 4% (262) preventable cases in 2050.
The future burden of lung and breast cancer could be markedly reduced by intervening in their risk factors. Prevent illustrates the benefit of interventions and may serve as guidance in political decision-making.
PubMed ID
20843490 View in PubMed
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Improved survival of Danish cancer patients 2007-2009 compared with earlier periods.

https://arctichealth.org/en/permalink/ahliterature129103
Source
Dan Med Bull. 2011 Dec;58(12):A4346
Publication Type
Article
Date
Dec-2011
Author
Hans Henrik Storm
Anne Mette Tranberg Kejs
Gerda Engholm
Author Affiliation
Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark. hans@cancer.dk
Source
Dan Med Bull. 2011 Dec;58(12):A4346
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Denmark - epidemiology
Female
Humans
Incidence
Life expectancy
Male
Middle Aged
Neoplasms - epidemiology - mortality
Registries
Survival Analysis
Time Factors
Abstract
For the majority of cancers, improved long-term survival may be accessed from survival during the first year after diagnosis. A steady improvement in survival was seen both before and after the introduction of cancer control plans in 2000 and 2005. On the basis of data from 2007-2009, we studied the trend in 1-year survival after the introduction of the 2005 plan.
All cancers from 1995-2009 were studied in five 3-year cohorts of incident cases which were followed-up for death to the end of 2010. Age-standardised 1-, 3- and 5-year relative survival was calculated and 1-year survival presented for 2004-2006 and 2007-2009 to allow comparison with our previous publication.
The improvement over time in overall 1-year age-standardised relative survival was maintained with a three percentage point increase to 72% for men and 75% for women. Exclusion of prostate and breast cancer from calculations lowered relative survival to 65% and 67%, respectively; but improvement was maintained. Cancer sites which previously enjoyed a high survival saw the least or no improvement as was the case for haematological cancers, except for non-Hodgkin lymphoma in men. The differences in survival between men and women are diminishing, especially for cancers of the digestive tract.
The improvements over time in survival after introduction of the cancer plans were maintained for non-haematological cancers. The fast-track system for diagnosis and treatment introduced gradually by cancer sites until the end of 2008 along with some centralisation of elective surgery may have narrowed the gap in cancer survival between men and women for digestive tract cancers and may also have improved survival for other cancers, e.g. the sex-specific types and kidney and brain cancers.
not relevant.
PubMed ID
22142575 View in PubMed
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44 records – page 1 of 5.