Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH) is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance.
The principal method in the Survey of Living Conditions in the Arctic (SLiCA) was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people's ethnic identity, and poorer spoken indigenous language ability (SILA). Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH.
Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P
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An organized mammography screening program was gradually implemented in Norway during the period 1996-2004. Norwegian authorities have initiated an evaluation of the program. Our study focused on breast cancer mortality. Using Poisson regression, we compared the change in breast cancer mortality from before to during screening in four counties starting the program early controlling for change in breast cancer mortality during the same time in counties starting the program late. A follow-up model included death in all breast cancers diagnosed during the follow-up period. An evaluation model included only breast cancers diagnosed in ages where screening was offered. The study group had been invited for screening one to three times and followed for on average of 5.9 years. In the follow-up model, 314 breast cancer deaths were observed in the study group, and 523, 404 and 638, respectively, in the four control groups. The ratio between the changes in breast cancer mortality between early and late starting counties was 0.93 (95% confidence interval [CI] 0.77-1.12). In the evaluation model, this ratio was 0.89 (95% CI: 0.71-1.12). In Norway, where 40% of women used regular mammography prior to the program, the implementation of the organized mammography screening program was associated with a statistically nonsignificant decrease in breast cancer mortality of around 11%.
Comment In: Int J Cancer. 2013 Apr 1;132(7):1721-222933058
Comment In: Int J Cancer. 2013 Apr 1;132(7):1723-422933134
Comment In: Int J Cancer. 2013 Apr 1;132(7):172722933244
Comment In: Int J Cancer. 2013 Apr 1;132(7):1725-622933188
OBJECTIVE: To examine the effect of smoking on breast cancer risk in a large population-based cohort of women, many of whom started smoking as teenagers.METHODS: We followed 102,098 women, ages 30 to 50 years, completing a mailed questionnaire at recruitment to the Norwegian-Swedish Cohort Study in 1991/1992, through December 2000. We used Cox proportional hazard regression models to estimate relative risk (RR) of breast cancer associated with different measures of smoking initiation, duration, and intensity adjusting for confounding variables. We conducted analyses on the entire study population, among women who had smoked for at least 20 years, among nondrinkers, and separately for each country.RESULTS: Altogether, 1,240 women were diagnosed with incident, invasive breast cancer. Compared with never smokers, women who smoked for at least 20 years and who smoked 10 cigarettes or more daily had a RR of 1.34 (95% CI, 1.06-1.70). Likewise, those who initiated smoking prior to their first birth (1.27, 1.00-1.62), before menarche (1.39, 1.03-1.87), or before age 15 (1.48, 1.03-2.13) had an increased risk. In contrast, women who had smoked for at least 20 years, but started after their first birth, did not experience an increased breast cancer risk. The increased RR associated with smoking was observed among nondrinkers of alcohol, women with and without a family history of breast cancer, premenopausal and postmenopausal women, and in both countries.CONCLUSION: Our results support the notion that women who start smoking as teenagers and continue to smoke for at least 20 years may increase their breast cancer risk.
Studies have shown that potato consumption in Norway have been on the decline in recent years. Increase in income and the association of potato consumption with weight gain and chronic diseases like type 2 diabetes have been identified as some of the factors responsible for the change. The aim of this study was to describe the change in potato consumption within persons and how non-dietary variables influenced that change among participants in the Norwegian Women and Cancer study (NOWAC). A prospective analysis was performed in the NOWAC cohort using linear regression. Data on dietary, lifestyle, socioeconomic and health-related factors were collected by mailed questionnaires. The change in potato consumption among 38,820 women aged 41-70 years was investigated using two measurements taken at intervals of 4-6 years. At baseline, mean intake was 112g per day; this had decreased to 94.5g per day at the second measurement. Results showed that the percentage of women who reported that they ate less than 1 potato a day increased from 24.6% at baseline to 35.5% at the second measurement. Those who reported that they ate more than 3 potatoes a day had decreased from 20.2% of the participants at baseline to 12.1% at the second measurement. Multivariable adjusted results show that geography was an important predictor of potato consumption at second measurement. Living in the north compared to Oslo (the capital) was associated with higher intake of potato at second measurement (B: 0.60, 95% CI: 0.55-0.65). Compared to women living with a partner, living alone was associated with lower potato intake at second measurement (B: -0.13, 95% CI: -0.17 --0.09) while living with children tended to be associated with higher potato intake at second measurement (B: 0.01, 95% CI: -0.02-0.04). Younger age, more years of education, higher income or BMI was associated with a lower potato intake at second measurement. Smoking was associated with a higher intake of potato at second measurement (B: 0.03, 95% CI: 0.00-0.06 for smokers compared to non-smokers). Having diabetes at baseline was associated with lower intake of potato at second measurement (B: -0.04, 95% CI: -0.14 --0.06 for non-diabetics compared to diabetics). Potato consumption among women in the NOWAC study showed a decline over the period studied. Change in the consumption was found to be influenced by age, education, income, household structure, region of residence as well as health-related factors like smoking and diabetes. The use of repeated measures is necessary to continue the monitoring and also to understand the stability and direction of the possible change in diet of a population.
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Cites: Food Nutr Res. 2015 Feb 19;59:2570325701150
To investigate dietary and non-dietary characteristics of wholegrain bread eaters in the Norwegian Women and Cancer study.
Cross-sectional study using an FFQ.
Women were divided into two groups according to wholegrain bread consumption.
Adult women (n 69 471).
Median daily consumption of standardized slices of wholegrain bread was 2·5 in the low intake group and 4·5 in the high intake group. The OR for high wholegrain bread consumption was 0·28, 2·19 and 4·63 for the first, third and fourth quartile of energy intake, respectively, compared with the second quartile. Living outside Oslo or in East Norway and having a high level of physical activity were associated with high wholegrain bread consumption. BMI and smoking were inversely associated with wholegrain bread consumption. Intake of many food items was positively associated with wholegrain bread consumption (P trend
The association between cigarette smoking and colorectal cancer (CRC) is still not established. In 2002, Norwegian women had the second highest incidence of CRC in the world. A large proportion of Norwegian women are ever smokers. We examined the association between cigarette smoking and CRC incidence among Norwegian women.
We followed 68,160 women, aged 30-69 years, from the Norwegian Women and Cancer Study who completed a questionnaire in 1996 or 1998 by linkages to national registers through 31 December 2005. Rate ratios (RRs) and 95% confidence intervals (CIs) were estimated by fitting Cox proportional hazard models. Subsequently, we estimated the population attributable fraction.
Altogether, 425 incident cases of primary, invasive CRC were identified. Ever smokers had a 20% increased risk of CRC (RR = 1.2; 95% CI = 1.0-1.5), a 30% increased risk of colon (RR = 1.3; 95% CI = 1.0-1.7), and a 10% increased risk of rectal (RR = 1.1; 95% CI = 0.7-1.5) cancer compared to never smokers. The population attributable fraction was estimated to be 12% which indicated that approximately one in eight of the CRC cases could have been prevented at a population level.
Our results support the hypothesis that cigarette smoking is a preventable cause of CRC among women.
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Studies on the association between heavy coffee consumption and risk of less frequently diagnosed cancers are scarce. We aimed to quantify the association between filtered, boiled, and total coffee consumption and the risk of bladder, esophageal, kidney, pancreatic, and stomach cancers. We used data from the Norwegian Women and Cancer Study and the Northern Sweden Health and Disease Study. Information on coffee consumption was available for 193,439 participants. We used multivariable Cox proportional hazards models to calculate hazard ratios (HR) with 95% confidence intervals (CI) for the investigated cancer sites by category of total, filtered, and boiled coffee consumption. Heavy filtered coffee consumers (= 4 cups/day) had a multivariable adjusted HR of 0.74 of being diagnosed with pancreatic cancer (95% CI 0.57-0.95) when compared with light filtered coffee consumers (= 1 cup/day). We did not observe significant associations between total or boiled coffee consumption and any of the investigated cancer sites, neither in the entire study sample nor in analyses stratified by sex. We found an increased risk of bladder cancer among never smokers who were heavy filtered or total coffee consumers, and an increased risk of stomach cancer in never smokers who were heavy boiled coffee consumers. Our data suggest that increased filtered coffee consumption might reduce the risk of pancreatic cancer. We did not find evidence of an association between coffee consumption and the risk of esophageal or kidney cancer. The increased risk of bladder and stomach cancer was confined to never smokers.
An association between coffee consumption and cancer has long been investigated. Coffee consumption among Norwegian women is high, thus this is a favorable population in which to study the impact of coffee on cancer incidence. Information on coffee consumption was collected from 91,767 women at baseline in the Norwegian Women and Cancer Study. These information were applied until follow-up information on coffee consumption, collected 6-8 years after baseline, became available. Multiple imputation was performed as a method for dealing with missing data. Multivariable Cox regression models were used to calculate hazard ratios (HR) for breast, colorectal, lung, and ovarian cancer, as well as cancer at any site. We observed a 17 % reduced risk of colorectal cancer (HR = 0.83, 95 % CI 0.70-0.98, p trend across categories of consumption = 0.10) and a 9 % reduced risk of cancer at any site (HR = 0.91, 95 % CI 0.86-0.97, p trend = 0.03) in women who drank more than 3 and up to 7 cups/day, compared to women who drank =1 cup/day. A significantly increased risk of lung cancer was observed with a heavy coffee consumption (>7 vs. =1 cup/day HR = 2.01, 95 % CI 1.47-2.75, p trend 5 vs. =1 cup/day HR = 1.42, 95 % CI 0.44-4.57, p trend = 0.30). No significant association was found between coffee consumption and the risk of breast or ovarian cancer. In this study, coffee consumption was associated with a modest reduced risk of cancer at any site. Residual confounding due to smoking may have contributed to the positive association between high coffee consumption and the risk of lung cancer.
Cites: Public Health Nutr. 2007 Oct;10(10):1094-103 PMID 17381903
Coffee contains biologically-active substances that suppress carcinogenesis in vivo, and coffee consumption has been associated with a lower risk of malignant melanoma. We studied the impact of total coffee consumption and of different brewing methods on the incidence of malignant melanoma in a prospective cohort of Norwegian women.
We had baseline information on total coffee consumption and consumption of filtered, instant, and boiled coffee from self-administered questionnaires for 104,080 women in the Norwegian Women and Cancer (NOWAC) Study. We also had follow-up information collected 6-8 years after baseline. Multiple imputation was used to deal with missing data, and multivariable Cox regression models were used to calculate hazard ratios (HR) for malignant melanoma by consumption category of total, filtered, instant, and boiled coffee.
During 1.7 million person-years of follow-up, 762 cases of malignant melanoma were diagnosed. Compared to light consumers of filtered coffee (=1 cup/day), we found a statistically significant inverse association with low-moderate consumption (>1-3 cups/day, HR?=?0.80; 95 % confidence interval [CI] 0.66-0.98) and high-moderate consumption of filtered coffee (>3-5 cups/day, HR?=?0.77; 95 % CI 0.61-0.97) and melanoma risk (p trend?=?0.02). We did not find a statistically significant association between total, instant, or boiled coffee consumption and the risk of malignant melanoma in any of the consumption categories.
The data from the NOWAC Study indicate that a moderate intake of filtered coffee could reduce the risk of malignant melanoma.
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Sickness absence is of considerable concern in both Norway and Denmark. Labour Force Surveys indicate that absence in Norway is about twice that in Denmark and twice that of the mean reported by the Organisation for Economic Co-operation and Development. This study compares absence patterns according to age, percentage of employment, and occupation between municipal employees in the health and care sectors in two municipalities in Norway and Denmark.
Data recorded in the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark were extracted for the years 2004 and 2008, revealing 3498 and 7751 employee-years, respectively. We calculated absence rates together with number of sick leave episodes, and their association with the above-mentioned covariates. Gender-specific comparative descriptive statistics and negative binomial regression analysis were performed.
The sickness absence rate in women was 11.3% in Norway (95% confidence interval [CI] 11.2-11.4) and 7.0% in Denmark (95% CI 7.0-7.1) whereas mean number of sick leave episodes among women was 2.4 in Denmark, compared to 2.3 in Norway (p = 0.02). Young employees in Denmark had more sick leave episodes than in Norway. Proportion of absentees was higher in Denmark compared to Norway (p