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Aggressiveness of screen-detected breast cancers.

https://arctichealth.org/en/permalink/ahliterature215968
Source
Lancet. 1995 Jan 28;345(8944):221-4
Publication Type
Article
Date
Jan-28-1995
Author
M. Hakama
K. Holli
J. Isola
O P Kallioniemi
A. Kärkkäinen
T. Visakorpi
E. Pukkala
I. Saarenmaa
U. Geiger
J. Ikkala
Author Affiliation
Department of Public Health, University of Tampere, Finland.
Source
Lancet. 1995 Jan 28;345(8944):221-4
Date
Jan-28-1995
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - mortality - pathology - prevention & control
DNA, Neoplasm - analysis
Female
Finland - epidemiology
Flow Cytometry
Humans
Lymphatic Metastasis
Mammography
Mass Screening - methods
Middle Aged
Neoplasm Staging
Abstract
It is not clear whether screening for breast cancer works as public health policy and whether early indicators of effect predict an ultimate reduction in mortality. The malignant potentials of 248 breast cancers detected by the screening service in Finland were compared with those of 490 control cancers diagnosed before the screening service was established. Aggressiveness was assessed by DNA flow cytometry and clinical status by cancer size and node involvement. After the first screening round, the results of DNA flow cytometry were the same in cancers diagnosed by screening and in controls; these findings are consistent with the hypothesis that the biological aggressiveness of breast cancer remains constant as the cancer progresses. The proportion of patients with node-negative and small T1 cancers after the first screening was higher among the screened population than among controls, indicating earliness of diagnosis among those screened. Cancers diagnosed in the first round had a low malignant potential, as indicated by the DNA flow-cytometry and by clinical stage. Lower aggressiveness of cancers found by screening than of control cancers would indicate overdiagnosis or length-biased sampling, but not earliness of diagnosis. Screening with mammography is practised as a public-health policy in Finland. The results predict that the mortality reduction found in randomised trials can be repeated with a screening service.
Notes
Comment In: Lancet. 1995 Apr 1;345(8953):853; author reply 854-57898236
Comment In: Lancet. 1995 Apr 1;345(8953):854; author reply 854-57898238
Comment In: Lancet. 1995 Apr 1;345(8953):853-4; author reply 854-57898237
PubMed ID
7741862 View in PubMed
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Alcohol intake, drinking patterns, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins.

https://arctichealth.org/en/permalink/ahliterature283880
Source
Cancer Causes Control. 2016 Sep;27(9):1049-58
Publication Type
Article
Date
Sep-2016
Author
BA Dickerman
SC Markt
M. Koskenvuo
E. Pukkala
LA Mucci
J. Kaprio
Source
Cancer Causes Control. 2016 Sep;27(9):1049-58
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcohol Drinking - adverse effects
Cohort Studies
Female
Finland - epidemiology
Humans
Male
Middle Aged
Models, Theoretical
Prospective Studies
Prostatic Neoplasms - epidemiology - mortality
Risk
Surveys and Questionnaires
Abstract
Alcohol intake may be associated with cancer risk, but epidemiologic evidence for prostate cancer is inconsistent. We aimed to prospectively investigate the association between midlife alcohol intake and drinking patterns with future prostate cancer risk and mortality in a population-based cohort of Finnish twins.
Data were drawn from the Older Finnish Twin Cohort and included 11,372 twins followed from 1981 to 2012. Alcohol consumption was assessed by questionnaires administered at two time points over follow-up. Over the study period, 601 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between weekly alcohol intake and binge drinking patterns with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were performed to control for potential confounding by shared genetic and early environmental factors.
Compared to light drinkers (=3 drinks/week; non-abstainers), heavy drinkers (>14 drinks/week) were at a 1.46-fold higher risk (HR 1.46; 95 % CI 1.12, 1.91) of prostate cancer, adjusting for important confounders. Among current drinkers, binge drinkers were at a significantly increased risk of prostate cancer (HR 1.28; 95 % CI 1.06, 1.55) compared to non-binge drinkers. Abstainers were at a 1.90-fold higher risk (HR 1.90; 95 % CI 1.04, 3.47) of prostate cancer-specific mortality compared to light drinkers, but no other significant associations for mortality were found. Co-twin analyses suggested that alcohol consumption may be associated with prostate cancer risk independent of early environmental and genetic factors.
Heavy regular alcohol consumption and binge drinking patterns may be associated with increased prostate cancer risk, while abstinence may be associated with increased risk of prostate cancer-specific mortality compared to light alcohol consumption.
Notes
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PubMed ID
27351919 View in PubMed
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Angiosarcoma after radiotherapy: a cohort study of 332,163 Finnish cancer patients.

https://arctichealth.org/en/permalink/ahliterature163416
Source
Br J Cancer. 2007 Jul 2;97(1):115-7
Publication Type
Article
Date
Jul-2-2007
Author
A. Virtanen
E. Pukkala
A. Auvinen
Author Affiliation
Tampere School of Public Health, FI-33014 University of Tampere, Tampere, Finland. anna.virtanen@uta.fi
Source
Br J Cancer. 2007 Jul 2;97(1):115-7
Date
Jul-2-2007
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Female
Finland
Follow-Up Studies
Hemangiosarcoma - epidemiology - etiology
Humans
Incidence
Male
Middle Aged
Neoplasms - drug therapy - radiotherapy
Neoplasms, Radiation-Induced - epidemiology
Neoplasms, Second Primary - epidemiology - etiology
Radiotherapy - adverse effects
Risk factors
Abstract
We evaluated the risk of angiosarcoma after radiotherapy among all patients with cancers of breast, cervix uteri, corpus uteri, lung, ovary, prostate, or rectum, and lymphoma diagnosed in Finland during 1953-2003, identified from the Finnish Cancer Registry. Only angiosarcomas of the trunk were considered, this being the target of radiotherapy for the first cancer. In the follow-up of 1.8 million person-years at risk, 19 angiosarcomas developed, all after breast and gynaecological cancer. Excess of angiosarcomas over national incidence rates were observed after radiotherapy without chemotherapy (standardised incidence ratio (SIR) 6.0, 95% confidence interval (CI) 2.7-11), after both radiotherapy and chemotherapy (SIR 100, 95% CI 12-360), and after other treatments (SIR 3.6, 95% CI 1.6-7.1). In the regression analysis however, the adjusted rate ratio for radiotherapy was 1.0 (95% CI 0.23-4.4). Although an increased risk of angiosarcoma among cancer patients is evident, especially with breast and gynaecological cancer, the excess does not appear to be strongly related to radiotherapy.
Notes
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Cites: Radiat Med. 1998 Jan-Feb;16(1):55-609568635
Cites: Cancer. 1991 Aug 1;68(3):524-312065271
PubMed ID
17519906 View in PubMed
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Arsenic concentrations in well water and risk of bladder and kidney cancer in Finland.

https://arctichealth.org/en/permalink/ahliterature201045
Source
Environ Health Perspect. 1999 Sep;107(9):705-10
Publication Type
Article
Date
Sep-1999
Author
P. Kurttio
E. Pukkala
H. Kahelin
A. Auvinen
J. Pekkanen
Author Affiliation
National Public Health Institute, Unit of Environmental Epidemiology, Kuopio, Finland. paivi.kurttio@ktl.fi
Source
Environ Health Perspect. 1999 Sep;107(9):705-10
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Arsenic - analysis
Arsenic Poisoning - complications
Female
Finland
Fresh Water - analysis
Humans
Kidney Neoplasms - chemically induced
Male
Risk
Smoking - adverse effects
Urinary Bladder Neoplasms - chemically induced
Water Pollutants, Chemical - toxicity
Water Supply - analysis
Abstract
We assessed the levels of arsenic in drilled wells in Finland and studied the association of arsenic exposure with the risk of bladder and kidney cancers. The study persons were selected from a register-based cohort of all Finns who had lived at an address outside the municipal drinking-water system during 1967-1980 (n = 144,627). The final study population consisted of 61 bladder cancer cases and 49 kidney cancer cases diagnosed between 1981 and 1995, as well as an age- and sex-balanced random sample of 275 subjects (reference cohort). Water samples were obtained from the wells used by the study population at least during 1967-1980. The total arsenic concentrations in the wells of the reference cohort were low (median = 0.1 microg/L; maximum = 64 microg/L), and 1% exceeded 10 microg/L. Arsenic exposure was estimated as arsenic concentration in the well, daily dose, and cumulative dose of arsenic. None of the exposure indicators was statistically significantly associated with the risk of kidney cancer. Bladder cancer tended to be associated with arsenic concentration and daily dose during the third to ninth years prior to the cancer diagnosis; the risk ratios for arsenic concentration categories 0.1-0.5 and [Greater/equal to] 0.5 microg/L relative to the category with
Notes
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PubMed ID
10464069 View in PubMed
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[Association between cancer and exposure to chlorophenols in a county located in southern Finland].

https://arctichealth.org/en/permalink/ahliterature227775
Source
Duodecim. 1991;107(9):702-10
Publication Type
Article
Date
1991

Attack rates of human papillomavirus type 16 and cervical neoplasia in primiparous women and field trial designs for HPV16 vaccination.

https://arctichealth.org/en/permalink/ahliterature198554
Source
Sex Transm Infect. 2000 Feb;76(1):13-7
Publication Type
Article
Date
Feb-2000
Author
M. Kibur
V. af Geijerstamm
E. Pukkala
P. Koskela
T. Luostarinen
J. Paavonen
J. Schiller
Z. Wang
J. Dillner
M. Lehtinen
Author Affiliation
Department of Epidemiology and Biostatistics, Institute of Experimental and Clinical Medicine, Tallinn, Estonia.
Source
Sex Transm Infect. 2000 Feb;76(1):13-7
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Female
Finland - epidemiology
Humans
Incidence
Longitudinal Studies
Papillomaviridae - immunology
Papillomavirus Infections - epidemiology - prevention & control
Parity
Pregnancy
Research Design
Risk factors
Uterine Cervical Neoplasms - epidemiology - virology
Viral Vaccines - administration & dosage
Abstract
Identification of human papillomavirus type 16 (HPV16) as the major risk factor for cervical neoplasia, and mass production of DNA free HPV capsids have paved the way to preventive vaccination trials. Design of such trials requires reliable attack rate data.
Determination of (1) HPV16 and (2) cervical neoplasia attack rates in primiparous women. Estimation of actuarial sample sizes for HPV16 vaccination phase IV trials.
A longitudinal cohort study.
Population based Finnish Maternity Cohort (FMC) and Finnish Cancer Registry (FCR) were linked for the identification of two cohorts of primiparous women: (1) a random subsample of the FMC: 1656 women with two pregnancies between 1983-9 or 1990-6 and living in the Helsinki metropolitan area, and (2) all 72,791 primiparous women living in the same area during 1983-94. Attack rate for persistent HPV16 infection (1) was estimated in 1279 seronegative women by proportion of seroconversions between the first and the second pregnancy. Comparable 10 year cumulative incidence rate (CR) of cervical intraepithelial neoplasia grade III and cervical cancer (CIN III+) (2) was estimated based on cases registered at the FCR during 1991-4.
The HPV16 attack rates were 13.8% (
Notes
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PubMed ID
10817062 View in PubMed
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Avoidable cancers in the Nordic countries. Alcohol consumption.

https://arctichealth.org/en/permalink/ahliterature11109
Source
APMIS Suppl. 1997;76:48-67
Publication Type
Article
Date
1997
Author
L. Dreyer
J F Winther
A. Andersen
E. Pukkala
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society.
Source
APMIS Suppl. 1997;76:48-67
Date
1997
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects
Animals
Female
Finland - epidemiology
Humans
Iceland - epidemiology
Incidence
Male
Neoplasms - epidemiology - etiology - prevention & control
Risk factors
Scandinavia - epidemiology
Abstract
Alcohol intake is causally associated with cancers of the larynx, oral cavity, pharynx, oesophagus and liver. In all five Nordic countries, alcohol consumption increased substantially between 1965 (6.5 litres per adult per year) and 1975 (10 litres), but remained at about 10 litres between 1975 and 1985. The daily consumption of men during the period was substantially higher than that of women, and that of both men and women was higher in Denmark than in the other Nordic countries. In about 2000, an annual total of almost 1,300 cancer cases (1,000 in men and 300 in women) would be avoided if alcohol drinking were eliminated. This corresponds to about 29% of all alcohol-related cancers, i.e. in the oesophagus (37%), oral cavity and pharynx (33%), larynx (29%) and liver (15%). About 2% of all cancers in men and 1% in women in the Nordic countries around the year 2000 will be caused by the drinking habits of the respective populations.
PubMed ID
9462819 View in PubMed
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Avoidable cancers in the Nordic countries. External environment.

https://arctichealth.org/en/permalink/ahliterature22274
Source
APMIS Suppl. 1997;76:80-2
Publication Type
Article
Date
1997
Author
L. Dreyer
A. Andersen
E. Pukkala
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society.
Source
APMIS Suppl. 1997;76:80-2
Date
1997
Language
English
Publication Type
Article
Keywords
Air Pollutants, Environmental - adverse effects
Carcinogens, Environmental - adverse effects
Finland - epidemiology
Humans
Iceland - epidemiology
Incidence
Neoplasms - chemically induced - epidemiology - prevention & control
Risk factors
Scandinavia - epidemiology
Abstract
Air pollutants arising from traffic clustering and industrial production include a number of chemical compounds that at high doses are carcinogenic in animal models and in some instances also in humans. Direct epidemiological evidence for a carcinogenic effect of air pollution in humans is, however, weak, and most of the available studies are limited by lack of adequate control of confounding factors and other methodological drawbacks. Limited evidence exists for a link between urban air pollution and lung cancer, with reported relative risks of 1.0-1.5. About one-third of the population of the Nordic countries, corresponding to 7.3 million people, lives in urban areas. If there is an excess risk associated with air pollution, the annual number of lung cancer cases around the year 2000 in the Nordic countries would range from 0 (no excess risk) to 1,800 (relative risk, 1.5). As the existence of a causal link between air pollution and cancer is not uncorroborated, measures for avoiding cancer from this source cannot be recommended.
PubMed ID
9462821 View in PubMed
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Avoidable cancers in the Nordic countries. Occupation.

https://arctichealth.org/en/permalink/ahliterature22275
Source
APMIS Suppl. 1997;76:68-79
Publication Type
Article
Date
1997
Author
L. Dreyer
A. Andersen
E. Pukkala
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society.
Source
APMIS Suppl. 1997;76:68-79
Date
1997
Language
English
Publication Type
Article
Keywords
Air Pollutants, Occupational - adverse effects
Carcinogens - adverse effects
Female
Finland - epidemiology
Humans
Iceland - epidemiology
Incidence
Male
Neoplasms - epidemiology - etiology - prevention & control
Risk factors
Scandinavia - epidemiology
Abstract
A number of chemicals encountered predominantly in occupational settings have been causally linked with cancer in humans; furthermore, several industrial processes and occupations have been associated convincingly with increased rates of cancer, although the specific carcinogens remain to be identified. The tissues affected are mainly the epithelial lining of the respiratory organs (nasal cavity, paranasal sinuses, larynx and lung), and urinary tract (renal parenchyma, renal pelvis and urinary bladder), the mesothelial linings, the bone marrow and the liver. During the period 1970-84, almost 4 million people (3.7 million men and 0.2 million women) in the Nordic countries were potentially exposed to above-average levels of one or more verified industrial carcinogens. It is expected that these exposures will result in a total of about 1,900 new cases of cancer every year in the Nordic countries around the year 2000, with 1,890 among men and fewer than 25 among women. The proportions that could be avoided if industrial carcinogens were eliminated would be 70% of mesotheliomas, 20% of cancers of the nasal cavity and sinuses, 12% of lung cancers, 5% of laryngeal cancers, 2% of urinary bladder cancers, 1% of the leukaemias, and 1% of renal cancers. Overall, it is estimated that verified industrial carcinogens will account for approximately 3% of all cancers in men and less than 0.1% of all cancers in women in the Nordic countries around the year 2000. No attempt was made to estimate the potential effects of suspected carcinogens in the workplace.
PubMed ID
9462820 View in PubMed
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Avoidable cancers in the Nordic countries. Radiation.

https://arctichealth.org/en/permalink/ahliterature22273
Source
APMIS Suppl. 1997;76:83-99
Publication Type
Article
Date
1997
Author
J F Winther
K. Ulbak
L. Dreyer
E. Pukkala
A. Osterlind
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society.
Source
APMIS Suppl. 1997;76:83-99
Date
1997
Language
English
Publication Type
Article
Keywords
Female
Finland - epidemiology
Humans
Iceland - epidemiology
Incidence
Male
Neoplasms - epidemiology - etiology - prevention & control
Risk factors
Scandinavia - epidemiology
Ultraviolet Rays - adverse effects
Abstract
Exposure to solar and ionizing radiation increases the risk for cancer in humans. Some 5% of solar radiation is within the ultraviolet spectrum and may cause both malignant melanoma and non-melanocytic skin cancer; the latter is regarded as a benign disease and is accordingly not included in our estimation of avoidable cancers. Under the assumption that the rate of occurrence of malignant melanoma of the buttocks of both men and women and of the scalp of women would apply to all parts of the body in people completely unexposed to solar radiation, it was estimated that approximately 95% of all malignant melanomas arising in the Nordic populations around the year 2000 will be due to exposure to natural ultraviolet radiation, equivalent to an annual number of about 4700 cases, with 2100 in men and 2600 in women, or some 4% of all cancers notified. Exposure to ionizing radiation in the Nordic countries occurs at an average effective dose per capita per year of about 3 mSv (Iceland, 1.1 mSv) from natural sources, and about 1 mSv from man-made sources. While the natural sources are primarily radon in indoor air, natural radionuclides in food, cosmic radiation and gamma radiation from soil and building materials, the man-made sources are dominated by the diagnostic and therapeutic use of ionizing radiation. On the basis of measured levels of radon in Nordic dwellings and associated risk estimates for lung cancer derived from well-conducted epidemiological studies, we estimated that about 180 cases of lung cancer (1% of all lung cancer cases) per year could be avoided in the Nordic countries around the year 2000 if indoor exposure to radon were eliminated, and that an additional 720 cases (6%) could be avoided annually if either radon or tobacco smoking were eliminated. Similarly, it was estimated that the exposure of the Nordic populations to natural sources of ionizing radiation other than radon and to medical sources will each give rise to an annual total of 2120 cancers at various sites. For all types of ionizing radiation, the annual total will be 4420 cancer cases, or 3.9% of all cancers arising in the Nordic populations, with 3.4% in men and 4.4% in women.
PubMed ID
9462822 View in PubMed
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217 records – page 1 of 22.