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  • 1
    Keywords: CANCER ; LUNG ; LUNG-CANCER ; COHORT ; MORTALITY ; POPULATION ; RISK ; RISKS ; SITES ; PATIENT ; FAMILY ; SKIN ; ASSOCIATION ; BREAST ; LYMPHOMA ; OVARIAN-CANCER ; smoking ; MELANOMA ; SWEDEN ; cancer risk ; DATABASE ; HIGH-RISK ; TRENDS ; MANAGEMENT ; asthma ; REGISTRY ; FAMILIES ; cancer registries ; AUTOIMMUNE-DISEASES ; allergy ; CANCERS ; CANCER-RISK ; national databases ; 33 ; TIMES ; ADULT ASTHMA
    Abstract: Asthma is an increasingly common disorder, affecting 5-10% of the population. It involves a dysregulated immune function, which may predispose to subsequent cancer. We examined cancer risk among Swedish subjects who had hospital admission once or multiple times for asthma. An asthma research database was created by identifying asthma patients from the Swedish Hospital Discharge Register and by linking them with the Cancer Registry. A total of 140 425 patients were hospitalised for asthma during 1965-2004, of whom 7421 patients developed cancer, giving an overall standardised incidence ratio (SIR) of 1.36. A significant increase was noted for most sites, with the exception of breast and ovarian cancers and non-Hodgkin's lymphoma and myeloma. Patients with multiple hospital admissions showed a high risk, particularly for stomach (SIR 1.70) and colon (SIR 1.99) cancers. A significant decrease was noted for endometrial cancer and skin melanoma. Oesophageal and lung cancers showed high risks throughout the study period, whereas stomach cancer increased towards the end of the period. The relatively stable temporal trends suggest that the asthmatic condition rather than its medication is responsible for the observed associations. British Journal of Cancer (2009) 100, 829-833. doi: 10.1038/sj.bjc.6604890 www.bjcancer.com Published online 27 January 2009 (C) 2009 Cancer Research UK
    Type of Publication: Journal article published
    PubMed ID: 19174822
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  • 2
    Keywords: CANCER ; CELL ; LUNG ; FOLLOW-UP ; COHORT ; EPIDEMIOLOGY ; liver ; POPULATION ; RISK ; RISKS ; TIME ; PATIENT ; kidney ; SKIN ; LYMPHOMA ; CARE ; smoking ; PATHOGENESIS ; SWEDEN ; cancer risk ; DATABASE ; HIGH-RISK ; TOBACCO ; ALCOHOL ; SKIN-CANCER ; PSORIASIS ; REGISTRY ; pancreas ; cancer registries ; non-Hodgkin lymphoma ; TWINS ; CANCERS ; CANCER-RISK ; SQUAMOUS-CELL ; SWEDISH ; national databases ; WELL ; TIMES ; CRC ; FINNISH PATIENTS ; PUVA
    Abstract: We examined overall and specific cancer risks among Swedish subjects who had been hospitalised one or more times for psoriasis. A database was created by identifying such patients from the Swedish Hospital Discharge Register and linking them with the Cancer Registry. Follow-up of patients was carried out from the last hospitalisation through 2004. A total of 15 858 patients were hospitalised for psoriasis during 1965-2004, of whom 1408 developed cancer, giving an overall standardised incidence ratios (SIRs) of 1.33. A significant excess was noted for squamous cell skin cancer, and for cancers of the upper aerodigestive tract, oesophagus, stomach, liver, pancreas, lung, kidney and bladder as well as non-Hodgkin lymphoma. Many of these may reflect the effects of alcohol drinking and tobacco smoking. Patients with multiple hospitalisations showed high risk, particularly for oesophageal (SIR 6.97) and skin (SIR 4.76) cancers
    Type of Publication: Journal article published
    PubMed ID: 19352386
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  • 3
    Keywords: CANCER ; tumor ; CELL ; FOLLOW-UP ; DISEASE ; EPIDEMIOLOGY ; RISK ; RISKS ; TUMORS ; PATIENT ; kidney ; FAMILY ; SKIN ; LYMPHOMA ; AGE ; leukemia ; SWEDEN ; cancer risk ; DATABASE ; HIGH-RISK ; SKIN-CANCER ; fibrosis ; REGISTRY ; FAMILIES ; cancer registries ; INCREASED RISK ; CANCERS ; CANCER-RISK ; SQUAMOUS-CELL ; SARCOIDOSIS ; SWEDISH ; UK ; national databases ; subsequent cancer ; HOSPITALIZATIONS ; PULMONARY SARCOIDOSIS
    Abstract: Background: Sarcoidosis patients show dysregulated immune function, which may be related to subsequent cancer. We examined here the overall and specific cancer risks among Swedish subjects who had been hospitalized for sarcoidosis. Methods: A sarcoidosis research database was created by identifying hospitalized sarcoidosis patients from the Swedish Hospital Discharge Register and by linking them with the Cancer Registry. Standardized incidence ratios (SIRs) were calculated for cancers in sarcoidosis patients compared with subjects without sarcoidosis. Results: A total of 10 037 patients were hospitalized for sarcoidosis during years 1964-2004. Among them 1045 patients developed subsequent cancer, giving an overall SIR of 1.40 and 1.18 for cancer diagnosed later than 1 year of follow-up. A significant excess was noted for skin (squamous cell), kidney and nonthyroid endocrine tumors and additionally for non-Hodgkin's lymphoma and leukemia. Patients with multiple hospitalizations showed high risks. Conclusions: A 40% overall excess incidence of cancer was noted among sarcoidosis patients, but the increase was confined mainly to the first year after hospitalization. However, the increased risks of skin cancer and non-Hodgkin's lymphoma and leukemia, especially for those with multiple hospitalizations or hospitalized at old age, call for clinical attention
    Type of Publication: Journal article published
    PubMed ID: 19211624
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  • 4
    Keywords: GENERATION ; liver ; RISK ; SITE ; TISSUE ; mechanisms ; ASSOCIATION ; PROGNOSTIC-FACTORS
    Abstract: PURPOSE Cancer of unknown primary (CUP) is diagnosed at the metastatic stage, and despite extensive diagnostic work-up, the primary tumor often remains unidentified. No data are available on familial clustering of CUP. We hypothesize that familial clustering of CUP with other cancers may be informative of the primary sites. PATIENTS AND METHODS A total of 35,168 patients with CUP were identified in the Swedish Family-Cancer Database, and risks between family members were calculated for concordant (CUP-CUP) and discordant (CUP-any other cancer) cancers using standardized incidence ratio (SIR). Results Familial cases of CUP accounted for 2.8% of all CUP cases in the offspring generation. Familial SIR for CUP was 1.69 when a sibling was diagnosed with CUP. As to discordant associations between siblings, CUP was associated with lung (SIR, 1.87), kidney (SIR, 1.82), liver (SIR, 1.67), ovarian (SIR, 1.45), colorectal (SIR, 1.26), and breast (SIR, 1.15) cancers and melanoma (SIR, 1.26). Upper aerodigestive tract, bladder, pancreatic, and prostate cancers were additionally associated with CUP. Notably, CUP was associated with families of kidney, lung, and colorectal cancers. CONCLUSION The present data show that CUP is not a disease of random metastatic cancers but, instead, a disease of a defined set of cancers. The association of CUP with families of kidney, lung, and colorectal cancers suggests a marked genetic basis and shared metastatic mechanisms by many cancer types. Familial sites shared by CUP generally match those arising in tissue-of-origin determinations and, hence, suggest sites of origin for CUP. Mechanistic exploration of CUP may provide insight into defense against primary tumors and the metastatic process.
    Type of Publication: Journal article published
    PubMed ID: 21189391
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  • 5
    Keywords: CANCER ; SURVIVAL ; COHORT ; DISEASE ; MORTALITY ; POPULATION ; RISK ; RISKS ; STAGE ; cancer survival ; SARCOIDOSIS ; hazard ratios
    Abstract: Background: Sarcoidosis has been reported to be associated with an increased risk of cancer; however, little information is available about the prognosis for sarcoidosis patients diagnosed with cancer. Patients and methods: A population-based cohort of sarcoidosis patients was identified from Swedish registers. Cause-specific and overall hazard ratios (HRs) were estimated by using Cox regression model to show the probability of death in the study group compared with the control population. Results: A total of 1167 sarcoidosis patients were identified with subsequent cancer compared with 1 023 725 cancer patients without sarcoidosis from 1964 to 2006, showing a significant survival disparity [overall HR 1.21, 95% confidence interval (CI) 1.13-1.30 and cause-specific HR 1.16, 95% CI 1.08-1.27]. Site-specific analyses revealed that an overall mortality excess in sarcoidosis patients was observed for six cancers in comparison with a cancer-specific mortality excess for four cancers. Notably, stratified analyses showed that the prognosis was worse for cancer patients diagnosed below age 65 years. Cancer sites with significant mortality excess after sarcoidosis were mutually exclusive for men and women. Conclusions: A previously diagnosed sarcoidosis worsens the prognosis of cancer, preferentially for those diagnosed at a relatively younger age. The underlying mechanisms and more prognostic factors warrant further investigation
    Type of Publication: Journal article published
    PubMed ID: 21186236
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  • 6
    Keywords: CANCER ; COHORT ; RISK ; SWEDEN ; adenocarcinoma ; CARCINOID-TUMORS ; PSORIASIS ; DISORDERS ; MYASTHENIA-GRAVIS ; autoimmune disease ; FAMILIAL RISKS ; PERNICIOUS-ANEMIA ; HOSPITALIZATIONS ; digestive tract
    Abstract: BACKGROUND: Dysregulation of the immune function in autoimmune diseases could potentially lead to cancer development and there is definite evidence linking some autoimmune mechanisms with cancer. We analyzed systematically the occurrence of histology-specific digestive tract cancers in patients diagnosed with 33 different autoimmune diseases in order to address the question of shared susceptibility. PATIENTS AND METHODS: Standardized incidence ratios (SIRs) were calculated for subsequent digestive tract cancers up to the year 2008 and in patients hospitalized for autoimmune disease after the year 1964. RESULTS: Myasthenia gravis associated with five different cancers with SIRs ranging from 1.35 to 2.78. Pernicious anemia, Crohn disease, ulcerative colitis, systemic lupus erythematosis and psoriasis were also associated with cancers at multiple sites. Rheumatoid arthritis associated with no cancer and the standardized incidence ratio was decreased for colon adenocarcinoma, also in ankylosing spondylitis patients. CONCLUSIONS: Increased risks of cancer were observed in patients with several autoimmune diseases. Myasthenia gravis and pernicious anemia were associated with many cancers; this is possibly related to immunosuppressant medication in myasthenia gravis. The decreased risks in colon and rectal adenocarcinomas in rheumatoid arthritis and ankylosing spondylitis suggest underlying inflammatory mechanisms as the risks may have been suppressed by the use of anti-inflammatory medication.
    Type of Publication: Journal article published
    PubMed ID: 21810731
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  • 7
    Keywords: FOLLOW-UP ; BREAST-CANCER ; SWEDEN ; aspirin ; MALIGNANCY ; RHEUMATOID-ARTHRITIS PATIENTS ; METAANALYSIS ; FAMILIAL RISKS ; HOSPITALIZATIONS ; HYPOTHYROIDISM
    Abstract: OBJECTIVES: Patients with autoimmune (AI) diseases are diagnosed with increased frequencies of some cancers, which may depend on the underlying dysregulation of the immune system or treatment. Data on female cancers are limited. METHODS: We analyzed systematically risk and survival of female cancers of the breast, uterus, ovary and other genital organs in close to 200,000 patients diagnosed with any of 33 different AI diseases. Standardized incidence ratios (SIRs) for risk and hazard ratios (HRs) for survival were calculated for subsequent incident cancers or cancer deaths up to year 2008. RESULTS: For all breast cancer after any AI diseases, the SIR was 0.94; SIRs were modestly increased after two AI diseases and decreased after nine AI diseases, including Sjogren syndrome (0.46). For cervical cancer, the risk was increased after discoid lupus erythematosus (3.34) and systemic sclerosis (2.43). The HR was 2.12 in chronic rheumatic heart disease patients. The overall SIR for endometrial cancer was 0.85, with low SIR in ankylosing spondylitis (0.37); the HR was 4.05 for Sjogren syndrome. The SIR for ovarian cancer was increased for polymyositis/dermatomyositis (3.26) while the HR was increased for multiple sclerosis (2.43). The overall SIR for other genital cancers was increased to 1.54 and a very high risk of 35.88 was observed in localized scleroderma. CONCLUSIONS: Breast, endometrial and ovarian cancers were decreased after all AI diseases and most significant changes after individual AI diseases were towards lower risks. Probably treatment related factors explain the findings. For cervical and other genital cancers all significant changes were increased risks.
    Type of Publication: Journal article published
    PubMed ID: 22819787
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  • 8
    Keywords: RISK ; AGE
    Type of Publication: Journal article published
    PubMed ID: 22826277
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  • 9
    Keywords: carcinoma ; SUSCEPTIBILITY ; BREAST ; germline mutations ; SKIN-CANCER ; MYCOSIS-FUNGOIDES ; CUTANEOUS MALIGNANT-MELANOMA ; SPECTRUM ; DYSPLASTIC NEVUS SYNDROME ; FAMMM SYNDROME
    Abstract: Using the Swedish Family-Cancer Database, we assessed the effect of a detailed family history of melanoma on risk for other tumors (other than melanoma). Among 248,011 individuals with a family history of melanoma, 43,931 other tumors were diagnosed from 1958 to 2010. Standardized incidence ratios (SIRs) were calculated for other tumors in patients who had a family history of melanoma, as compared with those without. A detailed family history of melanoma was investigated according to an increasing number of melanomas in either 1 or 〉= 2 first-degree relatives (FDRs). Associations were considered significant when there were at least two independently significant SIRs or a statistically significant trend of increasing SIRs with increasing number of melanomas in relatives. The applied criteria for significant associations were convincingly met by pancreatic, breast, prostate, and squamous cell skin tumors and ependymoma, although there was significant but not overwhelming evidence for thyroid, parathyroid, lung, and unknown primary tumors, meningioma, mycosis fungoides, and myeloid leukemia. To our knowledge, no studies have previously considered a detailed family history of melanoma and the use of internal validation to assess familial associations of melanoma with other tumors. We established associations for 12 other tumors, and the associations for myeloid leukemia, parathyroid, and unknown primary tumors are, to our knowledge, previously unreported.
    Type of Publication: Journal article published
    PubMed ID: 24192716
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  • 10
    Keywords: COMMON ; RISKS ; smoking ; DATABASE ; TOBACCO ; ENVIRONMENTAL-FACTORS ; ALCOHOL-DRINKING ; HUMAN CARCINOGENS
    Abstract: The population attributable fraction (PAF) defines the proportion of a disease that would be prevented if the exposure to a particular risk factor was avoided. Familial risk is a known risk factor for many cancers, but an unbiased estimation of the PAF for familial risk requires a large study population to include rare cancers. PAFs and their corresponding standardized incidence ratios (SIRs) were calculated for familial relative risk among first-degree relatives (FDRs) and second-degree relatives (SDRs) diagnosed with the same (concordant) invasive or in situ cancers. Calculations were based on the Swedish Family-Cancer Database considering 8,148,737 individuals. To assess environmental effects, PAFs were also calculated for concordant cancers among spouses. Almost all cancers showed a significant familial risk. The highest PAFs were found for the common cancers of the prostate (13.94%), breast (7.46%) and colorectum (6.78%) among the FDRs. In the FDRs, the overall PAF for any concordant cancer was 4.20%, but in the SDRs, it was only 0.34%. The overall PAFs for in situ cancers were 0.86% and 0.56% for the FDRs and SDRs, respectively. The overall independent familial PAF was 5.96% for the invasive and in situ cancers in the FDRs and SDRs. The cancers between spouses yielded an overall PAF of 0.14%. For esophageal cancer, the risk among spouses was higher than the familial risk. Our study shows that the overall familial PAF of 5.96%, although underestimated for sex-specific cancers, ranks as the third most common population burden after tobacco smoking and unhealthy diet.
    Type of Publication: Journal article published
    PubMed ID: 24590453
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