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  • 1
    Publication Date: 2018-03-09
    Description: Background Cardiovascular disease (CVD) is the main cause of death in most industrialised countries, including those in Europe. The mortality rates due to coronary heart disease (CHD), one of the most serious CVD conditions, have been decreasing in most European countries during the last decades. However, whether the trends over time in CHD mortality rates differ depending on neighbourhood deprivation has rarely been investigated. Methods For each year of the study period, 1988–2012, in Sweden, age-standardised mortality rates were calculated for three different types of neighbourhoods, characterised by a Neighbourhood Deprivation Index. Joinpoint regression was used to investigate potential changes in age-standardised mortality rates by neighbourhood deprivation and over time. Results Over the study period, age-standardised mortality rates due to CHD were consistently the highest in the deprived neighbourhoods and the lowest in the affluent neighbourhoods. We observed a statistically significant overall decline, ranging from 67% to 59%, in the age-standardised CHD mortality rates for each level of neighbourhood deprivation. Furthermore, the decline for the affluent neighbourhoods was significantly higher compared with the decline in the deprived neighbourhoods. Conclusion Age-standardised CHD mortality rates decreased significantly in Sweden between 1988 and 2012. This decline was more pronounced in the affluent neighbourhoods, which indicates that the improvements in prevention and treatment of CHD have not benefited individuals residing in deprived neighbourhoods to an equal extent. Knowledge of time trends in CHD mortality by level of neighbourhood deprivation may help guide decision-makers in the development of appropriate healthcare policies for deprived neighbourhoods.
    Print ISSN: 0143-005X
    Electronic ISSN: 1470-2738
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  54. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds); 20090907-20090910; Essen; DOC09gmds065 /20090831/
    Publication Date: 2009-08-31
    Keywords: familial breast cancer ; hereditary breast cancer ; age of onset ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 3
  • 4
    Keywords: CANCER ; Germany ; COHORT ; cohort studies ; cohort study ; RISK ; GENES ; familial risk ; MULTIPLE-SCLEROSIS ; RE ; multiple sclerosis
    Type of Publication: Journal article published
    PubMed ID: 16554342
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  • 5
    Keywords: CANCER ; FOLLOW-UP ; HISTORY ; incidence ; MORTALITY ; POPULATION ; RISK ; RISKS ; SAMPLE ; FAMILY ; NO ; HEALTH ; DIFFERENCE ; AGE ; family history ; WOMEN ; genetics ; MEN ; SWEDEN ; DATABASE ; REGION ; SIR ; familial risk ; NATIONWIDE ; HYPERTENSION ; sibling risks ; RELATIVES ; hereditary factors ; sibling risk ; SIBLINGS ; FAMILIES ; SIZE ; HERITABLE CAUSES ; LIMIT ; ENVIRONMENTAL-FACTORS ; family studies ; sex ; subarachnoid hemorrhage ; UNRUPTURED INTRACRANIAL ANEURYSMS
    Abstract: This nationwide study aimed to enhance available data by determining sibling risks of subarachnoid hemorrhage in a total population. The MigMed database at the Karolinska Institute, Stockholm, was used to identify all cases of subarachnoid hemorrhage diagnosed in Sweden between 1987 and 2001. Incidence ratios standardized for age, region, and socioeconomic status (SIRs) were calculated for persons with at least 1 sibling with subarachnoid hemorrhage. The reference group consisted of persons whose siblings had no subarachnoid hemorrhage. A total of 90 affected siblings were identified; their SIR of subarachnoid hemorrhage was 2.75. The risk decreased with increasing age in both men and women. Within the limits of the sample size, no sex differences could be observed. The relatively high sibling risks are likely to be due to heritable causes and shared environmental factors. Genetic causes possibly weigh more in early-than late-onset cases. This study shows the feasibility of carrying out nationwide family studies on subarachnoid hemorrhage. Copyright (c) 2007 S. Karger AG, Basel
    Type of Publication: Journal article published
    PubMed ID: 18043002
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  • 6
    Keywords: CANCER ; Germany ; neoplasms ; HISTORY ; RISK ; SITE ; LYMPHOMA ; leukemia ; ONCOLOGY ; CHILDHOOD ; RE ; ENGLAND ; MALIGNANT NEOPLASMS ; neoplasm
    Type of Publication: Journal article published
    PubMed ID: 17943169
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  • 7
    Keywords: CANCER ; tumor ; Germany ; human ; neoplasms ; DIAGNOSIS ; INFORMATION ; DISEASE ; incidence ; MORTALITY ; RISK ; RISKS ; SITE ; meningioma ; TUMORS ; TIME ; PATIENT ; primary ; SUSCEPTIBILITY ; LYMPHOMA ; MALIGNANCIES ; PATTERNS ; NUMBER ; AGE ; chemotherapy ; MODULATION ; DAMAGE ; DATABASE ; 2ND PRIMARY CANCERS ; RELATIVE RISK ; SKIN-CANCER ; ONCOLOGY ; CHILDHOOD ; RE ; SOLID TUMORS ; SURVIVORS ; methods ; PRIMARY NEOPLASMS ; USA ; CANCERS ; quantitative ; QUANTITATIVE DATA ; VA ; neoplasm ; SWEDISH ; subsequent cancer ; BRITISH COHORT
    Abstract: Purpose Quantitative data on subsequent cancers after primary cancers provide information on treatment-related risks on second cancers, with implications for therapeutic adverse effects and human susceptibility in general. Quantitative data on solid tumors are limited. We focus on survivors of non-Hodgkin's lymphoma (NHL) because the disease is diagnosed at a wide range of ages and treated uniformly primarily with chemotherapy. Patients and Methods The nationwide Swedish Family-Cancer Database included 11.5 million individuals whose cancers were retrieved from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for subsequent neoplasms among 28,131 patients with NHL. Results The SIR for solid tumors after NHL was 1.65 (2,290 patients) and that for lymphohematopoietic neoplasms was 5.36 (369 patients). Among the 25 most common solid tumors, the SIRs were increased for all but nine sites; the highest SIR (40.8) was observed for spinal meningioma. The SIRs for solid tumors declined in an age-dependent manner from 4.52 in diagnostic age younger than 20 years to 1.12 in diagnostic age 70 +/- years. In the most common patient groups, the SIRs for solid tumors increased up to 30 years after NHL diagnosis. Because of the high incidence of solid tumors in these age groups, they contributed the largest numbers of therapy-related cases. Conclusion These data indicate that age at treatment determines both the magnitude of the initial relative risk and the time-dependent modulation of the response. Therapy-related damage persists at least 30 years and its toll of solid tumors is largest 21 to 30 years after diagnosis
    Type of Publication: Journal article published
    PubMed ID: 18347006
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  • 8
    Keywords: CANCER ; Germany ; SYSTEM ; SYSTEMS ; DISEASE ; incidence ; RISK ; RISKS ; SITE ; FAMILY ; BREAST-CANCER ; RECOGNITION ; prevention ; AGE ; COLORECTAL-CANCER ; PROSTATE-CANCER ; DATABASE ; MUTATIONS ; familial risk ; CANCER DATABASE ; SUSCEPTIBILITY GENE ; GUIDELINES ; ONCOLOGY ; CHILDHOOD ; GENETIC EPIDEMIOLOGY ; FAMILIES ; LEVEL ; methods ; familial aggregation ; CRITERIA ; USA ; CANCERS ; ESOPHAGEAL CANCER ; GENOME-WIDE ASSOCIATION ; SWEDISH ; clinical genetic counseling ; ENVIRONMENTAL ETIOLOGY ; genetic testing ; POPULATION-BASED ASSESSMENT ; referral of familial cancers
    Abstract: Objectives. Reliable, clinically useful data on familial risks have not been available for all types of cancer, and familial aggregations of cancers, which are not known to belong to an inherited cancer syndrome, are often overlooked by medical referral systems. We provide uniform data on familial risks in all common cancers. Methods. The nationwide Swedish Family- Cancer Database includes 11.5 million individuals, born in 1932 and later, along with their parents. Standardized incidence ratios ( SIRs) were calculated for age- specific familial risks in offspring. Results. The familial risks for offspring cancer were increased at 24 of 25 sites when a parent was diagnosed with concordant cancer, at 20 of 24 sites when a sibling was affected, and at 14 of 16 sites when a parent and at least one other sibling were affected. Among the offspring of affected parents, testicular cancer showed the highest risk, 4.52, followed by Hodgkin's disease ( 3.95) and esophageal cancer ( 3.36). At many sites, the risks between siblings were higher than those between offspring and affected parents, probably in part because of childhood environmental effects. Conclusions. The data show convincingly that familial clustering is a common feature for all cancer sites. The results will be helpful in implementing evidence- based guidelines for clinical genetic counseling and in facilitating the recognition of familial risk at all levels of the general medical referral system
    Type of Publication: Journal article published
    PubMed ID: 18378534
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  • 9
    Keywords: CANCER ; Germany ; RISK ; PATIENT ; RISK-FACTORS ; SUSCEPTIBILITY ; risk factors ; DATABASE ; familial risk ; RE ; RHEUMATOID-ARTHRITIS ; RISK-FACTOR ; ENGLAND
    Type of Publication: Journal article published
    PubMed ID: 18308735
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  • 10
    Keywords: CANCER ; SURVIVAL ; tumor ; Germany ; FOLLOW-UP ; DEATH ; DISEASE ; NEW-YORK ; RISK ; DISTINCT ; TIME ; PATIENT ; MECHANISM ; FAMILY ; prognosis ; mechanisms ; MEMBERS ; ASSOCIATION ; POLYMORPHISMS ; SUSCEPTIBILITY ; BREAST ; breast cancer ; BREAST-CANCER ; METASTASIS ; SWEDEN ; DATABASE ; PROGNOSTIC-FACTORS ; MAMMOGRAPHY ; PROGNOSTIC FACTORS ; familial risk ; PROGNOSTIC FACTOR ; TRENDS ; heredity ; ONCOLOGY ; RE ; FAMILIES ; overall survival ; PROGNOSTIC-FACTOR ; analysis ; USA ; familial breast cancer ; FAMILY-MEMBERS ; SWEDISH ; heritability of survival
    Abstract: Several earlier studies have assessed survival in breast cancer based on familial risk of this disease. The results have been conflicting and suggest that the risk and prognostic factors of cancer are largely distinct. As a novel concept, we searched for familial clustering of survival, i.e., concordance of survival among family members. We used the nation-wide Swedish Family-Cancer Database to estimate hazard ratios (HRs) for cause-specific and overall survival in invasive breast cancer. HR shows the probability of death in the study group compared the reference group. The study covered 1277 mother-daughter pairs with familial breast cancer. Their median follow-up times for survival ranged from 96 to 122 months. When the survival in daughters was analyzed according to the mothers' length of survival, there was a concordance of prognosis. The HR was 0.65 in daughters whose mothers had survived 〉 = 120 months compared to daughters whose mothers had survived less than 36 months (P-value for trend 0.02). When the analysis was reversed and HRs were derived for mothers, the results were essentially similar (P-value for trend 0.02). The survival did not differ between patients with familial or sporadic breast cancer. The results are consistent in showing that both good and poor survival in breast cancer aggregates in families, which is a novel population-level finding for any cancer. The consistency of the results suggests that the prognosis in breast cancer is in part heritable which is likely to be explained by yet unknown genetic mechanisms
    Type of Publication: Journal article published
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