| 1. |
- Hemminki, Kari, et al.
(författare)
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Risk of Cancer Following Hospitalization for Type 2 Diabetes
- 2010
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Ingår i: The Oncologist. - : Oxford University Press (OUP). - 1083-7159 .- 1549-490X. ; 15:6, s. 548-555
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Cancer and type 2 diabetes (T2D) are two common diseases that may share risk factors. We aimed at determining subsequent cancer risks in patients hospitalized for T2D in Sweden. Methods. T2D patients were obtained from the nationwide Hospital Discharge Register; cancers were recorded from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for cancer following last hospitalization for T2D. The comparison group was the general Swedish population. Results. The number of hospitalized T2D patients from 1964 to 2007 was 125,126, of whom 26,641 had an affected family member. Altogether 24 cancers showed an elevated risk when follow-up was started after the last hospitalization. The highest SIRs were for pancreatic (6.08) and liver (4.25) cancers. The incidences of these cancers were even elevated when follow-up was started 5 years after the last hospitalization for T2D, with primary liver cancer showing the highest SIR of 4.66. Also increased were the incidences of upper aerodigestive tract, esophageal, colon, rectal, pancreatic, lung, cervical, endometrial, ovarian, and kidney cancers. Prostate cancer showed a lower risk. Familial T2D patients showed no exceptional elevated cancer risks but their prostate cancer and melanoma risks were lower. Conclusions. This study, covering approximately one half of Swedish T2D patients, showed an elevated risk for several cancers after hospitalization for T2D, probably indicating the profound metabolic disturbances of the underlying disease. The highest risks were found for liver and pancreatic cancers. No excess cancer risks were observed in familial diabetics. The lower risk for prostate cancer remains intriguing. The Oncologist 2010;15:548-555
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| 2. |
- Hemminki, Kari, et al.
(författare)
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Autoimmune disease and subsequent digestive tract cancer by histology
- 2012
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Ingår i: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 23:4, s. 6-927
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Tidskriftsartikel (refereegranskat)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.
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| 3. |
- Hemminki, Kari, et al.
(författare)
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Cancer risk in amyloidosis patients in Sweden with novel findings on non-Hodgkin lymphoma and skin cancer
- 2014
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Ingår i: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 25:2, s. 511-518
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Tidskriftsartikel (refereegranskat)abstract
- Background: Systemic amyloidosis (SSA) is a common form of amyloidosis but it remains often unnoticed because of the slow progression in old patients. The cause for SSA is the accumulation of wild-type transthyretin amyloids in critical tissues. We provide here data showing that SSA may be associated with old-age non-Hodgkin lymphoma.Systemic amyloidoses include immunoglobulin light chain (AL) amyloidosis, serum amyloid (AA)-related amyloidosis and senile systemic amyloidosis (SSA). AL amyloidosis is associated with myeloma, and we showed recently that transthyretin-related hereditary amyloidosis was related to non-Hodgkin lymphoma (NHL). In SSA, amyloids constitute wild-type transthyretin. We wanted to analyze cancer risks in amyloidosis, particularly in SSA. Nonhereditary amyloidosis patients were identified from the Swedish Hospital Discharge and Outpatients Registers from years 1997 through 2010. Their cancer risk was assessed based on the Swedish Cancer Registry using standardized incidence ratio (SIR) between amyloidosis patients and the remaining population. To gain information about amyloidosis subtypes, we used the Swedish Prescribed Drug Register from years 2005 through 2010 to find out the specific medication prescribed. Among 1400 identified amyloidosis patients, cancer risk was increased for myeloma, NHL and squamous cell skin cancer. Myeloma and skin cancers were diagnosed 7-8 years earlier than in the population, whereas NHL was diagnosed in elderly patients. The SIR was 204 for myeloma in patients who received AL amyloidosis medication, and it was 17.22 in patients receiving rheumatoid arthritis medication, suggesting AA amyloidosis. In remaining patients, including SSA, NHL risk was 14.78, including lymphoplasmacytic lymphoma and Waldenstrom macroglobulinemia (51.41) and diffuse large B-cell lymphoma (18.69). In these patients, endometrial cancer (7.04) and cancer of unknown primary site (6.56) were also increased. SSA is likely to be a main cause of NHL in the elderly population. The present findings suggest a novel mechanism for amyloidosis-related cancer, highlighting the role of chronic stimulation by amyloid.
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| 4. |
- Mousavi, Seyed Mohsen, et al.
(författare)
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Age- and time-dependent changes in cancer incidence among immigrants to Sweden: colorectal, lung, breast and prostate cancers
- 2012
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 131:2, s. 122-128
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Tidskriftsartikel (refereegranskat)abstract
- To examine the role of gender, age at immigration and length of stay on incidence trends of common cancers, we studied risk of colorectal, lung, breast and prostate cancers in immigrants to Sweden from 1958 to 2008. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios for common cancers among immigrants compared to Swedes. Immigrants were classified into high-risk countries when their risk was increased, into low-risk when their risk was decreased and into other when their risk was nonsignificant. Among those who immigrated at younger age (<30 years), we found an increasing trend for colorectal cancer risk in low-risk men and high-risk women. Among those who immigrated at older age (=30 years), a decreasing lung cancer risk in high-risk men and an increasing breast cancer risk in low-risk women were observed. The increasing trend of prostate cancer risk was independent of age at immigration. The risk trends for other immigrants were between the risks of low- and high-risk countries. The gender-specific shifts in cancer risks in immigrants toward the risk in natives indicate a major role of sex, age at immigration and environmental exposures in colorectal and lung cancers risks. In contrast, the unchanged trend of breast cancer among those who immigrated at younger ages and an increasing trend for those who migrated at older ages may suggest a limited effect for environmental exposures, especially at younger age. Our study points out a role of age at immigration on the risk trend of cancer.
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| 5. |
- Mousavi, Seyed Mohsen, et al.
(författare)
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Does the risk of stomach cancer remain among second-generation immigrants in Sweden?
- 2012
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Ingår i: Gastric Cancer. - : Springer Science and Business Media LLC. - 1436-3291 .- 1436-3305. ; 15:2, s. 213-215
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Tidskriftsartikel (refereegranskat)abstract
- The observed increased risks of noncardia stomach cancer among foreign-born second-generation immigrants compared to the Swedes suggest that these immigrants were infected by Helicobacter pylori before immigration.
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| 6. |
- Mousavi, Seyed Mohsen, et al.
(författare)
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Morbidity and mortality in gynecological cancers among first- and second-generation immigrants in Sweden
- 2012
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 131:2, s. 497-504
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Tidskriftsartikel (refereegranskat)abstract
- We studied the effect of new environment on the risk in and mortality of gynecological cancers in first- and second-generation immigrants in Sweden. We used the nationwide Swedish Family-Cancer Database to calculate standardized incidence/mortality ratios (SIRs/SMRs) of cervical, endometrial and ovarian cancers among immigrants in comparison to the native Swedes. Risk of cervical cancer increased among first-generation immigrants with Danish (SIR = 1.64), Norwegian (1.33), former Yugoslavian (1.21) and East European (1.35) origins, whereas this risk decreased among Finns (0.88) and Asians (SIRs varies from 0.11 in Iranians to 0.54 in East Asians). Risk of endometrial (SIRs varies from 0.28 in Africans to 0.86 in Finns) and ovarian (SIRs varies from 0.23 in Chileans to 0.82 in Finns) cancers decreased in first-generation immigrants. The overall gynecological cancer risk for the second-generation immigrants, independent of the birth region, was almost similar to that obtained for the first generations. The birth region-specific SMRs of gynecological cancers in first- and second-generation immigrants co-varied with the SIRs. Risk of gynecological cancers among the first-generation immigrants is similar to that in their original countries, except for cervical cancer among Africans and endometrial cancer among North Americans and East Europeans. Our findings show that risk and mortality of gynecological cancers observed in the first-generation immigrants remain in the second generation. We conclude that the risk and protective factors of gynecological cancers are preserved upon immigration and through generations, suggesting a role for behavioral factors or familial aggregation in the etiology of these diseases.
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| 7. |
- Mousavi, Seyed Mohsen, et al.
(författare)
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Risk of lung cancer by histology among immigrants to Sweden
- 2012
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Ingår i: Lung Cancer. - : Elsevier BV. - 1872-8332 .- 0169-5002. ; 76:2, s. 159-164
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Tidskriftsartikel (refereegranskat)abstract
- Background: We wanted to define lung cancer incidence rates by histological subtype among immigrants in Sweden to explore the effect of new environments on the incidence of lung cancer by histological subtype in different ethnic populations. Methods: The nationwide Swedish Family-Cancer Database w used to calculate age-standardized incidence rates (ASR) (per 100,000) and standardized incidence ratios (SIRs). The patient series covered 19,255 male and 14,601 female Swedes, and 3236 male and 1751 female immigrants. Results: By time since immigration, Former Yugoslavian (ASR = 46.4) and Asian Arab (38.8) men, and Danish (23.3), Norwegian (19.5) and Finnish (14.5) women had the highest rates for lung cancer, while the lowest rate was seen among Asian Arab women (5.8). The highest adenocarcinoma rates were seen among South European men (11.5), and Danish (7.4) and Norwegian (6.9) women, while squamous cell (SCC) and small cell carcinomas rates were the highest among former Yugoslavian (16.0) and Baltic (8.8) men, respectively. Former Yugoslavian men (2.6) had the highest rate for large cell carcinoma. Compared to Swedes, former Yugoslavian men had the highest significant risk for SCC (SIR = 3.62), small cell (3.14) and large cell (4.21) carcinomas, whereas the highest adenocarcinoma risk was seen among Asian Arabs (2.35). Danish women had the highest risks for SCC (1.91) and small cell carcinoma (2.56). Conclusion: The ethnic-specific lung cancer rates by histology followed the rates in the countries of origin. Our findings may suggest that preservation of smoking habits in the host country is linked to the ethnic diversity of lung cancer incidence by histology. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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| 8. |
- Riihimäki, Matias, et al.
(författare)
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Comparison of survival of patients with metastases from known versus unknown primaries: survival in metastatic cancer
- 2013
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cancer of unknown primary site (CUP) is considered an aggressive metastatic disease but whether the prognosis differs from metastatic cancers of known primary site is not known. Such data may give insight into the biology of CUP and the metastatic process in general. Methods: 6,745 cancer patients, with primary metastatic cancer at diagnosis, were identified from the Swedish Cancer Registry, and were compared with 2,881 patients with CUP. Patients were diagnosed and died between 2002 and 2008. The influence of the primary site, known or unknown, on survival in patients with metastases at specific locations was investigated. Hazard ratios (HRs) of death were estimated for several sites of metastasis, where patients with known primary sites were compared with CUP patients. Results: Overall, patients with metastatic cancers with known primary sites had decreased hazards of death compared to CUP patients (HR = 0.69 [95% CI = 0.66-0.72]). The exceptions were cancer of the pancreas (1.71 [1.54-1.90]), liver (1.58 [1.36-1.85]), and stomach (1.16 [1.02-1.31]). For individual metastatic sites, patients with liver or bone metastases of known origin had better survival than those with CUP of the liver and bone. Patients with liver metastases of pancreatic origin had an increased risk of death compared with patients with CUP of the liver (1.25 [1.06-1.46]). The median survival time of CUP patients was three months. Conclusions: Patients with CUP have poorer survival than patients with known primaries, except those with brain and respiratory system metastases. Of CUP sites, liver metastases had the worst prognosis. Survival in CUP was comparable to that in metastatic lung cancer. The aggressive behavior of CUP may be due to initial immunosuppression and immunoediting which may allow accumulation of mutations. Upon escape from the suppressed state an unstoppable tumor spread ensues. These novel data on the epidemiology of the metastatic process at the population level demonstrated large survival differences in organ defined metastases depending on the original cancer.
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| 9. |
- Kharazmi, Elham, et al.
(författare)
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Effect of multiplicity, laterality, and age at onset of breast cancer on familial risk of breast cancer: a nationwide prospective cohort study
- 2014
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 1573-7217 .- 0167-6806. ; 144:1, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this nationwide prospective cohort study is to find out the risk of breast cancer (BC) in relatives of patients with multiple BCs by laterality and age at diagnosis of first BC. Having family history of single (HR 1.8; 95 % CI 1.8-1.9) or multiple (HR 2.7; 95 % CI 2.6-2.9) BC was associated with higher risk of BC. Those with an FDR with contralateral BC at any age had the highest risk of familial cancer except at age < 40 in which those whose young FDR was affected by multiple ipsilateral BC had the highest risk (HR 9.7; 95 % CI 6.0-15.6). The familial risk of BC in these families decreased as the subject's and FDRs' age at diagnosis of first BC increased. The HR was still significantly increased (2.2) for old individuals (> 60) having a FDR with contralateral BC at an advanced age (a parts per thousand yen80). Despite the common belief that later onset breast cancer is more associated with sporadic breast cancer, our data suggest that breast cancer at any age in the family is associated with some increase in the familial risk, though that risk decreases as the age of onset increases. Contralateral and multiple ipsilateral breast cancers might be associated with distinct shared familial risk factors. Our results have implication for genetic counseling and urge gene identification studies.
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| 10. |
- Bevier, Melanie, et al.
(författare)
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Risk of breast cancer in families of multiple affected women and men
- 2012
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 1573-7217 .- 0167-6806. ; 132:2, s. 723-728
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Tidskriftsartikel (refereegranskat)abstract
- Family history of first and second-degree relatives is known to increase the risk for breast cancer. Less data are available on the risks between defined multiple affected close and distant relatives for which the reliability of data may be an issue. Data on affected males are sparse. These questions and the probable genetic models were addressed in this study by means of a nationwide Swedish Family-Cancer Database. We estimated the effect of family history of breast cancer by Poisson regression for women of at least 30 years of age after adjusting for age, period, region, socioeconomic status, number of children, and age at first birth. The results of the study showed that relative risk (RR) for breast cancer was associated with a first degree as well as second-degree family history. Having at least two female affected first-degree relatives increased the RR at least to 2.8, favoring an additive interaction. The risk was increased around ten times in women with both parents affected. When either a father or a mother was affected, the RRs were nearly identical (RR = 1.73 and 1.74, respectively). The RR for a woman increased more when a brother was affected (RR = 2.48) compared to when a sister was affected (RR = 1.87). Having an affected grandmother showed lower familial excess risks than having an affected half sister (RR = 1.27, and 1.26; and RR = 1.39, and 1.50; respectively, for maternal and paternal relatives). We concluded that when both parents were diagnosed with breast cancer, the risk for the daughter was increased tenfold. Having an affected brother showed a somewhat higher risk than having an affected sister. The data suggest that male breast cancer has a higher genetic basis than female breast cancer, which invites further search of the underlying mechanisms.
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