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- Glimelius, Bengt, et al.
(författare)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 3. |
- Sköld, Camilla, 1981-
(författare)
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Impact of pregnancies on ovarian cancer : Risk, prognosis and tumor biology
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Ovarian cancer is the most lethal gynecological malignancy. The etiology is complex and not fully understood, partly since ovarian cancer is not one distinct disease, but rather several histologically and clinically different subtypes. The two main groups are epithelial (90%) and non-epithelial (10%) cancers, further divided into five epithelial and two main non-epithelial subtypes. Women who have given birth have a lower risk of developing epithelial ovarian cancer, and the risk is further reduced with each additional childbirth. However, the association between several pregnancy-related factors, such as pregnancy length, maternal age at birth, offspring size, and subsequent risk of ovarian cancer has been unclear. In addition, the impact of pregnancy-related risk factors on non-epithelial ovarian cancer is unknown. Further, the underlying mechanism behind the protection of childbirth has not been revealed and the prognostic impact of pregnancies is not established.In my first two studies, I evaluated associations between pregnancy-related factors and risk of epithelial ovarian cancer and its different subtypes [Study I] and non-epithelial ovarian cancer [Study II]. These case-control studies were based on linked data from the population-based medical birth registers and cancer registers in Denmark, Finland, Norway and Sweden. In Study I, preterm birth was associated with an increased risk of epithelial ovarian cancer among parous women, whereas increased number of births and pregnancies at older age were associated with decreased risk. In Study II, increasing age at last birth was associated with lower risk of sex cord-stroma cell tumors (SCSTs), as was shorter time since last birth.In Study III, the prognostic impact of parity on both epithelial and non-epithelial ovarian cancer by subtype was investigated by linkage of data from the Swedish medical birth register, the cancer register and the cause of death register. Parity was associated with reduced cancer-specific mortality in ovarian germ cell tumors. We found no prognostic impact of parity in patients with SCSTs or epithelial ovarian cancer.In Study IV, we investigated whether hormones and proteins involved in pregnancy and tumor development differed according to the woman’s parity status in patients with high-grade serous ovarian cancer. Parous women more often had progesterone receptor (PR) positive tumors, in comparison with nulliparous women, and increased number of children was associated with PR positive tumors.In summary, a woman’s reproductive history will not only impact on the risk of developing ovarian cancer, but also have a long-lasting influence on the tumor biology.
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| 4. |
- Sköld, Camilla, et al.
(författare)
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Parity is associated with better prognosis in ovarian germ cell tumors, but not in other ovarian cancer subtypes
- 2022
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Ingår i: International Journal of Cancer. - : John Wiley & Sons. - 0020-7136 .- 1097-0215. ; 150:5, s. 773-781
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Tidskriftsartikel (refereegranskat)abstract
- Ovarian cancer is influenced by reproductive factors, with a reduced risk of epithelial ovarian cancer in parous women. Nonepithelial ovarian cancer frequently affects young women and often precedes or occurs during the childbearing years. However, the impact of reproductive factors on ovarian cancer survival remains unclear: in epithelial ovarian cancer, data are conflicting, and subtype-specific associations have not been examined, and in nonepithelial ovarian cancer, it has not been studied. Using Swedish registers, we evaluated associations between women's reproductive history and cancer-specific mortality by subtype of epithelial and nonepithelial ovarian cancer in 3791 women born 1953 and later, diagnosed from 1990 to 2018. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated using Cox-proportional hazard models. Parity was associated with a 78% decreased risk of cause-specific mortality in 243 women with germ cell tumors (GCTs) (parous vs nulliparous, adjusted for age at diagnosis: HR: 0.22 [95% CI 0.07-0.62]), with a decreased risk with increasing number of births (per birth: HR: 0.60 [95% CI 0.38-0.95]). We found no evidence of associations between parity and cause-specific mortality among the 334 patients with sex-cord stromal tumors, nor among the 3214 patients with epithelial ovarian cancer; neither overall, nor by subtype. In conclusion, in our large, population-based study, parity was associated with a clearly better prognosis in GCTs but not in the other ovarian cancer subtypes. Future research on how hormone exposure impacts GCT development may lead to a better understanding of mechanisms affecting survival.What's new?While risk of epithelial ovarian cancer is known to be influenced by pregnancy, the mechanisms underlying this association remain unclear. In this population-based study, the impact of reproductive history on ovarian cancer prognosis was evaluated by ovarian cancer subtype. Among women with germ cell tumors, parity was associated with 78 percent reduction in risk of cause-specific mortality. No associations were detected between parity and prognosis among women with sex-cord stromal tumors or epithelial ovarian cancer. These observations raise new questions about relationships between ovarian cancer prognosis and reproductive factors, including possible impacts of hormone exposure in pregnancy.
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