| 1. |
- Attner, Bo, et al.
(författare)
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Cancer among patients with diabetes, obesity and abnormal blood lipids: a population-based register study in Sweden.
- 2012
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 1573-7225 .- 0957-5243. ; 23:5, s. 769-777
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study how the incidence of cancer is related to diabetes, obesity or abnormal blood lipids. METHODS: Diagnosis of diabetes, obesity or abnormal blood lipids was studied 0-10 years prior to the diagnosis of cancer in 19,756 cases of cancer and in 147,324 controls matched regarding age, sex and domicile. RESULTS: Diabetes was significantly more common prior to diagnosis in patients with liver, pancreatic, colon and urinary tract/bladder cancer and in patients with breast cancer diagnosed with diabetes 0-4 years prior to the cancer diagnosis. A lower risk of diabetes was seen in patients with prostate carcinoma among individuals with diabetes diagnosed 5-10 years prior to the cancer diagnosis. The findings remained after adjusting for obesity and high blood lipids. Obesity was significantly more common in patients with endometrial, colon and kidney cancer and with breast cancer above the age of 60 years in those where obesity was diagnosed close to the diagnosis of cancer. High blood lipids were significantly more common in patients with ovarian cancer and less common in patients with breast cancer. CONCLUSIONS: The study confirms some previous findings concerning comorbidity and cancer and highlights some new ones.
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| 2. |
- Attner, Bo, et al.
(författare)
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Low Cancer Rates among Patients with Dementia in a Population-Based Register Study in Sweden.
- 2010
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 30:1, s. 39-42
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Tidskriftsartikel (refereegranskat)abstract
- Background: Some studies have suggested a lower incidence of cancer in patients with dementia. We studied this further for 18 cancer types in population-based registers. Methods: In 19,756 cases and in 147,324 age- and sex-matched controls a diagnosis of dementia was studied 9-45 months prior to the diagnosis of cancer. Results: Overall a diagnosis of dementia was significantly less common among the cancer cases (risk ratio, RR = 0.60; 95% CI = 0.52-0.69). Conclusion: The study confirms previous findings that patients with dementia have a lower risk of cancer. Because the effect was seen for all tumour types and especially for patients older than 70 years and since the deficit was more pronounced for patients with tumours situated within the body, the data suggest that malignancies are underdiagnosed for persons with dementia.
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| 3. |
- Attner, Bo
(författare)
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Register studies of cancer in the Southern Health Care Region in Sweden
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim was to study different aspect of health care use and health care costs on a population based level for persons with cancer and their partners, and from an individual level to explore the impact of comorbidities in incidence and survival. In the beginning of the study all persons in the Southern Health Care Region in Sweden diagnosed with colon, rectal, breast, prostate and lung cancer during the period 2000 to 2005 were identified via the Swedish Cancer Register. Lately, including the period 2006 to 2007, all persons diagnosed with cancer were analysed with specification of 18 types of cancer. The obtained information was linked to other population based registries. Comorbidity diagnoses for patients and all data for up to 8 eight control persons were also extracted from health care registries in Skåne. Results showed that the major part of health care costs for prostate and lung cancer patients occurred during the first year following the diagnosis. A clear difference was seen between costs for survivors and patients who later died. For patients with prostate cancer health care costs increased with higher Gleason score (rate of aggressiveness) in the year following the diagnosis. Higher health care costs were seen for patients treated with primary radiotherapy and costs were higher for patients with curative treatments compared to those with palliative treatments. For patients with lung cancer the costs totally were declining with higher stage. Highest health care costs were seen for patients treated with endoscopic therapy of the bronchus. Health care costs were higher for operated patients compared to those with treatments only by chemotherapy or radiotherapy. Higher survival in patients with non-small cell lung cancer (NSCLC) was explained by surgery, short waiting time, treatments by chemotherapy or radiotherapy and patients living in a specific geographic area. Lower survival was connected to no treatment, tumour stage, performance status and alcoholic related diseases. Overall a diagnosis of dementia was significantly less common among the cancer cases. Because the effect was seen for all tumour types and especially for patients older than 70 years and since the deficit was more pronounced for patients with tumours situated within the body, the data suggest that malignancies are underdiagnosed for persons with dementia. Diabetes was significantly more common prior to diagnosis in patients with liver, pancreatic, colon and urinary tract/bladder cancer and in patients with breast cancer diagnosed with diabetes 0–4 years prior to the cancer diagnosis. A lower risk of diabetes was seen in patients with prostate carcinoma among individuals with diabetes diagnosed 5–10 years prior to the cancer diagnosis. Obesity was significantly more common in patients with endometrial, colon and kidney cancer and with breast cancer above the age of 60 years in those where obesity was diagnosed close to the diagnosis of cancer. High blood lipids were significantly more common in patients with ovarian cancer and less common in patients with breast cancer. From a public health view avoiding overweight and obesity, as well as preventing type II diabetes mellitus, are important in preventing cancer and other diseases. Measures should be taken early on and should be based on healthy eating and physical activity patterns throughout life. Health care consumption and health care costs for partners increased in the years following the cancer diagnosis of the person with cancer especially for partners to colon, prostate and lung cancer patients. The number of diagnoses increased significantly among partners in the whole sample with the largest increase in psychiatric diagnoses. In the future, new treatments, especially new pharmacy, are to change the relationship between treatments, costs and survival. It is of importance further examine in what way results are affected by how the patient contacts the health care system, the patient´s lifestyle and socioeconomic background or the health care system itself (organisation, competence etc). Furthermore, the new knowledge concerning cancer and comorbidities may provide an insight into the mechanisms of tumour development. Postponing the onset of comorbidity may also prevent/postpone the diagnosis of cancer. Further research is needed to learn more about the situation of the partner and to identify persons at risk of psychiatric morbidity. Knowledge is also needed on how to support the partner in the most efficient way. When planning for care and allocation of resources for care the impact on the partner should also be considered.
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| 4. |
- Sjövall, Katarina, et al.
(författare)
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Influence on the Health of the Partner Affected by Tumor Disease in the Wife or Husband Based on a Population-Based Register Study of Cancer in Sweden.
- 2009
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Ingår i: Journal of Clinical Oncology. - 1527-7755. ; 27, s. 4781-4786
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To examine health care use and health care costs among partners of persons with cancer. PATIENTS AND METHODS: Partners of patients with colon, rectal, lung, breast, and prostate cancer (N = 11,076) were identified via linked data from the Tumor Registry of Southern Sweden and Census Registry of Sweden. Health care use, total costs of health care, and diagnosis of the partner were studied before and after diagnosis of the cancer patient. RESULTS: Health care use for partners increased in terms of in-patient care after the cancer diagnosis. A significant increase was seen the second year for partners of patients with colon cancer (risk ratio [RR], 1.55; 95% CI, 1.28 to 1.87) and lung cancer (RR, 1.50; 95% CI, 1.26 to 1.79). Psychiatric diagnoses increased after the cancer diagnosis in the total sample, with a significant increase for partners of colon (RR, 2.66; 95% CI, 1.71 to 4.22), lung (RR, 3.16; 95% CI, 2.23 to 4.57), and prostate cancer patients (RR, 1.68; 95% CI, 1.32 to 2.15). Costs of care increased more than the consumer price index the two years after the cancer diagnosis. Costs of care increased most for male partners and especially for younger male partners (age 25 to 64 years) of patients with colon, rectal, and lung cancers. CONCLUSION: The results showed increased health care costs and an increase in psychiatric diagnoses after the cancer diagnosis among partners of cancer patients. Further research is needed to learn more about the situation of the partner and to identify persons at risk of psychiatric morbidity. Knowledge is also needed on how to support the partner in the most efficient way.
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| 5. |
- Sjövall, Katarina, et al.
(författare)
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Influence on the health of the partner affected by tumor disease in the wife or husband based on a population-based register study of cancer in Sweden
- 2009
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Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 27:28, s. 4781-4786
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To examine health care use and health care costs among partners of persons with cancer.Patients and Methods Partners of patients with colon, rectal, lung, breast, and prostate cancer (N = 11,076) were identified via linked data from the Tumor Registry of Southern Sweden and Census Registry of Sweden. Health care use, total costs of health care, and diagnosis of the partner were studied before and after diagnosis of the cancer patient.Results Health care use for partners increased in terms of in-patient care after the cancer diagnosis. A significant increase was seen the second year for partners of patients with colon cancer (risk ratio [RR], 1.55; 95% CI, 1.28 to 1.87) and lung cancer (RR, 1.50; 95% CI, 1.26 to 1.79). Psychiatric diagnoses increased after the cancer diagnosis in the total sample, with a significant increase for partners of colon (RR, 2.66; 95% CI, 1.71 to 4.22), lung (RR, 3.16; 95% CI, 2.23 to 4.57), and prostate cancer patients (RR, 1.68; 95% CI, 1.32 to 2.15). Costs of care increased more than the consumer price index the two years after the cancer diagnosis. Costs of care increased most formale partners and especially for younger male partners (age 25 to 64 years) of patients with colon, rectal, and lung cancers.Conclusion The results showed increased health care costs and an increase in psychiatric diagnoses after the cancer diagnosis among partners of cancer patients. Further research is needed to learn more about the situation of the partner and to identify persons at risk of psychiatric morbidity. Knowledge is also needed on how to support the partner in the most efficient way.
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| 6. |
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| 7. |
- Sjövall, Katarina, et al.
(författare)
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Sick leave of spouses to cancer patients before and after diagnosis.
- 2010
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 49, s. 467-473
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background. The impact of cancer on spouses of cancer patients may be considerable in many aspects. Our objective was to evaluate sick leave in spouses of cancer patients before and after the diagnosis. Material and methods. Using Swedish population-based registries, we studied sick leave of spouses to patients with newly diagnosed colon, rectal, lung, prostate, or breast cancer. We identified the cancer patients via the Swedish Cancer Registry and obtained information of their spouse through linkage with the population register. We assessed the number of sick leave episodes and sick days one year before until one year after the spouses' cancer diagnosis by cross-referencing with Swedish Social Insurance Agency data. We also compared the number of sick days of spouses with the general population adjusted for age, sex and partner status. Results. In general, spouses (N=1 923) to cancer patients had an increase in the frequency of new episodes of sick leave in the months before and after the cancer diagnosis. Spouses of lung cancer patients had most sick leave episodes, and the largest number of sick days per person. In comparison to the general population, spouses in the lung cancer group also had the highest standardised sick day ratio 1.76; 95% confidence interval 1.24, 2.40. The corresponding risk for spouses in other groups of cancer was not significantly increased. Discussion. In Sweden there is often increased sick leave of spouses to cancer patients. It may be due to emotional stress and physical reactions that follow with cancer which needs to be further explored in order to provide adequate support and care.
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| 8. |
- Sjövall, Katarina, et al.
(författare)
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Sick leave of spouses to cancer patients before and after diagnosis
- 2010
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 49:4, s. 467-473
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Tidskriftsartikel (refereegranskat)abstract
- Background. The impact of cancer on spouses of cancer patients may be considerable in many aspects. Our objective was to evaluate sick leave in spouses of cancer patients before and after the diagnosis. Material and methods. Using Swedish population-based registries, we studied sick leave of spouses to patients with newly diagnosed colon, rectal, lung, prostate, or breast cancer. We identified the cancer patients via the Swedish Cancer Registry and obtained information of their spouse through linkage with the population register. We assessed the number of sick leave episodes and sick days one year before until one year after the spouses' cancer diagnosis by cross-referencing with Swedish Social Insurance Agency data. We also compared the number of sick days of spouses with the general population adjusted for age, sex and partner status. Results. In general, spouses (N=1 923) to cancer patients had an increase in the frequency of new episodes of sick leave in the months before and after the cancer diagnosis. Spouses of lung cancer patients had most sick leave episodes, and the largest number of sick days per person. In comparison to the general population, spouses in the lung cancer group also had the highest standardised sick day ratio 1.76; 95% confidence interval 1.24, 2.40. The corresponding risk for spouses in other groups of cancer was not significantly increased. Discussion. In Sweden there is often increased sick leave of spouses to cancer patients. It may be due to emotional stress and physical reactions that follow with cancer which needs to be further explored in order to provide adequate support and care.
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| 9. |
- Sjövall, Katarina, et al.
(författare)
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Sickness absence among cancer patients in the pre-diagnostic and the post-diagnostic phases of five common forms of cancer.
- 2012
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 20, s. 741-747
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to observe sickness absence before and after the cancer diagnosis among cancer patients with five common forms of cancer. METHODS: Using cohort data, we observed sick leave in the pre- and post-diagnostic phase among patients with colon, rectal, breast, prostate, or lung cancer (n = 2,738). We also identified reference subjects without cancer (total n = 12,246) who were individually matched for age and gender for each specific cancer cohort in order to compare sickness absence between patients with a specific form of cancer and the background population without cancer. RESULTS: Lung cancer patients had the highest increase in sick days both pre- and post-diagnosis and prostate cancer patients had the lowest increase. Irrespective of the form of cancer, cancer patients had significantly more sick days in the post-diagnostic phase compared to their reference subjects, ranging from 5 (prostate cancer) to 12 times the amount of sick days (colon and lung cancer). One year post-diagnosis, less than half of the cancer patients were on sick leave, except for lung cancer patients where 63% were still on sick leave. CONCLUSION: Sick leave among cancer patients seems related not only to the cancer diagnosis and its treatment but also to the prodromal illness in the pre-diagnostic phase, especially for forms of cancer with heavier symptom burden such as colon and lung cancer. Although cancer results in substantial increase in sick leave, it is important to acknowledge that a major part of cancer patients return to work within 1 year after the cancer diagnosis.
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| 10. |
- Sjövall, Katarina, et al.
(författare)
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Sickness absence among cancer patients in the pre-diagnostic and the post-diagnostic phases of five common forms of cancer
- 2012
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 20:4, s. 741-747
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose of this study was to observe sickness absence before and after the cancer diagnosis among cancer patients with five common forms of cancer.Methods Using cohort data, we observed sick leave in the pre- and post-diagnostic phase among patients with colon, rectal, breast, prostate, or lung cancer (n = 2,738). We also identified reference subjects without cancer (total n = 12,246) who were individually matched for age and gender for each specific cancer cohort in order to compare sickness absence between patients with a specific form of cancer and the background population without cancer.Results Lung cancer patients had the highest increase in sick days both pre- and post-diagnosis and prostate cancer patients had the lowest increase. Irrespective of the form of cancer, cancer patients had significantly more sick days in the post-diagnostic phase compared to their reference subjects, ranging from 5 (prostate cancer) to 12 times the amount of sick days (colon and lung cancer). One year post-diagnosis, less than half of the cancer patients were on sick leave, except for lung cancer patients where 63% were still on sick leave.Conclusion Sick leave among cancer patients seems related not only to the cancer diagnosis and its treatment but also to the prodromal illness in the pre-diagnostic phase, especially for forms of cancer with heavier symptom burden such as colon and lung cancer. Although cancer results in substantial increase in sick leave, it is important to acknowledge that a major part of cancer patients return to work within 1 year after the cancer diagnosis.
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