| 1. |
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| 2. |
- Akrawi, Delshad, et al.
(författare)
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End stage renal disease risk and neighbourhood deprivation: A nationwide cohort study in Sweden.
- 2014
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 25:9, s. 853-859
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Tidskriftsartikel (refereegranskat)abstract
- Chronic kidney disease has been associated with socioeconomic disparities and neighbourhood deprivation. We aimed to determine whether there is an association between neighbourhood deprivation and end stage renal disease (ESRD), and whether this association is independent of individual-level sociodemographic factors and comorbidities.
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| 3. |
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| 4. |
- Akrawi, Delshad Saleh, et al.
(författare)
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Familial risks of glomerulonephritis : a nationwide family study in Sweden
- 2016
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Ingår i: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 48:5, s. 313-322
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Familial risks of glomerulonephritis (acute, chronic and unspecified glomerulonephritis) have not been studied. This study aims to determine the familial risks of glomerulonephritis. Methods: Individuals born from1932 onwards diagnosed with glomerulonephritis (acute [n = 7011], chronic [n = 10,242] and unspecified glomerulonephritis [n = 5762]) were included. The familial risk (Standardized incidence ratio = SIR) was calculated for individuals whose parents/full-siblings were diagnosed with glomerulonephritis compared to those whose parents/full-siblings were not. The procedure was repeated for spouses. Familial concordant risk (same disease in proband and exposed relative) and discordant risk (different disease in proband and exposed relative) of glomerulonephritis were determined. Results: Familial concordant risks (parents/full-sibling history) were: SIR = 3.57 (95% confidence interval, 2.77–4.53) for acute glomerulonephritis, SIR = 3.84 (3.37–4.36) for chronic glomerulonephritis and SIR = 3.75 (2.85–4.83) for unspecified glomerulonephritis. High familial risks were observed if two or more relatives were affected; the SIR was 209.83 (150.51–284.87) in individuals with at least one affected parent as well as one full-sibling. The spouse risk was only moderately increased (SIR = 1.53, 1.33–1.75). Conclusions: Family history of glomerulonephritis is a strong predictor for glomerulonephritis, and is a potentially useful tool in clinical risk assessment. Our data emphasize the contribution of familial factors to the glomerulonephritis burden in the community.Key messagesThe familial risks (full-sibling/parent history) of glomerulonephritis (acute, chronic and unspecified glomerulonephritis) have not been determined previously.The familial risks of glomerulonephritis were increased among individuals with family history of acute, chronic or unspecified glomerulonephritis.The familial risks of glomerulonephritis were slightly increased among spouses indicating a modest non-genetic contribution.Very high familial risks were observed in multiplex families, i.e. with one or more affected first-degree relatives.
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| 5. |
- Andell, Pontus, et al.
(författare)
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Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study
- 2017
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 103:21, s. 1696-1703
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking.Methods: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed.Results: In the Swedish population (n=10 164 211), the incidence of VHD was 63.9 per 100 000 person-years, with aortic stenosis (AS; 47.2%), mitral regurgitation (MR; 24.2%) and aortic regurgitation (AR; 18.0%) contributing most of the VHD diagnoses. The majority of VHDs were diagnosed in the elderly (68.9% in subjects aged ≥65 years), but pulmonary valve disease incidence peaked in newborns. Incidences of AR, AS and MR were higher in men who were also more frequently diagnosed at an earlier age. Mitral stenosis (MS) incidence was higher in women. Rheumatic fever was rare. Half of AS cases had concomitant atherosclerotic vascular disease (48.4%), whereas concomitant heart failure and atrial fibrillation were common in mitral valve disease and tricuspid regurgitation. Other common comorbidities were thoracic aortic aneurysms in AR (10.3%), autoimmune disorders in MS (24.5%) and abdominal hernias or prolapse in MR (10.7%) and TR (10.3%).Conclusions: Clinically diagnosed VHD was primarily a disease of the elderly. Rheumatic fever was rare in Sweden, but specific VHDs showed a range of different comorbidity profiles . Pronounced sex-specific patterns were observed for AR and MS, for which the mechanisms remain incompletely understood.
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| 6. |
- Andell, Pontus, et al.
(författare)
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Neighborhood socioeconomic status and aortic stenosis : A Swedish study based on nationwide registries and an echocardiographic screening cohort
- 2020
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 318, s. 153-159
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Tidskriftsartikel (refereegranskat)abstract
- Background: Aortic stenosis (AS) is the most common valvular heart disease in developed countries, confers high mortality in advanced cases, but can effectively be reversed using endovascular or open-heart surgery. We evaluated the association between AS and neighborhood socioeconomic status (NSES). Methods: We used Swedish population-based nationwide registers and an echocardiography screening cohort during the study period 1997–2014. NSES was determined by an established neighborhood deprivation index composed of education, income, unemployment, and receipt of social welfare. Multilevel adjusted logistic regression models determined the association between NSES and incident AS (according to ICD-10 diagnostic codes). Results: The study population of men and women (n=6,641,905) was divided into individuals living in high (n = 1,608,815 [24%]), moderate (n = 3,857,367 [58%]) and low (n = 1,175,723 [18%]) SES neighborhoods. There were 63,227 AS cases in total. Low NSES (versus high) was associated with a slightly increased risk of AS (OR 1.06 [95% CI 1.03–1.08]) in the nationwide study population. In the echocardiography screening cohort (n = 1586), the association between low NSES and AS was markedly stronger (OR: 2.73 [1.05–7.12]). There were more previously undiagnosed AS cases in low compared to high SES neighborhoods (3.1% versus 1.0%). Conclusions: In this nationwide Swedish register study, low NSES was associated with a slightly increased risk of incident AS. However, the association was markedly stronger in the echocardiography screening cohort, which revealed an almost three-fold increase of AS among individuals living in low SES neighborhoods, possibly indicating an underdiagnosis of AS among these individuals.
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| 7. |
- Berntsson, John, et al.
(författare)
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Risk of Stroke in Patients With Atrial Fibrillation Is Associated With Stroke in Siblings : A Nationwide Study
- 2020
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Ingår i: Journal of the American Heart Association. - 2047-9980. ; 9:3, s. 014132-014132
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Tidskriftsartikel (refereegranskat)abstract
- Background: It remains unclear whether heritable factors can contribute to risk stratification for ischemic stroke in patients with atrial fibrillation (AF). We examined whether having a sibling with ischemic stroke was associated with increased risk of ischemic stroke and mortality in patients with AF. Methods and Results: In this nationwide study of the Swedish population, patients with AF and their siblings were identified from the Swedish patient registers and the Swedish MGR (Multi-Generation Register). Ischemic stroke events were retrieved from the Swedish patient registers and CDR (Cause of Death Register). Risk of ischemic stroke was compared between patients with AF with and without a sibling affected by ischemic stroke, AF, or both ischemic stroke and AF. The total study population comprised 113 988 subjects (mean age, 60±12 years) diagnosed with AF between 1989 and 2012. In total, 11 709 of them were diagnosed with a first ischemic stroke and 20 097 died during a mean follow-up time of 5.5 years for ischemic stroke and 5.9 years for mortality. After adjustment for covariates having a sibling with ischemic stroke, or both ischemic stroke and AF, was associated with increased risk of ischemic stroke (hazard ratio, 1.31; 95% CI, 1.23-1.40 or hazard ratio, 1.36; 95% CI, 1.24-1.49, respectively). Furthermore, ischemic stroke in a sibling was associated with all-cause mortality (hazard ratio, 1.09; 95% CI, 1.05-1.14). In contrast, the risk of stroke was only marginally increased for patients with AF with a spouse affected by ischemic stroke. Conclusions: Having a sibling affected by ischemic stroke confers an increased risk of ischemic stroke and death independently of traditional risk factors in patients with AF.
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| 8. |
- Brieditis, Emelie, et al.
(författare)
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Vulvovaginal candidiasis and type 2 diabetes : A nationwide retrospective cohort study
- 2024
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Ingår i: Diabetes, Obesity and Metabolism. - 1462-8902. ; 26:9, s. 4043-4051
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To examine whether vulvovaginal candidiasis (VVC) precedes type 2 diabetes and to quantify the possible time period between VVC and subsequent diabetes. Material and Methods: We conducted a nationwide retrospective primary healthcare study including 1 838 929 women aged 35–65 years in Sweden (2007–2018). Cox regression models were used to examine associations between VVC and type 2 diabetes, while controlling for possible confounders. Propensity-score-weighted analysis was also conducted. Results: The incidence rate of diabetes per 1000 person-years was 3.06 (95% confidence interval [CI] 3.05–3.08) in women without preceding VVC and 4.05 (95% CI 3.86–4.24) in women with preceding VVC. The incidence rate was particularly high in women aged 55 years and older with VVC: 9.56 (95% CI 8.01–11.11). Women with VVC had a hazard ratio (HR) of 1.41 (95% CI 1.28–1.55) for diabetes compared to women without VVC in the multivariable-adjusted model. The corresponding HR was 1.63 (95% CI 1.53–1.74) in propensity-score-weighted analysis. Women with prior VVC also seemed to have a stronger risk of diabetes with older age, particularly after the age of 55 years. The mean (range) time between VVC and subsequent diabetes was 0.57 (0–2) years, depending on the age of the woman. Conclusion: We found temporal associations between VVC and diabetes. The findings demonstrate that the presence of VVC may indicate a future diagnosis of diabetes, especially in women aged 55 years and older. This knowledge could be valuable for clinicians when treating women with VVC.
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| 9. |
- Calling, Susanna, et al.
(författare)
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Impact of neighborhood resources on cardiovascular disease : A nationwide six-year follow-up
- 2016
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. The aim was to study whether the odds of cardiovascular disease vary with the neighbourhood availability of potentially health-damaging and health-promoting resources. Methods: A nationwide sample of 2 040 826 men and 2 153 426 women aged 35-80 years were followed for six years for first hospitalization of coronary heart disease or stroke. Neighborhood availability of health-damaging resources (i.e., fast-food restaurants and bars/pubs) and health-promoting resources (i.e., health care facilities and physical activity facilities) were determined by use of geographic information systems (GIS). Results: We found small or modestly increased odds ratios (ORs) for both coronary heart disease and stroke, related to the availability of both health-damaging and health-promoting resources. For example, in women, the unadjusted OR (95 % confidence interval) for stroke in relation to availability of fast-food restaurants was 1.18 (1.15-1.21). Similar patterns were observed in men, with an OR = 1.08 (1.05-1.10). However, the associations became weaker or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Conclusions: This six year follow-up study shows that neighborhood availability of potentially health-damaging as well as health-promoting resources may make a small contribution to the risk of coronary heart disease and stroke. However, most of these associations were attenuated or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Future studies are needed to further examine factors in the causal pathway between neighborhood deprivation and cardiovascular disease.
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| 10. |
- Calling, Susanna, et al.
(författare)
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Socioeconomic inequalities and infant mortality of 46 470 preterm infants born in Sweden between 1992 and 2006
- 2011
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Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022. ; 25:4, s. 357-365
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Tidskriftsartikel (refereegranskat)abstract
- Socioeconomic inequalities and infant mortality of 46 470 preterm infants born in Sweden between 1992 and 2006. Paediatric and Perinatal Epidemiology 2011; 25: 357-365. Studies on possible sociodemographic inequities in the survival of preterm infants are scarce. Individual and neighbourhood sociodemographic factors are related to preterm birth and to infant mortality in full-term infants. The aim here was to examine whether infant mortality in Swedish preterm infants is related to individual and neighbourhood sociodemographic factors, and to study whether the hypothesised association between neighbourhood deprivation and infant mortality persists after accounting for individual sociodemographic factors. The study included 46 470 infants with a gestational length of < 37 weeks, born in Sweden between 1992 and 2006. Neighbourhood deprivation was assessed by an index (education, income, unemployment, welfare assistance) in small geographical units, and categorised into low, moderate and high deprivation. Adjusted odds ratios for infant mortality were examined in relation to individual and neighbourhood sociodemographic factors. After adjusting for maternal age, infant mortality was associated with the following sociodemographic variables: maternal non-married/non-cohabiting status, low family income, low maternal education and rural status. After full adjustment, the odds ratio [95% confidence interval] was 2.98 [2.42, 3.67] for low family income compared with high family income. An increase in infant mortality was also associated with high neighbourhood deprivation; however, this increased risk no longer remained statistically significant after adjusting for individual sociodemographic factors. In conclusion, this study showed an increased infant mortality in preterm infants born to women with a less favourable sociodemographic profile.
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| 11. |
- Carlsson, Axel C, et al.
(författare)
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Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years : A nationwide cohort study from Sweden
- 2017
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Ingår i: International Journal of Stroke. - : SAGE PUBLICATIONS LTD. - 1747-4930 .- 1747-4949. ; 12:8, s. 815-826
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years.Methods: All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated.Results: A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78-0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06-1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02-1.23).Conclusions: In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.
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| 12. |
- Carlsson, Axel C., et al.
(författare)
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Neighbourhood socioeconomic status and coronary heart disease in individuals between 40 and 50 years.
- 2016
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 102:10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The incidence of myocardial infarction (MI) has decreased in general but not among younger middle-aged adults. We performed a cohort study of the association between neighbourhood socioeconomic status (SES) at the age of 40 and risk of MI before the age of 50 years. METHODS: All individuals in Sweden were included in the year of their 40th birthday, if it occurred between 1998 and 2010. National registers were used to categorise neighbourhood SES into high, middle and low, and to retrieve information on incident MI and coronary heart disease (CHD). Cox regression models, adjusted for marital status, education level, immigrant status and region of residence, provided an estimate of the HRs and 95% CIs for MI or CHD. RESULTS: Out of 587 933 men and 563 719 women, incident MI occurred in 2877 (0.48%) men and 932 (0.17%) women; and CHD occurred in 4400 (0.74%) men and 1756 (0.31%) women during a mean follow-up of 5.5 years. Using individuals living in middle-SES neighbourhoods as referents, living in high-SES neighbourhoods was associated with lower risk of MI in both sexes (HR (95% CI): men: 0.72 (0.64 to 0.82), women: 0.66 (0.53 to 0.81)); living in low-SES neighbourhoods was associated with a higher risk of MI (HR (95% CI): men: 1.31 (1.20 to 1.44), women: 1.28 (1.08 to 1.50)). Similar risk estimates for CHD were found. CONCLUSIONS: The results of our study suggest an increased risk of MI and CHD among residents from low-SES neighbourhoods and a lower risk in those from high-SES neighbourhoods compared with residents in middle-SES neighbourhoods.
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| 13. |
- Chaikiat, Åsa, et al.
(författare)
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Neighborhood deprivation and inequities in coronary heart disease among patients with diabetes mellitus: A multilevel study of 334,000 patients.
- 2012
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Ingår i: Health and Place. - : Elsevier BV. - 1873-2054 .- 1353-8292. ; 18:4, s. 877-882
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Tidskriftsartikel (refereegranskat)abstract
- We used multilevel models to investigate whether the odds of coronary heart disease (CHD) is higher in patients with diabetes mellitus (DM) living in deprived neighborhoods versus those living in wealthy neighborhoods. The Swedish nationwide prescription register was used to identify 334,000 patients aged 30 years and older with DM. The OR of CHD was significantly higher among patients with DM living in deprived neighborhoods than among patients with DM living in wealthy neighborhoods. These findings are useful for clinicians working in deprived neighborhoods. Future research could focus on how to reduce inequities in CHD among patients with DM.
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| 14. |
- Cook, Won Kim, et al.
(författare)
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Drinking cultures and socioeconomic risk factors for alcohol and drug use disorders among first- and second-generation immigrants : A longitudinal analysis of Swedish population data
- 2021
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Ingår i: Drug and Alcohol Dependence. - : Elsevier BV. - 0376-8716. ; 226
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few longitudinal studies investigate predictors of substance use incidence among immigrants. The current study describes substance use disorders in immigrants to Sweden, focusing on drinking culture in the country of origin and socioeconomic status (SES), and how these intersect with generational status to influence risk. Methods: Using pseudonymized Swedish population registry data, we track onset of alcohol use disorder and drug use disorder in a longitudinal study of 815,778 first-generation immigrants and 674,757 second-generation immigrants from 64 countries over a 6-year period. Cox regression analysis estimated risks of alcohol and drug use disorders in second-generation immigrants compared to first-generation, and moderation analyses assessed interactions of generational status with country-of-origin per capita alcohol consumption and SES. Results: Immigrants and second-generation immigrants originating from countries with high levels of alcohol consumption had higher risks for alcohol and drug use disorders. Immigrants with high SES had lower risks for alcohol and drug use disorders. The interaction between generational status and country-of-origin alcohol consumption was significant for drug use disorder (not for alcohol use disorder), with drug use disorder risk for second-generation immigrants being highest for those from countries with the lowest level of country-of-origin per capita alcohol consumption. The interaction between generational status and SES was significant for alcohol use disorder, with low-SES second-generation immigrants showing markedly higher risk than first-generation immigrants with comparable SES. Conclusions: Among immigrants in Sweden, second-generation immigrants are at increased risk of developing alcohol and drug use disorders, particularly if they have lower SES. Policy and community attention to these high-risk subgroups in immigrant communities is warranted.
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| 15. |
- Crump, Casey, et al.
(författare)
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Preterm birth and risk of sleep-disordered breathing from childhood into mid-adulthood
- 2019
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 48:6, s. 2039-2049
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Preterm birth (gestational age <37 weeks) has previously been associated with cardiometabolic and neuropsychiatric disorders into adulthood, but has seldom been examined in relation to sleep disorders. We conducted the first population-based study of preterm birth in relation to sleep-disordered breathing (SDB) from childhood into mid-adulthood.METHODS: A national cohort study was conducted of all 4 186 615 singleton live births in Sweden during 1973-2014, who were followed for SDB ascertained from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth in relation to SDB while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed for potential confounding by unmeasured shared familial factors.RESULTS: There were 171 100 (4.1%) persons diagnosed with SDB in 86.0 million person-years of follow-up. Preterm birth was associated with increased risk of SDB from childhood into mid-adulthood, relative to full-term birth (39-41 weeks) [adjusted hazard ratio (aHR), ages 0-43 years: 1.43; 95% confidence interval (CI), 1.40, 1.46; P <0.001; ages 30-43 years: 1.40; 95% CI, 1.34, 1.47; P <0.001]. Persons born extremely preterm (<28 weeks) had more than 2-fold risks (aHR, ages 0-43 years: 2.63; 95% CI, 2.41, 2.87; P <0.001; ages 30-43 years: 2.22; 95% CI, 1.64, 3.01; P <0.001). These associations affected both males and females, but accounted for more SDB cases among males (additive interaction, P = 0.003). Co-sibling analyses suggested that these findings were only partly due to shared genetic or environmental factors in families.CONCLUSIONS: Preterm-born children and adults need long-term follow-up for anticipatory screening and potential treatment of SDB.
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| 16. |
- Dahlman, Disa, et al.
(författare)
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Cervical cancer among Swedish women with drug use disorders : A nationwide epidemiological study
- 2021
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Ingår i: Gynecologic Oncology. - : Elsevier BV. - 0090-8258. ; 160:3, s. 742-747
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aim: Cervical cancer incidence and mortality has decreased after introduction of national screening in Sweden, but women with drug use disorders (DUD) are less likely to participate in screening programs. We aimed to investigate cervical cancer incidence and mortality among women with DUD compared to the general female population in Sweden. Methods: We conducted a cohort study based on Swedish national register data for the period January 1997–December 2015. Data was collected for 3,838,248 women aged 15–75 years of whom 50,858 had DUD. Adjusted hazard ratios (HRs) for incident and fatal cervical cancer were calculated for women with and without DUD using Cox regression analysis. Results: DUD was significantly associated with incident cervical cancer (HR = 1.39, 95% confidence interval [CI] 1.39–1.61), but not fatal cervical cancer (HR = 1.25, 95% CI: 0.91–1.71), after adjusting for age, educational attainment, social welfare, region of residence, marital status and HIV infection. Conclusion: Women with DUD were thus identified as a risk group for incident cervical cancer, which calls for attention from clinicians and policy makers. It is possible that non-attendance in cancer screening and other healthcare seeking barriers may affect the risk of incident cervical cancer among women with DUD but more research on this topic is needed.
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| 17. |
- Dahlman, Disa, et al.
(författare)
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Drug use disorder and risk of incident and fatal breast cancer : a nationwide epidemiological study
- 2021
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 186:1, s. 199-207
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Breast cancer is one of the most common cancer forms in women and it is often detected by screening. However, women with drug use disorders (DUD) are less likely to be reached by screening programs. In this study, we aimed to investigate breast cancer incidence, mortality and stage at time of diagnosis among women with DUD compared to the general female population in Sweden. Methods: We performed a follow-up study based on Swedish national register data for the period January 1997–December 2015. The study was based on 3,838,248 women aged 15–75 years, of whom 50,858 were registered with DUD. Adjusted hazard ratios (HRs) for incident and fatal breast cancer, and cancer stage at time of diagnosis, were calculated for women with and without DUD using Cox regression analysis. Results: DUD was associated with incident breast cancer (HR 1.08, 95% confidence interval [CI] 1.02–1.14, p = 0.0069), fatal breast cancer (HR 1.60, 95% CI 1.42–1.82, p < 0.001), and stage IV breast cancer, i.e. metastasis at diagnosis (HR 2.06, 95% CI 1.44–2.95, p < 0.001). Conclusions: Women with DUD were identified as a risk group for incident, fatal and metastasized breast cancer, which calls for attention from clinicians and policy makers. Cancer screening attendance and other healthcare seeking barriers are likely to affect the risk increase among women who use drugs; however, more research is needed on the underlying mechanisms.
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| 18. |
- Dahlman, Disa, et al.
(författare)
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Drug use disorder and risk of incident and fatal prostate cancer among Swedish men : a nationwide epidemiological study
- 2022
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 33:2, s. 213-222
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Prostate cancer is the second most common cancer in men and a leading cause of cancer mortality worldwide. Men with drug use disorders (DUD) may potentially be at high risk for prostate cancer mortality because of delayed diagnosis and/or undertreatment. In this study, we aimed to investigate prostate cancer incidence, mortality, and stage at time of diagnosis among men with DUD compared to the general male population in Sweden. Methods: We performed a follow-up study based on Swedish national register data for the period January 1997–December 2016. The study was based on 1,361,532 men aged 50–75 years at inclusion, of whom 9,259 were registered with DUD. Cox regression analysis was used to compute adjusted hazard ratios (HRs) for incident and fatal prostate cancer, and cancer stage at time of diagnosis, associated with DUD. Results: DUD was associated with a slightly increased risk of incident prostate cancer (HR: 1.07, 95% confidence interval [CI] 1.00–1.14, p = 0.048) and substantially higher risk of fatal prostate cancer (HR: 1.59, 95% CI 1.40–1.82, p < 0.001), adjusted for age, socioeconomic factors, and comorbidities related to tobacco smoking and alcohol use disorder. No association was found between DUD and prostate cancer stage at diagnosis. Conclusions: Men with DUD have an increased risk of fatal prostate cancer, possibly related to undertreatment in this patient population. Our findings should raise attention among medical staff and decision-makers towards a disadvantaged group of men in need of easily accessible prostate cancer evaluation and treatment.
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| 19. |
- Dobilas, Arturas, et al.
(författare)
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Risks of non-ovarian cancers in women with borderline ovarian tumor : a national cohort study in Sweden
- 2023
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Ingår i: BMC Cancer. - 1471-2407. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Associations between different cancer types are known. The affirmation of the risk for non-ovarian cancer after ovarian borderline tumors (BOT) is, however, sparse. Aim: To analyze the risk of subsequent or simultaneous cancers in women with BOTs compared with the general female Swedish population. Methods: An open cohort study (1995–2018) was conducted where a diagnosis of BOTs as well as subsequent or simultaneous cancer diagnoses were obtained from the Swedish Cancer Register and matched to the Total Population Register. Each woman with BOT was followed until non-ovarian cancer, death or emigration and could only be included once for the outcome. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for specific non-ovarian cancers were analyzed. Results: The 4998 women with serous and mucinous BOTs were diagnosed during 1995–2018 with a mean age of 55.7 years (SD 16.0) at diagnosis. Compared with the general female population, women with BOTs had increased risks for non-ovarian cancer in colon (SIR = 2.5; 95% CI 2.0–3.1), rectum (SIR = 1.7; 95% CI 1.1–2.5), small intestine (SIR = 5.0; 95% CI 2.3–9.5), cervix (SIR = 2.5; 95% CI 1.4–4.2), endometrium (SIR = 2.4; 95% CI 1.9–3.1), pancreas (SIR = 2.3; 95% CI 1.4–3.5), upper aerodigestive tract (SIR = 2.2; 95% CI 1.2–3.8), lung (SIR = 1.8; 95% CI 1.4–2.3), kidney (SIR = 2.3; 95% CI 1.4–3.7) and bladder (SIR = 1.8; 95% CI 1.1–2.8). Among women with serous BOTs, the risk of thyroid gland cancer (SIR = 3.1; 95% CI 1.2–6.4) was also increased. Lung and pancreas cancer showed increased risks more than 1 year after a diagnosis of BOT. Conclusions: This Swedish population-based study demonstrated an increased risk of multiple malignancies including lung and pancreatic cancers beyond the first year of diagnosis in patients with borderline ovarian tumors (BOTs), suggesting a potential shared etiology.
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| 20. |
- Forsberg, Per Ola, et al.
(författare)
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Neighborhood socioeconomic characteristics and statin medication in patients with myocardial infarction : A Swedish nationwide follow-up study
- 2016
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Coronary heart disease (CHD) and myocardial infarction (MI) are associated with neighborhood-level socioeconomic status (SES). Statins are important drugs for secondary prevention of MI. However, no study has determined whether neighborhood-level SES is associated with statin medication in MI patients. We aimed to determine whether there is a difference in statin medication rate in MI patients across different levels of neighborhood SES. Methods: All patients in Sweden, diagnosed with incident MI from January 1st, 2000 until December 31st 2010, were followed (n = 116,840). Of these, 89.7 % received statin medication. Data were analyzed by multilevel logistic regression, with individual-level characteristics (age, marital status, family income, educational attainment, country of origin, urban/rural status and comorbidities/chronic conditions related to MI) as covariates. Results: Low neighborhood-level SES was significantly associated with low statin medication rate (Odds Ratio 0.80). In the full model, which took into account individual-level socioeconomic characteristics and MI comorbidities, the odds no longer remained significant. Conclusions: Individual-level approaches may be most important in health care policies regarding statin medication in MI patients.
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| 21. |
- Friberg, Danielle, et al.
(författare)
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Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing.
- 2015
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1878-5506 .- 1389-9457. ; 16:9, s. 1169-1175
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have found associations between pediatric sleep-disordered breathing (SDB) and socioeconomic status (SES), as well as a neighborhood-related disadvantage. This study analyzes the association among familial SES, parental occupation, and SDB in Swedish offspring.
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| 22. |
- Gilliver, Stephen, et al.
(författare)
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Recent research on the mental health of immigrants to Sweden: a literature review.
- 2014
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 24 Suppl 1, s. 72-79
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Tidskriftsartikel (refereegranskat)abstract
- The arrival of large numbers of economic migrants and refugees has seen the Swedish immigrant population increase rapidly. Research has shown that immigrants may be more susceptible to mental disorders because of traumatic events prior to immigration and adverse circumstances in their new country. The aim of this literature review is to summarize and interpret recent research on the mental health of immigrants to Sweden.
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| 23. |
- Hamano, Tsuyoshi, et al.
(författare)
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Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets : A Nationwide 6-Year Follow-Up Study of 944,487 Children
- 2017
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Ingår i: Obesity Facts. - : S. Karger AG. - 1662-4025 .- 1662-4033. ; , s. 559-568
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this 6-year follow-up study was to examine whether neighbourhood accessibility to fast-food outlets was associated with diagnosed childhood obesity, after adjustment for neighbourhood- and individual-level socio-demographic factors. Methods: This 6-year follow-up study comprised 484,677 boys and 459,810 girls aged 0-14 years in Sweden. The follow-up period ran from January 1, 2005, until hospitalisation/out-patient treatment for obesity, death, emigration or the end of the study period on December 31, 2010. Multilevel logistic regression models (individual-level factors at the first level and neighbourhood-level factors at the second level) were used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: We identified 6,968 obesity cases (3,878 boys and 3,090 girls) during the follow-up period. Higher odds of childhood obesity for those living in neighbourhoods with accessibility to fast-food outlets was observed (OR = 1.14, 95% CI = 1.07-1.22) that remained significant after adjustments (OR = 1.06, 95% CI = 1.00-1.13). Conclusions: This prospective nationwide study showed that the neighbourhood accessibility to fast-food outlets was independently associated with increased odds of diagnosed childhood obesity. This finding implicates that residential environments should be considered when developing health promotion programmes.
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| 24. |
- Hamano, Tsuyoshi, et al.
(författare)
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Depression, stroke and gender: evidence of a stronger association in men.
- 2015
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 1468-330X .- 0022-3050. ; 86:3, s. 319-323
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Tidskriftsartikel (refereegranskat)abstract
- Depression is associated with an increased risk for stroke. The aim of this study was to examine whether demographic and socioeconomic factors modify this association.
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| 25. |
- Hamano, Tsuyoshi, et al.
(författare)
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Is familial risk for depression confounded by individual and familial socioeconomic factors and neighborhood environmental factors? A 7-year follow-up study in Sweden
- 2018
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781. ; 266, s. 30-35
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Tidskriftsartikel (refereegranskat)abstract
- Family history of depression is an important risk factor for depression. The aim of this study was to examine whether the effect of family history of depression is confounded by individual and familial socioeconomic factors (i.e., country of origin, educational attainment, family income and mobility) and neighborhood environmental factors (i.e., neighborhood deprivation and neighborhood social capital). The study population comprised 188,907 individuals aged 20–44 years from a nationwide sample of primary care centers in Sweden. Among these individuals, 22,014 with a first event of depression (6,486 men and 15,528 women) were identified during the 7-year follow-up period. Family history of depression was defined as depression in at least one parent. Cross-classified multilevel logistic regression models were used to calculate odds ratios with 95% credible intervals. Increased familial odds were observed after adjustment for individual and familial socioeconomic factors and neighborhood environmental factors for both men and women. Our results suggest that family history of depression is an independent risk factor for depression. Offspring of parents with depression are important targets for disease prevention, regardless of individual and familial socioeconomic factors and neighborhood environmental factors.
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