| 1. |
- Adolfsson, Jan, et al.
(författare)
-
Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005 : Data from the national prostate cancer register in Sweden
- 2007
-
Ingår i: Scandinavian Journal of Urology and Nephrology. - Stockholm : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 41:6, s. 456-477
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of >100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score ≤6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged ≥75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer
|
|
| 2. |
- Adolfsson, Jan, et al.
(författare)
-
Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005
- 2007
-
Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:6, s. 456-477
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. MATERIAL AND METHODS: Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. RESULTS: In total, 72,028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of > 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score <6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged > or =75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. CONCLUSIONS: All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer.
|
|
| 3. |
- Fall, Katja, et al.
(författare)
-
Prostate-specific antigen levels as a predictor of lethal prostate cancer
- 2007
-
Ingår i: Journal of the National Cancer Institute. - Oxford : Oxford Univ. Press. - 0027-8874 .- 1460-2105. ; 99:7, s. 526-532
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Rates of long-term survival among patients with untreated localized prostate cancer are high. To avoid unnecessary treatment, tools are needed to identify the small proportion of patients who are destined to develop lethal prostate cancer. Methods: To evaluate the accuracy of early changes in prostate-specific antigen (PSA) levels as predictors of prostate cancer outcome, we assessed serial measurements of PSA level among 267 men with localized prostate cancer in a Scandinavian cohort of men who were diagnosed between 1989 and 1999 and who were managed by watchful waiting. We then 1) fitted individual regression lines to the PSA values assessed for each patient during the first 2 years of follow-up by using three different models, 2) evaluated early PSA curve characteristics as determinants of the cumulative incidence of lethal prostate cancer and calculated hazard ratios for baseline PSA value and rate of change in PSA level to prostate cancer outcome, and 3) plotted time-dependent receiver operating characteristic (ROC) curves. All P values are two-sided. Results: During complete follow-up for a mean of 8.5 years, 34 patients (13%) died from prostate cancer, and 18 (7%) developed metastases but were still alive at end of follow-up. In a log-linear model, both PSA value at baseline (P = .05) and the rate of PSA change (P<.001) were associated with the development of lethal prostate cancer. In the ROC analysis, however, the accuracy of classifying the disease as either indolent or destined to progress was low, regardless of the cut point chosen for initial PSA level or rate of change in PSA level. Conclusions: Although baseline PSA value and rate of PSA change are prognostic factors for lethal prostate cancer, they are poor predictors of lethal prostate cancer among patients with localized prostate cancer who are managed by watchful waiting.
|
|
| 4. |
- Hagel, Eva, et al.
(författare)
-
PCBaSe Sweden : a register-based resource for prostate cancer research
- 2009
-
Ingår i: Scandinavian Journal of Urology and Nephrology. - London : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 43:5, s. 342-9
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To construct a database for clinical epidemiological prostate cancer research based on linkages between the National Prostate Cancer Register (NPCR) of Sweden, a population-based, nationwide quality database, and other nationwide registries. Material and methods. By use of the individually unique Swedish Personal Identity Number, the NPCR was linked to the Swedish Cancer Registry, the Cause of Death Register, the Prescribed Drug Register, the National Patient Register and the Acute Myocardial Infarction Register, all held at the Centre for Epidemiology at the National Board of Health and Welfare, and the Register of the Total Population, the Longitudinal Integration Database for Health Insurance and Labor Market Studies and the Multi-Generation Register, held at Statistics Sweden, and to the Swedish Hernia Register. Results. Record linkages between the NPCR and the Swedish Cancer Registry, the Cause of Death Register and the Register of the Total Population generated a database, named PCBaSe Sweden, including 80 079 prostate cancer cases, diagnosed between 1 January 1996 and 31 December 2006. Record linkage between PCBaSe Sweden and the Prescribed Drug Register generated 59 721 unique matches and linkage to the Acute Myocardial Infarction Register resulted in 11 459 matches. Conclusion. PCBaSe Sweden is a newly created and unique database with over 80 000 cases of prostate cancer with comprehensive data on inpatient and outpatient care, patterns of use of prescribed drugs and socioeconomic and familial factors. Many topics in clinical prostate cancer epidemiology can be investigated. using PCBaSe Sweden.
|
|
| 5. |
|
|
| 6. |
- Bill-Axelson, Anna, et al.
(författare)
-
Radical prostatectomy versus watchful waiting in localized prostate cancer : the Scandinavian prostate cancer group-4 randomized trial
- 2008
-
Ingår i: Journal of the National Cancer Institute. - : Oxford University Press. - 0027-8874 .- 1460-2105. ; 100:16, s. 1144-1154
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The benefit of radical prostatectomy in patients with early prostate cancer has been assessed in only one randomized trial. In 2005, we reported that radical prostatectomy improved prostate cancer survival compared with watchful waiting after a median of 8.2 years of follow-up. We now report results after 3 more years of follow-up.METHODS: From October 1, 1989, through February 28, 1999, 695 men with clinically localized prostate cancer were randomly assigned to radical prostatectomy (n = 347) or watchful waiting (n = 348). Follow-up was complete through December 31, 2006, with histopathologic review and blinded evaluation of causes of death. Relative risks (RRs) were estimated using the Cox proportional hazards model. Statistical tests were two-sided.RESULTS: During a median of 10.8 years of follow-up (range = 3 weeks to 17.2 years), 137 men in the surgery group and 156 in the watchful waiting group died (P = .09). For 47 of the 347 men (13.5%) who were randomly assigned to surgery and 68 of the 348 men (19.5%) who were not, death was due to prostate cancer. The difference in cumulative incidence of death due to prostate cancer remained stable after about 10 years of follow-up. At 12 years, 12.5% of the surgery group and 17.9% of the watchful waiting group had died of prostate cancer (difference = 5.4%, 95% confidence interval [CI] = 0.2 to 11.1%), for a relative risk of 0.65 (95% CI = 0.45 to 0.94; P = .03). The difference in cumulative incidence of distant metastases did not increase beyond 10 years of follow-up. At 12 years, 19.3% of men in the surgery group and 26% of men in the watchful waiting group had been diagnosed with distant metastases (difference = 6.7%, 95% CI = 0.2 to 13.2%), for a relative risk of 0.65 (95% CI = 0.47 to 0.88; P = .006). Among men who underwent radical prostatectomy, those with extracapsular tumor growth had 14 times the risk of prostate cancer death as those without it (RR = 14.2, 95% CI = 3.3 to 61.8; P < .001).CONCLUSION: Radical prostatectomy reduces prostate cancer mortality and risk of metastases with little or no further increase in benefit 10 or more years after surgery.
|
|
| 7. |
- Bolling, Hans, 1966-
(författare)
-
Sin egen hälsas smed : Idéer, initiativ och organisationer inom svensk motionsidrott 1945–1981
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation studies the spread of sports for all in Sweden during the years 1945 to 1981. The purposes of the dissertation are twofold: in part to survey the forms of physical activities which were launched as sports for all after 1945, in part to answer the question: Why have almost all voluntarily organized sports in Sweden been part of one organization since the 1970s? In order to handle the diversities of activities that can fall within the concept of sport, two principal abstractions of the concept are used: one rigorous and one flexible. Which definition one uses influences how physical activities are organized in a society. Earlier research into the history of the Swedish sports movement has concluded that it has had a relatively high degree of autonomy in relation to the state. This finding is questioned in this dissertation. Sveriges Riksidrottsförbund (RF) was the largest Swedish sports organization throughout the 20th century and at same time the organization the government relied on to develop sports policies and distribute the financial contribution from the state to the sports movement. This means that RF has played two roles, as an umbrella organization within the Swedish sports movement and as leader of the organizations within the Swedish sports movement, popular movement and semi-public authority. The dissertation shows that the two roles, that RF played, have caused conflicts of interest within the organization. That is made plain when one studies the spread of sports for all. Most members of the organization just wanted to practise different sports and were not interested in the leading organization’s desire to promote a great many different kinds of physical acitivites according to a flexible concept of sport. These members were not interested in strengthening the organization’s leading position within sports. There are not many conceptions that are so universally and uncritically accepted as the conception of the connection between physical activity and health. Sports for all came to age in a society where more and more people were told to use part of their leisure time to take part in physical activities. A societal consensus prevailed that the population’s health was on the decline due to the increased standard of living, which was creating an inactive and unhealthy population. This has meant that sports for all have been an asset of power for the sports organizations and that they have fought for authority and control over sports for all; a struggle fought over the language and thoughts as much as over sport activities. Since 1945 large campaigns to get the population to become more physically active irrespective of physical ability have been common.
|
|
| 8. |
|
|
| 9. |
- Edberg, Rune, 1946-
(författare)
-
Vikingaskeppet Ormen Friskes undergång : Ett drama i det kalla krigets skugga
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation consists of three separately published parts, all dealing with problems involving reconstructions of Viking Age ships, travelling experiments with such ships and people’s relations and attitudes to them. The Ormen Friske, a Swedish replica of the Norwegian Gokstad ship, sank in the North Sea in June 1950, drowning all 15 on board. The ship was caught in ugly weather and steered for Helgoland, but at the same time U.S. aircraft carried out a high-altitude practice bombing run, targeting the island, unintentionally preventing the ship from reaching sheltered waters. Swedish officials suppressed the role of the bombing in the accident and rejected proposals for an inspection of the wreck. The disaster was instead blamed on the ship’s alleged deficiencies and the crew’s inexperience. The reason for the cover-up was to avoid annoying the Western allies. Most of the ship’s wreckage was then cleared away. But a few parts and artifacts were safeguarded, some of which still survive in museums, archives and private homes. They are discussed in terms of the varying meaning attributed to them by different authorities and people involved. Also, the remaining artifacts have their sentimental value thanks to their accompanying narratives. Together with graves and memorial sites these objects continue to mark people’s memories and conception of the disaster. The archaeologist studying the contemporary past must move beyond Archaeology’s traditional sources. Documents and files in government and private archives, letters, photos, newspaper articles, interviews, ethno-archaeological experiments and participating observation may be used. He shall feel free to intersect borders to other disciplines, fitting and interpreting evidence into a narrative context. Archaeology of the contemporary past deals with issues inseparable from the present and is therefore unevitably controversial. It is argued that the scholar should apply a reflexive approach, also scrutinizing his own background, social position and research incentives. During the 1990’s the author co-organized a number of experimental river journeys in Russia, Ukraine, Belarus and Latvia, analyzing the results in an archaeological, etnographical and historical context. The ship formed the required experimental platform but the essential feature was the voyage itself. Rowing vessels of the Scandinavian type upstream, through rapids and long portages, proved to be a strong, often impossible, challenge even for a very well trained and singe-minded crew. It is improbable that travellers ever brought ships all the way from the Baltic Sea to the Black Sea. It is suggested that Viking Age travellers instead traversed the part of the route ”From the Varangians to the Greeks” between the Novgorod area and the upper Dnepr area by foot or horse and sledge during winter. Russian archaeological material supports this explanatory model. The popular image of Viking ships crossing Russia on rivers seems, at least in part, to derive from folklore and legends in an international tradition.
|
|
| 10. |
|
|
