| 10871. |
- Lagergren, Jesper, et al.
(författare)
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Marital status, education, and income in relation to the risk of esophaegal and gastric cancer by histological type and site
- 2016
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Ingår i: Cancer. - Stockholm : Wiley. - 0008-543X .- 1097-0142. ; 122:2, s. 207-212
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDMarital status, income, and education might influence the risk of esophageal and gastric cancer, but the literature is limited. A large study addressing subtypes of these tumors was used to clarify these associations.METHODSA nationwide, Swedish population–based cohort study from 1991 to 2010 included individuals who were 50 years old or older. Data on exposures, covariates, and outcomes were obtained from well-maintained registers. Four esophagogastric tumor subtypes were analyzed in combination and separately: esophageal adenocarcinoma, esophageal squamous cell carcinoma, cardia adenocarcinoma, and noncardia gastric adenocarcinoma. Poisson regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Analyses were stratified by sex and adjusted for confounders.RESULTSAmong 4,734,227 participants (60,634,007 person-years), 24,095 developed esophageal or gastric cancer. In comparison with individuals in a long marriage, increased IRRs were found among participants who were in a shorter marriage or were never married, remarried, divorced, or widowed. These associations were indicated for each tumor subtype but were generally stronger for esophageal squamous cell carcinoma. Higher education and income were associated with decreased IRRs in a seemingly dose-response manner and similarly for each subtype. In comparison with the completion of only primary school, higher tertiary education rendered an IRR of 0.64 (95% CI, 0.60-0.69) for men and an IRR of 0.68 (95% CI, 0.61-0.75) for women. Comparing participants in the highest and lowest income brackets (highest 20% vs lowest 20%) revealed an IRR of 0.74 (95% CI, 0.70-0.79) for men and an IRR of 0.83 (95% CI, 0.76-0.91) for women.CONCLUSIONSDivorce, widowhood, living alone, low educational attainment, and low income increase the risk of each subtype of esophageal and gastric cancer. These associations require attention when high-risk individuals are being identified.
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| 10872. |
- Lagerlund, Magdalena, et al.
(författare)
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Change in mammography screening attendance after removing the out-of-pocket fee : a population-based study in Sweden (2014–2018)
- 2021
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 32:11, s. 1257-1268
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess the change in mammography screening attendance in Sweden—overall and in sociodemographic groups at risk of low attendance—after removal of the out-of-pocket fee in 2016. Methods: Individual-level data on all screening invitations and attendance between 2014 and 2018 were linked to sociodemographic data from Statistics Sweden. Odds ratios and 95% confidence intervals (CIs) for attendance by time period and sociodemographic factor were computed using mixed logistic regression to account for repeated measures within women. The study sample included 1.4 million women, aged 40–75, who had a mammography screening appointment in 2014–2015 and/or 2017–2018 in 14 of Sweden’s 21 health care regions. Results: Overall screening attendance was 83.8% in 2014–2015 and 84.1% in 2017–2018 (+ 0.3 percentage points, 95% CI 0.2–0.4). The greatest increase in attendance was observed in non-Nordic women with the lowest income, where attendance rose from 62.9 to 65.8% (+ 2.9 points, 95% CI 2.3–3.6), and among women with four or more risk factors for low attendance, where attendance rose from 59.2 to 62.0% (+ 2.8 points, 95% CI 2.2–3.4). Conclusion: Screening attendance did not undergo any important increase after implementing free screening, although attendance among some sociodemographic groups increased by almost three percentage points after the policy change.
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| 10873. |
- Lagerlund, Magdalena, et al.
(författare)
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Do reproductive and hormonal risk factors for breast cancer associate with attendance at mammography screening?
- 2013
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 1573-7225 .- 0957-5243. ; 24:9, s. 1687-1694
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine whether reproductive and hormonal risk factors for breast cancer associate with mammography attendance. METHODS: We linked data from the Malmö Diet and Cancer Study to the Malmö mammography register (Sweden, 1992-2009). We analyzed 11,409 women (age 44-72) who were free of breast cancer at study entry and a total of 69,746 screening invitations. Generalized Estimating Equations were used to account for repeated measures within subjects. Models were adjusted for age and other sociodemographic factors. RESULTS: In this study cohort, mammography screening attendance ranged from 87.6 to 94.5 % between calendar years, with an average attendance of 92 %. Higher attendance was found among women who had given birth to fewer than three children (ORs ranging between 1.15 and 1.37) and had used oral contraceptives (OC) within the last decade (OR = 1.22, 95 % CI 1.07-1.38) and for a longer period (OR = 1.13, 95 % CI 1.01-1.27). A lower odds of attendance was found among post-menopausal women (OR = 0.86, 95 % CI 0.77-0.96). Age <13 at menarche, age ≥30 at first childbirth, age ≥55 at menopause, age <20 at first OC use, nulliparity, breastfeeding, and hormone replacement therapy were not associated with mammography attendance. CONCLUSION: Reproductive and hormonal risk factors for breast cancer have little effect on mammography screening attendance. This may indicate a potential for under-screening of some women at higher risk.
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| 10874. |
- Lagerlund, Magdalena, et al.
(författare)
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Health-related lifestyle factors and mammography screening attendance in a Swedish cohort study.
- 2015
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Ingår i: European Journal of Cancer Prevention. - 1473-5709. ; 24:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- To determine whether health-related lifestyle factors are associated with attendance at a population-based invitational mammography screening program in southern Sweden, data on health-related lifestyle factors (smoking, alcohol use, physical activity, BMI, diet, self-rated health, and stress) were obtained from the Malmö Diet and Cancer Study and linked to the Malmö mammography register (Sweden, 1992-2009). Women (n=11 409) who were free from breast cancer at study entry were included in the cohort, and mammography attendance was followed from cohort entry to 31 December 2009. Generalized estimating equations were used to account for repeated measures within patients. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Nonattendance occurred in 8% of the 69 746 screening opportunities that were observed. Nonattendance was more common among women who were current or former smokers [OR=1.60 (1.45-1.76) and OR=1.15 (1.05-1.28)], had not used alcohol in the past year [OR=1.55 (1.32-1.83)], were less physically active outside of work [OR=1.10 (1.00-1.20)], had high physical activity at work (OR=1.13, 95% CI: 1.00-1.28), were vegetarians or vegans [OR=1.49 (1.11-1.99)], had not used dietary supplements [OR=1.11 (1.01-1.21)], had poor self-rated health [OR=1.24 (1.14-1.36)], and were experiencing greater stress [OR=1.25 (1.14-1.36)]. In this cohort, nonattendance was associated with smoking, alcohol abstinence, physical activity, poor self-rated health, stress, and following a vegetarian/vegan diet. These findings generally support the notion that women with less healthy lifestyles are less likely to engage in mammography screening.
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| 10875. |
- Lagerlund, Magdalena, et al.
(författare)
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Population-based mammography screening attendance in Sweden 2017–2018 : A cross-sectional register study to assess the impact of sociodemographic factors
- 2021
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Ingår i: Breast. - : Elsevier BV. - 0960-9776. ; 59, s. 16-26
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Tidskriftsartikel (refereegranskat)abstract
- Sweden has a population-based mammography screening programme for women aged 40–74. The objective of this study was to examine the association between mammography screening attendance and sociodemographic factors in 15 of Sweden's 21 health care regions. Register-based information was collected on all mammography screening invitations and attendance during 2017 and 2018, and linked to individual-level sociodemographic data from Statistics Sweden. Odds ratios (ORs) and 95% confidence intervals (CIs) for attendance were computed by sociodemographic factor. The study sample included 1.5 million women, aged 40–75, with an overall screening attendance of 81.3%. The lowest odds of attending were found for women living without a partner (OR = 0.52, 95% CI: 0.52–0.53), low-income women (OR = 0.57, 95% CI: 0.56–0.57), and non-Nordic women born in Europe (OR = 0.60, 95% CI: 0.59–0.61). Other groups with lower odds of attending were women whose main source of income was social assistance or benefits (OR = 0.62, 95% CI: 0.62–0.63), those not owning their home (OR = 0.66, 95% CI: 0.66–0.67), and those with low level of education (OR = 0.72, 95% CI: 0.71–0.73). Having multiple of these sociodemographic characteristics further lowered the odds of attending. Although overall mammography screening attendance in Sweden is high, sociodemographic inequalities exist, and efforts should be made to address these. Particular attention should be given to low-income women who live without a partner.
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| 10876. |
- Lagerlund, M, et al.
(författare)
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Predictors of non-attendance in a population-based mammography screening programme; socio-demographic factors and aspects of health behaviour
- 2000
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Ingår i: European Journal of Cancer Prevention. - : Ovid Technologies (Wolters Kluwer Health). - 0959-8278 .- 1473-5709. ; 9:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify predictors of non-attendance in a population-based mammography-screening programme in central Sweden, on the basis of telephone interviews with 434 non-attendees and 515 attendees identified in a mammography register, Non-attendance was studied in relation to sociodemographic factors, indicators of general health behaviour, self-rated health and experience of cancer in others and own cancer or breast problems. Being single or being non-employed were the only important socio-demographic predictors of non-attendance. Non-attendance was more likely among women who never visited a dentist, had not visited a doctor in 5 years, had never used oral contraceptives or hormone replacement therapy, had never had cervical smear tests, never drank alcohol, smoked regularly, reported no breast cancer in family or friends or own breast problems, We conclude that socio-demographic factors alone do not appear to constitute strong predictors of non-attendance, General health behaviour and previous experience of cancer and breast disease seem to be more important factors. Our results suggest that in the setting of population-based outreach mammography programmes, previous contacts with the health care system and encouragement from health professionals represent determinants of attendance.
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| 10877. |
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| 10878. |
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| 10879. |
- Lagerlöf, Ingemar, 1971-
(författare)
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Survival and treatment related toxicity in classical Hodgkin lymphoma
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Treating early-stage classical Hodgkin lymphoma (cHL) by adding radiotherapy to chemotherapy gives better disease control compared to chemotherapy only. With a low median age at diagnosis, the risk from cHL needs to be weighed against the risk of treatment toxicity. Historical reports indicate substantial toxicity from radiotherapy, with excess morbidity and mortality. These results are based on radiotherapy techniques no longer in use. Modern radiotherapy might not cause the same level of long-term risks. By linking lymphoma registers and health registers, the present thesis analyses results for two cohorts of patients treated for early-stage cHL with combined modality. The cohorts are population-based and have been treated with radiation fields that are reduced compared with fields used in earlier population-based cohorts.The cohorts exhibit excess morbidity, hazard ratio (HR) 1.6 (95% Confidence Interval, CI, 1.1–2.4) for second cancers, HR 1.4 (95%CI, 1.1–1.8) for diseases of the circulatory system, and HR 2.6 (95%CI, 1.6–4.3) for diseases of the respiratory system. The first cohort, diagnosed 1999–2005, does not deviate from expected survival in the general population. The only subgroup analysed with excess mortality consists of patients with progressive cHL within 5 years of follow-up. The later cohort, patients diagnosed 2006–2015, exhibits a small but statistically significant excess mortality, relative survival rate 0.97 (95%CI, 0.95–0.99) at 10 years of follow-up. In analyses of years of life lost according to cause of death, second malignancies are the leading cause of death, 1.17 years/patient compared with 0.41 years/comparator (p=0.004) in the first cohort. Progressive cHL is the dominating cause of death in the second cohort. In these two cohorts with early-stage cHL treated with combined modality, excess morbidity exists, but on a much lower level than in previously published population-based cohorts, which reported standardised incidence ratios of 4–5 for second cancers and 4–7 for cardiovascular disease. Survival is excellent with only marginal or no excess mortality compared with the general population. The excess mortality in the second cohort is almost certainly caused by deaths due to progressive cHL. In conclusion, the substantial reduction in excess morbidity from treatment toxicity result in no, or minimal excess mortality. The cause of death that can be correlated to any significant excess mortality is progressive cHL. These results argue in favour of continuing to strive for disease control, suggesting that, at present, combined modality should be used to treat early-stage cHL.
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| 10880. |
- Lagerstedt, Kristina, 1976, et al.
(författare)
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Tumor Genome Wide DNA Alterations Assessed by Array CGH in Patients with Poor and Excellent Survival Following Operation for Colorectal Cancer.
- 2007
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Ingår i: Cancer informatics. - 1176-9351. ; 3, s. 341-55
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Tidskriftsartikel (refereegranskat)abstract
- Genome wide DNA alterations were evaluated by array CGH in addition to RNA expression profiling in colorectal cancer from patients with excellent and poor survival following primary operations.DNA was used for CGH in BAC and cDNA arrays. Global RNA expression was determined by 44K arrays. DNA and RNA from tumor and normal colon were used from cancer patients grouped according to death, survival or Dukes A, B, C and D tumor stage. Confirmed DNA alterations in all Dukes A - D were judged relevant for carcinogenesis, while changes in Dukes C and D only were regarded relevant for tumor progression.Copy number gain was more common than loss in tumor tissue (p < 0.01). Major tumor DNA alterations occurred in chromosome 8, 13, 18 and 20, where short survival included gain in 8q and loss in 8p. Copy number gains related to tumor progression were most common on chromosome 7, 8, 19, 20, while corresponding major losses appeared in chromosome 8. Losses at chromosome 18 occurred in all Dukes stages. Normal colon tissue from cancer patients displayed gains in chromosome 19 and 20. Mathematical Vector analysis implied a number of BAC-clones in tumor DNA with genes of potential importance for death or survival.The genomic variation in colorectal cancer cells is tremendous and emphasizes that BAC array CGH is presently more powerful than available statistical models to discriminate DNA sequence information related to outcome. Present results suggest that a majority of DNA alterations observed in colorectal cancer are secondary to tumor progression. Therefore, it would require an immense work to distinguish primary from secondary DNA alterations behind colorectal cancer.
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