The risk of early‐onset (EO) breast cancer is known to be increased in relatives of EO breast cancer patients, but less is known about the familial risk of other EO cancers. We assessed familial ...risks of EO cancers (aged ≤40 years) other than breast cancer in 54 753 relatives of 5562 women with EO breast cancer (probands) by using a population‐based cohort from Finland. Standardized incidence ratios (SIRs) and 95% confidence intervals (CI) were estimated by using gender‐, age‐ and period‐specific cancer incidences of the general population as reference. The risk of any cancer excluding breast cancer in first‐degree relatives was comparable to population cancer risk (SIR 0.99, 95% CI: 0.84‐1.16). Siblings' children of women with EO breast cancer were at an elevated risk of EO testicular and ovarian cancer (SIR = 1.74, 95% CI: 1.07‐2.69 and 2.69, 95% CI: 1.08‐5.53, respectively). The risk of EO pancreatic cancer was elevated in siblings of the probands (7.61, 95% CI: 1.57‐22.23) and an increased risk of any other cancer than breast cancer was observed in children of the probands (1.27, 95% CI: 1.03‐1.55). In conclusion, relatives of women with EO breast cancer are at higher familial risk of certain discordant EO cancers, with the risk extending beyond first‐degree relatives.
What's new?
Family members of early‐onset breast cancer patients are at a higher risk of early‐onset breast cancer. However, it is unclear whether the familial risk is limited to early‐onset cancer of the same site. Here, the authors estimate the familial risks of discordant early‐onset cancers in relatives of female early‐onset breast cancer patients, using an extensive, prospective population‐based cohort. The findings suggest that the familial risk extends to discordant early‐onset cancers, including ovarian, testicular and pancreatic cancers, as well as beyond first‐degree relatives.
Abstract
There is limited evidence for any dietary factor, except alcohol, in breast cancer (BC) risk. Therefore, studies on a whole diet, using diet quality indices, can broaden our insight. We ...examined associations of the Nordic Diet (mNDI), Mediterranean diet (mMEDI) and Alternative Healthy Eating Index (mAHEI) with postmenopausal BC risk. Five Finnish cohorts were combined including 6374 postmenopausal women with dietary information. In all, 8–9 dietary components were aggregated in each index, higher total score indicating higher adherence to a healthy diet. Cox proportional hazards regression was used to estimate the combined hazard ratio (HR) and 95% confidence interval (CI) for BC risk. During an average 10-year follow-up period, 274 incident postmenopausal BC cases were diagnosed. In multivariable models, the HR for highest vs. lowest quintile of index was 0.67 (95 %CI 0.48–1.01) for mNDI, 0.88 (0.59–1.30) for mMEDI and 0.89 (0.60–1.32) for mAHEI. In this combined dataset, a borderline preventive finding of high adherence to mNDI on postmenopausal BC risk was found. Of the indices, mNDI was more based on the local food culture than the others. Although a healthy diet has beneficially been related to several chronic diseases, the link with the etiology of postmenopausal BC does not seem to be that obvious.
Abstract
Background
We assessed population-level changes in glioblastoma survival between 2000 and 2013 in Finland, with focus on elderly patients (>70 y) in order to assess if changes in treatment ...of glioblastoma are reflected also in population-based survival rates.
Methods
We identified all patients (age ≥18 y) from the Finnish Cancer Registry (FCR) with a histopathological diagnosis of primary glioblastoma in 2000–2013. Patients were followed up until December 2015. The accuracy of register-based search of glioblastoma patients was internally validated. We report age-standardized relative survival ratios and relative excess risks (RERs) of death in 2000–2006 (pre-period) and 2007–2013 (post-period).
Results
We identified 2045 glioblastoma patients from the FCR. The accuracy of the FCR-based search was 97%. Median age was 63.3 years, and 42% were women. Incidence increased on average by 1.6% (P = 0.004) and median age by 0.4 years per calendar year. Between the pre- and post-periods, the proportion of patients >70 years increased from 24% to 27%. In >70-year-old patients, the median survival time increased from 3.6 months in 2000–2006 to 4.5 months in 2007–2013 (RER 0.82, 95% CI: 0.68–0.98). In ≤70-year-old patients, the median survival time increased from 9.3 months in 2000–2006 to 11.7 months in 2007–2013 (RER 0.74, 95% CI: 0.67–0.82).
Conclusion
Despite the increased proportion of elderly glioblastoma patients, population-level survival of glioblastoma patients has improved since the year 2000. However, increasing incidence, increasing age of patients, and poor survival in elderly are alarming, and future studies should perhaps focus more on elderly.
Given that the assessment of health-related quality of life (HRQoL) is an essential outcome measure to optimize chronic obstructive pulmonary disease (COPD) patient management, there is a need for a ...short and fast, reliable and valid instrument for routine use in clinical practice. The objective of this study was to analyse the relationship between the disease-specific Airways questionnaire (AQ20) and the generic 15D health-related quality of life (HRQoL) instrument simultaneously in a large cohort of patients with COPD. We also compare the HRQoL of COPD patients with that of the general population.
The AQ20 and 15D were administered to 739 COPD patients representing an unselected hospital-based COPD population. The completion rates and validity of, and correlations among the questions and dimension scores were examined. A factor analysis with varimax rotation was performed in order to find subsets of highly correlating items of the questionnaires.
The summary scores of AQ20 and 15D were highly correlated (r = - 0.71, p < 0.01). In AQ20 over 50% of patients reported frequent cough, breathlessness during domestic work, and chest problem limiting their full enjoyment of life. 15D results showed a noteworthy decrease of HRQoL in breathing, mobility, sleeping, usual activities, discomfort and symptoms, vitality, and sexual activity (scores ≤ 0.75). Compared to the age- and gender-standardized Finnish general population, the COPD patients were statistically significantly worse off on 13 of 15 dimensions.
The AQ20 and 15D summary scores are comparable in terms of measuring HRQoL in COPD patients. The data support the validity of 15D to measure the quality of life in COPD. COPD compromises the HRQoL broadly, as reflected by the generic instrument. Both questionnaires are simple and short, and could easily be used in clinical practice with high completion rates.
Background: Smoking is a severe risk factor for periodontal health in adults, but data on the effect of smoking on periodontal health in teenage populations are sparse. The aim of this study was to ...investigate the effect of duration and quantity of smoking on periodontal health in teenagers and possible differences between genders.
Methods: The oral health of 501 adolescents (15‐ to 16‐year‐old boys n = 258 and girls n = 243) was examined. A structured questionnaire about self‐reported smoking and health habits was filled out, and bitewing x‐rays were taken. Clinical examinations included measuring periodontal indexes, such as visible plaque index, bleeding on probing, root calculus (RC), probing depth, and attachment loss. Results were analyzed by generalized linear logistic regression.
Results: Twenty‐five percent of boys and 27% of girls were smokers. The boys and girls who smoked had higher RC values than non‐smokers (P <0.001). The adjusted scores for smoking boys and girls were 17.3 (95% confidence interval CI: 8.6 to 31.7) and 13.6 (95% CI: 5.5 to 29.7), respectively. The adjusted scores for non‐smokers were 10.4 (95% CI: 5.7 to 18.3) and 7.7 (95% CI: 3.3 to 17.3), respectively. Smoking boys and girls also had more periodontal pockets ≥4 mm than non‐smokers: the score for boys was 4.6 (95% CI: 2.2 to 9.1), and the score for girls was 5.4 (95% CI: 1.1 to 23.2; P <0.001).
Conclusion: Smoking significantly impaired periodontal health in teenagers.
The aim of our study was to investigate how teenage smoking affects the prevalence of periodontal bacteria and periodontal health with the hypothesis that smoking increases the prevalence of the ...bacteria. Oral health of 264 adolescents (15- to 16-year-olds) was clinically examined, and their smoking history was recorded. The participants also filled in a structured questionnaire recording their general health and health habits. Pooled subgingival plaque samples were taken for polymerase chain reaction analysis of
Aggregatibacter actinomycetemcomitans
,
Porphyromonas gingivalis
,
Tannerella forsythia
,
Prevotella intermedia
,
Prevotella nigrescens
, and
Treponema denticola
. The prevalence of
P. intermedia
(21% vs. 4%,
p
= 0.01) and
T. forsythia
and
T. denticola
(23% vs. 8%,
p
< 0.05, for both) was higher among female smokers than among non-smokers.
T. forsythia
and
T. denticola
were more often associated with bleeding on probing (29% vs. 12%; 25% vs. 10%, respectively) and deep pockets (25% vs. 15%; 23% vs. 10%, respectively) with smokers than non-smokers. Among the girls, a significant association was found between pack-years and the prevalence of
P. nigrescens
(
p
< 0.007). In both genders,
A. actinomycetemcomitans
and
P. gingivalis
were rare in this study. To conclude, periodontal bacteria were associated with higher periodontal index scores among all teenage smokers. Smoking girls harbored more frequently certain periodontal bacteria than non-smokers, but this was not seen in boys. Hence, our study hypothesis was only partly confirmed.
Background: The aim of this study was to investigate if the incidence of colorectal cancer (CRC) is associated with education and socioeconomic status (SES) in Finland, and if there are any changes ...in incidence differences between the groups over the period 1976-2014.
Material and methods: CRC cases (N = 77,614) were retrieved from the Finnish Cancer Registry and linked with information on the education level and SES from Statistics Finland. We used Poisson regression model to quantify differences in incidence rates between the groups, and to assess changes over calendar time.
Results and conclusions: Colon cancer incidence was higher among the highly educated, than in those with basic education. Similar differences were observed by SES in men. Incidence rates increased steeply over time among men with basic education (from 16.7/100,000 in 1976-1979 to 31.8 in 2010-2014), resulting in narrowed differences between the groups (p < .001). Incidence trends of proximal and distal colon and rectal cancer in men showed similar patterns. Heterogeneity across time periods by SES was observed only in colon cancer incidence in men (p = .009). No such large differences were detected in women. Steep increase in colon cancer incidence in men with basic education, and the respective persistent high incidence in the highly educated highlights the importance of focusing the preventive measures on modifiable lifestyle factors in order to reduce CRC incidence and to narrow the educational and socioeconomic health differences.
Background and purpose: The objective of this study was to explore the incidence of second malignant neoplasms (SMNs) among adult cancer patients in Finland diagnosed with their first primary cancer ...(FPC) in 1992–2021. Material and methods: The study used data from the population-based Finnish Cancer Registry (FCR). Risk estimates were calculated using the standardised incidence ratio (SIR), the ratio of observed second cancers compared to the expected numbers assuming the same cancer incidence as the corresponding sex-age-calendar year -split of the general population. Results: A total of 573,379 FPCs were diagnosed during 1992–2021. During the follow-up, 60,464 SMNs were diagnosed. Male cancer patients had neither a decreased nor an increased risk (SIR 1.00 95% CI, 0.99–1.01) and female patients had an 8% increased risk (SIR 1.08 95% CI, 1.06–1.09) of developing any SMN compared to a FPC in the general population. The highest SIR of any SMN was observed in patients aged 20–39 -years at FPC diagnosis, and the SIR decreased by increasing age at diagnosis. Patients with lymphoid and haematopoietic tissue neoplasms, cancers of the mouth and pharynx, endocrine glands, respiratory and intrathoracic organs, skin, and urinary organs had the highest SIRs, while patients with cancers of the male genital organs and the female breast had the lowest SIRs. Interpretation: Elevated SIRs were observed in cancer patients diagnosed at an early age and for FPCs known to be in large part attributable to lifestyle factors, which highlights the importance of monitoring and encouraging lifestyle changes.
In this study, we analyze the Genetic Analysis Workshop 18 data to identify the genes and underlying single-nucleotide polymorphisms on 11 chromosomes that exhibit significant association with ...systolic blood pressure. We propose a novel family-based method for rare-variant association detection based on the hierarchical Bayesian framework. The method controls spurious associations caused by population stratification, and improves the statistical power to detect not only individual rare variants, but also genes with either continuous or binary outcomes. Our method utilizes nuclear family information, and takes into account the effects of all single-nucleotide polymorphisms in a gene, using a hierarchical model. When we apply this method to the genome-wide Genetic Analysis Workshop 18 data, several genes and single-nucleotide polymorphisms are identified as potentially related to systolic blood pressure.
Familial aggregation of early‐onset cancers Heikkinen, Sanna M. M.; Madanat‐Harjuoja, Laura‐Maria; Seppä, Karri J. M. ...
International journal of cancer,
1 April 2020, Letnik:
146, Številka:
7
Journal Article
Recenzirano
Odprti dostop
This registry‐linkage study evaluates familial aggregation of cancer among relatives of a population‐based series of early‐onset (≤40 years) cancer patients in Finland. A cohort of 376,762 relatives ...of early‐onset cancer patients diagnosed between 1970 and 2012 in 40,538 families was identified. Familial aggregation of early‐onset breast, colorectal, brain and other central nervous system (CNS) cancer and melanoma was explored by standardized incidence ratios (SIR), stratified by relatedness. Gender‐, age‐ and period‐specific population cancer incidences were used as reference. Cumulative risks for siblings and offspring of the proband up to age ≤40 years were also estimated. Almost all early‐onset cancers were sporadic (98% or more). Among first‐degree relatives, SIR was largest in colorectal cancer (14, 95% confidence interval 9.72–18), and lowest in melanoma (1.93, 1.05–3.23). Highest relative‐specific SIRs were observed for siblings in families, where also parent had concordant cancer, 90 (43–165) for colorectal cancer and 29 (11–64) for CNS cancer. In spouses, all SIRs were at population level. Cumulative risk of colorectal cancer by age 41 was 0.98% in siblings and 0.10% in population, while in breast cancer the corresponding risks were 2.05% and 0.56%. In conclusion, early‐onset cancers are mainly sporadic. Findings support high familial aggregation in early‐onset colorectal and CNS cancers. Familial aggregation in multiplex families with CNS cancers was mainly attributed to neurofibromatosis and in colorectal cancer to FAP‐ and HNPCC‐syndromes. The pattern of familial aggregation of early‐onset breast cancer could be seen to support very early exposure to environmental factors and/or rare genetic factors.
What's new?
The tendency for certain cancer types to cluster in families generally is explained by shared environmental exposures or inherited mutations. In particular, early‐onset cancer, diagnosed between ages 0 and 40, is considered indicative of familial factors. Here, investigation of cancer risk among more than 376,760 relatives of probands, or individuals with early‐onset cancer, shows that the likelihood of early‐onset cancer affecting even just one other relative in addition to the proband is exceedingly rare. Nearly all early‐onset cancers in the study population were sporadic. Estimated cumulative risks observed for specific cancers may prove useful in the context of genetic counseling.
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