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Ugge, H., Udumyan, R., Carlsson, J., Andrén, O., Montgomery, S., Davidsson, S. & Fall, K. (2018). Acne in late adolescence and risk of prostate cancer. International Journal of Cancer, 1580-1585
Open this publication in new window or tab >>Acne in late adolescence and risk of prostate cancer
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2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, p. 1580-1585Article in journal (Refereed) Published
Abstract [en]

Accumulating evidence suggest that Propionibacterium acnes may play a role in prostate carcinogenesis, but data are so far limited and inconclusive. The aim of this population-based cohort study was therefore to test whether presence of acne vulgaris during late adolescence is associated with an increased risk of prostate cancer later in life. We identified a large cohort of young men born in Sweden between 1952 and 1956, who underwent mandatory assessment for military conscription around the age of 18 (n= 243,187). Test information along with health data including medical diagnoses at time of conscription was available through the Swedish Military Conscription Register and the National Patient Register. The cohort was followed through linkages to the Swedish Cancer Register to identify the occurrence of prostate cancer until December 31st 2009. We used Cox regression to calculate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between acne in adolescence and prostate cancer risk. A total of 1,633 men were diagnosed with prostate cancer during a median follow-up of 36.7 years. A diagnosis of acne was associated with a statistically significant increased risk for prostate cancer (adjusted HR: 1.43 95%; CI: 1.06-1.92), particularly for advanced stage disease (HR: 2.37 95%; CI 1.19-4.73). A diagnosis of acne classified as severe conferred a 6-fold increased risk of prostate cancer (HR: 5.70 95% CI 1.42-22.85). Data from this large prospective population-based cohort add new evidence supporting a role of P acnes infection in prostate cancer.

Place, publisher, year, edition, pages
Hoboken, NJ, USA: John Wiley & Sons, 2018
Keyword
Propionibacterium acnes; prostate cancer; acne vulgaris; inflammation; acne vulgaris
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-63302 (URN)10.1002/ijc.31192 (DOI)000425184800009 ()29205339 (PubMedID)2-s2.0-85037982996 (Scopus ID)
Note

Funding Agency:

UK Economic and Social Research Council (ESRC)  RES-596-28-0001  ES/JO19119/1

Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-04-17Bibliographically approved
Ugge, H., Udumyan, R., Carlsson, J., Davidsson, S., Andrén, O., Montgomery, S. & Fall, K. (2018). Appendicitis before age 20 years is associated with an increased risk of later prostate cancer. Cancer Epidemiology, Biomarkers and Prevention, Article ID cebp.1204.2017.
Open this publication in new window or tab >>Appendicitis before age 20 years is associated with an increased risk of later prostate cancer
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2018 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, article id cebp.1204.2017Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Appendicitis before age 20 years has been observed to influence the risk of several inflammatory conditions, possibly through underlying immunological mechanisms. Inflammation has further been suggested to be involved in prostate cancer development. We therefore hypothesized that immunological characteristics signaled by appendicitis before late adolescence might influence the risk of later prostate cancer, and aimed to evaluate this association in a population-based study.

METHODS: We identified a large cohort of Swedish men who underwent assessment for military conscription around the age of 18 years (n= 242,573). Medical diagnoses at time of conscription were available through the Swedish Military Conscription Register. The Swedish Cancer Register was used to identify diagnoses of prostate cancer. Multivariable adjusted Cox regression analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between appendicitis and prostate cancer.

RESULTS: During a median of 36.7 years of follow-up, 1,684 diagnoses of prostate cancer occurred. We found a statistically significant association between appendicitis and overall prostate cancer (adjusted HR: 1.70; 95% CI: 1.08-2.67). The risk was notably increased for advanced (HR: 4.42; 95% CI: 1.74-11.22) and lethal (HR: 8.95; 95% CI: 2.98-26.91) prostate cancer.

CONCLUSION: These results suggest that a diagnosis of appendicitis before adulthood potentially signals underlying immune characteristics and a pattern of inflammatory response relevant to prostate cancer risk.

IMPACT: The study lends support to the proposed role of inflammation in prostate carcinogenesis, and adds another area of investigation potentially relevant to prostate cancer development.

Place, publisher, year, edition, pages
American Association for Cancer Research, 2018
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-66449 (URN)10.1158/1055-9965.EPI-17-1204 (DOI)29588305 (PubMedID)
Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2018-04-13Bibliographically approved
Cheng, H., Montgomery, S., Treglown, L. & Furnham, A. (2018). Associations between childhood biomedical factors, maternal smoking, personality traits, Body and Mass Index and the prevalence of asthma in adulthood. Psychology and Health, 1-14
Open this publication in new window or tab >>Associations between childhood biomedical factors, maternal smoking, personality traits, Body and Mass Index and the prevalence of asthma in adulthood
2018 (English)In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321, p. 1-14Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: The study set out to investigate socio-economic, biomedical, health and behavioural and psychological factors in childhood and adulthood associated with the prevalence of asthma in adulthood, drawing data from The National Child Development Studies (NCDS), a birth cohort in the UK.

DESIGN: The National Child Development Study, a nationally representative sample of 17,415 babies born in Great Britain in 1958 and followed up at 7, 11, 33 and 50 years was used.

MAIN OUTCOME MEASURE: The prevalence of asthma at age 50 was the outcome measure. The analytic sample consists of 5118 participants with complete data on a set of measures at birth, at ages 7, 11, 33 and 50 years.

RESULTS: Using logistic regression analyses, results showed that childhood asthma (OR = 6.77: 4.38-10.48, p < .001) and respiratory symptoms (OR = 1.83: 1.18-2.86, p < .01), maternal smoking during pregnancy (OR = 1.26: 1.00-1.59, p < .05), Body and Mass Index (BMI) (OR = 1.03: 1.02-1.05, p < .001), traits Neuroticism (OR = 1.13: 1.01-1.21, p < .05) and Conscientiousness (OR = 0.76: 0.76-0.96, p < .01), as well as sex (OR = 1.49: 1.15-1.94, p < .001) were all significantly associated with the prevalence of asthma in adulthood.

CONCLUSION: The study shows that both childhood and adulthood psychological and sociological factors are significantly associated with the prevalence of asthma in adulthood, though more work need to be done in this area.

Place, publisher, year, edition, pages
Harwood Academic, 2018
Keyword
Asthma, cross -sectional and longitudinal, maternal smoking, personality traits, respiratory symptoms
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-67013 (URN)10.1080/08870446.2018.1467014 (DOI)29737224 (PubMedID)
Available from: 2018-05-24 Created: 2018-05-24 Last updated: 2018-05-24Bibliographically approved
Sato, Y., Hiyoshi, A., Melinder, C., Suzuki, C. & Montgomery, S. (2018). Asthma and atopic diseases in adolescence and antidepressant medication in middle age. Journal of Health Psychology, 23(6), 853-859
Open this publication in new window or tab >>Asthma and atopic diseases in adolescence and antidepressant medication in middle age
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2018 (English)In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 23, no 6, p. 853-859Article in journal (Refereed) Published
Abstract [en]

This Swedish register-based cohort study examined whether asthma, hay fever and allergic dermatitis in late adolescence identified in the early 1970s are associated with antidepressant medication in middle age, between 2006 and 2009. After adjustment for childhood and adulthood sociodemographic characteristics, psychological, cognitive and physical function, and comorbidity, the magnitude of the associations diminished for asthma, while hay fever and atopic dermatitis retained associations. Hay fever and atopic dermatitis in adolescence have potentially important implications for future mental health, while asthma may already have influenced an individual's ability to cope with stress by late adolescence.

Place, publisher, year, edition, pages
London, United Kingdom: Sage Publications, 2018
Keyword
Adolescence, adults, allergy, asthma, cohort, depression
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-51473 (URN)10.1177/1359105316660181 (DOI)000430332700009 ()27466290 (PubMedID)2-s2.0-85045628411 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-01365
Note

Funding Agencies:

UK Economic and Social Research Council (ESRC)  RES-596-28-0001  ES/J019119/1 

Japan Allergy Foundation  

Scandinavia-Japan Sasakawa Foundation  15-15 

Lindhes Advokatbyrå AB  LA2015-0219 

Available from: 2016-08-05 Created: 2016-08-02 Last updated: 2018-05-02Bibliographically approved
Stegberg, M., Hasselgren, M., Montgomery, S., Lisspers, K., Ställberg, B., Janson, C. & Sundh, J. (2018). Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD. European Clinical Respiratory Journal, 5, Article ID 1421389.
Open this publication in new window or tab >>Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD
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2018 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 5, article id 1421389Article in journal (Refereed) Published
Abstract [en]

Introduction: Our aim was to investigate changes in smoking prevalence, smoking cessation support and factors associated with successful smoking cessation in patients with asthma and COPD.

Methods: Questionnaires about available smoking cessation resources were completed by 54 primary health-care centers and 14 hospitals in central Sweden in 2005 and 2012. Patient data were collected using record reviews and patients questionnaires for two cohorts of randomly selected asthma and COPD patients in 2005 (n = 2306; with a follow up in 2012), and in 2014/ 2015 (n = 2620). Smoking prevalence, available individual and group smoking cessation support, and factors associated with successful smoking cessation were explored.

Results: Smoking prevalence decreased from 11% to 6% (p < 0.0001) in patients with asthma but was almost unchanged in patients with COPD (28 to 26%, p = 0.37). Smoking cessation support increased from 53% to 74% (p = 0.01). A high cardiovascular risk factor level, including diabetes mellitus and hypertension was associated with improved smoking cessation in patients with asthma (OR (95% CI) 3.87 (1.04-14.4), p = 0.04). A higher magnitude success was observed in men with asthma (OR (95% CI) 27.9 (1.73-449), p = 0.02). More highly educated women with asthma had successful greater smoking cessation (4.76 (1.22-18.7), p = 0.04). No significant associations were found in COPD.

Conclusions: The smoking prevalence in patients with asthma but not in COPD has almost halved in Sweden during a 7-year period. The availability of smoking cessation support has increased. Suggested factors related to successful smoking cessation are higher level of education in women with asthma and cardiovascular risk factors in men and women with asthma.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keyword
Smoking prevalence, smoking cessation support, primary care, secondary care, cardiovascular risk factors, high educational level
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-64414 (URN)10.1080/20018525.2017.1421389 (DOI)000419510300001 ()29321831 (PubMedID)
Available from: 2018-01-19 Created: 2018-01-19 Last updated: 2018-01-19Bibliographically approved
Kennedy, B., Ruoqing, C., Valdimarsdóttir, U., Montgomery, S., Fang, F. & Fall, K. (2018). Childhood Bereavement and Lower Stress Resilience in Late Adolescence. Journal of Adolescent Health
Open this publication in new window or tab >>Childhood Bereavement and Lower Stress Resilience in Late Adolescence
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2018 (English)In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: Although childhood traumatic experiences are recognized as important determinants for adolescent psychiatric health in general, our objective was to explore the specific influence of childhood bereavement on the stress resilience development trajectory.

METHODS: In this national register-based cohort study, we identified 407,639 men born in Sweden between 1973 and 1983, who underwent compulsory military enlistment examinations in late adolescence, including measures of psychological stress resilience. We defined exposure as loss of a first-degree family member in childhood, and estimated relative risk ratios (RRRs) for reduced (moderate or low), compared with high, stress resilience with 95% confidence intervals (CIs) using multinomial logistic regression.

RESULTS: Loss of a parent or sibling in childhood conferred a 49% increased risk of subsequent low stress resilience (RRR, 1.49, 95% CI, 1.41-1.57) and an 8% increased risk of moderate stress resilience (RRR, 1.08, 95% CI, 1.03-1.13) in late adolescence. There was also a graded increase in risk with increasing age at loss; teenagers were at higher risk for low resilience (RRR, 1.64, 95% CI, 1.52-1.77) than children aged 7-12 (RRR, 1.47, 95% CI, 1.34-1.61) and ≤6 years (RRR, 1.16 95% CI, 1.02-1.32). The excess risk was observed for all causes of death, including suicide and unexpected deaths as well as deaths due to other illnesses. The associations remained after exclusion of parents with a history of hospitalization for psychiatric diagnoses.

CONCLUSIONS: The long-term consequences of childhood bereavement may include lower stress resilience in late adolescence.

Keyword
Adolescent health, Childhood bereavement, Stress resilience
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry
Identifiers
urn:nbn:se:oru:diva-67020 (URN)10.1016/j.jadohealth.2018.02.002 (DOI)29724669 (PubMedID)
Available from: 2018-05-24 Created: 2018-05-24 Last updated: 2018-05-24Bibliographically approved
Eriksson, C., Rundquist, S., Cao, Y., Montgomery, S. & Halfvarson, J. (2018). Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study. Gut, Article ID gutjnl-2017-315521.
Open this publication in new window or tab >>Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study
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2018 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, article id gutjnl-2017-315521Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: Thiopurines are used as maintenance therapy in ulcerative colitis (UC), but whether these drugs influence the natural history of the disease is unknown. We aimed to assess the effect of thiopurines in terms of colectomy, hospital admission, progression in disease extent and anti-tumour necrosis factor (TNF) therapy within 10 years from initiation.

DESIGN: Patients diagnosed with UC within the Örebro University Hospital catchment area, during 1963-2010, who initiated thiopurines (n=253) were included. To overcome the risk of confounding by indication, we compared patients who stopped treatment within 12 months because of an adverse reaction (n=76) with patients who continued therapy or discontinued due to other reasons (n=177) and assessed long-term outcomes using Cox regression with adjustment for potential confounding factors.

RESULTS: The cumulative probability of colectomy within 10 years was 19.5% in tolerant patients compared with 29.0% in intolerant (adjusted HR 0.49; 95% CI 0.21 to 0.73). The probability of hospital admission was 34.0% in tolerant versus 56.2% in intolerant patients (adjusted HR 0.36; 95% CI 0.23 to 0.56). The risk for progression in disease extent was 20.4% in tolerant patients compared with 48.8% in intolerant (adjusted HR 0.47; 95% CI 0.21 to 1.06). Within 10 years, 16.1% of tolerant and 27.5% of intolerant patients received anti-TNF therapy (adjusted HR 0.49; 95% CI 0.26 to 0.92).

CONCLUSION: Based on the novel approach of comparing patients tolerant and intolerant to thiopurines, we reveal that thiopurines have a profound beneficial impact of the natural history and long-term colectomy rates of UC.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keyword
6-mercaptopurine, azathioprine, chronic ulcerative colitis, tnf-alpha
National Category
Medical and Health Sciences Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66417 (URN)10.1136/gutjnl-2017-315521 (DOI)29618498 (PubMedID)
Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-04-20Bibliographically approved
Melinder, C., Hiyoshi, A., Kasiga, T., Halfvarson, J., Fall, K. & Montgomery, S. (2018). Resilience to stress and risk of gastrointestinal infections. European Journal of Public Health, 28(2), 364-369
Open this publication in new window or tab >>Resilience to stress and risk of gastrointestinal infections
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2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 2, p. 364-369Article in journal (Refereed) Published
Abstract [en]

Background: Exposure to psychological stress can elicit a physiological response that may influence characteristics of the gastrointestinal mucosa, including increased intestinal permeability, in turn possibly increasing susceptibility to gastrointestinal infections. We investigated whether low stress resilience in adolescence is associated with an 'increased' risk of gastrointestinal infections in subsequent adulthood.

Methods: Data were provided by Swedish registers for a cohort of 237 577 men who underwent military conscription assessment in late adolescence (1969-76). As part of the assessment procedure, certified psychologists evaluated stress resilience through semi-structured interviews. The cohort was followed from conscription assessment until 31 December 2009 (up to age 57 years). Cox regression assessed the association of stress resilience with gastrointestinal infections (n = 5532), with adjustment for family background measures in childhood and characteristics in adolescence. Peptic ulcer disease (PUD) in adulthood was modelled as a time-dependent covariate.

Results: Compared with high stress resilience, lower stress resilience was associated with a 'reduced' risk of gastrointestinal infections after adjustment for family background in childhood, characteristics in adolescence and PUD in adulthood, with hazard ratios (and 95% confidence intervals) of 0.88 (0.81-0.97) and 0.83 (0.77-0.88) for low and moderate stress resilience, respectively.

Conclusion: Lower stress resilience in adolescence is associated with reduced risk of gastrointestinal infections in adulthood, rather than the hypothesized increased risk.

Place, publisher, year, edition, pages
Oxford, United Kingdom: Oxford University Press, 2018
National Category
Gastroenterology and Hepatology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-62194 (URN)10.1093/eurpub/ckx179 (DOI)000429036800032 ()29048469 (PubMedID)
Note

Funding Agency:

Stiftelsen Olle Engkvist Byggmästare, UK Economic and Social Research Council (ESRC)  RES-596-28-0001  ES/JO19119/1

Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-04-25Bibliographically approved
Eriksson, C., Rundquist, S., Cao, Y., Montgomery, S. & Halfvarson, J. (2018). The impact of thiopurine drugs on the natural history and surgical outcome of ulcerative colitis: A cohort study. Journal of Crohn's & Colitis, 12(Suppl. 1), S481-S481
Open this publication in new window or tab >>The impact of thiopurine drugs on the natural history and surgical outcome of ulcerative colitis: A cohort study
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2018 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 12, no Suppl. 1, p. S481-S481Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66752 (URN)000427318902114 ()
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-04-26Bibliographically approved
Iacobaeus, E., Burkill, S., Bahmanyar, S., Hakim, R., Byström, C., Fored, M., . . . Montgomery, S. (2018). The national incidence of PML in Sweden, 1988-2013. Neurology, 90(6), E498-E506
Open this publication in new window or tab >>The national incidence of PML in Sweden, 1988-2013
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2018 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 90, no 6, p. E498-E506Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the incidence of progressive multifocal leukoencephalopathy (PML) and patient characteristics in Sweden between 1988 and 2013.

Methods: All PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis and patient characteristics was obtained from medical records.

Results: Medical record review classified 108 out of 250 patients (43%) as definite (n = 84), probable (n = 4), or possible (n = 20) PML according to diagnostic criteria. Accurate diagnoses were more common in records obtained from neurology departments (82% of patients seen in neurology departments) compared with other departments (31%) (p < 0.001). The incidence of PML increased from a largely stable level at 0.026 (95% confidence interval [CI] 0.021-0.031) per 100,000 individuals per year during 1988-2010 to 0.11 (95% CI 083-0.137) during 2011-2013, during which time there was a notable increase (p < 0.001). Hematologic malignancies (n = 34), HIV/AIDS (n = 33), and autoimmune disease (n = 23) were the most common underlying diseases. Treatment with a monoclonal antibody prior to PML diagnosis was identified in 26 patients.

Conclusion: An increased incidence of PML in Sweden was observed and coincided with the prior use of monoclonal antibody treatment. The high level of misdiagnosis emphasizes the importance of immediate contact with a neurology center upon suspicion of PML.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Neurology
Identifiers
urn:nbn:se:oru:diva-66935 (URN)10.1212/WNL.0000000000004926 (DOI)000427800200007 ()29321229 (PubMedID)
Funder
The Swedish Brain Foundation
Note

Funding Agencies:

F. Hoffmann-La Roche Ltd.  

Stockholm County Council  

Swedish Medical Research Council  

Karolinska Institutet 

Available from: 2018-05-14 Created: 2018-05-14 Last updated: 2018-05-14Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6328-5494

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