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Liu, Q., László, K. D., Wei, D., Yang, F., Fall, K., Valdimarsdóttir, U., . . . Fang, F. (2024). Suicide attempt and death by suicide among parents of young individuals with cancer: A population-based study in Denmark and Sweden. PLoS Medicine, 21(1), Article ID e1004322.
Open this publication in new window or tab >>Suicide attempt and death by suicide among parents of young individuals with cancer: A population-based study in Denmark and Sweden
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2024 (English)In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 21, no 1, article id e1004322Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The psychological toll on parents of a child receiving a cancer diagnosis is known to be high, but there is a knowledge gap regarding suicidal behavior among these parents. The aim of this study was to investigate the risk of suicide attempt and death by suicide in relation to having a child with cancer.

METHODS AND FINDINGS: We performed a binational population-based and sibling-controlled cohort study, including all parents with a child diagnosed with cancer in Denmark (1978 to 2016) or Sweden (1973 to 2014), 10 matched unexposed parents per exposed parent (population comparison), and unaffected full siblings of the exposed parents (sibling comparison). Suicide attempt was identified through the Patient Register and the Psychiatric Central Register in Denmark and the Patient Register in Sweden, whereas death by suicide was identified through the Danish Causes of Death Register and the Swedish Causes of Death Register. In population comparison, we used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of suicide attempt and death by suicide associated with cancer diagnosis of a child, adjusting for sex, age, country of residence, calendar year, marital status, highest attained educational level, household income, history of cancer, history of psychiatric disorder, and family history of psychiatric disorder. The sibling comparison was performed to assess the role of familial confounding in the studied associations. The population comparison consisted of 106,005 exposed parents and 1,060,050 matched unexposed parents, with a median age of 56 at cohort entry and 46.9% male. During the median follow-up of 7.3 and 7.2 years, we observed 613 (incidence rate [IR], 58.8 per 100,000 person-years) and 5,888 (IR, 57.1 per 100,000 person-years) cases of first-onset suicide attempt among the exposed and unexposed parents, respectively. There was an increased risk of parental suicide attempt during the first years after a child's cancer diagnosis (HR, 1.15; 95% CI, [1.03, 1.28]; p = 0.01), particularly when the child was 18 or younger at diagnosis (HR, 1.25; 95% CI, [1.08, 1.46]; p = 0.004), when the child was diagnosed with a highly aggressive cancer (HR, 1.60; 95% CI, [1.05, 2.43]; p = 0.03), or when the child died due to cancer (HR, 1.63; 95% CI, [1.29, 2.06]; p < 0.001). The increased risk did not, however, maintain thereafter (HR, 0.86; 95% CI: [0.75, 0.98]; p = 0.03), and there was no altered risk of parental death by suicide any time after the child's cancer diagnosis. Sibling comparison corroborated these findings. The main limitation of the study is the potential residual confounding by factors not shared between full siblings.

CONCLUSIONS: In this study, we observed an increased risk of parental suicide attempt during the first years after a child's cancer diagnosis, especially when the child was diagnosed during childhood, or with an aggressive or fatal form of cancer. There was, however, no altered risk of parental death by suicide at any time after a child's cancer diagnosis. Our findings suggest extended clinical awareness of suicide attempt among parents of children with cancer, especially during the first few years after cancer diagnosis.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2024
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-110726 (URN)10.1371/journal.pmed.1004322 (DOI)001150188400002 ()38227561 (PubMedID)2-s2.0-85182577478 (Scopus ID)
Funder
Swedish Cancer Society, 20 0846 PjFKarolinska InstituteNovo Nordisk Foundation, NNF18OC0052029Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00531; 2015-00837
Note

This study was supported by the Swedish Cancer Society (grant number: 20 0846 PjF to FF), Karolinska Institutet (Senior Researcher Award and Strategic Research Area in Epidemiology to FF), the China Scholarship Council (grant number: 201700260291 to QL; grant number: 201700260276 to DW), the Novo Nordisk Foundation (grant number: NNF18OC0052029 to JL), the Independent Research Fund Denmark (grant numbers: DFF-6110-00019B, DFF-9039-00010B, and 1030-00012B to JL), the Nordic Cancer Union (grant number: R275-A15770 and R278-A15877 to JL), the Karen Elise Jensens Fond (2016 to JL), and the Swedish Research Council for Health, Working Life and Welfare (grant numbers: 2017-00531 to FF and 2015-00837 to KDL).

Available from: 2024-01-17 Created: 2024-01-17 Last updated: 2024-02-09Bibliographically approved
Vingeliene, S., Hiyoshi, A., Lentjes, M., Fall, K. & Montgomery, S. (2023). Ageing accounts for much of the association between decreasing grip strength and subsequent loneliness: the English Longitudinal Study of Ageing. Journal of Epidemiology and Community Health, 77(3), 175-181
Open this publication in new window or tab >>Ageing accounts for much of the association between decreasing grip strength and subsequent loneliness: the English Longitudinal Study of Ageing
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2023 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 77, no 3, p. 175-181Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Loneliness at older ages has been associated with higher morbidity and mortality. One of the risk factors for loneliness may be age-related decline in skeletal muscle strength, which may limit the possibilities for engagement in usual social activities and maintaining relationships. We aimed to identify if decrease in grip strength is an independent determinant of subsequent change in loneliness.

METHODS: Prospective cohort study of participants aged 50 years or older living in private households and provided data in the English Longitudinal Study of Ageing waves 2 (2004/2005), 4 (2008/2009) and 6 (2012/2013) (n=6118). We used fixed effects linear models to estimate β coefficients and 95% confidence intervals.

RESULTS: The adjusted estimates for a 5-kilogramme decrease in grip strength and loneliness score (ranging from 3 to 9) are β 0.04 and 95% CI -0.003 to 0.08 among men and β 0.03 and 95% CI -0.02 to 0.09 among women. In age-stratified analysis, a statistically significant association was observed among men below the age of 80 years (0.04, 0.0001 to 0.08) but not among older men (0.04, -0.28 to 0.35), and among women below the age of 80 years (0.03, -0.002 to 0.09) or above (-0.02, -0.32 to 0.28).

CONCLUSION: Muscle strength declines with age and may help explain the greater social isolation that occurs at older ages. Decline in strength was only independently associated with modestly increased loneliness among men younger than 80 years of age, indicating its limitation as a potential marker of loneliness risk.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
Aging, epidemiology, gerontology, longitudinal studies, public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-97904 (URN)10.1136/jech-2021-218635 (DOI)000766735700001 ()35256526 (PubMedID)2-s2.0-85142665246 (Scopus ID)
Note

Funding agency:

Orebro University doctoral studentship MV3028

Available from: 2022-03-09 Created: 2022-03-09 Last updated: 2023-12-08Bibliographically approved
Davidsson, S., Messing Eriksson, A., Udumyan, R., Swanholm, P., Lewin Lundh, M., Widing, C., . . . Fall, K. (2023). Androgen deprivation therapy in men with prostate cancer is not associated with COVID-2019 infection. The Prostate, 83(6), 555-562
Open this publication in new window or tab >>Androgen deprivation therapy in men with prostate cancer is not associated with COVID-2019 infection
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2023 (English)In: The Prostate, ISSN 0270-4137, E-ISSN 1097-0045, Vol. 83, no 6, p. 555-562Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Androgens may play a role in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and host responses as the virus is dependent on the androgen-regulated protein transmembrane serine protease 2 for cell entry. Studies have indicated that prostate cancer patients receiving androgen deprivation therapy (ADT) are at reduced risk of SARS-CoV-2 infection and serious complications compared with patients without ADT, but data are inconsistent.

METHODS: A total of 655 prostate cancer patients who were under surveillance at two urology departments in Sweden on April 1, 2020 were included in the study as well as 240 patients with benign prostatic hyperplasia (BPH). At follow-up early in 2021, the participants completed a questionnaire containing information about symptoms compatible with coronavirus disease 2019 (COVID-19). Blood samples were also collected for the assessment of SARS-CoV-2 IgG antibodies (SARS-CoV-2 Total; Siemens). We used multivariable logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between ADT and the risk of SARS-CoV-2 infection.

RESULTS: The cumulative incidence of SARS-CoV-2 seropositivity was 13.4% among patients receiving ADT and 10.4% among patients without ADT. After adjusting for potential confounders, we observed no differences in symptoms or risk of SARS-CoV-2 infection between patients with and without ADT (OR: 0.98; 95% CI: 0.52-1.85). Higher body mass index, Type 1 diabetes, and prostate cancer severity, defined by high Gleason score (8-10; OR: 2.06; 95% CI: 1.04-4.09) or elevated levels of prostate-specific antigen (>20 µg/l; OR: 2.15; 95% CI: 1.13-4.07) were associated with increased risk of SARS-CoV-2 infection. Overall, the risk of SARS-CoV-2 infection was not higher among men with prostate cancer than among men with BPH.

CONCLUSIONS: Our results do not support the hypothesis that ADT use in prostate cancer patients reduces the risk or symptom severity of SARS-CoV-2 infection or that prostate cancer patients are at increased risk of COVID-19 compared with men without prostate cancer.

Place, publisher, year, edition, pages
Alan R. Liss Inc., 2023
Keywords
COVID-19, SARS-CoV-2, androgen deprivation therapy, prostate cancer
National Category
Infectious Medicine Urology and Nephrology Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-103314 (URN)10.1002/pros.24485 (DOI)000915900700001 ()36658755 (PubMedID)2-s2.0-85147012865 (Scopus ID)
Funder
Prostatacancerförbundet
Note

Funding agency:

Örebro County Research Foundation

Available from: 2023-01-26 Created: 2023-01-26 Last updated: 2023-04-11Bibliographically approved
Vingeliene, S., Hiyoshi, A., Carlberg, M., Garcia-Argibay, M., Lentjes, M., Fall, K., . . . Montgomery, S. (2023). Atopic dermatitis, systemic inflammation and subsequent dementia risk. JEADV Clinical Practice, 2(4), 839-848
Open this publication in new window or tab >>Atopic dermatitis, systemic inflammation and subsequent dementia risk
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2023 (English)In: JEADV Clinical Practice, E-ISSN 2768-6566, Vol. 2, no 4, p. 839-848Article in journal (Refereed) Published
Abstract [en]

Background: Atopic dermatitis is a chronic inflammatory skin disease and inflammation has been implicated in development of other chronic diseases, but few studies have examined the relationship with dementia.

Objectives: This study examines associations of atopic dermatitis (AD) and systemic inflammation in adolescence measured using erythrocyte sedimenta-tion rate (ESR), as well as AD diagnosed in adulthood, with dementia risk.

Methods: We used three Swedish register‐based cohorts. Cohort I (N= 795,680) comprised men, born in 1951–1968, who participated in themilitary conscription examinations with physician‐assessed AD and ESR; Cohort II (N= 1,757,600) included men and women, born in 1951–1968; and Cohort III (N= 3,988,783) included all individuals in Sweden, born in 1930–1968. We used Cox regression, estimating hazard ratios (HR), with thefollow‐up from 50 years of age to dementia diagnosis, date of emigration, death, or 31 December 2018, which ever occurred first. Further, we used asibling comparison design to adjust for unmeasured confounders shared among siblings.

Results: Cohort I: 1466 dementia events were accrued during follow‐up of 7.8 years, with a crude rate of 21.6 [95% confidence interval (CI): 20.6, 22.8] per 100,000 person‐years. Cohort II: 3549 dementia events were accrued duringfollow‐up of 7.4 years, with a crude rate of 23.7 (95% CI: 22.9, 24.5) per 100,000 person‐years. Cohort III: 120,303 dementia events were accrued during follow‐up of 23.7 years, with a crude rate of 180.3 (95% CI: 179.3, 181.3) per 100,000 person‐years. In multivariable analysis using Cohort I, there was no association between AD and dementia [HR 0.68 (95% CI 0.32, 1.43)], norwith moderate [HR 0.71 (95% CI: 0.46, 1.10)] or high [HR 1.23 (95% CI: 0.87, 1.75)] ESR. AD was not associated with dementia risk in Cohort II [HR 1.28(0.97, 1.71)] or Cohort III [HR 1.01 (0.92, 1.11)].

Conclusions: AD was not associated with dementia risk, neither was systemic inflammation measured by ESR in adolescence.

Keywords
Atopic dermatitis, dementia, erythrocyte sedimentation rate
National Category
Dermatology and Venereal Diseases
Research subject
Dermatology and Venerology
Identifiers
urn:nbn:se:oru:diva-108570 (URN)10.1002/jvc2.249 (DOI)2-s2.0-85181467049 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019‐01236The Kamprad Family Foundation
Available from: 2023-09-26 Created: 2023-09-26 Last updated: 2024-01-12Bibliographically approved
Hiyoshi, A., Rostila, M., Fall, K., Montgomery, S. & Grotta, A. (2023). Caregiving and changes in health-related behaviour. Social Science and Medicine, 322, Article ID 115830.
Open this publication in new window or tab >>Caregiving and changes in health-related behaviour
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2023 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 322, article id 115830Article in journal (Refereed) Published
Abstract [en]

Potential health risks for informal caregivers have been hypothesised to be partly related to adverse changes in health-related behaviour, but evidence is limited. We examined whether smoking, drinking, eating, physical activity or leisure pursuits change in relation to co-resident or out-of-home caregiving (for someone outside the household), and if associations differ by sex, educational attainment, and welfare state typology. We conducted a longitudinal study using six waves of the Survey of Health, Ageing and Retirement in Europe, collecting data repeatedly from 2004 to 2017 for adults aged 50 years and older living in 17 European countries (57,962 individuals). To control for measured and unmeasured within-individual time-invariant confounders, we used fixed effects logistic models to analyse the repeated measures of caregiving, behaviour and covariates and estimated odds ratios (OR) with 95% confidence intervals (95%CI). Among male participants, unhealthy eating increased while smoking decreased [ORs 1.26 (95%CI 1.01-1.58) and 0.53 (0.36-0.78), respectively] in survey waves in which they provided co-resident care, compared with the waves that they did not. Among female participants, there was little change in behaviour between waves with and without co-resident caregiving. When providing out-of-home care, lacks of physical activity and leisure pursuits declined. But in the same time, drinking increased both men and women, and especially among individuals with lower educational attainment and residing in non-Nordic countries. To conclude, overall, increased drinking when providing out-of-home care was most consistent, especially among individuals with lower educational attainment and residing in non-Nordic countries. Otherwise, the associations varied by the type of care, behaviour and population subgroups. These findings indicated that not all caregivers are susceptible to behavioural changes, and that not all behaviour may be involved similarly in linking caregiving to health risks. This opens possibilities to target specific behaviour and groups to prevent adverse changes in health behaviour in caregivers.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Caregivers, Education, Europe, Fixed effects models, Health behaviour, Longitudinal studies, Sex, Welfare state
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-105097 (URN)10.1016/j.socscimed.2023.115830 (DOI)000972618500001 ()36930838 (PubMedID)2-s2.0-85150075819 (Scopus ID)
Funder
Swedish Research Council, 2017-03266Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01236 2021-00676
Note

Funding agency:

Osaka University International Joint Research Promotion Programme (Type A) 2019-2022

General Electric

Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2023-05-09Bibliographically approved
Liu, Q., Wang, X., Engstrand, L., Sadr-Azodi, O., Fall, K. & Brusselaers, N. (2023). Maintenance proton pump inhibitor usage and risk of colorectal cancer: A population-based Swedish cohort study. Annals of Oncology, 34(Suppl. 1), S8-S8, Article ID PD-18.
Open this publication in new window or tab >>Maintenance proton pump inhibitor usage and risk of colorectal cancer: A population-based Swedish cohort study
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2023 (English)In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 34, no Suppl. 1, p. S8-S8, article id PD-18Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-108127 (URN)10.1016/j.annonc.2023.04.045 (DOI)001037960400491 ()
Funder
Swedish Society of Medicine, SLS-788731 SLS788751 SLS-783091Swedish Research Council, 2020-01058
Note

Funding agency:

China Scholarship Council 201700260302

Available from: 2023-09-13 Created: 2023-09-13 Last updated: 2023-09-13Bibliographically approved
Ulvskog, E., Persson, E. K., Kirrander, P., Fall, K. & Ahlgren, J. (2023). Nationwide Data Support Centralised Decision-making in Penile Cancer Care: A Before-and-After Study on Guideline Adherence and Disease-specific survival for Patients with an Indication for Perioperative Oncological Treatment. European Urology Open Science, 51, 70-77
Open this publication in new window or tab >>Nationwide Data Support Centralised Decision-making in Penile Cancer Care: A Before-and-After Study on Guideline Adherence and Disease-specific survival for Patients with an Indication for Perioperative Oncological Treatment
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2023 (English)In: European Urology Open Science, ISSN 2666-1691, E-ISSN 2666-1683, Vol. 51, p. 70-77Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The benefit of perioperative oncological treatment in men with penile cancer is uncertain. In 2015, treatment recommendations were centralised in Sweden and treatment guidelines were updated. OBJECTIVE: To evaluate if the use of oncological treatment in men with penile cancer increased after the introduction of centralised recommendations, and whether such therapy is associated with better survival.

DESIGN SETTING AND PARTICIPANTS: This was a retrospective cohort study including a total of 426 men diagnosed with penile cancer with lymph node or distant metastases in Sweden during 2000-2018.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We first assessed the change in the proportion of patients with an indication for perioperative oncological treatment who actually received such treatment. Second, we used Cox regression to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for disease-specific mortality associated with perioperative treatment. Comparisons were made for both all men without perioperative treatment and for those who did not receive treatment but who lacked apparent contraindications for treatment.

RESULTS AND LIMITATIONS: The use of perioperative oncological treatment increased from 2000 to 2018, from 32% of patients with an indication for treatment during the first 4 yr to 63% during the last 4 yr. In comparison to patients potentially eligible for oncological treatment who did not receive it, those who were treated had a 37% lower risk of disease-specific death (HR 0.63, 95% CI 0.40-0.98). Stage migration because of improvements in diagnostic tools over time may have inflated the more recent survival estimates. An influence of residual confounding due to comorbidity and other potential confounders cannot be excluded.

CONCLUSIONS: The use of perioperative oncological treatment increased after the centralisation of penile cancer care in Sweden. Although the observational study design precludes causal inference, the findings suggest that perioperative treatment in patients with penile cancer eligible for treatment may be associated with better survival.

PATIENT SUMMARY: In this study, we looked at the use of chemotherapy and radiotherapy for men with penile cancer and lymph node metastases in Sweden during 2000-2018. We found an increase in the use of cancer therapy and an increase in survival for patients who received such therapy.

Keywords
Chemotherapy, Penile cancer, Radiotherapy
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-105960 (URN)10.1016/j.euros.2023.03.005 (DOI)001029069000001 ()37187721 (PubMedID)2-s2.0-85151350182 (Scopus ID)
Funder
Region Örebro County
Available from: 2023-05-16 Created: 2023-05-16 Last updated: 2023-08-01Bibliographically approved
Shen, Q., Mikkelsen, D. H., Luitva, L. B., Song, H., Kasela, S., Aspelund, T., . . . Valdimarsdóttir, U. (2023). Psychiatric disorders and subsequent risk of cardiovascular disease: a longitudinal matched cohort study across three countries. eClinicalMedicine, 61, Article ID 102063.
Open this publication in new window or tab >>Psychiatric disorders and subsequent risk of cardiovascular disease: a longitudinal matched cohort study across three countries
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2023 (English)In: eClinicalMedicine, E-ISSN 2589-5370, Vol. 61, article id 102063Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Several psychiatric disorders have been associated with increased risk of cardiovascular disease (CVD), however, the role of familial factors and the main disease trajectories remain unknown.

METHODS: In this longitudinal cohort study, we identified a cohort of 900,240 patients newly diagnosed with psychiatric disorders during January 1, 1987 and December 31, 2016, their 1,002,888 unaffected full siblings, and 1:10 age- and sex-matched reference population from nationwide medical records in Sweden, who had no prior diagnosis of CVD at enrolment. We used flexible parametric models to determine the time-varying association between first-onset psychiatric disorders and incident CVD and CVD death, comparing rates of CVD among patients with psychiatric disorders to the rates of unaffected siblings and matched reference population. We also used disease trajectory analysis to identify main disease trajectories linking psychiatric disorders to CVD. Identified associations and disease trajectories of the Swedish cohort were validated in a similar cohort from nationwide medical records in Denmark (N = 875,634 patients, same criteria during January 1, 1969 and December 31, 2016) and in Estonian cohorts from the Estonian Biobank (N = 30,656 patients, same criteria during January 1, 2006 and December 31, 2020), respectively.

FINDINGS: During up to 30 years of follow-up of the Swedish cohort, the crude incidence rate of CVD was 9.7, 7.4 and 7.0 per 1000 person-years among patients with psychiatric disorders, their unaffected siblings, and the matched reference population. Compared with their siblings, patients with psychiatric disorders experienced higher rates of CVD during the first year after diagnosis (hazard ratio [HR], 1.88; 95% confidence interval [CI], 1.79-1.98) and thereafter (1.37; 95% CI, 1.34-1.39). Similar rate increases were noted when comparing with the matched reference population. These results were replicated in the Danish cohort. We identified several disease trajectories linking psychiatric disorders to CVD in the Swedish cohort, with or without mediating medical conditions, including a direct link between psychiatric disorders and hypertensive disorder, ischemic heart disease, venous thromboembolism, angina pectoris, and stroke. These trajectories were validated in the Estonian Biobank cohort.

INTERPRETATION: Independent of familial factors, patients with psychiatric disorders are at an elevated risk of subsequent CVD, particularly during first year after diagnosis. Increased surveillance and treatment of CVDs and CVD risk factors should be considered as an integral part of clinical management, in order to reduce risk of CVD among patients with psychiatric disorders.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Cardiovascular disease, Disease trajectory, Family design, Psychiatric disorders, Sibling
National Category
Psychiatry Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-107069 (URN)10.1016/j.eclinm.2023.102063 (DOI)001054892100001 ()37425374 (PubMedID)2-s2.0-85173492654 (Scopus ID)
Funder
EU, Horizon 2020, 847776Swedish Research Council, D0886501The Research Council of Norway, 223273, 296030, 300309, 324252European Regional Development Fund (ERDF), 2014-2020.4.01.15-0012
Note

Funding agencies:

European Research Council Consolidator grant 726413

Icelandic Research fund

US NIMH R01 MH123724

Outstanding Clinical Discipline Project of Shanghai Pudong PWYgy2021-02

Fundamental Research Funds for the Central Universities

South-East Regional Health Authority 2017-112 2022-073 

Stiftelsen Kristian Gerhard Jebsen SKGJ-MED-008 SKGJ-MED-021 

EEA-RO-NO-2018-0535

Available from: 2023-07-11 Created: 2023-07-11 Last updated: 2023-12-08Bibliographically approved
Hardardottir, H., Aspelund, T., Fall, K., Broström, E., Sigurdsson, B. B., Cook, E., . . . Valdimarsdottir, U. A. (2023). Psychobiological stress response to a lung cancer diagnosis: a prospective study of patients in Iceland and Sweden. Acta Oncologica, 62(10), 1338-1347
Open this publication in new window or tab >>Psychobiological stress response to a lung cancer diagnosis: a prospective study of patients in Iceland and Sweden
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2023 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 62, no 10, p. 1338-1347Article in journal (Refereed) Published
Abstract [en]

Background: A diagnostic work-up leading to a lung cancer diagnosis is a severely stressful experience that may impact tumor progression. Yet, prospective data are scarce on psychological and biological components of stress at the time of lung cancer diagnosis. The aim of this study was to assess pre-to-post diagnosis change in psychological distress and urinary excretion of catecholamines in patients with suspected lung cancer.

Methods: Participants were 167 patients within the LUCASS study, recruited at referral for suspected lung cancer to University Hospitals in Iceland and Sweden. Patients completed questionnaires on perceived distress (Hospital Anxiety and Depression Scale, HADS) before and after diagnosis of lung cancer or a non-malignant origin. A subpopulation of 85 patients also provided overnight urine for catecholamine analysis before and at a median of 24 days after diagnosis but before treatment.

Results: A lung cancer diagnosis was confirmed in 123 (73.7%) patients, with a mean age of 70.1 years. Patients diagnosed with lung cancer experienced a post-diagnosis increase in psychological distress (p = 0.010), while patients with non-malignant lung pathology showed a reduction in distress (p = 0.070). Both urinary epinephrine (p = 0.001) and norepinephrine (p = 0.032) levels were higher before the diagnosis among patients eventually diagnosed with lung cancer compared to those with non-malignant lung pathology. We observed indications of associations between pre-to-post diagnosis changes in perceived distress and changes in urinary catecholamine levels.

Conclusion: Receiving a lung cancer diagnosis is associated with an increase in psychological distress, while elevated catecholamine levels are evident already before lung cancer diagnosis.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-108562 (URN)10.1080/0284186X.2023.2258445 (DOI)001071528400001 ()37747345 (PubMedID)2-s2.0-85172760041 (Scopus ID)
Funder
Swedish Cancer Society, 16 0720
Note

This work was supported by the Rannis Research Fund (grant number: 141667-051), the Swedish Cancer Foundation (grant number: 16 0720), the Doctoral Grant from the University of Iceland Research Fund/Eimskip University Fund2018, and the Landspitali University Hospital Research Fund 2015.

Available from: 2023-09-26 Created: 2023-09-26 Last updated: 2023-11-24Bibliographically approved
Liu, Q., László, K. D., Wei, D., Obel, C., Yang, F., Fall, K., . . . Fang, F. (2023). Risk of cardiovascular disease among parents of children diagnosed with cancer: a population-based study from Denmark and Sweden [Letter to the editor]. Cancer communications (London, England), 43(7), 834-837
Open this publication in new window or tab >>Risk of cardiovascular disease among parents of children diagnosed with cancer: a population-based study from Denmark and Sweden
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2023 (English)In: Cancer communications (London, England), E-ISSN 2523-3548, Vol. 43, no 7, p. 834-837Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Cancer and Oncology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-105780 (URN)10.1002/cac2.12426 (DOI)000980494700001 ()37120758 (PubMedID)2-s2.0-85158060044 (Scopus ID)
Available from: 2023-05-02 Created: 2023-05-02 Last updated: 2023-08-11Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3649-2639

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