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Kantor, E. D., Udumyan, R., Giovannucci, E. L., Valdimarsdottir, U. A., Signorello, L. B., Montgomery, S. & Fall, K. (2019). Association of Blood Marker of Inflammation in Late Adolescence With Premature Mortality. JAMA pediatrics
Open this publication in new window or tab >>Association of Blood Marker of Inflammation in Late Adolescence With Premature Mortality
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2019 (English)In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
American Medical Association, 2019
National Category
Biochemistry and Molecular Biology
Identifiers
urn:nbn:se:oru:diva-76166 (URN)10.1001/jamapediatrics.2019.2835 (DOI)31479147 (PubMedID)
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10Bibliographically approved
Ugge, H., Downer, M. K., Carlsson, J., Bowden, M., Davidsson, S., Mucci, L. A., . . . Andrén, O. (2019). Circulating inflammation markers and prostate cancer. The Prostate, 79(11), 1338-1346
Open this publication in new window or tab >>Circulating inflammation markers and prostate cancer
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2019 (English)In: The Prostate, ISSN 0270-4137, E-ISSN 1097-0045, Vol. 79, no 11, p. 1338-1346Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Chronic inflammation is thought to influence the risk of prostate cancer. The purpose of this population-based case-control study was to evaluate the association of 48 circulating inflammation markers with prostate cancer, to identify candidate markers for further investigation.

METHODS: Serum samples collected from 235 prostate cancer patients and 198 population-based controls recruited in Örebro County, Sweden, in 1989-1991, were assessed using a multiplex bead-based immunoassay to determine concentrations of 48 circulating inflammation markers. Logistic regression was first used to evaluate the association between individual markers (highest vs lowest concentration quartile) and prostate cancer in unadjusted and mutually adjusted models. Second, patients with inflammatory conditions, metastatic or advanced prostate cancer, were excluded to address the possible influence of systemic disease on inflammation markers.

RESULTS: Individual analyses first identified 21 markers associated with prostate cancer (P < .05), which after mutual adjustment were reduced to seven markers. After the exclusion of men with conditions linked with systemic inflammation, associations between prostate cancer and deviant levels of C-X3-C motif chemokine ligand 1, platelet-derived growth factor subunit B homodimer, interleukin 10, C-C motif chemokine ligand (CCL) 21, and CCL11 remained statistically significant.

CONCLUSIONS: In this explorative study, we identified candidate inflammation markers of possible importance for prostate cancer pathophysiology, for further evaluation in prospective studies.

Place, publisher, year, edition, pages
Alan R. Liss Inc., 2019
Keywords
Circulating, cytokines, inflammation, markers, prostate cancer
National Category
Cancer and Oncology Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-74753 (URN)10.1002/pros.23842 (DOI)000473235500014 ()31212389 (PubMedID)2-s2.0-85068041866 (Scopus ID)
Note

Funding Agency:

Lions Cancerforskningsfond vid Akademiska sjukhuset i Uppsala. (Part of Lions International)

Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-08-09Bibliographically approved
Sundin, P.-O., Udumyan, R., Fall, K. & Montgomery, S. (2019). Grip strength modifies the association between estimated glomerular filtration rate and all-cause mortality. Nephrology, Dialysis and Transplantation, Article ID gfz140.
Open this publication in new window or tab >>Grip strength modifies the association between estimated glomerular filtration rate and all-cause mortality
2019 (English)In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, article id gfz140Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-75586 (URN)10.1093/ndt/gfz140 (DOI)31317193 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-09-19Bibliographically approved
Kennedy, B., Ruoqing, C., Fang, F., Valdimarsdottir, U., Montgomery, S., Larsson, H. & Fall, K. (2019). Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life. Journal of Epidemiology and Community Health, 73(6), 469-501
Open this publication in new window or tab >>Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life
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2019 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 6, p. 469-501Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While compromised stress resilience constitutes a recognised risk factor for somatic and psychiatric disease development in general, the knowledge about how individual variation in vulnerability to stress may specifically influence the long-term risks of disadvantageous health behaviours is limited.

METHODS: In this Swedish cohort study, we aimed to investigate the association between stress resilience in late adolescence and adult use of addictive substances. We included 9381 men with information on psychological stress resilience measured during military conscription examinations, who later responded to an extensive health survey (mean age 34.0±7.2 years) including detailed information on substance use. We modelled continuous outcomes using linear regression, binary outcomes with logistic regression and other categorical outcomes with multinomial logistic regression.

RESULTS: We found that low stress resilience in adolescence conferred increased risks of all studied measures of addictive behaviour. After adjusting for childhood socioeconomic information, low stress resilience was associated with adult current regular smoking (relative risk ratio: 5.85, 95% CI 4.32 to 7.93), higher nicotine dependence scores (beta: 0.76, 95% CI 0.29 to 1.23), hazardous use of alcohol (>14 alcoholic drink-equivalents per week, OR: 1.72, 95% CI 1.37 to 2.16), DSM-IV criteria for alcohol dependence (OR: 1.74, 95% CI 1.35 to 2.25), and drug use (OR: 1.77, 95% CI 1.51 to 2.08). The results remained largely unchanged after further adjustments for adult educational attainment and occupation as well as for additional conscription covariates.

CONCLUSION: Low stress resilience in late adolescence appears to be associated with an increased risk of disadvantageous and addictive health behaviours in adulthood.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
Alcohol, epidemiology, health behaviour, psychological stress, smoking
National Category
Substance Abuse
Identifiers
urn:nbn:se:oru:diva-72375 (URN)10.1136/jech-2018-211815 (DOI)000471850400004 ()30718261 (PubMedID)2-s2.0-85061156675 (Scopus ID)
Note

Funding Agencies:

European Research Council Consolidator Grant  726413 

Swedish Council for Information on Alcohol and Other Drugs  2017-0095 

Karolinska Institutet through a Senior Researcher Award  

Karolinska Institutet through a Strategic Research Area in Epidemiology Award 

Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-07-23Bibliographically approved
Jerlström, T., Ruoqing, C., Liedberg, F., Andrén, O., Ströck, V., Aljabery, F. A. S., . . . Fall, K. (2019). No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study. World journal of urology
Open this publication in new window or tab >>No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study
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2019 (English)In: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: Preoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking.

METHODS: We identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not.

RESULTS: Minimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82-1.39) or mortality (OR 0.75 95% CI 0.36-1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30-0.81).

CONCLUSION: This nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Bladder cancer, Induction chemotherapy, Neoadjuvant chemotherapy, Postoperative complications, Radical cystectomy
National Category
Cancer and Oncology Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-73968 (URN)10.1007/s00345-019-02770-2 (DOI)31020424 (PubMedID)
Available from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-04-29Bibliographically approved
Landberg, A., Fält, A., Montgomery, S., Sundqvist, P. & Fall, K. (2019). Overweight and obesity during adolescence increases the risk of renal cell carcinoma. International Journal of Cancer, 145(5), 1232-1237
Open this publication in new window or tab >>Overweight and obesity during adolescence increases the risk of renal cell carcinoma
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2019 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 145, no 5, p. 1232-1237Article in journal (Refereed) Published
Abstract [en]

While overweight among adults has been linked with renal cell carcinoma (RCC) risk, little is known about the potential influence of overweight and obesity during adolescence. To ascertain if adolescent body mass index is associated with subsequent risk of RCC, we identified a cohort of 238,788 Swedish men who underwent mandatory military conscription assessment between 1969 and 1976 at a mean age of 18.5 years. At the time of conscription assessment, physical and psychological tests were performed including measurements of height and weight. Participants were followed through linkage to the Swedish Cancer Registry to identify incident diagnoses of RCC. The association between body mass index (BMI, kg/m(2)) at conscription assessment and subsequent RCC was evaluated using multivariable Cox regression. During a follow-up of up to 37 years, 266 men were diagnosed with RCC. We observed a trend for higher RCC risk with increasing BMI during adolescence, where one-unit increase in BMI conferred a 6% increased risk of RCC (95% CI 1.01-1.10). compared to normal weight men (BMI 18.5- < 25), men with overweight (BMI 25- < 30) or obesity (BMI >= 30) had hazard ratios for RCC of 1.76 (95% CI 1.16-2.67) and 2.87 (95% CI 1.26-6.25), respectively. The link between overweight/obesity and RCC appear to be already established during late adolescence. Prevention of unhealthy weight gain during childhood and adolescence may thus be a target in efforts to decrease the burden of RCC in the adult population.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
adolescence, cancer epidemiology, obesity, overweight, renal cell carcinoma
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-72780 (URN)10.1002/ijc.32147 (DOI)000474668200007 ()30790271 (PubMedID)2-s2.0-85068033223 (Scopus ID)
Note

Funding Agency:

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

Available from: 2019-02-27 Created: 2019-02-27 Last updated: 2019-07-30Bibliographically approved
Hálfdánarson, Ó. Ö., Fall, K., Ogmundsdottir, M. H., Lund, S. H., Steingrímsson, E., Ogmundsdottir, H. M. & Zoega, H. (2019). Proton pump inhibitor use and risk of breast cancer, prostate cancer, and malignant melanoma: An Icelandic population-based case-control study. Pharmacoepidemiology and Drug Safety, 28(4), 471-478
Open this publication in new window or tab >>Proton pump inhibitor use and risk of breast cancer, prostate cancer, and malignant melanoma: An Icelandic population-based case-control study
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2019 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 28, no 4, p. 471-478Article in journal (Refereed) Published
Abstract [en]

Purpose: Increased expression of Vacuolar-type H+ ATPases (V-ATPases), in the plasma membrane of cancer cells has been suggested to contribute to the development of aggressive cancer phenotypes by promoting acidic tumor microenvironments. Accumulating data suggest that proton pump inhibitors (PPIs) may elicit a chemopreventive effect via V-ATPase inhibition in some cancers, but evidence is still limited. Therefore, we aimed to explore a potential preventive role of PPIs in this study.

Methods: In this population-based case-control study, we identified incident cases of breast cancer (n=1739), prostate cancer (n=1897), and malignant melanoma (n=385) in Iceland between 2005 and 2014 from the Icelandic Cancer Registry. We assessed varying levels of PPI use through record linkages to the Icelandic Medicines Registry. For each case, we selected up to 10 age-matched, sex-matched, and calendar-matched population controls using risk-set sampling. Using conditional logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) controlling for NSAID use.

Results: Adjusted ORs associated with ever use of PPIs were 1.03 (95% CI: 0.92-1.16) for breast cancer, 1.12 (95% CI: 1.00-1.25) for prostate cancer, and 0.84 (95% CI: 0.69-1.12) for malignant melanoma. Analyses of high use of PPIs (>= 1000 DDDs) yielded ORs of 0.97 (95% CI: 0.78-1.19), 1.20 (0.99-1.47), and 0.59 (0.40-1.13) for breast cancer, prostate cancer, and malignant melanoma, respectively. Analyses of cumulative exposure to PPIs did not support a dose-response relationship for any of the three cancer types.

Conclusions: Our findings do not support a chemopreventive effect of PPI use on breast cancer, prostate cancer, or malignant melanoma.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
breast cancer, melanoma, pharmacoepidemiology, prostate cancer, proton pump inhibitors, V-ATPase
National Category
Public Health, Global Health, Social Medicine and Epidemiology Pharmacology and Toxicology
Identifiers
urn:nbn:se:oru:diva-74544 (URN)10.1002/pds.4702 (DOI)000467999700009 ()30565786 (PubMedID)2-s2.0-85058845482 (Scopus ID)
Note

Funding Agency:

Icelandic Research Fund  152715-053

Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-06-03Bibliographically approved
Lu, D., Andrae, B., Valdimarsdottir, U., Sundström, K., Fall, K., Sparen, P. & Fang, F. (2019). Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer. Cancer Research, 79(15), 3965-3972
Open this publication in new window or tab >>Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer
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2019 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 79, no 15, p. 3965-3972Article in journal (Refereed) Published
Abstract [en]

Emerging evidence suggests a role of psychologic factors in the progression of different cancer types. However, it is unclear whether psychologic distress around the time of diagnosis of invasive cervical cancer places patients at a higher risk of cancer-specific mortality, independently of tumor characteristics and treatment modalities. We conducted a nationwide cohort study, including 4,245 patients with newly diagnosed cervical cancer during 2002-2011 in Sweden. Psychologic distress was indicated by a clinical diagnosis of depression, anxiety, or stress reaction and adjustment disorders, or the experience of a stressful life event, including death or severe illness of a family member, divorce, or between jobs, from one year before cancer diagnosis and onwards. We calculated the HRs of cancer-specific mortality among the patients exposed to psychologic distress, compared with unexposed patients, controlling for socioeconomic characteristics and other known prognostic indicators such as tumor and treatment characteristics. We found that patients exposed to psychologic distress had an increased risk of cancer-specific mortality (HR 1.33; 95% CI, 1.14-1.54). The association was primarily driven by distress experienced within one year before or after diagnosis (HR 1.30; 95% CI, 1.11-1.52), but not thereafter (HR 1.12; 95% CI, 0.84-1.49). In summary, our study shows that psychiatric disorders and stressful life events around cancer diagnosis are associated with increased cancer-specific mortality among patients with cervical cancer, independent of tumor characteristics and treatment modality.

Significance: These findings support the integration of psychologic screening and intervention in the clinical management of patients with cervical cancer, particularly around the time of cancer diagnosis.

Place, publisher, year, edition, pages
American Association for Cancer Research Inc., 2019
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-75786 (URN)10.1158/0008-5472.CAN-19-0116 (DOI)000478017700017 ()31253667 (PubMedID)2-s2.0-85070082661 (Scopus ID)
Funder
Swedish Cancer Society, CAN 2017/322Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00531The Karolinska Institutet's Research Foundation
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Lu, D., Andrae, B., Valdimarsdóttir, U., Sundström, K., Fall, K., Sparén, P. & Fang, F. (2019). Psychological distress is associated with cancer-specific mortality among patients with cervical cancer. Cancer Research, Article ID canres.0116.2019.
Open this publication in new window or tab >>Psychological distress is associated with cancer-specific mortality among patients with cervical cancer
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2019 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, article id canres.0116.2019Article in journal (Refereed) Epub ahead of print
Abstract [en]

Emerging evidence suggests a role of psychological factors in the progression of different cancer types. However, it is unclear whether psychological distress around the time of diagnosis of invasive cervical cancer places patients at a higher risk of cancer-specific mortality, independently of tumor characteristics and treatment modalities. We conducted a nationwide cohort study, including 4,245 patients with newly diagnosed cervical cancer during 2002-2011 in Sweden. Psychological distress was indicated by a clinical diagnosis of depression, anxiety, or stress reaction and adjustment disorders, or the experience of a stressful life event, including death or severe illness of a family member, divorce, or between jobs, from one year before cancer diagnosis and onwards. We calculated the hazard ratios (HRs) of cancer-specific mortality among the patients exposed to psychological distress, compared to unexposed patients, controlling for socioeconomic characteristics and other known prognostic indicators such as tumor and treatment characteristics. We found that patients exposed to psychological distress had an increased risk of cancer-specific mortality (HR 1.33, 95% CI 1.14 to 1.54). The association was primarily driven by distress experienced within one year before or after diagnosis (HR 1.30, 95% CI 1.11 to 1.52), but not thereafter (HR 1.12, 95% CI 0.84 to 1.49). In summary, our study shows that psychiatric disorders and stressful life events around cancer diagnosis are associated with increased cancer-specific mortality among patients with cervical cancer, independent of tumor characteristics and treatment modality.

Place, publisher, year, edition, pages
American Association for Cancer Research, 2019
National Category
Cancer and Oncology Psychology
Identifiers
urn:nbn:se:oru:diva-75612 (URN)10.1158/0008-5472.CAN-19-0116 (DOI)31253667 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-20Bibliographically approved
Bergh, C., Hiyoshi, A., Eriksson, M., Fall, K. & Montgomery, S. (2019). Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence. Acta Paediatrica
Open this publication in new window or tab >>Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIM: We investigated the association between low Apgar score, other perinatal characteristics and low stress resilience in adolescence. A within-siblings analysis was used to tackle unmeasured shared familial confounding.

METHODS: We used a national cohort of 527,763 males born in Sweden between 1973 and 1992 who undertook military conscription assessments at mean age 18 years (17-20). Conscription examinations included a measure of stress resilience. Information on Apgar score and other perinatal characteristics was obtained through linkage with the Medical Birth Register. Analyses were conducted using ordinary least squares and fixed-effects linear regression models adjusted for potential confounding factors.

RESULTS: Infants with a prolonged low Apgar score at five minutes had an increased risk of low stress resilience in adolescence compared to those with highest scores at one minute, with an adjusted coefficient and 95% confidence interval of -0.26 (-0.39, -0.13). The associations were no longer statistically significant when using within-siblings models. However, the associations with stress resilience and birthweight remained statistically significant in all analyses.

CONCLUSION: The association with low Apgar score seems to be explained by confounding due to shared childhood circumstances among siblings from the same family, while low birthweight is independently associated with low stress resilience.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019
Keywords
Apgar score, adolescence, low birth weight, psychological stress, resilience
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-74554 (URN)10.1111/apa.14881 (DOI)31140196 (PubMedID)
Available from: 2019-06-05 Created: 2019-06-05 Last updated: 2019-06-05Bibliographically approved
Organisations
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ORCID iD: ORCID iD iconorcid.org/0000-0002-3649-2639

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