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  • 1.
    Hiyoshi, Ayako
    et al.
    Örebro University, School of Medical Sciences.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Bottai, Matteo
    Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Hoven, Emma I.
    Division of Childhood Cancer Research, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
    Trajectories of Income and Social Benefits for Mothers and Fathers of Children With Cancer: A National Cohort Study in Sweden2018In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 124, no 7, p. 1492-1500Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The contribution of different income sources from work and social benefits to trajectories of income for the parents of children with cancer has not been empirically investigated.

    METHODS: Using Swedish registers, parents of children with an incidence cancer diagnosis between 2004 and 2009 were identified and matched with parents of children without cancer (reference parents). A total of 20,091 families were followed from the year before the diagnosis to a maximum of 8 years. Generalized linear models estimated the ratios of mean incomes from work and social benefits and of its total.

    RESULTS: Around the time of the child's cancer diagnosis, the total income was on average up to 6% higher among the mothers of children with cancer compared with reference mothers, but no differences were noted among fathers. Income from work dropped to the lowest level around the time of a cancer diagnosis, with swift recovery noted for fathers but not for mothers. Sickness and childcare-related benefits were up to 6 times larger for the parents of children with cancer than reference parents. As social benefits diminished after approximately 3 years, the total income of mothers of children with cancer became lower than that of reference mothers, and the gap widened over time.

    CONCLUSIONS: Social benefits appeared to ease the financial burden during the years around a cancer diagnosis. However, mothers experienced persistently lower income after benefits diminished. Experiences differed by single-parent versus dual-parent households, the survival of the child with cancer, and other relevant characteristics. Further investigation is needed for potential long-term consequences for mothers, including their career and future pension in retirement.

  • 2.
    Jahnson, Staffan
    et al.
    Department of Urology, Örebro Medical Centre, Örebro, Sweden.
    Karlsson, Mats G.
    Department of Pathology, Örebro Medical Centre, Örebro, Sweden.
    Tumor mapping of regional immunostaining for p21, p53, and mdm2 in locally advanced bladder carcinoma2000In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 89, no 3, p. 619-629Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to elucidate the associations among immunostaining for p53, p21, and mdm2; their respective expression within each tumor; and the value of these variables for predicting treatment outcome after cystectomy for patients with locally advanced bladder carcinoma.

    Methods: The hospital records from all 173 patients treated with cystectomy for locally advanced urothelial bladder carcinoma between 1967 and 1992 were retrospectively reviewed. Three consecutive sections from biopsies taken before any treatment were stained using the standard immunohistochemical technique for p53, p21, and mdm2, respectively. The cutoff limit was 20% or more for positive p53 expression and 10% or more for positive p21 and mdm2 expression.

    Results: Positive immunostaining was observed for p53 in 98 tumors (57%), for p21 in 89 tumors (51%), and for mdm2 in only 16 tumors (9%). The only association found between immunostaining for the three antibodies was that most mdm2-positive tumors had positive p21 expression. Tumor mapping of regional immunostaining showed no association between immunostaining for p53 and p21. In a proportional hazards analysis, no association was found between the results of immunostaining for the three antibodies and treatment outcome.

    Conclusions: Positive or negative expression of p53, p21, or mdm2, or combinations of these, was not associated with cancer specific mortality after cystectomy for bladder carcinoma. There was no association between immunostaining for p21 and p53, whereas positive immunostaining for mdm2 was observed in a minority of the tumors. These results indicate that, in addition to p21, p53, and mdm2, there are other oncoproteins and tumor suppressor proteins along the p53 pathway that are involved in tumor development and progression.

  • 3.
    Lindahl Norberg, Annika
    et al.
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Montgomery, Scott M.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Bottai, Matteo
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Heyman, Mats
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Hovén, Emma I.
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Short-term and long-term effects of childhood cancer on income from employment and employment status: A national cohort study in Sweden2017In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 123, no 7, p. 1238-1248Article in journal (Refereed)
    Abstract [en]

    Background: There is insufficient knowledge regarding the economic impact of childhood cancer on parents. The objectives of the current study were to investigate the short-term and long-term effects of childhood cancer on mothers' and fathers' income from employment and employment status.

    Methods: The study sample consisted of the parents of children diagnosed with cancer from 2004 to 2009 in Sweden (3626 parents of 1899 children). Annual register data concerning income from employment and employment status (employed/not employed) were retrieved from the Longitudinal Integration Database for Health Insurance and Labor Market Studies. Using generalized linear models, the mean income from employment and employment status were compared with a matched control cohort of 34,874 parents sampled from the general population.

    Results: Parents' income was found to decrease significantly after the child's cancer diagnosis. The effect was most pronounced for mothers, whose income was reduced for 6 years after diagnosis, whereas fathers' income was similar to that of control fathers 3 years after the diagnosis. Mothers were more likely to stop working after a child's cancer diagnosis compared with controls. No association was found for fathers' employment status. Younger age of parents; lower level of education; and, among mothers, being born outside of Sweden were found to be associated with more adverse effects on income.

    Conclusions: Parents' income from employment and employment status appear to be adversely affected by having a child with cancer. Socioeconomic consequences are not distributed equally: the income of fathers appears to catch up after a few years, whereas mothers tend to be disadvantaged in their professional life for several years after a child's cancer diagnosis.

  • 4.
    McCabe, Mary S.
    et al.
    Cancer Survivorship Program, Memorial Sloan-Kettering Cancer Center, New York, USA.
    Faithfull, Sara
    Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.
    Makin, Wendy
    Palliative Medicine and Oncology, The Christie National Health Service Foundation Trust, Manchester, United Kingdom.
    Wengström, Yvonne
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
    Survivorship programs and care planning2013In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 119, no S11, p. 2179-2186Article in journal (Refereed)
    Abstract [en]

    Formal cancer survivorship care is a growing focus internationally. This article provides a broad overview of the national strategies currently in progress for the development of survivorship programs and care plans within the United States and across Europe. The different approaches taken in their implementation, staffing, and clinical focus are highlighted, with an emphasis on how they are incorporated into various models of care. The considerable variation in making survivorship a formal period of care across countries and health care systems is discussed, including the factors influencing these differences. A review of research focused on the evaluation of definitions and outcomes is provided along with a discussion of important areas requiring future research. (C) 2013 American Cancer Society.

  • 5.
    Pettersson, Andreas
    et al.
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA; Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.
    Gerke, Travis
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center, Tampa FL, USA.
    Fall, Katja
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Pawitan, Yudi
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Holmberg, Lars
    Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom.
    Giovannucci, Edward L.
    Department of Epidemiology & Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston MA, USA.
    Kantoff, Philip W.
    Department of Medical Oncology, Dana-Farber Cancer Institute, Boston MA, USA; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, USA.
    Adami, Hans-Olov
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA: Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Rider, Jennifer R.
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston MA, USA.
    Mucci, Lorelei A.
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston MA, USA.
    The ABC model of prostate cancer: A conceptual framework for the design and interpretation of prognostic studies2017In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 123, no 9, p. 1490-1496Article, review/survey (Refereed)
    Abstract [en]

    There has been limited success in identifying prognostic biomarkers in prostate cancer. A partial explanation may be that insufficient emphasis has been put on clearly defining what type of marker or patient category a biomarker study aims to identify and how different cohort characteristics affect the ability to identify such a marker. In this article, the authors put forth the ABC model of prostate cancer, which defines 3 groups of patients with localized disease that an investigator may seek to identify: patients who, within a given time frame, will not develop metastases even if untreated (category A), will not develop metastases because of radical treatment (category B), or will develop metastases despite radical treatment (category C). The authors demonstrate that follow-up time and prostate-specific antigen screening intensity influence the prevalence of patients in categories A, B, and C in a study cohort, and that prognostic markers must be tested in both treated and untreated cohorts to accurately distinguish the 3 groups. The authors suggest that more emphasis should be put on considering these factors when planning, conducting, and interpreting the results from prostate cancer biomarker studies, and propose the ABC model as a framework to aid in that process.

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