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  • 151.
    Zhang, Yiwen
    et al.
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA.
    Zhou, Cindy Ke
    Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA.
    Rencsok, Emily M.
    Health Sciences & Technology, Harvard Medical School, Boston MA, USA.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Lotan, Tamara L.
    Department of Pathology, Johns Hopkins University School of Medicine, Baltimore MD, USA.
    Loda, Massimo
    Pathologist-in-Chief, Weill Cornell Medicine, New York NY, USA.
    Giunchi, Francesca
    Pathology Unit, Addarii Institute, S. Orsola-Malpighi Hospital, Bologna, Italy.
    Platz, Elizabeth A.
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA.
    De Marzo, Angelo M.
    Department of Pathology, Johns Hopkins University School of Medicine, Baltimore MD, USA.
    Mucci, Lorelei A
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA.
    Fiorentino, Michelangelo
    Pathology Service, University of Bologna, Bologna, Italy.
    Ebot, Ericka M.
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA.
    A prospective study of intraprostatic inflammation, focal atrophy, and progression to lethal prostate cancer2019Inngår i: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 28, nr 12, s. 2047-2054Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Inflammation and focal atrophy are common features adjacent to prostate tumors. Limited evidence exists on whether these features have prognostic significance.

    METHODS: In the Health Professionals Follow-Up Study and Physicians' Health Study, we studied 1,035 men diagnosed with prostate cancer. A genitourinary pathologist centrally reviewed tumor and normal areas of hematoxylin and eosin slides from prostate cancer specimens for the presence of acute and chronic inflammation, and four subtypes of focal atrophy. Cox proportional hazards models adjusted for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of these features with lethal prostate cancer, defined as development of metastatic disease or death during follow-up.

    RESULTS: During a median of 12 years of follow-up, 153 men developed lethal prostate cancer. Eighty-four percent of men had histologic evidence of chronic inflammation and 30% had acute inflammation. Both chronic and acute inflammation were inversely associated with lethal prostate cancer in age- and lifestyle-adjusted models. Chronic inflammation remained inversely associated with lethal prostate cancer after additionally adjusting for prognostic clinical features (HR=0.45, 95% CI 0.30 to 0.69 for mild, HR=0.51, 95% CI 0.33 to 0.80 for moderate to severe). None of the atrophic lesions were associated with lethal prostate cancer.

    CONCLUSIONS: Our data suggest that the presence of inflammation, particularly chronic inflammation, in prostate cancer tissue is associated with better prognosis among prostate cancer patients.

    IMPACT: This is the largest prospective cohort study to examine the association between inflammation, focal atrophy, and lethal prostate cancer.

  • 152.
    Zhu, Jianwei
    et al.
    Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, P. R. China.
    Chen, Ruoqing
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Davidsson, Sabina
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Urology.
    Carlsson, Jessica
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Urology.
    Messing-Eriksson, Anna
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Urology.
    Fridfeldt, Jonna
    Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Andrén, Ove
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Urology.
    Andersson, Sven-Olof
    Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Valdimarsdóttir, Unnur
    Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, P. R. China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, SA, USA.
    Fang, Fang
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Psychological and physiological impacts of a fast-track diagnostic workup for men with suspected prostate cancer: Preliminary report from a randomized clinical trial2020Inngår i: Cancer communications (London, England), ISSN 2523-3548Artikkel i tidsskrift (Fagfellevurdert)
  • 153.
    Zhu, Jianwei
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fang, Fang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sjölander, Arvid
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Adami, Hans Olov
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway .
    Valdimarsdottir, Unnur Anna
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Center of Public Health Sciences, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
    First-onset mental disorders after cancer diagnosis and cancer-specific mortality: a nationwide cohort study2017Inngår i: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 28, nr 8, s. 1964-1969Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The diagnosis of cancer is strongly associated with the risk of mental disorders even in patients with no previous history of mental disorders. Accumulating data suggest that mental distress may accelerate tumor progression. We hypothesized therefore that mental disorders after a cancer diagnosis may increase the risk of cancer-specific mortality.

    Patients and methods: We conducted a nationwide cohort study including 244 261 cancer patients diagnosed in Sweden during 2004-2009 and followed them through 2010. Through the Swedish Patient Register, we obtained clinical diagnoses of all mental disorders and focused on mood-, anxiety-, and substance abuse disorders (ICD10: F10-F16, F18-F19, F32-F33, F40-F41, and F43-45) that are commonly diagnosed among patients with cancer. We further classified the studied mental disorders into first-onset or recurrent mental disorders. We used Cox regression to estimate multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) as a measure of the association between mental disorders after cancer diagnosis and cancer-specific mortality, adjusting for age, sex, calendar period, educational level, cancer stage, and cancer type at diagnosis.

    Results: After cancer diagnosis, 11 457 patients were diagnosed with mood-, anxiety-, and substance abuse disorders; of which 7236 were first-onset mental disorders. Patients with a first-onset mental disorder were at increased risk of cancer-specific mortality (HR: 1.82, 95% CI: 1.71-1.92) while patients with a recurrent mental disorder had much lower risk elevation (HR: 1.14, 95% CI: 1.05-1.24). The increased cancer-specific mortality by first-onset mental disorders was observed for almost all cancer sites/groups and the association was stronger for localized cancers (HR: 2.00, 95% CI: 1.73-2.31) than for advanced cancers (HR: 1.49, 95% CI: 1.32-1.69).

    Conclusions: Patients with a first-onset common mood-, anxiety-, or substance abuse disorder after cancer diagnosis may be at increased risk of cancer-specific death.

  • 154.
    Zhu, Jianwei
    et al.
    Karolinska Institutet, Stockholm, Sweden; Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
    Fang, Fang
    Karolinska Institutet, Stockholm, Sweden.
    Sjölander, Arvid
    Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Valdimarsdottir, Unnur
    University of Iceland, Reykjavík, Iceland.
    Myocardial infarction or mental disorders after cancer diagnosis and cancer-specific survival2015Inngår i: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 61, s. 23-23Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Background: Receiving a cancer diagnosis has been associated with immediate risks of mental disorders and cardiovascular disease which may reflect a severe stress-response to the diagnosis. We aimed to explore the association of myocardial infarction or mental disorders shortly after a cancer diagnosis and cancer-specific survival.

    Methods: We conducted a prospective cohort study based on the Swedish Cancer Register including 227,943 cancer patients diagnosed during 2004-2009. Non-fetal myocardial infarction (MI) and any mental disorders during the first 90 days after cancer diagnosis were identified by record linkage to the Patient Register. We used Cox proportional hazards regression to calculate the hazard ratio (HR) and 95% confidence interval(CI) as an estimate of the association between MI or mental disorder and total cancer- and cancer-site specific survival.

    Results: During the first 90 days post diagnosis, 724 patients experienced MI and 2,391 were diagnosed with mental disorders. During the average of 3.2 years of follow-up, the rate of any cancer specific-death was increased among patients who experienced MI (HR:1.46, 95%CI:1.27-1.68) with the highest mortality increments observed for lung cancer (HR:1.60, 95%CI:1.21-2.12) and blood cancers (HR:1.83, 95%CI:1.18-2.84). Similarly, patients diagnosed with mental disorder had higher total cancer-specific mortality rates (HR:1.25, 95%CI:1.15-1.37) with the highest mortality increments observed for breast cancer (HR:1.56, 95%CI:1.14-2.14), lung cancer (HR:1.34, 95%CI:1.10-1.63) and blood cancer (HR:1.61, 95%CI:1.21-2.15).

    Conclusion: MI or mental disorder shortly after a cancer diagnosis may decrease cancer-specific survival, especially in breast-, lung-, and blood cancers (Funded by Swedish Cancer Society, Swedish Research Council for Health, Working Life and Welfare, and others).

  • 155.
    Zhu, Jianwei
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Orthopedics, Shandong Provincial Hospital, Shandong University, Jinan, China.
    Lu, Donghao
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sveinsson, Olafur
    Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
    Wirdefeldt, Karin
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Piehl, Fredrik
    Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
    Valdimarsdóttir, Unnur
    Center of Public Health, University of Iceland, Reykjavík, Iceland.
    Fang, Fang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Is a cancer diagnosis associated with subsequent risk of transient global amnesia?2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 4, artikkel-id e0122960Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Psychological stress has been associated with transient global amnesia (TGA). Whether a cancer diagnosis, a severely stressful life event, is associated with subsequent risk of TGA has not been studied.

    Methods: Based on the Swedish Cancer Register and Patient Register, we conducted a prospective cohort study including 5,365,608 Swedes at age 30 and above during 2001-2009 to examine the relative risk of TGA among cancer patients, as compared to cancer-free individuals. Incidence rate ratios (IRRs) and their 95% confidence intervals (CIs) derived from Poisson regression were used as estimates of the association between cancer diagnosis and the risk of TGA.

    Results: During the study 322,558 individuals (6.01%) received a first diagnosis of cancer. We identified 210 cases of TGA among the cancer patients (incidence rate, 0.22 per 1000 person-years) and 4,887 TGA cases among the cancer-free individuals (incidence rate, 0.12 per 1000 person-years). Overall, after adjustment for age, sex, calendar year, socioeconomic status, education and civil status, cancer patients had no increased risk of TGA than the cancer-free individuals (IRR, 0.99; 95% CI, 0.86-1.13). The IRRs did not differ over time since cancer diagnosis or across individual cancer types. The null association was neither modified by sex, calendar period or age.

    Conclusion: Our study did not provide support for the hypothesis that patients with a new diagnosis of cancer display a higher risk of TGA than cancer-free individuals.

  • 156.
    Zhu, Jianwei
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sjölander, Arvid
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Valdimarsdottir, Unnur
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA; Faculty of Medicine, Center of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
    Fang, Fang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Mental disorders around cancer diagnosis and increased hospital admission rate: a nationwide cohort study of Swedish cancer patients2018Inngår i: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 18, nr 1, artikkel-id 322Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Whether the emotional distress around cancer diagnosis is associated with the long-term outcomes and care utilization is unknown. We aimed to examine the association of mental disorders around cancer diagnosis with the hospital admission rates of cancer patients thereafter.

    METHODS: We conducted a nationwide cohort study including 218,508 cancer patients diagnosed in Sweden during 2004-2009 and followed them from 90 days after cancer through 2010. We used a clinical diagnosis of stress-related mental disorders from 90 days before to 90 days after cancer diagnosis as the exposure. We studied first all hospital admissions and then separately three common admissions, including external injuries, infections, and cardiovascular diseases. The Cox model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

    RESULTS: Four thousand one hundred five patients received a diagnosis of stress-related mental disorders around the cancer diagnosis, and experienced a 35% increased rate of any hospital admission during follow-up (HR: 1.35, 95%CI: 1.28-1.41) as well as hospital admissions for external injuries (HR: 1.89, 95%CI: 1.67-2.14), infections (HR: 1.28, 95%CI: 1.08-1.52), and cardiovascular diseases (HR: 1.16, 95%CI: 1.03-1.30). Similar association was noted for most common cancer types.

    CONCLUSIONS: These data suggest that cancer patients diagnosed with a stress-related mental disorder immediately before or after cancer diagnosis are subsequently at increased risk of hospital admissions for major comorbidities of cancer.

1234 151 - 156 of 156
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