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Elsebeth Lynge

Publications and source records attributed to Elsebeth Lynge.

At least 19 recordsLinked to original sources
PubMed2005

European multi-centre case-control study on risk factors for rare cancers of unknown aetiology.

To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed). Numbers identified corresponded to those in the EUROCIM database for Denmark, but were below those observed for France, Italy and Sweden in the database. We recruited 3374 population (61% interviewed) and 1284 colon cancer controls (86% interviewed). It was possible to undertake this complicated study across Europe, but we encountered three main problems. It was difficult to ensure complete case ascertainment, for population controls, we found a clear divide in the response rate from 75% in the South to only 55% in the North, and a somewhat selective recruitment was noted for the colon cancer controls. The study showed there is a clear dose-response relationship between alcohol intake and the risk of male breast cancer, and an excess risk of mycosis fungoides among glass formers, pottery and ceramic workers. Further data are expected.

Adult↗
PubMed2005

Do nonattenders in mammography screening programmes seek mammography elsewhere?

The objectives of our study were to analyse the use of diagnostic mammography among nonattenders and attenders in organised mammography screening in Denmark in 2000, to assess the contamination from organised screening of noninvited age groups and to measure the impact of local policy on opportunistic screening. Data on all diagnostic mammographies performed in Denmark in 2000 and data on women targeted by the 2 organised mammography screening programmes in Copenhagen and the county of Fyn were collected. All data were linked by the Danish personal identification number. Information on the official policy in 2000 with regard to opportunistic screening was collected from all counties. The proportion of women using diagnostic mammography was only 1-3% for both attenders and nonattenders in organised mammography screening, but it was significantly higher in Copenhagen than in Fyn, due to availability of mammography in private clinics. The proportion of women using diagnostic mammography varied from 1-4% across counties. The official policy on access to diagnostic mammography and contamination from organised mammography screening of adjacent age groups had no impact on the use. Instead, urbanisation was positively correlated with use of diagnostic mammography. In conclusion, our results clearly showed that nonattenders in organised mammography screening programmes do not seek mammography outside the programme. Since a positive policy toward opportunistic screening did not have any effect, our results add further evidence to existing knowledge that the only reasonable way to achieve high mammography coverage is through a well-organised screening programme.

Adult↗
PubMed2005

Breast cancer mortality in Copenhagen after introduction of mammography screening: cohort study.

OBJECTIVES: To evaluate the effect on breast cancer mortality during the first 10 years of the mammography service screening programme that was introduced in Copenhagen in 1991. DESIGN: Cohort study. SETTING: The mammography service screening programme in Copenhagen, Denmark. PARTICIPANTS: All women ever invited to mammography screening in the first 10 years of the programme. Historical, national, and historical national control groups were used. MAIN OUTCOME MEASURES: The main outcome measure was breast cancer mortality. We compared breast cancer mortality in the study group with rates in the control groups, adjusting for age, time period, and region. RESULTS: Breast cancer mortality in the screening period was reduced by 25% (relative risk 0.75, 95% confidence interval 0.63 to 0.89) compared with what we would expect in the absence of screening. For women actually participating in screening, breast cancer mortality was reduced by 37%. CONCLUSIONS: In the Copenhagen programme, breast cancer mortality was reduced without severe negative side effects for the participants.

Aged↗
PubMed2005

Occupational risks for uveal melanoma results from a case-control study in nine European countries.

OBJECTIVE: Uveal melanoma is a rare disease with poor prognosis and largely unknown etiology. We studied potential occupational risk factors. METHODS: A population based case-control study was undertaken during 1995-1997 in nine European countries using population and colon cancer controls with personal interviews. Occupational exposure to sunlight and artificial UV radiation was assessed with a job exposure matrix. In total, 320 uveal melanoma cases were eligible at pathology review, and 292 cases were interviewed, participation 91%. Out of 3357 population controls, 2062 were interviewed, 61%, and out of 1272 cancer controls 1094 were interviewed, 86%. RESULTS: Using population controls, occupational exposure to sunlight was not associated with an increased risk (RR=1.24, 95% CI=0.88-1.74), while an excess risk found with use of colon cancer controls was attributed to confounding factors. An excess risk in welders was restricted to the French part of the data. Cooks, RR=2.40; cleaners, RR 2.15; and laundry workers, RR=3.14, were at increased risk of uveal melanoma. CONCLUSION: Our study does overall not support an association between occupational sunlight exposure and risk of uveal melanoma. The finding of an excess risk of eye melanoma in cooks in several European countries is intriguing.

Adult↗
PubMed2005

A model for determining the effect of mammography service screening.

In an overview, Swedish mammography screening trials demonstrated a 29% reduction in breast cancer mortality in women aged 50-69 and no effect on total mortality. Three Danish regions introduced mammography screening in the 1990s. The authors developed a method to evaluate the effect of mammography service screening on breast cancer mortality and validated it applying it to total mortality, where no effect was expected. Study groups and historical and national control groups were analysed using Poisson regression. Total mortality in the screening regions and periods was close to that expected in the absence of screening. A small (3%) excess risk, also seen in a non-screening area, probably results from regional differences changing over time. The effect of this is inseparable from the screening effect. The design is adequate for analysing the effect of mammography service screening on breast cancer mortality.

Aged↗
PubMed2004

Fertility pattern does not explain social gradient in breast cancer in denmark.

The present study was undertaken to assess the impact of reproductive behavior on the social class gradient in breast cancer occurrence in Denmark. Objectives were to study whether the gradient across socioeconomic groups could be explained by fertility differences, whether the gradient across educational groups could be explained by fertility differences and whether the effect of socioeconomic group on breast cancer incidence and mortality could be explained by education and vice versa. We studied 674,084 women aged 20-39 at the census on 9 November 1970 for whom we had complete data on fertility history. The cohort was followed up for breast cancer incidence and mortality until 8 November 1998. Fertility history varied considerably across socioeconomic group, where 38% of the academics were childless at the age of 30, in contrast to only 8% of women in agriculture. The academics had the highest risk of breast cancer and women in agriculture had the lowest risk. For incidence, the gradient in the relative risks was 1.74, which changed to 1.49 when fertility history was incorporated and to 1.29 when school education was also taken into account. For school education, women with > or = 12 years of schooling had the highest risk and women with < or = 7 years of schooling had the lowest risk. For incidence, the gradient in the relative risk was 1.38, which changed to 1.26 when fertility history was incorporated and to 1.22 when socioeconomic group was also taken into account.

Adult↗
PubMed2004

Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe.

Epidemiologic studies have shown an increased risk of breast cancer following hormone replacement therapy (HRT). The aim of this study was to investigate whether different treatment regimens or the androgenecity of progestins influence the risk of breast cancer differently. The Danish Nurse Cohort was established in 1993, where all female nurses aged 45 years and above received a mailed questionnaire (n = 23,178). A total of 19,898 women returned the questionnaire (86%). The questionnaire included information on HRT types and regimens, reproductive history and lifestyle-related factors. Breast cancer cases were ascertained using nationwide registries. The follow-up ended on 31 December 1999. Women with former cancer diagnoses, women with missing information on HRT, surgical menopause, premenopausal, as well as hysterectomized women were excluded, leaving 10,874 for analyses. Statistical analyses were performed using Cox proportional hazards model. A total of 244 women developed breast cancer during follow-up. After adjustment for confounding factors, an increased risk of breast cancer was found for the current use of estrogen only (RR = 1.96; 95% CI = 1.16-3.35), for the combined use of estrogen and progestin (RR = 2.70; 95% CI = 1.96-3.73) and for current users of tibolone (RR = 4.27; 95% CI = 1.74-10.51) compared to the never use of HRT. In current users of combined HRT with testosterone-like progestins, the continuous combined regimens were associated with a statistically significant higher risk of breast cancer than the cyclical combined regimens (RR = 4.16, 95% CI = 2.56-6.75, and RR = 1.94, 95% CI = 1.26-3.00, respectively). An increased risk of breast cancer was noted with longer durations of use for the continuous combined regimens (p for trend = 0.048). The European traditional HRT regimens were associated with an increased risk of breast cancer. The highest risk was found for the use of continuous combined estrogen and progestin.

Aged↗
PubMed2004

Colon cancer controls versus population controls in case-control studies of occupational risk factors.

BACKGROUND: Since updated population registers do not exist in many countries it is often difficult to sample valid population controls from the study base to a case-control study. Use of patient controls is an alternative option if the exposure experience under study for these patients are interchangeable with the experience for population controls. Patient controls may even be preferable from population controls under certain conditions. In this study we examine if colon cancer patients can serve as surrogates for proper population controls in case-control studies of occupational risk factors. METHODS: The study was conducted from 1995 to 1997. Incident colon cancer controls (N = 428) aged 35-69 years with a histological verified diagnosis and population controls (N = 583) were selected. Altogether 254 (59%) of the colon cancer controls and 320 (55%) of the population controls were interviewed about occupational, medical and life style conditions. RESULTS: No statistical significant difference for educational level, medical history or smoking status was seen between the two control groups. There was evidence of a higher alcohol intake, less frequent work as a farmer and less exposure to pesticides among colon cancer controls. CONCLUSIONS: Use of colon cancer controls may provide valid exposure estimates in studies of many occupational risk factors for cancer, but not for studies on exposure related to farming.

Adult↗
PubMed2004

Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study.

OBJECTIVE: It has been estimated that alcohol drinking increases the risk of breast cancer in women by approximately 7% for each increment of 10 g alcohol per day. However, the few studies conducted on breast cancer among men have failed to detect an association with quantitative measures of alcohol drinking, even if the alcohol intake is generally higher in men than in women. On the other hand, increased risks of male breast cancer were inconsistently reported in alcoholics or patients with liver cirrhosis. We have investigated the role of alcohol drinking in male breast cancer using data collected in a population-based case-control study on seven rare cancers, conducted in Denmark, France, Germany, Italy, and Sweden. METHODS: The cases were 74 histologically verified male breast cancer patients aged 35-70 years. The controls (n = 1432) were selected from population registers, and frequency-matched to the cases by age group and geographic area. To check for consistency, a separate analysis was conducted using as controls the patients with a rare cancer other than male breast recruited simultaneously in the European study (n = 519 men). RESULTS: Based on population controls, the risk of developing breast cancer in men increased by 16% (95% CI: 7-26%) per 10 g alcohol /day (p < 0.001). An odds ratio of 5.89 (95% CI: 2.21-15.69) was observed for alcohol intake greater than 90 g per day, as compared with light consumers (< 15 g per day). Similar associations were observed when other rare cancers patients were used as controls. CONCLUSION: We found that the relative risk of breast cancer in men is comparable to that in women for alcohol intakes below 60 g per day. It continues to increase at high consumption levels not usually studied in women.

Adult↗
PubMed2004

Women's death in Scandinavia--what makes Denmark different?

OBJECTIVE: To compare the mortality for women in Sweden, Norway and Denmark in order to search for clues for the low life expectancy of Danish women. METHODS: Prospective age-period-cohort study covering 40 years for all Swedish, Norwegian and Danish women aged 40-84 during the period 1960-2000, and born 1900-1950. OUTCOME MEASURES: Relative risks and 95% confidence intervals for deaths. RESULTS: The high risk of dying among Danish women was associated with being born between the two World Wars, and that a similar pattern was not found for women in Norway and Sweden. A tendency of a cohort effect was observed for Swedish women born around 1940. CONCLUSIONS: The currently low life expectancy of Danish women compared with that of women in Norway and Sweden is partly a transitional phenomenon caused by excessive death rates for women born between the two World Wars. Data on smoking prevalence by birth cohort and age indicate that a high percentage of Danish women in these cohorts were smokers throughout their adult life.

Adult↗
PubMed2004

Use of census data for construction of fertility history for Danish women.

BACKGROUND: Modern epidemiology increasingly uses data on families. The authors constructed an extended fertility database for women born in Denmark from 1930 onwards by supplementing the existing Fertility Database with household data from the 1970 census. METHODS: A fertility history was constructed for all women participating in the 1970 census, but aiming for complete data only for women aged 20-39. The fertility history of these women prior to the 1970 census was constructed from the census data including 1,648,813 persons coded as children. An algorithm was used transforming household information into fertility history data by matching women and children according to family position. Children for whom the algorithm gave no match were searched for in the Fertility Database; children not found in the Fertility Database either were searched for manually. The fertility history after the 1970 census was retrieved from the Fertility Database. RESULTS: Using data from the census 1970, 98.5% of the children were linked to a mother, and 99.6% of these links were estimated to be correct, corresponding to 98.1% of the children being linked correctly. In total, 964,720 children of women aged 20-39 in 1970 were identified, which was equivalent to 96.6% of the expected live-born children, and to 99.1% of the expected surviving children. CONCLUSION: Census household data proved to be an excellent data source for construction of fertility histories.

Adult↗
PubMed2003

Reliability of data from next-of-kin: results from a case-control study of occupational and lifestyle risk factors for cancer.

BACKGROUND: Use of surrogate responders often needs to be considered in case-control studies with a high case fatality. METHODS: Agreement between 98 colon cancer patients and their closest relative was expressed as a percentage of the exact agreement and by Kappa coefficients and intra-class correlation coefficients. RESULTS: The percentage of "don't know" answers was higher for surrogates than for index cases and the highest percentage was seen for questions on early events like childhood diseases. Agreement was best for responses to dichotomous questions on smoking and for prevalent or chronic diseases like diabetes or psoriasis, and lower (54-64%) when a quantitative response of, e.g., smoking was requested. The next-of-kin reported fewer job periods than the study person, 4.5 and 2.8, respectively, and there was a higher agreement for the latest job held than for the longest held job. We found an overall agreement between 91% and 100% for responses to ever having worked in a specific type of industry or occupation. CONCLUSIONS: Use of next-of-kin data will often be a better alternative than excluding severely ill or deceased cases, if the exposure under study correlates with disease progression.

Adenocarcinoma↗
PubMed2003

Occupation and bladder cancer among men in Western Europe.

OBJECTIVES: We examined which occupations and industries are currently at high risk for bladder cancer in men. METHODS: We combined data from 11 case-control studies conducted between 1976-1996 in six European countries. The study comprised 3346 incident cases and 6840 controls, aged 30-79 years. Lifetime occupational and smoking histories were examined using common coding. RESULTS: Odds ratios for eight a priori defined high-risk occupations were low, and with the exception of metal workers and machinists (OR = 1.16, 95% CI = 1.02-1.32), were not statistically significant. Higher risks were observed for specific categories of painters, metal, textile and electrical workers, for miners, transport operators, excavating-machine operators, and also for non-industrial workers such as concierges and janitors. Industries entailing a high risk included salt mining, manufacture of carpets, paints, plastics and industrial chemicals. An increased risk was found for exposure to PAHs (OR for highest exposure tertile = 1.23, 95% CI = 1.07-1.4). The risk attributable to occupation ranged from 4.2 to 7.4%, with an estimated 4.3% for exposure to PAHs. CONCLUSIONS: Metal workers, machinists, transport equipment operators and miners are among the major occupations contributing to occupational bladder cancer in men in Western Europe. In this population one in 10 to one in 20 cancers of the bladder can be attributed to occupation.

Adult↗