Search PubMed⌕ Search

Biomedical subjects

H O Adami

Publications and source records attributed to H O Adami.

At least 253 records · Page 14Linked to original sources
PubMed1991

Response bias in a case-control study: analysis utilizing comparative data concerning legal abortions from two independent Swedish studies.

Independent reports of legal abortions in two Swedish epidemiologic studies of breast cancer in young women, covering the same women and overlapping the same time period, have been compared in order to estimate a putative response bias. One study used case-control methods and obtained data by retrospective interviews from 317 cases and 512 controls. The other study was based on objectively documented information froma nationwide registry covering legally induced abortions. Analysis demonstrated a ratio between the odds ratios from the two studies of 1.5 (95 percent confidence interval 1.1-2.1) and an observed ratio of 22.4 (p less than 0.007) between underreporting of previous induced abortions among controls relative to overreporting among cases. This response bias may explain the tendency toward increased risk of breast cancer which, according to several case-control studies, appears to be associated with induced abortion.

Abortion, Legal↗
PubMed1991

Is there clustering of inflammatory bowel disease at birth?

Evidence points to possible cohort effects in inflammatory bowel disease, the possible role of perinatal infection as a risk factor for inflammatory bowel disease, and the occurrence of clusters of Crohn's disease. This evidence suggests the value of searching for birth date clustering among cases of inflammatory bowel disease. The authors looked for clustering by birth date and maternal residence at birth in a population-based series of 845 Crohn's disease patients and 1,330 ulcerative colitis patients born from 1924 through 1957 and diagnosed in the Uppsala Health Care Region, Sweden, until the end of 1983. Over this period, 43% of persons with Crohn's disease had been born within 6 days of another case, compared with 36% of controls simulated to account for monthly variation in births (p = 0.0002). The number of pairs of inflammatory bowel disease cases whose births occurred in the same county (close in space) and whose birth dates were also close in time was statistically significantly greater than expected for most birth dates 23-57 days apart. Results after 1944, when ascertainment was more complete, generally corroborate these findings and suggest some seasonality in the birth dates of ulcerative colitis cases. Results from the entire study period and after 1944 thus provide evidence for clustering by birth (including seasonality) among Crohn's disease cases and also, to a lesser extent, among ulcerative colitis cases.

Causality↗
PubMed1991

Maternal and perinatal risk factors for childhood leukemia.

This report describes an exploratory population-based study of maternal and perinatal risk factors for childhood leukemia in Sweden. The Swedish National Cancer Registry ascertained 411 cases in successive birth cohorts from 1973 through 1984 recorded in the Swedish Medical Birth Registry. Using the latter, we matched five controls without cancer to each case by sex and month and year of birth. Mothers of children with leukemia were more likely to have been exposed to nitrous oxide anesthesia during delivery than mothers of controls [odds ratio (OR) = 1.3; 95% confidence interval (CI) = 1.0, 1.6]. Children with leukemia were more likely than controls to have Down's syndrome (OR = 32.5; 95% CI = 7.3, 144.0) or cleft lip or cleft palate (OR = 5.0; 95% CI = 1.0, 24.8); to have had a diagnosis associated with difficult labor but unspecified complications (OR = 4.5; 95% CI = 1.1, 18.2) or with other conditions of the fetus or newborn (OR = 1.5; 95% CI = 1.1, 2.1), specifically, uncomplicated physiological jaundice (OR = 1.9; 95% CI = 1.2, 2.9); or to have received supplemental oxygen (OR = 2.6; 95% CI = 1.3, 1.3, 4.9). Because multiple potential risk factors were analyzed in this study, future studies need to check these findings. We did not confirm the previously reported higher risks for childhood leukemia associated with being male, having a high birth weight, or being born to a woman of advanced maternal age.

Child↗
PubMed1991

Trends in thyroid cancer incidence in Sweden, 1958-1981, by histopathologic type.

Time trends in the incidence of malignant neoplasms of the thyroid were examined for Sweden for the period 1958-81, 5,838 cases being studied. Autopsy-diagnosed cases were excluded. Mean annual changes in the age-standardized rates over this period were 1.9% and 1.2% for women and men, respectively, for all thyroid carcinomas combined; 4.9% and 2.1% for papillary carcinoma; 0.9% and 2.1% for follicular carcinoma; and -1.0% and -2.1% for anaplastic carcinoma. Age, period and cohort models were fitted. There was a progressive increase in papillary cancer incidence for cohorts born since 1919. This increase cannot be satisfactorily explained as an artefact of trends in classification, and probably reflects a real increase in incidence. A less marked increase was seen for follicular cancer, and there was a decline for cohorts born since 1939. While the risk of papillary and anaplastic carcinoma was lower in iodine-deficient areas, follicular cancer risk was twice as high in these areas, for men only. There was a steady decline of anaplastic cancer in both sexes after 1965, largely attributable to a decline in cohorts born since 1924.

Age Factors↗
PubMed1991

Extracolonic malignancies in inflammatory bowel disease.

A population-based cohort with inflammatory bowel disease consisting of 4776 patients (3121 with ulcerative colitis and 1655 with Crohn's disease) was followed for 1 to 50 years for the occurrence of malignant neoplasms. Two hundred eighty-three cancers were observed versus 189.1 expected (standardized incidence ratio [SIR] = 1.5, 95% confidence limits [CL] 1.3 to 1.7). One hundred seventy-eight extracolonic cancers were observed versus 168.8 expected (SIR = 1.1, 95% CL 0.9 to 1.2). In Crohn's disease and extensive ulcerative colitis, observed cases were close to those expected but in ulcerative proctitis, the relative risk of extracolonic cancers was close to significantly increased (SIR = 1.3, 95% CL 1.0 to 1.7). Squamous skin cancers after Crohn's disease (SIR = 5.5, 95% CL 2.0 to 11.9) and connective tissue cancers after ulcerative colitis (SIR = 4.0, 95% CL 1.0 to 10.2) were significantly increased. Those having extensive ulcerative colitis at diagnosis had an increased risk of brain cancers (SIR = 2.4, 95% CL 1.0 to 4.6). Patients with extensive ulcerative colitis had lower than expected risk of breast cancer (SIR = 0.4, 95% CL 0.1 to 1.0).

Brain Neoplasms↗
PubMed1991

The decline in the incidence of stomach cancer in Sweden 1960-1984: a birth cohort phenomenon.

Trends in the incidence of stomach cancer among 52,604 patients notified to the National Swedish Cancer Registry in 1960 through 1984 were analysed. Age-standardized incidence rates declined throughout the period, from 47.1 to 24.6 per 10(5) in males and from 23.8 to 12.7 per 10(5) in females. Among males the decline in incidence was more pronounced in younger age strata, 35-54 years, while in females it reached a maximum at ages 70-74 years. In a multivariate analysis the age-cohort model adequately represented the data and there was no reason to separate the effects of the full age-period-cohort model. Compared with the cohort born in 1876-1884, the relative risk of developing stomach cancer was 0.46 (95% CI:0.44-0.48) in males and 0.39 (95% CI:0.37-0.42) in females born in 1906-1914. This supports the view that the declining incidence is due to a change in the exposure of the population to aetiological factors of stomach cancer and not to refinement of the diagnosis and classification of abdominal tumours. The results also imply that exposure to aetiological factors early in life together with a long induction period is of importance in the development of stomach cancer.

Adult↗
PubMed1991

Time trends in incidence rates of acute, non-traumatic extremity ischaemia: a population-based study during a 19-year period.

Time trends in the occurrence of acute limb ischaemia were studied from 1965 to 1983 in a defined geographical area in Sweden. Data were obtained from a computerized register which covers all instances of inpatient care for a population of 1.3 million. Analysis based on 5394 first admissions for acute arterial occlusion revealed that the annual number increased by 2.7 per cent yearly in women and 3.9 per cent in men whereas the age-adjusted incidence remained stable for women and increased by 2.6 per cent yearly for men. A study of 1189 patients who underwent surgical procedures showed that the annual number of embolectomy procedures increased 7.6 per cent for females and 8.6 per cent for males. The corresponding age-adjusted incidence rose annually by 3.0 per cent for women and by 7.5 per cent for men. The introduction of the Fogarty catheter and an increasing interest in vascular surgery may have contributed to the increasing rates of operations during the period of study.

Adult↗
PubMed1991

Risk factors for early lower limb loss after embolectomy for acute arterial occlusion: a population-based case-control study.

To identify risk factors for lower limb loss after arterial embolectomy a cohort of 1189 patients was studied. Detailed data were obtained for 165 patients who underwent a major amputation within 30 days of embolectomy and for 165 matched controls. The amputation risk was increased in patients with two or more myocardial infarctions (odds ratio (OR) 3.1, 95 per cent confidence interval (CI) 0.8-11.2), chronic ischaemia (OR 2.1, CI 0.9-4.9), long duration of symptoms (OR 4.3, CI 1.9-9.6, for greater than or equal to 25 h versus less than or equal to 6 h) or postoperative heart failure (OR 3.4, CI 1.8-6.5). Reduced risks were found in association with acute myocardial infarction (OR 0.3, CI 0.1-0.9) and postoperative anticoagulation treatment with warfarin (OR 0.3, CI 0.1-0.9). The independent prognostic value of chronic ischaemia and symptom duration, and the beneficial effect of postoperative anticoagulation gained additional support in multivariate analysis. We conclude that the risk of early amputation after arterial embolectomy or thrombectomy can be predicted by several clinical characteristics.

Acute Disease↗
PubMed1991

Cancer risk in patients with diabetes mellitus.

Cancer incidence was ascertained in a population-based cohort of 51,008 patients in Uppsala, Sweden, who were given a discharge diagnosis of diabetes mellitus during 1965-83. Complete follow-up through 1984 with exclusion of the first year of observation showed that the observed number of cancers in females (1,294) was eight percent higher than expected (relative risk [RR] = 1.1, 95 percent confidence interval = 1.0-1.1), whereas in males the observed number (1,123) was close to the expected (RR = 1.0, 0.9-1.1). Significantly increased risks of pancreatic (RR = 1.4, 1.2-1.7), primary liver (RR = 1.5, 1.2-1.7), and endometrial (RR = 1.5, 1.2-1.8) cancers and a lower than expected number of prostatic cancers (RR = 0.7, 0.7-0.9) were found in this cohort of diabetic patients. The excess risk of pancreatic cancer was similar in females and males and evident both during one through four years (RR = 1.7, 1.4-2.1) and five through nine years (RR = 1.3, 0.9-1.7) of follow-up, but not thereafter. A similar pattern was found for primary liver cancer, but the RRs were generally higher in males than in females.

Adult↗
PubMed1991

Evaluation of a prescription based record-linkage model for epidemiological studies of long-term adverse effects of drugs--with special regard to combined oral contraceptives.

The Department of Drugs of the Swedish National Board of Health and Welfare undertook a study of the possibilities of a new scheme for post-marketing surveillance by means of prescription and register based epidemiological studies, primarily of combined oral contraceptives (COC). Based on available data on COC usage patterns and incidence rates of the disease at study, it was estimated that study periods, including the necessary time periods for disease development and generation of a sufficient number of cases, would amount to at least 1 to 13 years for cardiovascular outcomes and 8 to 17 years for reproductive cancers. Prospective and unbiased exposure ascertainment would be the most important advantage. However, delay in follow up, the need for extensive individual questionnaire probing and fear of violation of personal integrity could adversely affect the feasibility of the scheme. Chiefly on the grounds of the extended study periods and magnitude of the necessary infrastructure, it was not judged cost-effective to pursue such a scheme for COC exposure only. It was, however, suggested that it would be considered for epidemiological surveillance of other drugs that are commonly used and for which short term and frequent serious side effects are expected, as for instance lipid lowering compounds, beta-blockers, bensodiazepines and other psychotropic drugs.

Adult↗
PubMed1991

Ulcerative proctitis in central Sweden 1965-1983. A population-based epidemiological study.

Ulcerative proctitis has by tradition been regarded as a subgroup of ulcerative colitis. Population-based epidemiological studies of ulcerative proctitis are, however, virtually nonexistent. In an epidemiological study of inflammatory bowel disease in the Uppsala Health Care Region, 1065 cases of ulcerative proctitis were diagnosed from 1965 through 1983. Males predominated, with the male to female ratio 1.4:1. Annual incidence rates were higher in urban than in rural areas. The annual incidence rates increased threefold from 2.8 per 10(5) to 6.6 per 10(5) during the period, affecting all age groups over 14 years of age, in both urban and rural areas and in both sexes. Differences in temporal trends and certain other epidemiological characteristics between ulcerative proctitis and extensive ulcerative colitis suggest that ulcerative proctitis is a specific disease whose etiology differs from that of extensive ulcerative colitis.

Adolescent↗
PubMed1991

Trends in cancer survival and mortality rates.

Survival, i.e. the time from report to cancer registry to death was studied for 591,456 cases of cancer diagnosed in vivo from 1960 to 1984. Ten years survival increased from 35 to 40%. Survival rates for women were higher than for men. Since 10 years survival almost suggests cure, lead time bias is assumed not to be a major factor. Nor are relaxed histological criteria, detecting non-fatal tumors, intensified microscopic examination, changes in the relative frequency of cancer types, or increasing numbers of elderly patients assumed to be major artefacts. In contrast, improved socio-economic and health status are. Early detection also improves survival in some cancer types.

Artifacts↗
PubMed1991

The epidemiology of inflammatory bowel disease: a large, population-based study in Sweden.

Previous population-based incidence studies of inflammatory bowel disease are limited by small numbers, short duration, or inadequate case-finding. To address these problems, we identified all persons with confirmed ulcerative colitis (n = 2509) or Crohn's disease (n = 1469) in the Uppsala Health Care Region from 1965 to 1983. Age-specific incidence rates by sex were slightly greater for males with ulcerative colitis and females with Crohn's disease. Incidence rates for ulcerative colitis and Crohn's disease were higher in urban than rural areas. The annual incidence rate of ulcerative colitis increased from less than 7 per 100,000 to more than 12 per 100,000 during the study period, while the rate for Crohn's disease remained between 5 and 7 per 100,000. The increase in the incidence of ulcerative colitis was the result of a marked increase in the number of patients with ulcerative proctitis. Analyses by 5-year birth cohorts suggest that those born from 1945 through 1954 were at higher risk for ulcerative colitis and Crohn's disease, and that this effect was accounted for by those born in the first half of the year. The seasonality in the cohort effect, combined with the urban preponderance of disease, suggests that environmental causes may be involved in ulcerative colitis and Crohn's disease.

Adolescent↗
PubMed1991

Occurrence of testicular cancer in patients operated on for cryptorchidism and inguinal hernia.

We studied the incidence of testicular cancer in 2 population-based cohorts comprising 2,918 men who underwent an operation for a cryptorchid testis and 30,199 who underwent surgery for an inguinal hernia. Complete followup during the 19-year period was achieved by record linkage to the National Swedish Cancer Registry. In the cryptorchidism cohort 4 cases of testicular cancer occurred versus 0.54 expected, yielding a relative risk of 7.4 (95% confidence interval 2.0 to 19.0). Of these patients 3 had undergone a bilateral operation due to intra-abdominal testes. There was no evidence of an association between inguinal hernia and risk of testicular cancer (relative risk = 1.1, 95% confidence interval 0.4 to 2.2). The validity of our data was further supported by relative risk estimates close to unity in a comparison group of appendectomy patients. We conclude that patients with a cryptorchid testis experience a substantially increased relative risk of testicular cancer. However, the low absolute risk, 4 cases during 25,360 person-years of observation, does not appear to justify special surveillance after an operation for an undescended testis.

Age Factors↗