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J W Coebergh

Publications and source records attributed to J W Coebergh.

At least 19 recordsLinked to original sources
PubMed2006

Differential roles of Angiotensinogen and Angiotensin Receptor type 1 polymorphisms in breast cancer risk.

While angiotensinogen (AGT) seems to have anti proliferative properties, angiotensin II (ATII) is a potent growth factor and it mediates its actions through the angiotensin type 1 receptor (AGTR1). In the AGT gene, the M235T polymorphism has been associated with the variation in angiotensinogen levels and in the AGTR1 gene; the C573T variant is associated with different pathologies. We aimed to evaluate the relationship of these two variants and the risk of breast cancer. These polymorphisms were genotyped in 3787 women participating the Rotterdam Study. We performed a logistic regression and a disease free survival analysis by genotype. The logistic regression yielded an odds ratio of 1.4 (95% CI: 1.1-1.9) for the MM genotype carriers versus the T allele carriers. The breast cancer free survival by AGT genotype was significantly reduced in MM genotype carriers compared to non-carriers (hazard ratio (HR) = 1.5; 95% CI: 1.1-2.2). We did not find any association of the AGTR1 polymorphism and breast cancer risk or disease free survival. Our results suggest that AGT plays a role in breast cancer risk in postmenopausal women, whereas the role of AGTR1 needs further studying.

Aged↗
PubMed2006

Interleukin 6 G-174 C polymorphism and breast cancer risk.

Interleukin-6 (IL-6) is a growth factor involved in many processes including carcinogenesis. The C allele of the G-174 C promoter single nucleotide polymorphism (SNP) in the IL-6 gene decreases levels of IL-6 expression and it has been studied in the context of breast cancer progression yielding contradicting results. Furthermore a recent study found that carriers of the C allele were at an increased risk for this disease. We aim to evaluate the association between this variant and breast cancer risk in Caucasian postmenopausal women. Women participating in the Rotterdam Study (N=3822), including 171 patients with breast cancer were genotyped for this polymorphism. In order to assess the relationship between this SNP and breast cancer we carried out a logistic regression in relation to the incidence of breast cancer. The C allele frequency was 41.3% and the genotypes followed Hardy-Weinberg distribution (p=0.3). The logistic regression analysis showed a slight increase of risk for C allele carriers (odds ratio=1.24, 95% CI: 0.8-1.9), compared to non-carriers of this allele. This increased risk was not statistically significant. Our data suggest that the IL-6 G-174 C polymorphism does not seem to play a role in breast cancer risk, although its role as a prognostic factor remains to be studied.

Aged↗
PubMed2006

Greater influence of age than co-morbidity on primary treatment and complications of prostate cancer patients: an in-depth population-based study.

We investigated the influence of age and co-morbidity on treatment, the occurrence of serious non-urological complications of treatment and prognosis for prostate cancer patients diagnosed and treated in community hospitals. Additional information from a random sample of 505 prostate cancer patients (aged 40 years or older) from the Eindhoven Cancer Registry diagnosed between 1995 and 1999 was collected. In all, 43% of the prostate cancer patients aged 40-69 years and 64% of those aged 70 or older suffered from one or more serious concomitant disease that barely affected primary treatment choice. However, compared to patients without co-morbidity, patients with cardiovascular diseases underwent radical prostatectomy less often (P=0.01). In all, 38% of the patients undergoing radical prostatectomy suffered from complications during the first year after diagnosis versus about 20% of those receiving radiotherapy. The number of complications did not seem to be affected by co-morbidity. After adjustment for age, stage, grade, prostate-specific antigen level and treatment, the cumulative risk of death was almost two times higher for patients with two or more concomitant diseases than for patients without co-morbidity. After adjustment for age, prostate cancer patients with co-morbidity were not treated differently, did not suffer from more complications but had a worse prognosis, compared to those without co-morbidity.

Adult↗
PubMed2005

Angiotensin-converting enzyme gene insertion/deletion polymorphism and breast cancer risk.

BACKGROUND: The renin-angiotensin system plays an important role in homeostasis and lately, its main effector, angiotensin II, has been attributed with angiogenic and growth factor actions in the breast tissue. Previous studies have shown that the insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene accounts for the variability of ACE plasma concentrations. The use of ACE inhibitors and the ACE I/D polymorphism may be linked to breast cancer risk. In this study, we evaluate the relationship of the ACE I/D polymorphism with breast cancer risk in Caucasian postmenopausal women. METHODS: The ACE I/D polymorphism was genotyped in 4,117 women participants in the Rotterdam Study. Baseline information was obtained through a questionnaire. We conducted a logistic regression and survival analysis to assess the risk of breast cancer by the ACE genotype. RESULTS: The DD carriers showed a significantly increased risk of developing breast cancer when compared with the II carriers (odds ratio, 1.86; 95% confidence interval, 1.06-3.27; P = 0.03). This association remained after adjusting for other risk factors, including body mass index, age at menarche, age at menopause, hormone replacement therapy, and hypertension. Our survival analysis showed that the cancer-free survival was significantly reduced in DD compared with II carriers (hazard ratio, 1.80; 95% confidence interval, 1.07-3.01; P = 0.03). CONCLUSIONS: Our results suggest that the ACE I/D polymorphism plays an important role in breast cancer risk and disease-free survival in Caucasian postmenopausal women.

Aged↗
PubMed2004

Prognostic value of morphology and hormone receptor status in breast cancer - a population-based study.

We analysed the 5-year relative survival among 4473 breast cancer cases diagnosed in 1990-1992 from cancer registries in Estonia, France, Italy, Spain, the Netherlands and the UK. Among eight categories based on ICD-O codes (infiltrating ductal carcinoma, lobular plus mixed carcinoma, comedocarcinoma, 'special types', medullary carcinoma, not otherwise specified (NOS) carcinoma, other carcinoma and cancer without microscopic confirmation), the 5-year relative survival ranged from 66% (95% CI 61-71) for NOS carcinoma to 95% (95% CI 90-100) for special types (tubular, apocrine, cribriform, papillary, mucinous and signet ring cell); 27% (95% CI 18-36) for cases without microscopic confirmation. Differences in 5-year relative survival by tumor morphology and hormone receptor status were modelled using a multiple regression approach based on generalised linear models. Morphology and hormone receptor status were confirmed as significant survival predictors in this population-based study, even after adjusting for age and stage at diagnosis.

Aged↗
PubMed2004

[Passive smoking: an environmental health risk].

The supposed health risks of passive smoking are leading to increasingly restrictive legislation on smoking. Tobacco smoke is undoubtedly irritating to the eyes, nose and throat of non-smokers, but politicians wanted more spectacular facts. There is some evidence of fatal consequences of passive smoking, particularly increases in lung cancer and heart-disease mortality among non-smokers exposed to tobacco smoke. Most studies compare the non-smoking partners of smokers and non-smokers. The observed relative risks are too small to be ascertained reliably. The more than twentyfold increased risk of lung cancer among smokers and the presence of tobacco-related metabolites in non-smokers' body fluids lend support to the hypothesis that passive smoking causes lung cancer. The less than twofold increased risk of heart disease among smokers and the documented social-risk factors cast doubt on the validity of the increased risk of heart disease in non-smokers, associated with having a smoking partner. The precautionary principle regulates potential environmental health hazards: the suspicion and the hazard must be sufficiently serious to take legislative action. There is ample evidence of tobacco smoke's carcinogenicity and the accumulated knowledge strongly suggests that the legal threshold of an acceptable environmental health risk has been exceeded.

Cardiovascular Diseases↗
PubMed2003

[Trends in the incidence and prevalence of cancer and in the survival of patients in southeastern Netherlands, 1970-1999].

OBJECTIVE: To describe the changes in incidence, mortality, survival and prevalence of cancer since 1970 in the south-eastern part of the Netherlands, the registration area of the Eindhoven Cancer Registry. DESIGN: Descriptive population-based study. METHOD: Data were collected on all patients diagnosed with cancer between 1970 and 1999 in the south-eastern part of the Netherlands, the registration area of the Eindhoven Cancer Registry. Trends in age-specific and age-adjusted incidence, mortality, prevalence and relative survival were calculated. The changes in incidence were compared with changes in exposure to risk factors, such as smoking, alcohol, diet, infections and sunlight, and with early detection. RESULTS: The incidence of cancer of the stomach and uterine cervix decreased in the study period. Among men, the incidence of lung cancer increased sharply until the mid 1980s, whereafter it decreased. Furthermore, the incidence of cancer of the oesophagus, colon, rectum, breast, prostate and lung (in women), cutaneous melanoma and non-Hodgkin's lymphoma also increased. The survival improved for patients with cancer of the rectum, breast, female genital tract, prostate, testis (non-seminoma), cutaneous melanoma and Hodgkin's disease. The improvement in survival could be explained in part by early detection and partly by the improvement in treatment strategies. The prevalence of the diagnosis 'cancer' in living subjects increased by almost 30%, which may be related to the increase in incidence and the improvement in survival. CONCLUSION: There was an alarming increase in tumours related to exposure to tobacco and alcohol, especially in women. Improved diagnostic techniques and treatment strategies coincided with improved prognosis. This was associated with an increased demand for health care.

Adolescent↗
PubMed2003

[Mortality due to smoking in the Netherlands: 1.2 million tobacco-related deaths between 1950 and 2015].

OBJECTIVE: To quantify the medical consequences of the tobacco use in the Netherlands for the past 50 years and the near future. DESIGN: Theoretical study based on the national death records and published risks by cause of death of tobacco use. METHOD: Observed lung cancer mortality (1950-1999) was related to birth cohort and age by a statistical model (according to Peto), and then projected into the near future. The smoking intensity was defined as the difference between the expected lung-cancer mortality if no one smoked and the observed lung-cancer mortality. Using this smoking intensity and published risks for other smoking-related causes of death, the model provided estimates of smoking-related mortality by age, sex and cause of death. RESULTS: In 1999, 18% (women) and 32% (men) of all mortality before the age of 70 was attributable to smoking. If no one had smoked, Dutch life expectancy for men and women would have been 3 years and 1 year higher, respectively. Between 1950 and 1999, 13% of all deaths were caused by smoking, the large majority (> 90%) of which occurred among men. Between 2000 and 2015, slightly more deaths are to be attributed to smoking (14%), 62% of which will be among men. In 2015, women will have caught up with men in terms of absolute numbers of lung-cancer mortality. CONCLUSION: Around one quarter of premature deaths were caused by smoking. In the near future, women of the baby-boom generation will have reached middle age and the highest (relative) smoking-related risks. It is important that clinical practice takes this increased risk of disease into account among middle-aged women who smoke.

Adult↗
PubMed2003

Cancer survival in European adolescents and young adults.

Survival of patients aged 15-24 years, diagnosed with cancer during the period of 1990-1994, is described within Europe. Data on 15101 patients, extracted from the files of the 56 adult cancer registries included in the EUROCARE-3 database, representing 20 European countries, were analysed and compared. Five-year survival for 'all cancers combined' was 75% in males (ranging from 59% in Estonia to 89% in Iceland), and 78% in females (ranging from 59% in Estonia to 89% in Norway). The Northern European countries (except Denmark) and Austria had the highest survival figures, while survival in the Eastern European countries was lower than the European average. Denmark, UK, and the pool of the central European countries, had intermediate survival figures. Haemopoietic tumours were the most common malignancies: 5-year survival was high for Hodgkin's disease (89%), intermediate for non-Hodgkin's lymphoma (68%) and lower for acute lymphoblastic leukaemia (ALL) (47%) and acute myeloblastic leukaemia (AML) (39%). Five-year survival for gonadal germ cell cancers, the second most common malignancy in young adults, was 90%. Five-year survival for the other cancers under consideration was as follows: 89% for skin melanoma, 66% for all Central Nervous System (CNS) tumours, 57% for bone tumours, 58% for osteosarcoma, 42% for Ewing's sarcoma, 57% for soft-tissue sarcomas, 99% for thyroid carcinoma, 82% for uterine cervical carcinoma, and 83% for ovarian carcinoma. For more 'adult-specific tumours', 5-year survival was good for colon (77%) and lung (60%) cancers, and less favourable, compared with adults, for breast cancer (68%). Adolescents (15-19 years) had significantly worse survival than young adults (20-24 years) for all malignancies combined. Survival for Hodgkin's lymphoma, CNS tumours, melanoma and colon cancer showed marked regional variability. Since many of the tumours occurring in young adults are curable, these results should encourage, without delay, efforts to identify obstacles to improving outcome and reducing geographical inequalities in survival for this group of patients.

Adolescent↗
PubMed2003

Differences in the epidemic rise and decrease of prostate cancer among geographical areas in Southern Europe. an analysis of differential trends in incidence and mortality in France, Italy and Spain.

This is a population-based study aimed at evaluating incidence and mortality trends for prostate cancer in France, Italy and Spain, during the prostate-specific antigen (PSA) era, considering elderly people aged 70 years and over and younger adults aged between 40 and 69 years. Trends were estimated by a log-linear Poisson regression model and expressed as an Estimated Annual Percent Change (EAPC). Incidence increased sharply in almost all areas. Spain showed the lowest increases. Incidence started to rise around 1985 in France and after 1990 in Italy and Spain. Mortality increased until the late 1980s in all countries, then declined in France and Italy (-2.5% in 40-69 year age group), but not in Spain. Younger people showed a much higher rise in incidence than the elderly, while mortality decreased mainly in the younger adults. The decrease in mortality was more marked in those areas and the younger age group where the rise in incidence was higher and started earlier, i.e. in France and in younger people, suggesting that the PSA test may have had a positive effect on mortality, although other clinical advances also have to be taken into account.

Adult↗
PubMed2003

European health systems and cancer care.

INTRODUCTION: Data on the survival of all incident cases collected by population-based cancer registries make it possible to evaluate the overall performance of diagnostic and therapeutic actions on cancer in those populations. EUROCARE-3 is the third round of the EUROCARE project, the largest cancer registry population based collaborative study on survival in European cancer patients. The EUROCARE-3 study analysed the survival of cancer patients diagnosed from 1990 to 1994 and followed-up to 1999. Sixty-seven cancer registries of 22 European countries characterised by differing health systems participated in the study. This paper includes essays providing brief overviews of the state and evolution of the health systems of the considered countries and comments on the relation between cancer survival in Europe and some European macro-economic and health system indicators, in the 1990s. OVERVIEW OF THE EUROPEAN HEALTH SYSTEMS: The European health systems underwent a great deal of reorganisation in the last decade; a general tendency being to facilitate expanding involvement of the private sector in health care, a process which occurred mainly in the eastern countries (i.e. the Czech Republic, Estonia, Poland, Slovakia and Slovenia). In contrast, organisational changes in the northern European countries (i.e. Denmark, Iceland, Finland and Sweden) tended to confirm the established public sector systems. Other countries, including the UK and some southern European countries (i.e. England, Scotland, Wales, Malta and Italy) have reduced the public role while the systems remain basically public, at least at present. Our findings clearly suggest that cancer survival (all cancer combined) is related to macro-economic variables such as the gross domestic product (GDP), the total national (public and private) expenditure on health (TNEH) and the total public expenditure on health (TPEH). We found, however, that survival is related to wealth (GDP), but only up to a certain level, after which survival continues to be related to the level of health investment (both TNEH and TPEH). According to the Organisation for Economic Co-operation and Development (OECD), the TNEH increased during the 1990s in all EUROCARE-3 countries, while the ratio of TPEH to TNEH reduced in all countries except Portugal. CONCLUSIONS: Cancer survival depends on the widespread application of effective diagnosis and treatment modalities, but our enquiry suggests that the availability of these depends on macro-economic determinants, including health and public health investment. Analysis of the relationship between health system organisation and cancer outcome is complicated and requires more information than is at present available. To describe cancer and cancer management in Europe, the European Cancer Health Indicator Project (EUROCHIP) has proposed a list of indicators that have to be adopted to evaluate the effects on outcome of proposed health system modifications.

Community Health Planning↗
PubMed2001

The genetic epidemiology of glioma.

With traditional epidemiologic research designs, few environmental risk factors for malignant brain tumors have been revealed, and although syndromes exist where brain tumors occur frequently, these explain a small proportion of the overall incidence. In a similar way, the search for genetic causes has been thwarted by the rarity of families with multiple affected relatives, inhibiting genetic linkage, sib-pair, or even population-based association studies. Molecular genetic studies generally involve searching for candidate proto-oncogenes and tumor suppressor genes by comparing DNA from tumor material with constitutional (germline) DNA. However, it remains difficult to distinguish causative genetic aberrations from chaotic neoplastic processes, and studies so far have not yielded consistent information on the location of such causative genetic lesions. The current literature covering the molecular genetics of glioma is discussed herein and alternative approaches that can be used to identify genetic causes of glioma described.

Adult↗
PubMed2001

[Melanoma of the skin: excision policy and pathology report writing in the 'Integraal Kankercentrum Zuid' region is in accordance with the guideline in slightly more than half of the patients].

OBJECTIVE: To determine the extent to which the guidelines for cutaneous melanoma had been implemented in the diagnostic and treatment approach of general hospitals. DESIGN: Retrospective, descriptive. METHOD: Patients were selected via the cancer registration system of the 'Integraal Kankercentrum Zuid' (Integral Cancer Centre South, the Netherlands). They were submitted through the pathology laboratory by 1 of the 16 general hospitals in the region. Data was collected from the pathology (PA) reports of the 573 patients for whom a cutaneous melanoma was diagnosed in 1988, 1993 and 1997. The treatment policy and the PA reports were compared with the recommendations in the guidelines concerned and the revised versions of these published in 1985, 1990 and 1997. The patients studied were 212 men (37%) and 361 women (63%) with an average age of 51 years (range 13-96). RESULTS: A diagnostic excision was performed in 485/573 patients (85%). Invasiveness was assessed in 99% of the preparations; in 14% a melanoma was encountered in situ. Invasive melanomas were less often seen in the head and neck region than on the trunk or limb. Thickness of the tumour was not determined in 8% of all 493 invasive tumours and in 19% the pathology report did not state whether the diagnostic biopsy was performed radically. In accordance with the guidelines, diagnostic excision biopsy was first performed in 59% of patients with a subsequent re-excision if necessary; 77% of the PA reports satisfied the fundamental recommendations from the guidelines. For 55% of the patients the diagnostic and therapeutic procedures as well as the pathology report were completed in accordance with the guideline recommendations. Modest improvement occurred over time. CONCLUSION: The excision and re-excision policies as well as the pathology report writing concurred with the recommendations in the consensus for cutaneous melanoma in slightly more than half of the patients who were diagnosed within the IKZ region in the years 1988, 1993 and 1997.

Adolescent↗