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Biomedical subjects

S O Thoresen

Publications and source records attributed to S O Thoresen.

At least 19 recordsLinked to original sources
PubMed2001

Mammography screening in Norway: results from the first screening round in four counties and cost-effectiveness of a modeled nationwide screening.

OBJECTIVE: To evaluate whether the results of the first screening round in the Norwegian Breast Cancer Screening Program predict future mortality reduction and to explore the cost-effectiveness of the program. METHODS: The results of surrogate measures were calculated and compared with the targets. A cost-effectiveness analysis was performed assuming a nationwide program starting in 1996 with an attendance rate of 80% and a mortality reduction of 30%. RESULTS: The attendance rate was 79.5% and the detection rate was 0.67%. The proportion of invasive tumors smaller than 15 mm was 53.1%, and 21.7% of the patients who underwent axillary surgery had lymphatic metastasis. The C/E ratios were found to be 3750 US dollars (USD) per year of life saved and 86,045 USD per life saved. CONCLUSION: The results of the first screening round will lead to a mortality reduction of at least 30%. The cost-effectiveness analysis shows that it is possible to run a highly cost-efficient screening program in Norway.

Aged↗
PubMed2000

Histopathologic subtyping of cervical adenocarcinoma reveals increasing incidence rates of endometrioid tumors in all age groups: a population based study with review of all nonsquamous cervical carcinomas in Norway from 1966 to 1970, 1976 to 1980, and 1986 to 1990.

BACKGROUND: The effect of histopathologic review and subclassification on incidence rates for nonsquamous cell carcinoma (non-SCC) of the uterine cervix in the Norwegian population was evaluated. METHODS: All non-SCC from three 5-year periods (1966-70, 1976-80, and 1986-90) were reviewed, classified, and graded. RESULTS: Incidence rates were 1.2, 1.2, and 1.7 per 100,000 for adenocarcinoma and 0.1, 0.3, and 0.5 per 100,000 for other carcinomas in the three periods. Adenocarcinomas increased in all age groups, most markedly in women younger than 35 years. Incidence rates for both major subgroups of endocervical (EC) and endometrioid (EM) carcinomas increased for women younger than 55 years. After 1976-80, the incidence rate for EC, but not for EM, decreased in women older than 55 years. Endometrioid carcinoma became the dominant histologic subtype in 1986-90. Shifts toward lower clinical stages and younger age were found for EC, EM, and carcinoma not otherwise specified (NOS). Patients with NOS, clear cell, serous, or glassy cell/undifferentiated carcinoma were older, and their disease was diagnosed at higher stages. Distribution of International Federation of Gynecology and Obstetrics (FIGO) stages was: Stage I: 62%; Stage II: 21%; Stage III: 12%; and Stage IV: 5%. Distribution of histologic subgroups was: EC:, 24%; EM: 21%; NOS: 16%; clear cell: 7%; adenosquamous: 7%; small cell: 6%; serous: 4%; undifferentiated: 3%; and villoglandular carcinoma: 2%. Other subgroups were seen only sporadically. CONCLUSIONS: Incidence rates of non-SCC of the uterine cervix are increasing in Norway. Improvements in diagnostic procedures may explain shifts toward lower stage and age of patients but not the observed differences between histologic subgroups.

Adenocarcinoma↗
PubMed2000

Ductal carcinoma in situ of the breast--a review of diagnosis, treatment and outcome in a hospital-based Norwegian series.

Between 1980 and 1994, 71 women with histologically proven ductal carcinoma in situ (DCIS) were diagnosed at Ullevål Hospital; bilateral tumours were found in two patients. Surgical treatment was mastectomy (42 lesions) or local excision (31 lesions). Median follow-up time was 7.2 years. Ten patients experienced a local recurrence, seven of which were invasive carcinomas. The actuarial 5-year local recurrence rate was 22% after local excision. A multivariate analysis found that tumour size was the only factor that predicted local recurrence after local excision. An analysis of relative survival in a nation-wide material of 832 DCIS patients in the period 1980 to 1994 demonstrates that relative survival after a DCIS diagnosis is almost 100%, irrespective of surgical treatment of the initial lesion.

Adult↗
PubMed1999

[Cost-effectiveness of mammography screening in Norway].

Since January 1996, mammography screening every second year has been offered to women aged 50 to 69 in four counties in Norway. As an input to the evaluation of the programme, medical authorities commissioned an analysis of the cost-efficacy of screening. The results are presented in this paper. This study of the screening in the City of Oslo is based on registration of time used on various procedure, data for all procedure performed, and financial accounting data. The result have been recalculated for a simulated nation-wide project. Only costs up to the time of diagnosis (malignant/benign) have been included. The total cost of the Oslo programme 1996/97 was NOK 12.1 m (USD 1.6 m). Cost per women examined was NOK 395 and per cancer detected NOK 57,639. Cost per life saved was estimated at NOK 680,000, per year-of-life saved NOK 30,000. Based on accounting data only, comparisons could be made between counties. Costs in other counties were between 39 and 73% higher than in Oslo. Using an estimate of a 40% higher costs nation-wide, we find that the total cost of one year of nation-wide (population 4.5 m) screening would amount to NOK 83 m, cost per life saved to NOK 950,000, and per year-of-life saved to NOK 41,000. Estimated cost per life saved by traffic safety measures has been NOK 10 m. On this basis, mammography screening in Norway seems to be a highly cost-effective measure.

Breast Neoplasms↗
PubMed1998

Breast cancer in Norway 1970-1993: a population-based study on incidence, mortality and survival.

The incidence, mortality and survival of breast cancer patients from 1970 to 1993 were studied using data from the Cancer Registry of Norway. The age-adjusted incidence rate increased from 62.0 to 76.9 per 100,000 person-years during the period, and more than 2000 cases are now registered annually. The increase tends to be highest in the age group below 40 years. The increase is mainly found in cases with localized tumours at the time of diagnosis. The mortality rate has been almost unchanged in the period; the age adjusted mortality rate is 27.0 per 100,000 person-years at the end of the study period. The 5-year overall survival has increased among cases with axillary lymph node metastases at the time of diagnosis; the other stages show only little improvement.

Adolescent↗
PubMed1997

[Mass screening for cervical cancer. Experiences after 25 years of voluntary screening and 2 years of organized screening].

In 1990 the Norwegian Ministry of Health and Social Services initiated an organised screening programme for cervical cancer, the main goal of which is to reduce the incidence of and mortality from cervical cancer in Norway. All women aged between 25-69 years are offered screening every third year. In the first three years of the programme, all voluntary screening was reported to The Cancer Registry of Norway. This showed that a high number of smear tests were carried out on young women, against a low rate of smear tests on older women. Since January 1995 invitations have been sent to all women aged between 25-69 years, where there is no record of a smear test having been done in the last three years. Results so far show that the number of women who have had a smear test done in the last three years is increasing in the older age groups. A total of 2.6 million smears have been recorded. Approximately 90% of the smears were normal, only 1.7% showing signs of dysplasia. All pathological smears will be followed up with a reminder either from the laboratories or The Cancer Registry.

Adult↗
PubMed1997

Uterine sarcomas in Norway 1956-1992: incidence, survival and mortality.

A total of 1042 patients diagnosed with uterine sarcoma were reported to The Cancer Registry of Norway from 1956 to 1992. In the present study long-term trends in incidence, survival and mortality were analysed. To evaluate the effect of the introduction of chemotherapy in the treatment of this disease, special attention was paid to the time periods 1971-1975 and 1983-1987. The reporting system is based on pathology reports, clinical records and death certificates. Histological type, diagnostic period, clinical stage and age were included in the study. The analysis of survival was based on 5-year relative survival. Both the incidence and mortality rate of uterine sarcomas in Norway doubled in the time period 1956-1992, mainly due to an increase of carcinosarcomas. The overall annual incidence rate in 1987-1992 was 1.7 per 100000 females in the population per year, accounting for 9.7% of all uterine corpus malignancies. In 1990-1992, 26% of the mortality due to uterine corpus malignancies was caused by sarcoma. No change in 5-year survival was seen after the introduction of chemotherapy in the treatment of the disease (P = 0.35). Stage (P < 0.001) and age (P < 0.001) were both important prognostic factors. Patients with an endometrial stromal sarcoma (P < 0.001) had a more favourable prognosis than those with other histological types.

Adult↗
PubMed1995

Second primary cancers in patients with carcinoma in situ of the uterine cervix. The Norwegian experience 1970-1992.

Multiple primary cancers in the same individual occur rarely. Consequently, a large number of cancer patients have to be followed for long periods to obtain adequate information about their risk of subsequent tumour development. Studies of multiple malignancies are of interest, since they may provide information on common or opposite risk factors. In the present study, the risk of second primary cancers following carcinoma in situ of the uterine cervix diagnosed in Norway in the period 1970-1992 was examined and quantified. Altogether, 37,001 patients with carcinoma in situ were followed from the date of diagnosis until 31 December 1992. The follow-up period was divided into 5-year intervals. The results were expressed as standardized incidence ratios (SIR = O/E), and their 95% confidence intervals were given. A total of 1,037 second primary cancers in 989 individuals were identified. There was no overall excess of second primary cancers. However, there were differences depending on the site: cancers of the oesophagus, nose, nasal cavities, trachea, bronchus, lung, vulva, vagina, bladder and other urinary organs, and other skin cancers, excluding basal-cell carcinoma, occurred more frequently. A lower risk than expected was noted for cancer of the cervix uteri and cancer of the corpus uteri. There was a rising trend with time in the observed/expected ratio for cancer of urinary organs. In the group of patients evaluated, the likelihood of subsequent tumour development was no greater than in the general female population. Nevertheless, cancer sites of higher and of lower risk than expected were identified among the carcinoma-in situ patients.

Adolescent↗
PubMed1995

Mass screening for cervical cancer in Norway: evaluation of the pilot project.

The Norwegian Department of Health and Social Affairs initiated a national screening program for cervical cancer in 1990, with all women aged 25 to 70 years to be offered cervical screening every three years. During the first three years of the program (November 1991-October 1994), all spontaneous cervical cytology in Norway was recorded at the Norwegian Cancer Registry. In addition, women in the counties of Vestfold and Sør-Trøndelag were invited individually to be screened. The aim of the present study was principally to evaluate the organization aspects of a nationwide, population-based screening program for cervical cancer in Norway. Special attention was paid to the coverage, the attendance rate, and the cytologic findings in the two-county study area. A total of 1,581,379 Pap smears were recorded from November 1991 to October 1994. Most smears were taken from women under age 30 years (31.7 percent). About 25 percent of the women aged 25 to 29 years had more than one normal smear. In the study area, a coverage of about 71 percent in the age group 25 to 69 years was achieved. The pilot project also has shown that it is possible to recruit elderly women into screening. However, no difference was noted between the study and the reference area with regard to findings per smear of precursor lesions (CIN 3, modified SNOMED coding system). The experiences from three years of recording and the implementation of the pilot project have provided useful guidelines for the national screening which began in January 1995.

Adult↗
PubMed1994

[Mass screening for cervical cancer. A one-year registration of cervical cytological tests].

In 1990 the Norwegian Ministry of Health and Social Affairs decided to start an organised screening programme for cervical cancer. All women aged 25-70 years will be offered screening every three years. During the first three years of the programme, all spontaneous screening in Norway is to be reported to a central unit located at the Cancer Registry of Norway. A pilot project has been implemented in the counties of Sør-Trøndelag and Vestfold to evaluate the organisational aspects of the screening programme. A total of 509,641 smears were recorded during the first year of recording. The majority of smears were taken from women below 50 years. Most smears (88.6%) had normal tissue morphology, while 2.9% displayed various cellular changes. Smears from younger women showed the highest rate of Human papillomavirus (HPV) changes and mild (CIN 1) and moderate (CIN 2) dysplasias, whereas the rated malignant cellular changes was highest in the older age groups. The findings support the wide age range of the target group.

Adolescent↗
PubMed1994

Cervical mass screening in Norway--510,000 smears a year.

In 1990 the Norwegian Department of Health and Social Affairs decided to start a national screening program for cervical cancer. All women aged 25 to 70 years are offered cervical screening every 3 years. The mass screening is organized and run by a central unit, comprising the Cancer Registry of Norway and the National Health Screening Service. For the first 3 years, all spontaneous cervical screening in Norway is recorded in a central, computerized register. In addition, a pilot project has been implemented in two counties to evaluate the organizational aspects of the screening program. A total of 509,641 cervical smears were recorded during the first year of registration. The test frequency was highest in the age group 20 to 29 years (28.4%), while relatively few tests were performed on women in the age group 60 to 69 years (6.6%). The majority of smears (88.6%) had normal tissue morphology, whereas 2.9% displayed different cytological abnormalities. Human papillomavirus (HPV) changes and mild (CIN 1) and moderate (CIN 2) dysplasia had the highest smear rate in women under 40 years. Malignant cellular changes had the highest rate in older age groups. The imbalance in the age distribution of smears and the confinement of cytological abnormalities to the youngest and the oldest age groups support the wide target age range of the screening program.

Adolescent↗