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Biomedical subjects

A Mellemgaard

Publications and source records attributed to A Mellemgaard.

At least 37 records · Page 2Linked to original sources
PubMed1994

Risk factors for renal-cell carcinoma in Denmark. III. Role of weight, physical activity and reproductive factors.

A population-based case-control study of risk factors for renal-cell carcinoma was conducted in Denmark from 1989 to 1992. A total of 368 histologically verified cases and 396 controls were included. Information on weight, height, physical activity and reproductive factors were collected in a structured interview, along with information on other suspected risk factors. A significant increase in risk was seen for obese women but not obese men. Although there was no clear gradient, the risk was highest among women with a relative weight in the upper 5% (OR 6.1; 95% CI, 2.3 to 16.1). The increased risk was most evident for high relative weight in ages 30 to 50. No association was observed for height or physical activity. Use of amphetamines was associated with increased risk but, because of the close link with obesity, we were unable to provide evidence that amphetamines are an independent risk factor. We found some evidence for an association with reproductive variables, including decreased risk for women with late menarche and first pregnancy and birth. We observed no association with number of pregnancies or age at menopause, or use of estrogen-containing medication.

Adult↗
PubMed1994

Risk factors for renal cell carcinoma in Denmark. I. Role of socioeconomic status, tobacco use, beverages, and family history.

Risk factors for renal cell carcinoma were examined in a population based case-control study in Denmark. A total of 368 cases and 396 age- and gender-matched controls were interviewed in their homes. Increased risk was associated with low socioeconomic status. For men, an increasing risk with decreasing socioeconomic status was seen (odds ratio [OR] = 2.2, 95 percent confidence interval [CI] = 1.0-4.6 for men in the lowest socioeconomic stratum cf the highest). For women, the risk was lower in the highest socioeconomic stratum compared with the rest (OR = 2.4, CI = 0.9-5.9 for the lowest strata cf the highest). Cigarette smoking was a risk factor in men with an OR = 2.3 (CI = 1.1-5.1) for cigarette smokers with a total consumption of more than 40 pack-years compared with nonsmokers. Family history of kidney cancer was associated with an increased risk in both genders (for men, OR = 4.1, CI = 1.1-14.9; for women, OR = 4.8, CI = 1.0-23). Observations were inconsistent regarding coffee and alcohol consumption, and we found no association with tea drinking. The association with socioeconomic status remained after adjustment for other factors.

Adult↗
PubMed1994

Obesity and cancer risk: a Danish record-linkage study.

A cohort of 43,965 obese persons was accrued on the basis of discharge registrations from Danish hospitals, and incidence of cancer in the cohort was compared to that in the Danish population as a whole using indirect standardisation for age and period. Increased incidence was observed for cancer of the uterine corpus independently of age [114 cases, relative risk (RR) = 2.0, confidence interval 1.6-2.4], and for breast cancer in women above the age of 70 (133 cases, RR = 1.2). These findings are consistent with previous studies. In younger women, breast cancer occurred less frequently and ovarian cancer occurred more frequently than expected. Increased incidence was observed for cancers of the oesophagus (26 cases, RR = 1.9) and the liver (58 cases, RR = 1.9), probably reflecting an increased prevalence of excessive alcohol consumption in the cohort. Increased incidence was furthermore observed for cancers of the pancreas (101 cases, RR = 1.7), the prostate (96 cases, RR = 1.3) and the colon (195 cases, RR = 1.2), which may indicate the existence of risk factors which are common to obesity and to these cancers, for example, dietary habits. Kidney cancer was increased in women only. Overall, the incidence of cancer was increased by 16% in the cohort. The results were essentially unchanged by restriction to the subcohort of 8207 persons in whom obesity was the primary discharge diagnosis, and were also similar in the first year of follow-up after hospital discharge. Selection bias is, therefore, not likely to have influenced the results.

Adolescent↗
PubMed1994

Risk factors for renal cell carcinoma in Denmark: role of medication and medical history.

BACKGROUND: Several recent studies of risk factors for renal cell carcinoma have indicated that use of diuretics may increase risk of this cancer. It has also been suggested that use of weak analgesics, which are known to increase risk of cancer of the renal pelvis and ureter, may also be associated with an increased risk of renal cell carcinoma--the most frequent type of kidney cancer. METHODS: A population-based case-control study was undertaken to investigate the role of diuretics, other anti-hypertensive drugs, analgesics, and medical history in the aetiology of renal cell carcinoma. The study base was the total Danish population, and 368 histologically verified cases and 396 sex- and age-matched controls who were interviewed from February 1989 to May 1992. RESULTS: Response rates were 76% among cases and 79% among controls. We found no general increase in risk among users of diuretics or analgesics, although women taking loop diuretics and heavy users of acetyl salicylic acid had slightly increased risks. The use of nondiuretic anti-hypertensive medications was associated with decreased risk in women. We found non-significantly increased risks for history of hypertension and other cardiovascular disorders. We also observed elevated risks for urological disorders in both sexes which may be a result of recall bias. CONCLUSION: This study provides only limited support for the suggested association between risk of renal cell carcinoma and use of diuretics and analgesics. The coexistence of renal cell carcinoma and cardiovascular diseases could be caused by risk factors that are common to these conditions.

Adult↗
PubMed1994

Risk of kidney cancer and other second solid malignancies in patients with chronic lymphocytic leukemia.

Patients with chronic lymphocytic leukemia (CLL) are known to to have an increased incidence of secondary cancers. We investigated the occurrence of secondary cancers in 7391 patients with CLL diagnosed between 1955 and 1988. The observed number of cancer cases was compared with the expected number of cancers calculated from national cancer incidence rates. The overall risk of cancer was significantly increased among persons with CLL. The standardized incidence ratios (ratio between the observed and the expected numbers) were 2.0 for men and 1.2 for women. Increased risks were found for cancer of the lung and prostate in men (RR = 2.0 and 1.5 respectively), renal parenchyma in both sexes (RR = 2.8 for men, RR = 3.6 for women) non-melanoma skin cancer in both sexes (RR = 4.7 for men, RR = 2.4 for women) and sarcomas (RR = 3.3 for men, RR = 2.8 for women). Although an increased risk of cancer is to be expected solely because individuals with CLL are being physically examined frequently, it appears that the risk is significantly increased for a number of cancer sites in persons with CLL.

Confidence Intervals↗
PubMed1994

Occupational risk factors for renal-cell carcinoma in Denmark.

OBJECTIVES: Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remains enigmatic. Time trends in incidence and changes in the regional distribution of this cancer are suggestive of environmental risk factors. This study reports on occupational risk factors for renal-cell carcinoma in Denmark. METHODS: In a population-based study, 365 persons with histologically verified renal-cell carcinoma and 396 referents were interviewed. Information was collected on occupation, education, and occupational exposure to a number of suspected substances, including hydrocarbons, asbestos, and radiation. RESULTS: Risk of renal-cell carcinoma was found to be associated with employment as a truck driver, exposure to gasoline, other hydrocarbons, and insecticides and herbicides. The risk of renal-cell carcinoma was higher in the lower socioeconomic strata for both the men and the women. Nonsignificantly elevated risks were observed for employment in oil refineries, gasoline stations, and the iron and steel industry. No association was found for exposure to radiation or for employment in industries such as leather manufacturing and health care, which have previously been linked to an increased risk of renal-cell carcinoma. CONCLUSIONS: The risk of renal-cell carcinoma is increased in lower socioeconomic strata, and previously identified or suspected risk factors do not explain the excess in risk. This study adds additional support to the hypothesis of a link between renal-cell carcinoma and hydrocarbons and also demonstrates the need for further studies on occupational risk factors for renal-cell carcinoma.

Adult↗
PubMed1993

Risk of kidney cancer among patients using analgesics and diuretics: a population-based cohort study.

The aim of this study was to determine the risk of kidney cancer in 2 cohorts defined on the basis of hospital discharge diagnoses associated with analgesic or diuretic use during the period 1965 to 1983. Patients were followed up through 1984 for cancer incidence. After excluding cancers in the first year of observation, 161 kidney cancers were observed vs. 138 expected among 54,662 patients in the analgesics cohort. The relative risk was higher for women than for men. When examined by sub-site within the kidney, risk for cancer of the renal pelvis was similar in magnitude to that for the renal parenchyma. Among 115,616 patients in the diuretics cohort, 278 kidney cancers occurred vs. 209 expected. The risk for women was higher than for men. This elevation in risk was confined to cancer of the renal parenchyma, with no significantly increased risk seen for cancer of the renal pelvis. Although we observed little excess risk among members of the analgesics cohort, the significantly elevated risk among patients using diuretics supports a number of recent studies, but inability to adjust for confounding factors such as obesity preclude drawing any conclusion regarding diuretics. Further research is warranted to assess in detail the relationship between diuretic use and cancer of the renal parenchyma.

Aged↗
PubMed1993

[Unrecognized Hodgkin's disease as cause of death. A review of 27 cases diagnosed post mortem].

The purpose of the study was to examine the incidence of unrecognised Hodgkin's disease (HD) as cause of death and to search for clinical features that could have ensured a correct pre-mortem diagnosis. A review of cases of HD reported to the Danish Cancer Registry from 1976 through 1987 in patients younger than 70 years old disclosed 27 where HD was the primary cause of death and the diagnosis was unrecognised at the time of death. The majority of the patients had no concurrent diseases and may have benefitted from a correct diagnosis and a potentially curative treatment. Most of the patients had persistent unexplained fever and weight loss. Pancytopenia, hepatic involvement, bone marrow involvement, advanced stage disease, and lymphocytic depletion histology were also frequent findings. Peripheral or retroperitoneal lymphadenopathy was noted in nine patients without biopsy. The many uncommon features of HD together with the frequent findings of falsely negative chest X-ray, bone marrow examination, liver biopsy, and abdominal ultrasound contributed to the difficulty in diagnosis. However, in about 1/3 of the patients clinical findings suggestive of lymphoma did not result in relevant diagnostic procedures.

Aged↗
PubMed1993

Colorectal cancer in Denmark 1943-1988.

Nation-wide incidence rates are presented of colorectal cancer in Denmark from 1943 to 1988. In Denmark notification of malignant and related diseases is mandatory. The percentage of histologically confirmed tumours is now 95. The annual incidence rate of colon cancer in Denmark has been increasing among men and women combined from 684 cases in 1943-47 to 2020 cases in 1988. In the same period the incidence of rectal cancer has been increasing from 762 cases in 1943-47 to 1108 cases in 1988. We analyzed the effects of age, calendar time, and birth cohort with multiplicative Poisson models. We did not find consistent period effects in the models. We suggest the trends in colorectal cancer incidence rates may be due to changes in environmental factors such as dietary habits and in physical activity. Furthermore, we suggest an etiologic distinction between carcinoma of the rectum, the left colon and the right colon.

Cohort Effect↗
PubMed1993

Increased incidence of sarcoma in patients treated for testicular seminoma.

In a nationwide cancer registry analysis of second primary malignancies in 6187 men with testicular cancer in the period 1943-1987, 13 sarcomas were found, yielding a 4-fold increase of the relative risk (RR). The majority of sarcomas occurred in men with seminoma, and the increased incidence was seen irrespectively of time since the diagnosis of testicular cancer. The interval between the testicular cancer and the sarcoma varied from 5-34 years. After investigation of the hospital records and re-examination of the histological specimens, 3 patients were excluded. In spite of this, the RR was still considerably increased (at least 3-fold). Seven of the 10 sarcomas were found to be located within the field of the radiation treatment administered and three at the periphery. The absolute number of these secondary sarcomas is low, but the risk of developing such neoplasms and other malignancies should, even so, be kept in mind in the follow-up of testicular cancer patients.

Adult↗
PubMed1993

Incidence of second primary cancer following testicular cancer.

The incidence of second primary cancers was investigated in 6187 Danish men diagnosed with testicular cancer in the period 1943-1987. During the course of 59,000 person years, 459 subsequent primary cancers occurred. The relative risks were significantly increased for leukaemia, gastric cancer, pancreatic cancer, bladder cancer, non-melanoma skin cancer and kidney cancer. Increased incidence was furthermore suggested for cancer of the rectum, prostate and lung. The increased incidence of leukaemia appeared in the first 10 years after testicular cancer diagnosis. The excess incidence for gastric cancer, pancreatic cancer, rectal cancer and lung cancer was strongest 10-19 years after testicular cancer, while the relative risk of non-melanoma skin cancer and prostate cancer increased throughout the period of follow-up. The increased incidence of cancer in this cohort is most likely an effect of radiotherapy used for testicular cancer. It is proposed that the different incidence patterns over time after testicular cancer diagnosis reflect differences in the growth rate of tumours originating in different tissues.

Adult↗
PubMed1993

Hodgkin's disease diagnosed post mortem: a population based study.

All cases of Hodgkin's disease (HD) notified to the Danish Cancer Registry from 1976 through 1987 in patients less than 70 years old were reviewed in order to identify patients in whom a correct diagnosis was established only post mortem. The case records of such patients were reviewed in a search for clinical features that could have ensured a correct pre mortem diagnosis. HD was diagnosed after death in 31 patients in this unselected population based study and thus constituting only 2.4% of all patients less than 70 years with HD, but 14.1% of the group aged 65-69 years. Most patients were identified during the first part of the study period, which may reflect a decreasing autopsy rate. HD was considered to be a coincidental finding in four patients and the primary cause of death in 27 patients. Among the later 27 patients a number of unfavourable prognostic factors were a common finding: persistent unexplained fever and weight loss, pancytopenia, hepatic involvement, bone marrow involvement, advanced stage disease, and lymphocytic depletion histology. However, most of the patients had no concurrent diseases and may have benefitted from a correct diagnosis and a potentially curative treatment. The many uncommon features of HD together with the frequent findings of falsely negative chest X-ray, bone marrow examination, liver biopsy, and ultrasound contributed to the difficulty in diagnosis. In about 1/3 of the patients clinical findings suggestive of lymphoma did not result in relevant diagnostic procedures.

Aged↗
PubMed1993

Trends in the incidence of cancer of the kidney, pelvis, ureter and bladder in Denmark 1943-88.

Temporal trends in the incidence of cancer of the renal parenchyma, renal pelvis, ureter, bladder, urethra and Wilm's tumor in the period 1943-88 were described. Log-linear Poisson models were used to estimate the changes over time and the geographical variations. We have found a steep increase in the incidence of pelvis and ureter cancer; and to some extent also for bladder cancer in men. The incidence of cancer of the renal parenchyma has increased more moderately while the rates of Wilm's tumor have been virtually stable throughout the period. These findings suggest that tumors in the urinary system differ with respect to risk factors and should be grouped by their histological origin as well as topographical site.

Adult↗
PubMed1993

Survival of Danish cancer patients 1943-1987. Urinary tract.

The 15,160 males and females diagnosed with kidney cancer in Denmark in the period 1943-87, and eligible for inclusion were covered in the analysis. Crude and relative five-year survival from this cancer has improved with calendar time, especially for men. For patients diagnosed in 1943-47, the relative five-year survival was 18% for men and 29% for women; for those diagnosed in 1983-87, it had improved to 35 and 36%, respectively. Patients with localized tumours at the time of diagnosis had a more favourable prognosis than those with disseminated disease, with a five-year survival of 51% for men and 53% for women; people of each sex with metastatic disease had a five-year survival of only 3%. Treatment of kidney cancer throughout the period was surgical removal of the kidney and lymph nodes. The moderate improvement in survival seen with calendar time may be due to better, more efficient surgical techniques. The 32,701 patients diagnosed with cancer of the urinary bladder in 1943-87 and included in the study experienced a marked improvement in crude five-year survival: for both men and women, from 24% for patients diagnosed in 1943-47 to 47% for those diagnosed in 1983-87. Patients whose tumours were localized at the time of diagnosis in 1978-87 had a more favourable prognosis, with survival after 10 years of 36% (men) and 43% (women), than patients with metastatic disease with 10-year survival of less than 1% (men and women). The treatment of bladder tumours underwent a number of changes during the study period. The improvement in survival with calendar time may be due to more efficient treatment, although registration artefacts cannot be excluded.

Age Factors↗
PubMed1992

Diuretics may increase risk of renal cell carcinoma.

The risk for kidney cancer was examined in a Danish cohort of 192,133 people on a hospital discharge register who had been given a diagnosis of hypertension, heart failure, or edema, and were presumed to be probable users of diuretics. The subjects were identified from 1977 to 1987 and followed-up for cancer through 1987. A total of 10,630 cancers was observed. While the risk for all cancers was increased slightly (standard mortality ratio [SMR] = 122, 95 percent confidence interval [CI] = 120-124), the risk for renal cell carcinoma was more than doubled (SMR(men) = 221, CI = 192-253; SMR(women) = 246, CI = 213-283). Increased risks were found in all age groups, and, although surveillance bias was present initially, the risk increased consistently in the years following discharge. Risk estimates for individuals discharged with hypertension were similar to those for the total cohort. Use of diuretics was validated in a random sample of 100 individuals. More than 70 percent were taking diuretics at the time of discharge. The increased risk for renal cell carcinoma in this cohort may indicate either that diuretics are involved in the etiology of renal cell carcinoma or that the risk can be attributed to confounders, including smoking, which affect risk for both the discharge diagnosis and renal cell carcinoma.

Aged↗
PubMed1992

Risk of kidney cancer in analgesics users.

The risk of kidney cancer was examined in a cohort of people discharged from Danish hospitals from 1977-1987 with a diagnosis of rheumatoid arthritis, osteoarthrosis or backpain. These individuals are presumably more or less regular users of mild analgesics. A total of 155,554 people were identified. The risk of cancer of the urinary tract was slightly increased [relative risk (RR) = 1.31], almost exclusively because of an increased risk of renal cell carcinoma (RR = 1.40). The relative risk was higher in individuals with rheumatoid arthritis than among individuals with osteoarthrosis or backpain, and higher among women than men. Although this study lacks information on the actual analgesics consumption of the individual, and various biases may be present, these findings offer little support to the concern that increased analgesics use raises the risk of kidney cancer.

Adult↗