PubMed Health⌕ Search

Biomedical subjects

Christian Vutuc

Publications and source records attributed to Christian Vutuc.

At least 19 recordsLinked to original sources
PubMed2006

Survival of patients with colorectal cancer in Austria by sex, age, and stage.

This paper for the first time presents Austrian data on survival of patients, diagnosed from 1998 through 2002, with colon cancer and with rectal cancer. Cumulative relative survival rates were calculated by age, standardized for all ages and stages combined, and by age groups (< 50 years, 50-64 years, and =65 years) according to stages (localized, regional metastases and distant metastases). In carcinoma of the colon 5-year relative survival was 66 % in males and 64 % in females. In carcinoma of the rectum 5-year relative survival was 64 % in males and 67 % in females. Compared to the earlier results from the Tyrol (based on patients diagnosed from 1990 through 1994) the 5-year survival of patients with colon cancer increased from 55 % to 66 % in males and from 58 % to 64 % in females. In patients with rectal cancer 5-year survival increased from 44 % to 64 % in males and from 46 % to 67 % in females. This increase in part can be explained by a positive effect of early detection and of better treatment.

Age Factors↗
PubMed2006

Breast cancer trends: opportunistic screening in Austria versus controlled screening in Finland and Sweden.

The objective of the study was to compare the trends of incidence and of mortality of breast cancer in Austria, Finland and Sweden, where different mammography screening strategies (opportunistic versus controlled) are applied. Furthermore, to find out whether a change in screening strategies would be feasible for Austria. Age-standardized incidence rates (1983-2000) and mortality rates (1980-2001/2) were analysed. Furthermore, the annual per cent change and the annual rate change (annual rate change=+/-n/100,000 per year) and the 95% confidence interval were calculated. In all three countries, incidence rates increased significantly (Austria +26.4%, Finland +86.7%, Sweden +38.8%) during the period analysed (P<0.01). The annual per cent change and the annual rate change in Austria (1.57 and 1.56, respectively) are below the annual per cent change and the annual rate change in Finland (3.38 and 3.49, respectively) and in Sweden (1.80 and 2.19, respectively) for the period analysed. Total breast cancer mortality decreased significantly in Sweden since 1980 (-20.5%, P<0.01), in Finland since 1988 (-18.3%, P<0.05) and in Austria since 1990 (-19.8%, P<0.01). The annual per cent change and the annual rate change in Austria (-1.81 and -0.59, respectively) are below the annual per cent change and the annual rate change in Finland (-0.57 and -0.16, respectively) and in Sweden (-1.02 and -0.28, respectively) for the period analysed. In conclusion, despite its unsophisticated opportunistic screening, Austria does well in comparison with countries operating organized breast cancer screenings.

Adult↗
PubMed2006

Self-reported prostate cancer screening in Austria.

OBJECTIVES: The prevalence of self-reported participation and frequency of prostate cancer screening (digital rectal examination (DRE), prostate-specific antigen (PSA)) in Austrian men aged 40-79 years in the year 2005 is reported. METHODS: In a population-based cross-sectional study, a representative sample of 500 men was asked whether they ever had heard of early detection of prostate cancer by DRE or PSA test and, if so, whether they had ever had a prostate cancer screening test during their life, and if so the number of tests and the type of physician. RESULTS: Overall, the prevalence of self-reported prostate cancer screening was 55.8% (23.7% DRE only). The highest prevalence was observed in the age group of 60-69 years with 68.8% (28.1% DRE only). The highest prevalence of PSA tests was observed in the age group 70-79 years (40.9%). About 75% of the screening tests were performed by urologists. CONCLUSIONS: More than half of the target population (men aged 40-79 years) have had at least one prostate cancer screening test. Nearly one-third of men have already had one or more PSA tests. One-fifth of the PSA tests were requested by general practitioners or internists.

Adult↗
PubMed2005

Prostate cancer and prostate-specific antigen (PSA) screening in Austria.

The possible effect of prostate-specific antigen (PSA) testing on prostate cancer mortality has remained controversial, despite the test's widespread application. We examined age-specific mortality trends for prostate cancer in Austria before and after the introduction of (opportunistic) PSA testing, to ask whether PSA screening reduces prostate cancer mortality in a uniform cohort of men with equal access to health care. Prostate cancer mortality data covering all 9 federal states of Austria were analysed from 1970 to 2002. PSA testing became widely available in Austria not before 1989. Tyrol, one of the nine federal states of Austria, independently launched a mass prostate cancer prevention project in 1993. We applied join-point regression models to identify changes in the slope of age-specific mortality trends in selected age groups (50-59, 60-69, 70-79, and 80-89 years) and calculated the annual percent change (APC) in mortality between 1970 and 2002 for Tyrol and the rest of Austria separately. After 12 years of follow-up, we were not able to observe a significant reduction in prostate cancer mortality since the introduction of the PSA test in the age groups of 50-59, 60-69, and 80-89 years. A significant decrease was found in the age group of 70-79 (Austria without Tyrol 1989 through 2002: APC, -2.36; 95% CI, -3.38 to -1.34; Tyrol 1991 through 2002: APC, -6.42; 95% CI, -8.92 to -3.86). In this age group the join points 1989 and 1991 cannot be related to PSA testing. PSA screening does not appear to reduce prostate cancer mortality in a uniform cohort of men with equal access to health care. However, given the long lead-time for prostate cancer, even longer follow-up may still be needed to detect any important trends.

Age Distribution↗
PubMed2005

Trends in infant mortality in Austria between 1984 and 2002.

Infant mortality rate is an important medical indicator and is often used for comparing countries with respect to welfare and public health. Among other factors, effective medical technology, better access to pre- and postnatal care for all socioeconomic groups and better nutrition have decreased infant mortality in Austria from about 200 deaths per 1000 live births at the beginning of the 20th century to about 5 deaths per 1000 live births at the end. In this study we present the trends in infant mortality, based on 1,654,519 individual birth records, in Austria since 1984. The infant mortality rate dropped rapidly from about 12 per 1000 live births in 1985 to 4.6 per 1000 live births during the last two years of our study (2001/02). Infant mortality rates stratified by cause of death show somewhat differing trends. In particular, the number of deaths due to peripartal problems decreased as the result of improvements in obstetrics and neonatology, but in 1995 a change in the definition of live birth led to a rise of about 20% in the stillbirth rate. At present, Austria has one of the lowest infant mortality rates of all European countries; however, between 1999 and 2002 the mortality rate has been fairly static. A further reduction in mortality clearly cannot be achieved by advances in medicine alone. It remains a challenge for health politicians, physicians and society at large to reduce the prevalence of well-known risk factors such as alcohol abuse, heavy overweight and smoking during pregnancy.

Austria↗
PubMed2004

Cancer mortality in Austria: 1970-2002.

PURPOSE: The aim of this study is to assess the overall progress against cancer in Austria by analyzing changes in age-adjusted mortality rates from 1970 to 2002. METHODS: For the years 1970 through 2002, age-adjusted rates for all malignant neoplasms together and for selected cancers individually were calculated for men and women according to year and age. The data were obtained from Statistik Austria. RESULTS: Age-adjusted mortality rates of all cancers decreased in men by 22% and in women by 27%. The annual decrease of cancer mortality was 0.8% per year in the time period analyzed and 1.7% per year from 1993 to 2002 in both sexes. Among older persons (> or = 55 years) the mortality decreased by 21% in men and by 25% in women; among younger persons (< or = 54 years) by 25% and 40%, respectively. In individual cancer sites, the highest mortality rates are observed before the year 1995 in both sexes, except for liver and brain cancer in men (with the most recent peaks in the year 2001) and lung and brain cancer in women (with the most recent peaks in the year 2002). CONCLUSIONS: The observed changes in cancer mortality are primarily related to changes in incidence and, in the last decade, to improved treatment and early detection, but neither of these contributions can be quantified. The strengthening of prevention research (primary and secondary prevention) and further implementation of preventive knowledge is urgently needed.

Adult↗
PubMed2004

Epidemiological aspects of hadron therapy: a prospective nationwide study of the Austrian project MedAustron and the Austrian Society of Radiooncology (OEGRO).

BACKGROUND: The planned MedAustron hadron therapy facility is designed to compare proton and carbon ion beam therapy under the same technical conditions. For the calculation of the number of potential patients for hadron therapy so far, only epidemiological estimations on cancer incidence are available without inclusion of the percentage of patients routinely referred to conventional radiotherapy. MATERIALS AND METHODS: Nationwide prospective survey to collect disease and treatment related data on patients receiving conventional radiotherapy at all 12 treatment facilities. Epidemiological cancer incidence (Statistic Austria 1999) were correlated with the number of patients receiving conventional radiotherapy. Based on published clinical and experimental results on proton and carbon ion therapy, a calculation of patient's subgroups suitable for hadron therapy was performed at five European University hospitals involved in the HICAT, CNAO, ETOILE and MEDAustron project. Using the mean values of the University specific percentages per tumour site, the number of potential patients was estimated. RESULTS: In Austria, a total of 3783 patients started radiotherapy during the study period of 3 months resulting in an approximated number of 15132 patients per year. The number of potential patients was estimated to 2044 per year, representing 5.6% of all newly diagnosed cancer patients and 13.5% of all irradiated cancer patients. CONCLUSION: There is a clear place for a hadron therapy facility in Austria, based on pattern of care in radiotherapy, cancer incidence and indications.

Adolescent↗
PubMed2004

The med AUSTRON/OGRO patterns of care study on radiotherapy indications in Austria.

PURPOSE: In Austria a national survey was conducted by Med AUSTRON/Osterreichische Gesellschaft for Radio--Onkologie, Radiobiologie und Medizinische Radiophysik (OGRO) in order to estimate the indications, patient numbers and radiotherapy treatment planning procedures and performances at all Austrian radiotherapy institutes. Results were correlated with incidence rates (Austrian cancer registry) to determine patterns of radiotherapy practice in Austria. MATERIAL AND METHODS: At 12 radiotherapy departments of Austria data of all patients receiving irradiation within a 3 months (2002/2003) period were assessed. On the basis of a questionnaire number of treated patients, indications, and parameters of disease (stage, histology) and treatment modalities were evaluated. Results were analysed with regard to different tumour groups, according to academic and non academic hospitals, and correlated with epidemiological data on cancer incidence. RESULTS: In total, 3783 patients were registered within this period. According to the different tumour entities percentages of patients receiving radiotherapy within initial treatment varied from 3% to 90 % (e.g. brain tumours: 77%, breast cancer: 90%, prostate cancer: 35%). The most frequent indications to radiotherapy per radiotherapy department were breast cancer (range 22%-35%; mean 26%), urological tumours (range 6%-27%; mean 12%) and bone metastases (mean 10%, range 3%-17%). CONCLUSION: In Austria breast cancer, urological tumours and bone metastases are representing the most common indications to radiotherapy. Among the different departments variations in indications to radiotherapy were observed. Our study is the first evaluation of radiotherapeutic management in Austria.

Adolescent↗
PubMed2003

Maternal health outcomes in Europe.

OBJECTIVES: To use PERISTAT data on indicators of maternal mortality and morbidity to explore maternal health outcomes in Europe, and to discuss the implications of variations in the data sources for these indicators. STUDY DESIGN: The PERISTAT feasibility study provides the source for this descriptive study, covering 15 European countries. Maternal mortality ratios are calculated, and data to describe maternal mortality by age, cause of death and mode of delivery are pooled for the countries that provided data. RESULTS: Data presented show an increased risk of maternal death among older mothers and for caesarean sections compared with other modes of delivery, and the three most prevalent causes of maternal deaths reported were embolism, hypertensive diseases of pregnancy, and haemorrhage. CONCLUSIONS: Variations in maternal mortality ratios reflect different data sources with varying levels of ascertainment in addition to differences in the number of maternal deaths. Further development is needed to construct comparable indicators of maternal morbidity.

Adult↗
PubMed2003

Complementary therapies in cancer patients: prevalence and patients' motives.

BACKGROUND: Data relating to the use of complementary/alternative medicine (CAM) in cancer patients have been published for a number of European countries. No recent data are available for Austria. AIM: To ascertain the extent of CAM use by cancer patients, what patients' motives are, what methods are used and who the CAM providers are. DESIGN: Self-administered questionnaire; cross-sectional study. PATIENTS AND METHODS: A sample of 231 cancer patients who had consulted the Viennese Cancer League. Chi-square and Mantel-Haenszel tests were used for the statistical evaluation. RESULTS: 27.3% of the cancer patients had received CAM therapy: 33.1% of the female and 20.5% of the male participants (p = 0.045). Those who were below the median of the age categories (53.8 years) had used CAM to a statistically higher degree (35.5% vs. 21.1%; p = 0.023). The most important motives were the enhancement of "nature" and the GPs' recommendation. CAM was administered in 44.4% of cases by the family doctor, in 39.7% by patients themselves, in 6.3% by a hospital doctor, in 6.3% by a lay-practitioner or "non-medical practitioner against payment" and in 4.8% of cases by a practising oncologist. CONCLUSION: From the high percentage of patients who use CAM without consulting a physician or who follow the advice of others, it would seem highly probable that conventional and complementary methods are rarely effectively coordinated. To rectify this we conclude that oncologists and GPs should have a basic knowledge of CAM and address the issue when counselling their cancer patients.

Adolescent↗
PubMed2002

Three decades of pleural cancer and mesothelioma registration in Austria where asbestos cement was invented.

Recently, a new mesothelioma epidemic was predicted from observations made in Western Europe. From early observations in Austria the lower increase in cases of mesothelioma compared with neighbor countries had been related to different uses of asbestos. In order to test this hypothesis, incidence and mortality of pleural cancer [International Classification of Diseases (ICD)-8/9 163] were analyzed for three decades and supplemented by data from a cohort study in the factory that had been the largest consumer of asbestos imported to Austria and from all Austrian occupational diseases registered between 1990 and 2001. In men, mortality rates (based on 15 to 45 deaths/year) were lowest in 1980-1989, but similar in 1970-1979 and 1990-2001. No increase in younger-birth cohorts was detected. Incidence rates (based on 13 to 44 cases/year) increased (36%) non-significantly ( P=0.14). In women, a significant decrease in mortality and incidence rates ( P<0.01) was observed from 1970. Rates from work-related mesothelioma (based on only 0-7 men and 0-4 women/year) must be interpreted with caution. In the cohort of 2,816 asbestos cement workers 26 pleural mesotheliomas were registered from 1990 through mid-1999. Six of these cases (three male and three female) had not been registered as an occupational disease, but all of these cases had been encoded under ICD 163 in mortality statistics. One female cohort member registered as having asbestosis according to the death certificate had died from mesothelioma according to the statistics of occupational diseases. We conclude that no epidemic of mesothelioma due to past asbestos exposure is to be expected in Austria.

Asbestos↗
PubMed2002

Association of polymorphisms within androgen receptor, 5alpha-reductase, and PSA genes with prostate volume, clinical parameters, and endocrine status in elderly men.

BACKGROUND: The aim of this study was to assess the impact of polymorphisms of three genes within the androgen pathway on prostate volume, clinical parameters, and endocrine status. METHODS: Elderly men with lower urinary tract symptoms underwent clinical and endocrine work-up. In parallel, polymorphisms within the 5alpha-reductase gene (SRD5A2 V89L and A49T), the androgen receptor gene (AR; number of CAG repeats), and the prostate specific antigen (PSA) gene (A --> G substitution at position-158) were determined by polymerase chain reaction and restriction-length polymorphism analysis by using DNA from peripheral blood. RESULTS: A total of 190 men (66.5 +/- 9.2 yr) were analyzed. The number of CAG repeats within the AR and the PSA polymorphism revealed no associations to clinical and endocrine parameters. Individuals carrying the mutated SRD5A2 A49T allele (5.3% of the total population) had larger prostates (54.1 vs. 39.3 ml), higher PSA levels (12.2 vs. 4.3 ng/ml), and a 35% reduction in prostatic stroma/epithelial cell ratio. Men with the mutated SRD5A2 V89L gene had lower testosterone levels. CONCLUSIONS: In contrast to prostate cancer, polymorphisms within AR and PSA genes do not seem to be of importance for benign prostatic hyperplasia. Polymorphisms within the 5alpha-reductase gene are interesting biomarkers for the development of benign prostatic hyperplasia and benign prostatic enlargement.

Aged↗
PubMed2002

Survival of women with breast cancer in Austria by age, stage and period of diagnosis.

PURPOSE: To investigate survival of breast cancer patients by 1) age, 2) tumor stage and 3) period of diagnosis, also to determine the contribution of improvements in treatment and opportunistic mammography screening in Austria. METHODS: Survival was calculated overall and by 1) age groups (in years) < 50, 50-64, > 65; 2) stage I, II, IV, unknown 3) for 17,025 patients diagnosed 1988-92, compared with 19,284 patients diagnosed 1993-97. Odds ratios for being diagnosed as stage I in the period 1993-97 compared to 1988-92 were calculated by age group and for all ages. RESULTS: In the later period (1993-97) age-adjusted mortality rate decreased overall by 3.3% (age: < 50; 8.2%, 50-64; 5.1%, > 65; 1.6%). Overall, stage I cases increased from 46.5% to 51%. Five year relative survival rates improved significantly overall, 6.7% (p < 0.001), and within age groups (age: < 50; 4.5% (p < 0.05), 50-64; 7.2% (p < 0.05) and > 65; 7.3% (p < 0.001). This improvement is confined to patients with stage I tumors in age groups 50-64 (4.1%, p < 0.05) and > 65 (7.2%, p < 0.001) and to patients with stage II in age groups < 50 (7.7%, p < 0.01) and 50-64 (8.3%, p < 0.01). For patients younger than 50, in stage IV, diagnosed 1993-97, survival was significantly poorer (-16.9%, p < 0.05) compared to 1988-92. The odds ratio of being diagnosed as stage I in the later period was 1.19 (95% CI: 1.14, 1.24) for all ages, 1.13 (95% CI: 1.03, 1.24) and for women < 50, 1.3 (95% CI: 1.20, 1.40) 50-64 and 1.15 (95% CI: 1.09, 1.22) > 65 years old. CONCLUSION: We conclude that treatment improvements, which are accessible to all patients countrywide due to the compulsory state insurance system, had a major impact on positive trends in mortality and survival. Opportunistic screening should have contributed to some extent beginning in the early nineties.

Adult↗
PubMed2002

Vitamin D receptor gene polymorphism and prostate cancer risk.

BACKGROUND: 1,25-dihydroxyvitamin D, the active form of vitamin D, exerts antiproliferative effect on prostatic cells, mediated through the vitamin D receptor. In a case-control study, we examined whether the vitamin D receptor (VDR) gene polymorphism in exon 9 could affect prostate cancer susceptibility. METHODS: One hundred ninety newly diagnosed prostate cancer patients and 190 age-matched men with benign prostatic hyperplasia (BPH), in whom the presence of prostate cancer was excluded clinically or histologically, were recruited for this study. The VDR TaqI polymorphism was investigated by polymerase chain reaction (PCR) following restriction fragment length polymorphism using DNA from lymphocytes. Depending on the presence or absence of the TaqI restriction site at the third position of codon 352, patients were classified as TT, Tt, or tt. RESULTS: The frequency of the tt genotype was not significantly different between prostate cancer patients (18%) and controls (12%; P = 0.07). The odds ratio (OR), calculated relative to individuals with the TT genotype was 1.76 (95% confidence limit (CL) = 0.90-3.45). After stratification for Gleason score and prostate specific antigen levels in a case-case comparison (n = 190), no significant associations with the VDR genotypes were detectable either. CONCLUSIONS: In this case-control study of Austrian Caucasians, no statistically significant association of the VDR TaqI polymorphism and prostate cancer risk was found.

Aged↗
PubMed2002

Under-reporting of direct and indirect obstetrical deaths in Austria, 1980-98.

BACKGROUND: Under-reporting and misclassification of maternal deaths are common, even in countries with a high quality of death statistics. The aims of this study were to determine to what extent maternal deaths are under-reported in Austria and to determine factors that might explain under-reporting. METHODS: Confidential enquiries on maternal deaths for the period 1980-98 were linked with the official mortality statistics from Statistics Austria. Maternal deaths were classified as direct and indirect obstetric deaths. RESULTS: Between 1980 and 1998 a total of 119 maternal deaths (112 direct and seven indirect obstetric deaths) were registered at Statistics Austria. Confidential inquiries into maternal deaths accumulated 191 maternal deaths (an additional 43 direct obstetric deaths and 29 indirect obstetric deaths). Total under-reporting was 38% (95% CI 31-45). Significantly more indirect obstetrical deaths were under-reported (81%; 95% CI 64-92) than direct obstetrical deaths (28%; 95% CI 21-36). CONCLUSIONS: This study demonstrates the shortcomings of official registration of maternal deaths. Thus, maternal mortality cannot be seen as a reliable basis for health policy decisions.

Adolescent↗
PubMed2002

Polymorphic CAG repeats in the androgen receptor gene, prostate-specific antigen polymorphism and prostate cancer risk.

As the development of prostate cancer is androgen-dependent, it has been hypothesized that variation in transcriptional activity by the androgen receptor (AR) related to polymorphic CAG repeats in exon 1, influences prostate cancer risk. The AR regulates gene transcription by binding to androgen-response elements (AREs) in target genes, such as the prostate-specific antigen (PSA). In the ARE-I sequence of the PSA gene an adenine to guanine polymorphism is described. It has been hypothesized that the AR binds the two PSA alleles (A and G) with differing affinities and may, thereby, differentially influence prostate cancer risk. To examine the role of the polymorphisms in the AR and PSA genes in prostate cancer susceptibility, we conducted a case-control study of Austrian Caucasians with 190 newly diagnosed prostate cancer patients and 190 age-matched control men with benign prostatic hyperplasia (BPH). The polymorphisms were determined by polymerase chain reaction (PCR)-based methods using DNA from peripheral white blood cells. Logistic regressions were performed to calculate odds ratios (OR) and confidence limits (CL) and to control for possible confounders. Our data provide no evidence for an association between prostate cancer and CAG repeat length. However, we found a significant influence of the ARE-I PSA polymorphism on prostate cancer risk, when calculating the combination of the A/G and G/G genotypes relative to subjects with the A/A genotype (OR = 0.63; 95% CL 0.39-0.99; P = 0.048), suggesting that the G allele has a protective effect. In a case analysis according to Gleason score, the PSA G/G genotype was significantly more frequent in patients with Gleason score >7 (35.1%) than in patients with Gleason score <7 (21.5%), providing evidence that the PSA G/G genotype is associated with more advanced disease at time of diagnosis. However, the ambivalent role of the PSA during prostate carcinogenesis needs further investigation.

Aged↗