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Christoffer Johansen

Publications and source records attributed to Christoffer Johansen.

At least 37 records · Page 2Linked to original sources
PubMed2005

Vital exhaustion and risk for cancer: a prospective cohort study on the association between depressive feelings, fatigue, and risk of cancer.

BACKGROUND: Vital exhaustion, defined as feelings of depression and fatigue, has previously been investigated mainly as a risk factor for cardiovascular disease. The authors investigated the association between depressive feelings and fatigue as covered by the concept of vital exhaustion and the risk for cancer. METHODS: The sample consisted of 8527 persons aged 21-94 who had been examined in 1991-1994 within the Copenhagen City Heart Study. For the analysis, the sample was divided into quartiles on the basis of vital exhaustion scores. Cancer cases were ascertained by linkage to the Danish Cancer Registry. The mean length of follow-up was 8.6 years. Regression analyses for etiology-based groups of cancer sites were conducted on the basis of the Cox proportional hazards model, with adjustment for a number of confounding variables. RESULTS: Cancer was diagnosed in 976 persons (12%) during follow-up. In comparison to those with the lowest scores, persons with the highest vital exhaustion scores had a significantly decreased risk for developing cancer at all sites (hazard ratio [HR], 0.80; 95% confidence interval [CI}, 0.66-0.96), smoking-related cancers (HR, 0.64; 95% CI, 0.46-0.90), and virus and immune-related cancers (HR, 0.51; 95% CI, 0.26-0.99). No significant change in risk was found for cancers related to alcohol consumption or hormones. CONCLUSIONS: The results did not support the hypothesis that symptoms of fatigue and depression, as ascertained in the vital exhaustion index, increased the risk for cancer.

Adult↗
PubMed2005

Personality traits, health behavior, and risk for cancer: a prospective study of Swedish twin court.

BACKGROUND: The authors conducted a prospective investigation into the relation between personality traits and the risk for cancer. METHODS: The study cohort consisted of 29,595 Swedish twins from the national Swedish Twin Registry who were ages 15-48 years at time of entry. In 1973, the twins completed a questionnaire eliciting information on personality traits and health behavior. The Eysenck Personality Inventory was used to measure neuroticism and extroversion as two personality dimensions. A Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals for extroversion and neuroticism separately as well as for their joint effect, and conditional logistic regression analyses were conducted to estimate the relation between personality traits and risks for cancer in twin pairs who were discordant for cancer. All analyses were conducted for six etiologically different groups of cancers: hormone-related organ cancers, virus-related and immune-related cancers, digestive organ cancers (excluding liver), respiratory organ cancers, cancers in other sites, and all cancer sites. RESULTS: Follow-up in the Swedish Cancer Registry for 1974-1999 revealed 1898 incidents of primary cancer. The authors found no significant association between neuroticism, extroversion, their joint effects and the risk for any cancer group. CONCLUSIONS: The current results did not support the hypothesis that certain personality traits are associated with cancer risk.

Adolescent↗
PubMed2005

Psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study.

PURPOSE: In 1993, a randomized intervention study among patients with malignant melanoma showed a significant decrease in psychological distress and increased coping capacity 6 months after the intervention and enhanced survival 6 years later. We applied a similar intervention with a few modifications in a randomized controlled trial among Danish patients with malignant melanoma and evaluated results on immediate and long-term effects on psychological distress and coping capacity. PATIENTS AND METHODS: A total of 262 patients with primary cutaneous malignant melanoma were randomly assigned to the control or intervention group. Patients in the intervention group were offered six weekly sessions of 2 hours of psychoeducation, consisting of health education, enhancement of problem-solving skills, stress management, and psychological support. The participants were assessed at baseline before random assignment and 6 and 12 months after surgery. The analyses of the main effects of the intervention were based on analyses of covariance. RESULTS: The patients in the intervention group showed significantly less fatigue, greater vigor, and lower total mood disturbance compared with the controls, and they used significantly more active-behavioral and active-cognitive coping than the patients in the control group. The improvements were only significant at first follow-up. CONCLUSION: The findings of this study support the results of an earlier intervention study among patients with malignant melanoma and indicate that a psychoeducational group intervention for such patients can decrease psychological distress and enhance effective coping. However, this effect is short term and the clinical relevance is not obvious.

Adaptation, Psychological↗
PubMed2005

Online interaction. Effects of storytelling in an internet breast cancer support group.

The internet provides new ways of forming social relationships among people with breast cancer and is increasingly used for this purpose. This qualitative study, using ethnographic case-study method, aimed to explore how support groups on the internet can break the social isolation that follows cancer and chronic pain, by analysing the storytelling emerging on the Scandinavian Breast Cancer Mailing list. Using participant observation and face-to-face or online interviews of participants, we investigated the motivations of 15 women who chose the internet to counteract social isolation after breast cancer. The results showed that the women were empowered by the exchanges of knowledge and experience within the support group. The internet was considered a means for finding ways of living with breast cancer. Our study suggests that internet support groups have important potential for the rehabilitation of cancer patients.

Adult↗
PubMed2005

A randomized psychosocial intervention study on the effect of home visits on the well-being of Danish colorectal cancer patients--the INCA Project.

Home visits by health care professionals may constitute a formalized social relationship in which cancer patients can be given emotional and informational support. We aimed at studying the effect of home visits on the well-being of colorectal cancer patients. A total of 249 Danish colorectal cancer patients undergoing abdominal surgery were randomly assigned to a control group or to an intervention group. The intervention group received 10 home visits carried out by a project nurse or a medical doctor during the first 2 years after discharge. Participants were interviewed 3, 6, 12, and 24 months after discharge in order to assess well-being. Using a linear mixed model, we found no overall effect of the intervention on well-being. We recommend that future psychosocial intervention studies include baseline screening for distress and recommend testing the effect of shorter but intensive interventions carried out by trained therapists.

Aged↗
PubMed2005

Evaluation and outcome of behavioural changes in the rehabilitation of cancer patients: a review.

The global increase in the number of newly diagnosed cancers has led in most affected countries to increased numbers of cancer survivors, who have specific needs for physical and psychosocial rehabilitation. In spite of recent progress, little is known about the specific rehabilitation measures that could increase the quality of life for cancer survivors. We reviewed published interventions that focussed on changing known risk factors for cancer recurrence and improving physical well-being; those we selected were exercise, smoking, alcohol consumption, diet and the use of sun screens. The published trials varied in the quality of the methods used, often had inadequate sample sizes and showed difficulty in validating outcomes. We conclude that there is still insufficient evidence to assess the importance of these behavioural risk factors in the rehabilitation of cancer patients. Future interventions should be designed to assess the separate effects of dietary changes, exercise and psychosocial interventions.

Alcohol Drinking↗
PubMed2005

Psychosocial aspects of lung cancer.

BACKGROUND: Lung cancer is one of the commonest cancers in the industrialised world, and persons with this grave disease must deal not only with the physical effects but also with the psychosocial aspects. METHODS: This review is based on an examination of intervention, prospective and case-control studies with more than 50 participants published between 1966 and 2003. RESULTS: The studies show that on average one out of four persons with lung cancer experience periods of depression or other psychosocial problems during their illness. Persons who are not offered treatment for their cancer and persons with small-cell lung cancer have a higher risk compared to other groups of lung cancer patients. The degree of depression can be reduced by psychosocial interventions. CONCLUSIONS: We suggest that psychosocial screening of persons with lung cancer could prevent depression and might result in improved quality of care.

Carcinoma, Small Cell↗
PubMed2005

Mental vulnerability as a predictor of early mortality.

BACKGROUND: Studies have demonstrated that mental vulnerability (ie, a tendency to experience psychosomatic symptoms or inadequate interpersonal interactions) is associated with various diseases. The objective of our study is to evaluate whether mental vulnerability is a risk factor for early mortality. METHODS: We conducted a prospective cohort study of 3 random samples of the population in Copenhagen County, Denmark selected in 1976, 1982-1984, and 1991 (n = 6435). Baseline data collection included measures of mental vulnerability, social factors, comorbidity, biologic risk markers (eg, blood pressure, lipid levels), and lifestyle factors. We determined vital status of the study sample through linkage to the Civil Registration System until 2001 and to the Cause of Death Registry until 1998. The mean follow-up time was 15.9 years for analysis of total mortality and 13.6 years for analysis of mortality as the result of natural causes. The association between mental vulnerability and survival was examined using Kaplan-Meir plots and Cox proportional-hazard models adjusting for possible confounding factors. RESULTS: With respect to mental vulnerability, 79% of the sample was classified as not vulnerable, 13% as moderately vulnerable, and 8% as highly vulnerable. Compared with the nonvulnerable group, highly vulnerable persons showed increased total mortality (hazard ratio = 1.6; 95% confidence interval = 1.3-1.9) and increased mortality from natural causes (1.6; 1.2-2.0). The inclusion of the mental vulnerability score as a continuous variable gave similar results. CONCLUSIONS: Mental vulnerability may be an independent risk factor for premature mortality. The biologic mechanisms that may underlie this association need further exploration.

Adult↗
PubMed2005

Polycyclic aromatic hydrocarbons and fatal ischemic heart disease.

BACKGROUND: Several toxicologic and epidemiologic studies have produced evidence that occupational exposure to polycyclic aromatic hydrocarbons (PAH) is a risk factor for ischemic heart disease (IHD). However, a clear exposure-response relation has not been demonstrated. METHODS: We studied a relation between exposure to PAH and mortality from IHD (418 cases) in a cohort of 12,367 male asphalt workers from Denmark, Finland, France, Germany, Israel, The Netherlands and Norway. The earliest follow up (country-specific) started in 1953 and the latest ended in 2000, averaging 17 years. Exposures to benzo(a)pyrene were assessed quantitatively using measurement-driven exposure models. Exposure to coal tar was assessed in a semiquantitative manner on the basis of information supplied by company representatives. We carried out sensitivity analyses to assess potential confounding by tobacco smoking. RESULTS: Both cumulative and average exposure indices for benzo(a)pyrene were positively associated with mortality from IHD. The highest relative risk for fatal IHD was observed for average benzo(a)pyrene exposures of 273 ng/m or higher, for which the relative risk was 1.64 (95% confidence interval=1.13-2.38). Similar results were obtained for coal tar exposure. Sensitivity analysis indicated that even in a realistic scenario of confounding by smoking, we would observe approximately 20% to 40% excess risk in IHD in the highest PAH-exposure categories. CONCLUSIONS: Our results lend support to the hypothesis that occupational PAH exposure causes fatal IHD and demonstrate a consistent exposure-response relation for this association.

Cause of Death↗
PubMed2004

Risk for cancer in a cohort of patients hospitalized for schizophrenia in Denmark, 1969-1993.

We investigated the cancer risk of patients hospitalized for schizophrenia in a nationwide cohort study. All 22766 adults admitted for schizophrenia, ICD-8 295, in Denmark between 1969 and 1993 were followed up for cancer through 1995. The incidence of site-specific cancers was compared with national incidence rates, adjusted for sex, age and calendar time. The risk for cancer was increased for both men and women during the first year of follow-up. When the first year of follow-up was excluded, the risk for all tobacco-associated cancers and for prostate and rectal cancers was reduced for male patients with schizophrenia. The standardized incidence ratio (SIR) of lung cancer was marginally reduced (SIR, 0.86; 95% CI: 0.65, 1.02) for male patients with schizophrenia; this was due, however, to a reduction in risk for older patients. An increased risk for breast cancer found for female patients with schizophrenia (SIR, 1.20; 95% CI: 1.05, 1.38) should be interpreted with caution, given the high proportion of nulliparous women with schizophrenia in Denmark. The data might support reduced risks for prostate and rectal cancer among male patients with schizophrenia, whereas a changing smoking pattern might explain the reduced risk for tobacco-related cancers.

Adolescent↗
PubMed2004

Colorectal cancer in Denmark 1943-1997.

PURPOSE: This article reports the incidence rates of colon and rectal cancer in Denmark during 55 years of data registration and estimates the number of cases identified attributable to four modifiable risk factors and potentially preventable. METHODS: On the basis of reports in the nationwide, population-based, Danish Cancer Registry, we calculated age-standardized, period-specific, incidence rates and age and birth cohort-specific incidence rates. To calculate the population attributable risk, relative risk estimates were obtained from meta-analyses, case-control, and prospective cohort studies, combined with data from surveys of the consumption of alcohol, red meat, vegetables, and level of physical activity. RESULTS: For both genders, the incidence rate of colon cancer increased, whereas the incidence rate for rectal cancer decreased during the period 1943 to 1997. The decrease in the incidence rate of rectal cancer was observed for both genders, but the incidence rate among males was higher than that among females. The proportion of cases that could have been prevented if the Danish population had not been exposed to the four known risk factors varied from 0 to 15 percent for each of the four risk factors. CONCLUSIONS: This study shows that the incidence rate of colon cancer has increased, whereas that of rectal cancer has decreased in Denmark during 55 years of observation. The potentially preventable proportions of incident cases are substantial but not as high as might have been expected.

Adenocarcinoma↗
PubMed2004

Tubal sterilization and risk of ovarian, endometrial and cervical cancer. A Danish population-based follow-up study of more than 65 000 sterilized women.

BACKGROUND: On the basis of a population-based cohort, we assessed the cancer risk, focusing on gynaecological cancers and pre-malignant lesions, among women with a previous tubal sterilization. METHODS: Using the Danish Hospital Discharge Register we identified 65 232 women who had a tubal sterilization (1977-1993). The cohort was followed for cancer occurrence, and compared with the expected number based on the national cancer incidence rates. RESULTS: The overall risk of ovarian cancer was decreased (standardized incidence ratio [SIR] = 0.82; 95% CI: 0.6, 1.0), and it was still decreased > or =10 years after the sterilization (SIR = 0.65; 95% CI: 0.4, 1.0). The rate of endometrial cancer was also decreased (SIR = 0.66; 95% CI: 0.5, 1.0), the risk continued being moderately reduced during follow-up, although it was not statistically significant. CONCLUSIONS: In this nationwide, population-based study we find that women with tubal sterilization have a decreased risk of subsequent development of ovarian cancer. As the protective effect is not decreasing with years of follow-up, our data do not support that 'screening' bias can explain the protective effect, but indicate that the sterilization itself may convey a reduction in risk. The same pattern is found for endometrial cancer, the association being less strong.

Adult↗
PubMed2004

Cellular telephone use and risk of acoustic neuroma.

Despite limited evidence, cellular telephones have been claimed to cause cancer, especially in the brain. In this Danish study, the authors examined the possible association between use of cellular telephones and development of acoustic neuroma. Between 2000 and 2002, they ascertained 106 incident cases and matched these persons with 212 randomly sampled, population-based controls on age and sex. The data obtained included information on use of cellular telephones from personal interviews, data from medical records, and the results of radiologic examinations. The authors obtained information on socioeconomic factors from Statistics Denmark. The overall estimated relative risk of acoustic neuroma was 0.90 (95% confidence interval: 0.51, 1.57). Use of a cell phone for 10 years or more did not increase acoustic neuroma risk over that of short-term users. Furthermore, tumors did not occur more frequently on the side of the head on which the telephone was typically used, and the size of the tumor did not correlate with the pattern of cell phone use. The results of this prospective, population-based, nationwide study, which included a large number of long-term users of cellular telephones, do not support an association between cell phone use and risk of acoustic neuroma.

Adult↗
PubMed2004

Incidence trends of adult primary intracerebral tumors in four Nordic countries.

Brain tumors are some of the most lethal adult cancers and there is a concern that the incidence is increasing. It has been suggested that the reported increased incidence can be explained by improvements in diagnostic procedures, although this has not been totally resolved. The aim of our study was to describe the incidence trends of adult primary intracerebral tumors in four Nordic countries during a period with introduction of new diagnostic procedures and increasing prevalence of mobile phone users. Information about benign and malignant primary intracerebral tumor cases 20-79 years of age was obtained from the national cancer registries in Denmark, Finland, Norway and Sweden for the years 1969-98 and estimates of person-years at risk were calculated from the information obtained from national population registries. Annual age standardized incidence rates per 100,000 person-years were calculated and time trends analyses were carried out using Poisson regression. The overall incidence of all intracerebral tumors ranged from 8.4-11.8 for men and 5.8-9.3 for women, corresponding to an average annual increase of 0.6% for men (95% confidence interval [CI] = 0.4, 0.7) and 0.9% for women (95% CI = 0.7, 1.0). The increase in the incidence was confined to the late 1970s and early 1980s and coinciding with introduction of improved diagnostic methods. This increase was largely confined to the oldest age group. After 1983 and during the period with increasing prevalence of mobile phone users, the incidence has remained relatively stable for both men and women.

Adult↗
PubMed2004

In a randomized controlled trial, missing data led to biased results regarding anxiety.

BACKGROUND AND OBJECTIVE: Randomization does not protect against bias due to missing observations. In addition, different reasons for missing observations may lead to different invalid results. The purpose of this study was to illustrate how randomized intervention studies can be threatened by bias due to missing observations because of death or nonresponse. METHODS: A randomized clinical trial of the effect of psychosocial intervention on well-being after an operation for colorectal cancer was conducted in Denmark. Patients were interviewed 3, 6, 12, and 24 months after discharge from hospital. RESULTS: We found that the probability of nonresponse decreased with increasing anxiety score in the intervention group, but it increased with increasing anxiety score in the control group. This could lead to severe bias in an analysis of the effect of intervention on anxiety. Low physical functioning and low global health status and quality of life were related to an increased probability of dying before the next follow-up, and this association could explain the associations between anxiety and depression, respectively, and the probability of dying observed in crude analyses. CONCLUSION: Our study emphasizes the importance of performing specific missing data analyses in any study of well-being variables.

Aged↗
PubMed2004

Occupational magnetic field exposure and myocardial infarction incidence.

BACKGROUND: Studies on healthy volunteers have seen reduced heart rate variability after exposure to extremely low-frequency electric and magnetic fields (EMF). Because reduced heart rate variability has been linked to cardiovascular disease risk, it has been hypothesized that exposure to EMF might increase the risk of cardiovascular disease. One epidemiologic study has shown increased mortality from cardiovascular conditions in utility workers with elevated exposure to magnetic fields, but several other epidemiologic studies have failed to confirm this result. We tested the hypothesis that occupational EMF exposure increases the risk of myocardial infarction in a large population-based case-control study of myocardial infarction, with detailed information on potential confounders. METHODS: We used data from the SHEEP study, which is a population-based case-control study of acute myocardial infarction in Stockholm. Occupational EMF exposure was based on job titles 1, 5, and 10 years before diagnosis. We used 2 approaches to classify exposure: first, specific individual job titles with presumed elevated EMF exposure, and second, classification of subjects according to a job-exposure matrix. RESULTS: We found no increased risk of myocardial infarction in subjects classified as having elevated EMF exposure. For the highest exposure category of > or = 0.3 microT according to the job-exposure matrix, the adjusted relative risk was = 0.57 (95% confidence interval = 0.36-0.89). CONCLUSIONS: The results of this study do not support the hypothesis that occupational EMF exposure increases the risk of myocardial infarction.

Acute Disease↗