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Hans H Storm

Publications and source records attributed to Hans H Storm.

10 recordsLinked to original sources
PubMed2003

Prediction of cancer incidence in the Nordic countries: empirical comparison of different approaches.

Prediction of the future number of cancer cases is of great interest to society. The classical approach is to use the age-period-cohort model for making cancer incidence predictions. We made an empirical comparison of different versions of this model, using data from cancer registries in the Nordic countries for the period 1958-1997. We have applied 15 different methods to 20 sites for each sex in Denmark, Finland, Norway and Sweden. Median absolute value of the relative difference between observed and predicted numbers of cases for these 160 combinations of site, sex and country was calculated. The medians varied between 10.4 per cent and 15.3 per cent in predictions 10 years ahead, and between 15.1 per cent and 32.0 per cent for 20 year predictions. We have four main conclusions: (i) projecting current trends worked better than assuming that future rates are equal to present rates; (ii) the method based on the multiplicative APC model often overestimated the number of cancer cases due to its exponential growth over time, but using a power function to level off this growth improved the predictions; (iii) projecting only half of the trend after the first 10 years also gave better long-term predictions; (iv) methods that emphasize trends in the last decade seem to perform better than those that include earlier time trends.

Cohort Studies↗
PubMed2003

Glomerulonephritis and malignancy: a population-based analysis.

BACKGROUND: An association between glomerulonephritis and malignant tumors has previously both been found and discarded in clinical series, but to our knowledge never has been tested in a population-based setting. METHODS: The Danish Kidney Biopsy Registry includes all kidney biopsies performed from 1985. Using a unique personal identification number, each person in the registry to the National Population Registry and the Danish Cancer Registry were linked. Cancer occurrence after the biopsy was compared in patients with morphological, glomerular diseases with that of the general Danish population, taking into account sex, age, calendar period and time since biopsy, and the 95% confidence interval (95% CI) for the observed-to-expected rates was calculated, assuming a Poisson distribution. Cancer occurrence was stratified to <1 year, 1 to 4, and >or=5 years after a biopsy. RESULTS: A total of 102 de novo cancers were found in 1958 patients. These cancers represent a two- to threefold excess of the expected number at <1 and 1 to 4, but not >or=5 years after a biopsy. Non-Hodgkin's lymphomas were observed six to eight times more than expected. Cancer excess was seen in glomerulonephritides with a known or suspected virus etiology. CONCLUSIONS: The excess cancer rate could be the result of underlying undiagnosed tumors whose antigens have initiated glomerulonephritis, or the immunosuppressive therapy that initiated or energized tumor cells. Based on the findings in our study, there is some support for an association to persistent viruses causing first the glomerulonephritides and then the malignancies, perhaps through a common pathogenesis. This calls for other studies to be done that are specifically designed to investigate this issue, with more data on patient characteristics and confounders.

Female↗
PubMed2003

Validity and representativity in the Danish Breast Cancer Cooperative Group--a study on protocol allocation and data validity from one county to a multi-centre database.

Population-based cancer registries collect basic information on incident cases, whereas clinical databases hold a broad range of variables that make them attractive sources in epidemiological research. Quality, completeness and representativeness of the clinical database in the Danish Breast Cancer Cooperative group (DBCG) were compared with those in a complete population-based database holding detailed information on patients with breast cancer. The study included 1765 patients diagnosed in Aarhus County between 1983 and 1989. Data on tumour characteristics were of high quality. Fifty percent of patients were included in DBCG trials and a total of 83% were notified in the DBCG register, the rest having significantly poorer stage distribution and survival probabilities. However, for patients younger than 70 years of age, the difference in overall survival between all patients and those notified in the DBCG register was only 2%. Follow-up was incomplete in patients treated outside the programme, and this had a major impact on recurrence-free survival. The DBCG database holds high-quality data, but as a population-based database, it is neither comprehensive nor representative.

Adult↗
PubMed2002

Risk for tumor and other disease transmission by transplantation: a population-based study of unrecognized malignancies and other diseases in organ donors.

BACKGROUND: Organ donation may involve the risk of transmittal of unwanted host factors such as infections and malignancy. These may be concealed in the emergent donation process. It may be unavoidable if first observed in a donor postmortem. A number of reports on transferred cancers have been published, but quantification of the risk has never been reliably performed. We report here the first population-based analysis of unrecognized malignancies and other diseases in cadaveric or living-related donors and the possible consequences for the recipients. METHODS: We compiled a cohort of all organ donors through 27 years (1969-1996) in one single kidney transplant center covering a population on one million people. This cohort was linked to the Danish Cancer Registry, the Danish National Hospital Register, and the Danish Register of Causes of Death by means of the unique personal identification number, and all cancers, diagnosis from hospital admissions, and causes of death were identified. Follow-up was to the end of 1996. RESULTS: A total of 626 donors (491 cadaveric and 135 living-related donors) was included in the study. Ten carcinoma in situ or dysplasia cervix uteri (by definition nonmalignant), and 13 malignant tumors (5 of these were detected in living-related donors after donation) were detected by linkage to the cancer registry. All together, 17 recipients received organs from donors with carcinoma in situ or dysplasia cervix uteri and 20 from donors with malignancies. Two recipients from organ donors with carcinoma in situ or dysplasia of the cervix uteri and two recipients from donors with malignancies had a cancer detected; however, these were likely unrelated. One died 1 year after transplantation from a melanoma transmitted from the donor. Two cadaveric donors had previous admissions for glomerulonephritis, five for pyelonephritis, five for nephrolithiasis or ureterolithiasis, four for cystitis, and one for hydronephrosis. CONCLUSION: Despite all efforts to secure a safe organ for transplantation, transmission of donor malignancy and other diseases nevertheless can happen, as is recorded many times in the literature. We have quantified the risk using the population-based cancer registry and found a risk of 8 in 626 (1.3%) for having a donor with undetected malignancy and a risk of 1 in 626 (0.2%) for transmitting a cancer. The risk for getting some transmitted glomerulonephritis is 2 in 626 (0.3%). None of the donors with cerebral malignancies transmitted any tumors to the recipients. Compared with the benefits of organ transplantation, these risks are small; however, if time allows, a search for additional medical information from registries could further minimize the risk of transmission of malignancies or other diseases. However, this requires updated, accurate, and accessible registries and legislation that allows access to personal data and transmission of such data across administrative borders.

Humans↗
PubMed2002

[Relative survival of Danish cancer patients diagnosed 1981 to 1997 and followed to 2001. A status report].

INTRODUCTION: The last comprehensive estimation of survival for Danish cancer patients was carried out 10 years ago. Based on this estimation and on Nordic and international survival comparisons, a national cancer plan was formulated in order to improve the poor relative survival in Danish cancer patients as compared to other Nordic countries. MATERIAL AND METHODS: We used the national cancer register data validated until the end of 1997 and followed up patients below 90 years of age, known from sources other than death certificates and autopsies to the end of 2000. One-, five-, and 10-year relative survival were computed for age groups 0-44, 45-64, 65-74 and 75-89 from 1981 and onwards in five-year calendar periods, ending with a two-year period, 1996-1997. RESULTS: Altogether 396,248 patients were studied. The five-year relative survival improved substantially over time for all sites together (except the skin) to 39% for men and 51% for women. This improvement was seen for cancer of the colon, rectum, breast, bladder, kidney, cervix and corpus uteri, testis, brain, haematological cancers, and malignant melanoma. No improvement was seen for cancer of the lungs in particular, the oesophagus, stomach, oral cavity, and the pharynx. In general, the prognosis was better for the younger age groups than the older groups. DISCUSSION: Future analysis compared to the present will demonstrate the immediate effect, and later the long-term effect, of the National Cancer Plan.

Adolescent↗
PubMed2002

[What is epidemiology and what is cancer epidemiology?].

We have the world's oldest cancer registry in Denmark. We also have a cancer society that has invested substantial funds in epidemiology, which have been well used by highly skilled cancer epidemiologists. This is the formula for success. Cancer epidemiology, which is now conducted at the highest international level in Denmark, is a subdiscipline within epidemiology, and most of its activities are related to public health problems. Clinical cancer epidemiology is, however, a field which will grow in the next decades. Cancer epidemiology requires data of good quality and access to data for use in research. New important results will emerge if trajectories of cancer occurrence can be studied in a lifelong perspective. Research involving genetic factors will also open up new avenues for studies, but it will not replace research, whose starting point is the population's social conditions, their lifestyle, and environmental influences.

Denmark↗
PubMed2002

[Prevention of cancer--what do we do in Denmark and what can we achieve?].

We know from our cancer registers and from epidemiological research that we have a major potential for cancer prevention. If the risk factors had been commonly known in the population and the population had been willing to change their risk behaviours, about one third or perhaps half of all new cases could have been avoided today. Cancer epidemiology has pointed to factors of major importance for public health, such as use of tobacco, dietary factors (including alcohol), physical activity, obesity, environmental exposure in leisure time (sun), and in the workplace. All of these can be subject to primary prevention, i.e. behavior to minimise the individual's risk of contracting cancer. Studies on secondary prevention such as screening for cancer have attracted much attention, perhaps at the expense of secondary prevention related to tobacco, alcohol, and diet in the treatment, thereby avoiding side effects and improving the outcome of therapy. Cancer epidemiology has a long tradition in Denmark, whereas translation of the epidemiological findings into prevention is lagging behind. In future, a close collaboration is needed between health professionals, communication and marketing experts, as well as specialists in education and psychology. Only by joining forces with different disciplines will it be possible to target primary and secondary prevention to ease the burden of disease in the population. Evidently, implementation of preventive measures, will benefit from political will and support.

Denmark↗
PubMed2002

Hematopoietic and lymphatic cancers in relatives of patients with infectious mononucleosis.

BACKGROUND: Young adults with a history of Epstein-Barr virus (EBV)-related infectious mononucleosis have an increased risk for Hodgkin's lymphoma. EBV is detected in Hodgkin's lymphoma Reed-Sternberg cells from some patients, but in young adult patients, it is detected at a relatively low frequency in these cells. Hodgkin's lymphoma and infectious mononucleosis are both associated with high social class, and unknown confounding factors that are also associated with socioeconomic status might explain or contribute to the apparent association between these diseases. To indirectly assess the importance of socioeconomic status on the association between these diseases, we determined the risk for hematopoietic and lymphatic cancers in first-degree relatives of patients with confirmed EBV-related infectious mononucleosis. METHODS: We identified parents, siblings, and offspring of 17,045 persons with serologically confirmed EBV-related infectious mononucleosis. Subjects in these cohorts were linked with the population-based Danish Cancer Register to identify those developing hematopoietic/lymphatic cancers after the index patient was diagnosed with infectious mononucleosis. The relative risk for cancer in the infectious mononucleosis family members was expressed as standardized incidence ratios (SIRs; i.e., the ratio between the number of cancers observed and the number of cancers expected, obtained from age-specific, sex-specific, and period-specific incidence rates). RESULTS: We identified 8052 parents, 5264 siblings, and 28,605 offspring of patients with EBV-related infectious mononucleosis who were followed for a total of 892,213 person-years at risk. The risk for Hodgkin's lymphoma was unaltered in the combined group of first-degree relatives of these patients (SIR = 0.99; 95% confidence interval [95% CI] = 0.62 to 1.59; number of cases [n] = 17), in the group of parents (SIR = 0.83; 95% CI = 0.31 to 2.22; n = 4), in the group of siblings (SIR = 0.96; 95% CI = 0.31 to 2.97; n = 3), and in the group of offspring (SIR = 1.08; 95% CI = 0.58 to 2.02; n = 10). CONCLUSION: The unremarkable risk for Hodgkin's lymphoma in family members of patients with EBV-related infectious mononucleosis indicates that socioeconomic confounding is an unlikely explanation for the association between EBV-related infectious mononucleosis and Hodgkin's lymphoma.

Adult↗
PubMed2002

Validity of diagnoses of and operations for nonmalignant gynecological conditions in the Danish National Hospital Registry.

The recording of surgical procedures for and diagnoses of nonmalignant gynecological conditions in the Danish National Hospital Registry in 1977-1988 were evaluated by comparison with discharge summaries for a sample of 4,919 women. A serious problem was found in the validity of the diagnoses. Little variation was seen over the period of observation. The coding of operations was considered valid. The results of the study raise concern in view of the widespread use of the registry data in medical research. The authors suggest that data from the registry should be thoroughly evaluated before firm conclusions based on such data are published, and that efforts to improve the validity of the data in the Danish National Hospital Registry are increased.

Denmark↗