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Biomedical subjects

K Giersiepen

Publications and source records attributed to K Giersiepen.

6 recordsLinked to original sources

[Screening for colorectal cancer: what is the most effective strategy?].

Colorectal cancer is one of the most common cancers in Western countries. The long natural history of colorectal cancer provides opportunities for detection of early stage cancer and for prevention of cancer by removal of adenomas. An effective screening technique should significantly reduce morbidity and mortality in the population. Several tests are available to screen healthy subjects at average risk for colorectal cancer: total colonoscopy, combined sigmoidoscopy and faecal occult blood test (FOBT), FOBT alone. At the present time clear evidence for the most effective screening strategy is not available. Colonoscopy screening in Germany needs an adequate tool to evaluate the programme. Follow up is essential and cancer registries would be an important partner.

Clinical Trials as Topic↗

[The Bremen mortality index].

The Bremen Mortality Index (BreMI) is an electronic data file providing all information found on death certificates of former Bremen citizens who have died after December 31, 1997. BreMI follows the example of the National Death Index (NDI) in the USA, which has provided information on the vital status of US citizens and cause of death since 1979. The Bremen Mortality Index has been linked successfully to the Bremen Cancer Registry and has improved the efficiency of following up cancer patients. A substantial number of death certificates may be checked automatically for the presence of a cancer diagnosis or any other diagnosis. The Bremen Mortality Index may be used as a primary source for data on particular causes of death. It will be used for developing a German thesaurus for automated coding of medical entities and for determining causes of death.

Cause of Death↗

Gender differences in carpal tunnel syndrome? occupational and non-occupational risk factors in a population-based case-control study.

PURPOSE: To determine the role of occupational and personal risk factors of carpal tunnel syndrome (CTS) separately in men and women.METHODS: Men (n = 404) and women (n = 404) younger than 65 years with first surgery for CTS in 1995/96 were sampled at random from the Bremen population (0.65 million) and matched to controls by age and gender sampled from the population registry. A self-administered questionnaire with 77 questions inquired about personal factors and activities during work and private environment (response: 60% of eligible cases and 52% in controls, respectively).RESULTS: CTS risk increased with body mass index (BMI): odds ratio for each unit of BMI [kg/m(2)] OR(men) = 1.13; (95%-confidence-limits CL(men) 1.06, 1.20), OR(women) = 1.09 (CL(women) 1.04, 1.14). Multivariate analysis adjusting for BMI showed more pronounced risks in men compared with women for repetitive movements of the hand: OR(m) = 2.89 (CL 1.82, 4.58); OR(w) = 2.10 (CL 1.37, 3.22), for forceful grip: OR(m) = 2.69 (CL 1.70, 4.27); OR(w) = 2.29 (CL 1.43, 3.66), but not for household chores: OR(m) = 0.64 (CL 0.40, 1.03); OR(w) = 0.88 (CL 0.34, 2.29). Women worked less hours per week than men but manual exposures remained more relevant in men after adjustment. Exposure-response-relationships could be demonstrated for all work related exposures. Women were at higher risk for CTS if they had had more than two births or a history of hysterectomy. Adding these factors to the logistic model still showed an association between manual work and CTS. Blinded expert rating (manual vs. non-manual) of jobs held by respondents and non-respondents and by cases and controls did not reveal relevant selection effects or recall-bias.CONCLUSIONS: CTS is a work related disease in both men and women, the fraction attributable to work in the Bremen population under age 65 is estimated to be 33% in men and 15% in women. Funding: German Federal Ministry for Education & Research: 01 EG 9512.

Journal Article↗

[Coding of cause of death for mortality statistics--a comparison with results of coding by various statistical offices of West Germany and West Berlin].

1.136 death certificates representing all 1985 Bremen cardiovascular deaths and a 50%-sample of non-cardiovascular deaths in the age group 25-69 years were analyzed for reliability of nosologists' coding according to ICD-coding rules (9th revision). The 1.136 photocopied death certificates were used to assess intra-observer-variation in Bremen and to determine inter-observer-variation among 7 nosologists from 6 different State Statistical Offices and the Federal Statistical Office. Intra-observer-agreement in Bremen was found to be similar to the results presented in a comparable US-study: Bremen: 92.1%; Curb et al. 1983: 94.8%-96.1%; 3-digit-ICD-Code. Inter-observer-agreement was found to be much lower in Germany than in two US-studies: 3 coders agreeing on 3-digit-ICD-Code: Bremen: 67.7% (average, 3 coders out of 7); Curb et al.: 90.2% (3 coders); 3 coders agreeing on 4-digit-ICD-Code: Bremen: 61.5%; NCHS 1980: 90.3%. Agreement-rates were also much lower in Germany than in the USA (Curb et al.) when particular disease groups were analysed: Ischaemic heart disease (ICD 410-414): Bremen: 82.7% (average); USA: 97.2%; cerebrovascular disease (ICD 430-438): Bremen 65.6% (average); USA: 93.2%; neoplasms (ICD 140-239): Bremen: 94.0% (average); USA: 97.8%. We conclude that training, individual characteristics of nosologists, and other factors may cause important artifacts when comparing German mortality statistics on a regional level or during different time intervals.

Berlin↗

Cardiovascular disease risk factors, CHD morbidity and mortality in the Federal Republic of Germany.

Analyses of data from the first National Health Examination Survey undertaken from 1984-1986 within the framework of the German Cardiovascular Prevention Study, show the following risk factor prevalences in 25-69 year-old men and women: overweight (BMI males: greater than 25, females greater than 24) or obese (BMI greater than 30): men 65.0%, women 57.6%; total serum cholesterol (less than 5.17 mmol/dl): men 73.7%, women 74.0%; normal blood pressure (according to JNC definitions): men 45.0%, women 59.1%; hypertension according to WHO criteria: men 26.0%, women 21.1%; controlled hypertensives (WHO criteria): men 19.9%, women 33.9%; current smoking: men 40.8%, women 26.1%. For most of the cardiovascular risk factors there is a clear negative association between prevalence and length of school education. Three myocardial infarction (MI) registries (WHO MONICA Project) are operating in the Federal Republic of Germany. Incidence and case-fatality data are within comparable ranges. Coronary heart disease (CHD) mortality has been relatively stable in both sexes from 1970 to 1986 with a minor peak in 1976 and a slight downward trend since then. A study of the reliability of coding procedures in West German state statistical offices revealed major disagreements so that trends derived from national mortality data as aggregate data of the federal states might be spurious. An ecological correlation of regional smoking prevalences (1978) and regional CHD mortality rates (1977-9) showed significant coefficients in men, but not in women.

Adult↗