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Susanne Krüger Kjaer

Publications and source records attributed to Susanne Krüger Kjaer.

At least 19 recordsLinked to original sources
PubMed2007

[Primary ovarian cancer. A comparison of registrations in the Danish Cancer Registry and the Pathology Data Bank].

INTRODUCTION: Ovarian cancer (OC) registrations in the Danish Cancer Registry (CR) and the Danish Pathology Data Bank (PDB) 1978-99 were compared in order to assess the possibility of identifying OC cases from another data source than the CR. MATERIAL AND METHODS: A total of 13,320 OC were identified in the CR/PDB and comparisons of the registrations were performed. RESULTS: The frequency of cases registered in both registries increased during 1978-99. Agreement in registration of histological subtypes in the two registries was found in 82% of the cases. Diagnosis among the rest was most often consistent; however, a more specific diagnosis was often found in one or the other registry. The frequency of women only registered with OC in the CR decreased from 81% to 35%, as the number of women with no diagnoses at all in the PDB declined from 1978 to 1997, whereafter it stabilised, primarily because all pathology departments now reported data to the PDB. In 1997-99, 29% of OC registered in the CR with a histologically verified OC diagnosis was still not registered with cancer in the ovaries in the PDB. Most of these, however, could be identified in the PDB with diagnoses consistent with metastases from OC. In total, 749 OC were not registered in the CR, though explanations for their missing registrations could be found in most cases. CONCLUSION: Data from the PDB may not be useful in complete identification of ovarian cancer cases for research purposes. However, it is a good supplement to data from the CR.

Denmark↗
PubMed2006

[The first HPV vaccine is now available].

More than two thirds of carcinomas of the uterine cervix are caused by human papilloma virus (HPV) types 16 and 18, and 90% of all genital warts are caused by HPV 6 and 11. In June 2006, the US Food and Drug Administration accepted the first prophylactic HPV vaccine against HPV 6, 11, 16 and 18 to be offered to girls and young women. This new vaccine is also now available in Denmark. Questions concerning economics, ethics, organization, and vaccine monitoring need to be discussed in connection with the establishment of a vaccine program. In addition, information to the general population as well as to health care providers and decision-makers should have been given a high priority.

Adolescent↗
PubMed2006

Association of reproductive factors, oral contraceptive use and selected lifestyle factors with the risk of ovarian borderline tumors: a Danish case-control study.

OBJECTIVE: The aim was to examine risk factors for ovarian borderline tumors overall, and according to histological subtype (serous vs. mucinous), in a large Danish population-based case-control study. METHODS: Ovarian borderline cases and controls were recruited from 1995 to 1999, and personal interviews were conducted. In all, 202 cases and 1,564 randomly selected controls were included. The analysis was performed using multiple logistic regression models. RESULTS: The risk of ovarian borderline disease decreased with increasing parity (OR=0.79 per birth, 95% CI: 0.63-0.98) and older age at first birth (OR=0.67 per 5 years, 95% CI: 0.53-0.84). Both a history of breastfeeding and use of oral contraceptives reduced the risk of borderline tumor, the effect being most pronounced for serous tumors. Increasing body mass index (BMI) was associated with elevated risk of serous borderline tumor (OR=1.05 per BMI unit; 95% CI: 1.00-1.10), whereas current smoking was a strong risk factor only for mucinous tumors (OR=2.10; 95% CI: 1.22-3.60). Finally, increasing consumption of milk (all types) was found to increase the risk of borderline disease (OR=1.04 per glass milk per week; 95% CI: 1.02-1.06), and increasing intake of total lactose also increased the risk significantly (OR=1.16 per 50 gram lactose per week; 95% CI: 1.06-1.26). CONCLUSION: The risk profile of ovarian borderline tumors is similar to that of ovarian carcinomas, and we observed significant etiological differences between serous and mucinous borderline tumors.

Adenocarcinoma, Mucinous↗
PubMed2006

Cervical cancer incidence in Denmark over six decades (1943-2002).

INTRODUCTION: The purpose of the study was to describe developments in the incidence of invasive cervical cancer in Denmark, focusing on histological types, over a period of 60 years. We also describe developments in the incidence of carcinoma in situ and mortality. MATERIAL AND METHODS: The study is based on the Danish Cancer Registry database of 39,623 reported cases of invasive cervical cancer diagnosed among Danish women in the period 1943-2002. The most important variables and measures are age-specific and age-standardized incidence and estimated annual percent changes in incidence. RESULTS: A significant reduction in incidence of invasive squamous cell carcinoma among women over 30 during the last 35 years and in incidence of invasive adenocarcinoma among women over 40 during the last 15 years has been seen. In both histological subgroups the relative estimated annual percent change in incidence was largest in the period 1988-2002 as compared to 1968-1987, coinciding with an increase in the number of Danish women covered by the organized screening program. Women 20-29 years old showed a relatively stable squamous cell carcinoma incidence but an increasing adenocarcinoma incidence throughout the study period. CONCLUSIONS: These results suggest that the increasing coverage of the Danish organized screening program is associated with a significant reduction in incidence of invasive squamous cell carcinoma among women over 30, and of invasive adenocarcinoma among women over 40. So far, squamous cell carcinoma incidence and adenocarcinoma incidence among women 20-29 years old seem quite unaffected by the organized screening program.

Adenocarcinoma↗
PubMed2006

Ovarian cancer and genetic susceptibility in relation to the BRCA1 and BRCA2 genes. Occurrence, clinical importance and intervention.

The Nordic countries have the highest incidences of ovarian cancer in the world (around 15 cases per 100,000 women). We have conducted a review of the recent literature with focus on the Nordic countries, on genetic susceptibility to ovarian cancer, and the clinical implications in relation to the BRCAI and BRCA2 genes. One of the strongest risk factors for ovarian cancer is a family history of ovarian and/or early-onset breast cancer. It is thought that germline mutations in BRCA1/2 might be responsible for as much as 10% of all ovarian cancer cases and all families containing either multiple case, site-specific ovarian cancer cases or breast and ovarian cancers together. Data from several international studies suggest that the lifetime risk of ovarian cancer in a BRCA 1 mutation carrier can vary from 18 to 56% and from 14 to 27% in a BRCA2 carrier, depending on the presence/absence of a family history of the disease. Genetic evaluation and testing is used in many countries to identify families with BRCA1/2 mutations. Once a mutation has been identified, genetic counseling and testing can be offered to unaffected family members. Prophylactic oophorectomy in unaffected mutation carriers will eliminate the risk of ovarian cancer, although there is a slight residual risk of peritoneal cancer. During oophorectomy, the Fallopian tube should also be removed. If a woman does not want prophylactic oophorectomy, then tubal ligation or oral contraceptive use can be considered as these have been shown to reduce ovarian cancer risk also in mutation carriers.

Contraceptives, Oral↗
PubMed2006

Maternal smoking predicts the risk of spontaneous abortion.

BACKGROUND: Few studies have examined smoking prior to pregnancy and the occurrence of spontaneous abortion, as most studies have addressed the risk of spontaneous abortion in relation to smoking during pregnancy. However, results are not entirely consistent. The aim of the present study was to assess the risk of spontaneous abortion considering smoking prior to pregnancy. METHODS: We performed a nested case-control study using prospective data from a population-based cohort comprising 11,088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n=343) or who gave birth (n=1,578) during follow-up were selected. Associations between self-reported smoking at enrollment and subsequent spontaneous abortion were analyzed by means of multiple logistic regression. RESULTS: The risk of spontaneous abortion in relation to pre-pregnancy smoking showed a clear dose-response effect. The adjusted odds ratio (95% confidence interval) for spontaneous abortion among current smokers prior to conception was 1.20 (1.04-1.39) per every extra five cigarettes smoked per day. The increased risk was only present for current smokers. The duration of smoking prior to pregnancy was not a significant predictor for subsequent spontaneous abortion. CONCLUSIONS: The amount of daily smoking prior to pregnancy seems to be associated with an increased risk of spontaneous abortion, whereas the duration of smoking does not seem to be related to an increased risk of spontaneous abortion.

Abortion, Spontaneous↗
PubMed2006

Preoperative CA125 as a prognostic factor in stage I epithelial ovarian cancer.

The purpose of the present study was to evaluate preoperative CA125 as a prognostic factor in stage I epithelial ovarian cancer (EOC). Preoperative serum CA125 levels from 118 women with FIGO (International Federation of Gynaecology and Obstetrics) stage I EOC were analysed and the prognostic value was evaluated and compared with other prognostic factors (age, grade, substages, histologic type). By the Kaplan-Meier estimate we demonstrated that patients with stage I EOC and preoperative serum CA125 levels <65 U/mL had a significantly longer survival compared to stage I EOC patients with preoperative serum CA125 > or = 65 U/mL (p=0.01). The results from the present study may be useful for decision making respecting postoperative chemotherapy in stage I EOC patients. Serum CA125 levels might therefore be included as a prognostic factor in future clinical trials of stage I EOC.

Adult↗
PubMed2005

Trends in testicular cancer incidence in the Nordic countries, focusing on the recent decrease in Denmark.

Testicular cancer is the most frequent malignancy among young men, and there have been steady increases in its incidence in most western countries for many decades. Recently, a decrease was seen in some countries, including Denmark. Here, we report recent trends in testicular cancer incidence in the Nordic countries. We address the hypothesis that the causal factors for testicular cancer in Denmark are related to birth cohort and that non-seminoma and seminoma tumours have a common aetiology. An overall increase in testicular cancer incidence was found in the Nordic countries, corresponding to increases with each consecutive birth cohort in each country. In Denmark, a decline in incidence was observed during the past 5 years, and men born around 1943 and around 1968 showed lower incidences than men born just before or just after these dates. These birth-cohort effects were seen both for seminoma and non-seminoma tumours. This descriptive study confirms the hypothesis that birth cohort has a major influence on the incidence pattern of testicular tumours and suggests that seminoma and non-seminoma have common aetiological factors.

Cohort Studies↗
PubMed2005

Trends in the incidence and mortality of ovarian cancer in Denmark 1978-2002. Comparison with other Nordic countries.

BACKGROUND: The Nordic countries are well-known high-incidence areas of ovarian cancer, but even within the Nordic countries, differences exist. METHODS: Focus in this descriptive epidemiological study is to assess developments in incidence and mortality of ovarian cancer in Denmark 1978-2002 and to make a comparison with the development in the other Nordic countries. The results are based on data from the nationwide Danish Cancer Registry as well as the other Nordic Cancer Registries. RESULTS: A total of 14,325 cases of ovarian cancer were registered from 1978 to 2002 in Denmark. In this period, the age-standardized incidence decreased slightly from 14.3 (1978-1982) to 13.3 per 100,000 woman-years (1998-2002). The histology-specific time trends showed a tendency towards more specified histological diagnoses. Iceland had the highest age-adjusted ovarian cancer incidence in the Nordic countries, whereas Denmark had the highest mortality rate. In the entire period, the Danish mortality rate declined from 10.8 (1978-1982) to 9.0 per 100,000 woman-years (1998-1999). Only 19% of ovarian cancers in Denmark from 1978 to 2002 were localized at the time of diagnosis, while 30% had distant metastases. Older women were more likely to have advanced disease at diagnosis. The Danish distribution of stage at diagnosis seems less favorable compared to results from other countries. CONCLUSIONS: The Danish incidence of ovarian cancer seemed to decrease slightly from 1978 to 2002. Even though the mortality rate of ovarian cancer also declined, Denmark had the highest mortality rate of ovarian cancer in the world. Part of it may be explained by a less-favorable distribution of stage at diagnosis.

Adolescent↗
PubMed2005

Acquisition and persistence of human papillomavirus infection in younger men: a prospective follow-up study among Danish soldiers.

No data is yet available on incidence or persistence of human papillomavirus (HPV) infection in men. We enrolled 374 younger male conscripts (18-29 years) in a prospective study, and they were examined twice with an interval of 6 to 8 months. Data collection included a questionnaire and a sample of cells from the penis for HPV detection using PCR. In addition, the presence of Chlamydia trachomatis DNA was assessed in urine samples by means of PCR. The HPV prevalence at the first and second examinations was 33.8% and 31.9%, respectively. The acquisition rate of HPV (overall) during follow-up was 13.8%, and nearly one fourth of the participants were HPV positive at both examinations. Number of sex partners during follow-up was the most important risk factor for acquiring HPV (odds ratio, 17.2; 95% confidence interval, 4.6-64.7, for > or = 3 partners versus < or = 1 partner). In contrast, acquisition of a new HPV type in initially HPV-positive men was strongly related to having multiple HPV types at enrollment (OR, 4.1; 95% confidence interval, 1.4-12.3). This was also the most important risk factor for HPV persistence together with current smoking and having a high-risk HPV type at enrollment. This is the first study to assess risk factors for acquisition and persistence of HPV. The sexually transmitted nature of the infection is confirmed, and the data point to an important role of having multiple HPV types for persistence.

Adult↗
PubMed2004

Reactivity of human sera in a sensitive, high-throughput pseudovirus-based papillomavirus neutralization assay for HPV16 and HPV18.

Sensitive high-throughput neutralization assays, based upon pseudoviruses carrying a secreted alkaline phosphatase (SEAP) reporter gene, were developed and validated for human papillomavirus (HPV)16, HPV18, and bovine papillomavirus 1 (BPV1). SEAP pseudoviruses were produced by transient transfection of codon-modified papillomavirus structural genes into an SV40 T antigen expressing line derived from 293 cells, yielding sufficient pseudovirus from one flask for thousands of titrations. In a 96-well plate format, in this initial characterization, the assay was reproducible and appears to be as sensitive as, but more specific than, a standard papillomavirus-like particle (VLP)-based enzyme-linked immunosorbent assay (ELISA). The neutralization assay detected type-specific HPV16 or HPV18 neutralizing antibodies (titers of 160-10240) in sera of the majority of a group of women infected with the corresponding HPV type, but not in virgin women. Sera from HPV16 VLP vaccinees had high anti-HPV16 neutralizing titers (mean: 45000; range: 5120-163840), but no anti-HPV18 neutralizing activity. The SEAP pseudovirus-based neutralization assay should be a practical method for quantifying potentially protective antibody responses in HPV natural history and prophylactic vaccine studies.

Alkaline Phosphatase↗
PubMed2004

Why do slim women consider themselves too heavy? A characterization of adult women considering their body weight as too heavy.

OBJECTIVE: The purpose of this study was to characterize women who, in spite of a low body mass index (BMI), considered themselves too heavy. METHOD: Of 11,905 women (27-38 years of age), we focused on 2,443 nonpregnant women with a low BMI (18.5-21.0 kg/m(2)), who considered their weight acceptable or too heavy. Participants completed a comprehensive questionnaire. By multiple logistic regression we examined associations between lifestyle and health variables and the risk of considering own body weight too heavy. RESULTS: Approximately 10 % considered their body weight too heavy. Risk factors included early severe life events, young age at start of risky lifestyle behaviors, weight fluctuation, self-reported lifetime history of eating disorders, perception of too heavy workload, and poor physical form and self-rated health. Body dissatisfaction decreased with increasing age. DISCUSSION: Our results indicate that body dissatisfaction is established in childhood and adolescence. It is unknown if this body dissatisfaction influences the life of the women, but it might influence the values they pass on to their children.

Adolescent↗
PubMed2004

Childhood tumor risk after treatment with ovulation-stimulating drugs.

OBJECTIVE: To assess childhood cancer risk among children conceived following the use of ovulation-stimulating drugs. DESIGN: Record linkage study. SETTING: Infertility patients and their offspring as identified through medical records. PATIENT(S): Cohort of 30,364 Danish women evaluated for infertility beginning in the early 1960s. MAIN OUTCOME MEASURE(S): Standardized incidence ratios (SIRs) compared cancer incidence in the children to the Danish population. Case-cohort techniques calculated rate ratios (RRs) according to prior maternal drug exposures. RESULT(S): A total of 51 cancers were identified among the study children, resulting in an SIR of 1.14 (95% confidence interval [CI] 0.8-1.5). Usage of any fertility drug was associated with an RR of 0.82 (95% CI 0.4-1.6) and clomiphene citrate with an RR of 0.77 (95% CI 0.4-1.6). Tumors occurring early in life and nonhematopoietic malignancies (including neuroblastomas) were not associated with drug usage. Nonsignificant elevations in the risk of cancers occurring later in life, especially childhood hematopoietic malignancies (RR for use of any ovulation-stimulating drugs of 2.30, 95% CI 0.8-6.6), may have been related to underlying reasons for medication usage. CONCLUSION(S): Although the findings of this study are reassuring, additional adequately powered studies should continue monitoring the effects of ovulation-stimulating drugs on specific tumors, including hematopoietic malignancies.

Adult↗
PubMed2003

Alcohol use as predictor for infertility in a representative population of Danish women.

BACKGROUND: Our aim was to examine the association between use of alcohol and subsequent incidence of primary infertility. METHODS: The study subjects were chosen from a population-based cohort of Danish women aged 20-29 years. Eligible women were nulliparous and not pregnant (n = 7760). Information on alcohol intake and potential confounders (age, education, marital status, diseases in the reproductive organs, and cigarette smoking) was assessed at enrollment. The incidence of fertility problems during follow-up was obtained by record linkage with the Danish Hospital Discharge Register and the Danish Infertility Cohort Register. Main outcome measures were hazard ratios of infertility according to alcohol intake at baseline estimated in a multivariate Cox proportional hazards model. RESULTS: During a mean follow-up of 4.9 years, 368 women had experienced infertility. Alcohol intake at baseline was unassociated with infertility among younger women, but was a significant predictor for infertility among women above age 30. In this age group, the adjusted hazard ratio for consuming seven or more drinks per week was 2.26 (95% confidence interval: 1.19-4.32) compared with women consuming less than one drink per week. CONCLUSIONS: These findings suggest that alcohol intake is a predictor for infertility problems among women in the later reproductive age group.

Adult↗
PubMed2003

Chapter 2: Natural history of anogenital human papillomavirus infection and neoplasia.

This chapter suggests promising areas of future epidemiologic research on human papillomavirus (HPV) and anogenital cancer, organized around our understanding of cervical carcinogenesis. The major steps in cervical carcinogenesis include HPV infection, HPV persistence over a certain period of time, progression to precancer, and invasion. Backward steps include clearance of HPV infection and regression of precancer. Additional studies of incident HPV infections among virgins initiating sexual activity could clarify the earliest aspects of transmission and immune response. Research on older women and their male partners should focus on understanding the determinants of varying age-specific HPV prevalence curves and underlying dynamics of viral persistence, clearance, and latency. It will be particularly important for epidemiologists to define HPV persistence rigorously in order to guide clinical management and vaccine trials. Intensive longitudinal studies that collect visual, microscopic (cytologic and histologic), and molecular data will be needed to understand the fate of individual HPV infections and to clarify whether multiple, concurrent infections act independently on the cervix. Case-control designs will be useful mainly in searching for new biomarkers of risk of progression among HPV-infected women that could then be validated prospectively. Prospective confirmation is also needed for the etiologic cofactors established by case-control studies of invasive cervical cancer. Much of the knowledge about cervical cancer might apply to anal neoplasia. Epidemiologic studies of other genital tumors such as penile neoplasia are still needed, but multicentric groups must place great emphasis on measurement technology, given the difficulty in obtaining reliable comprehensive measurements.

Age Distribution↗
PubMed2002

[Human papillomavirus and the risk of anogenital cancer].

Strong evidence suggests that virtually all cases of cervical cancer are caused by infection with oncognenic types of human papillomavirus (HPV). HPV is also found frequently in neighbouring anogenital epithelia and their neoplastic lesions. This review describes the general aspects of the natural history of anogenital HPV infections and summarises the evidence for an association between HPV and cancers of the uterine cervix, vulva, anus and penis.

Anus Neoplasms↗