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PubMed1989

Risk factors for cervical cancer in Greenland and Denmark: a population-based cross-sectional study.

The incidence of cervical cancer in Greenlandic women aged 20-39 years is nearly 6 times higher than in Danish women of the same age. Possible determinants of cervical cancer incidence were investigated in a population-based cross-sectional study. From Nuuk (Greenland) and Nykøbing Falster (Denmark) a sample of 800 women aged 20-39 years was drawn at random. A total of 586 and 661 women were studied in Greenland and Denmark, respectively. All underwent a personal interview. In Greenland, 13% of the women reported first intercourse before the age of 14 in contrast to 3.5% in Denmark, and nearly 85% of the Greenlanders had their sexual debut before the end of the 16th year of age whereas this applied to only 45% of the Danish women. The prevalence of women with 0-1 lifetime sexual partner was 20.4% in Denmark, and only 1.7% in Greenland. In contrast, 53.2% of the Greenlandic women reported more than 20 partners and 22.4% more than 40 partners. The corresponding figures for Denmark were 3.6% and 0.3%, respectively. In Greenland the most common contraceptive method was the use of intra-uterine devices (73.6%), whereas, in Denmark, oral contraceptive use was most frequent (87.9%). Few Greenlanders had ever used "barrier" contraceptives (diaphragm: 1.4%; condom: 18.1%) compared to Denmark (diaphragm: 10.1%; condom: 53.9%). As many as 87.4% were current smokers in Greenland (Denmark: 53.6%) and 5.6% claimed to have never smoked, whereas this applied to 35.3% in Denmark. The indications of a higher sexual activity (multiple partners, early age at first intercourse) in Greenland compared to Denmark are in line with the observed higher rates of sexually transmitted diseases and with the hypothesis that differences in cervical cancer incidence between Greenland and Denmark are determined by aspects of sexual background.

Adult↗
PubMed1988

Human papillomavirus, herpes simplex virus and cervical cancer incidence in Greenland and Denmark. A population-based cross-sectional study.

In Greenland, the incidence of cervical cancer is 5.7 times higher than in Denmark among women aged 20-39. From Nuuk (Greenland) and Nykøbing Falster (Denmark) a sample of 800 women aged 20-39 years was drawn at random. A total of 586 and 661 women were investigated in Greenland and Denmark respectively. All women had a gynecological examination including a PAP-smear and cervical scrape for HPV-analysis (filter in situ hybridization). A blood sample was taken for analysis of HSV type-specific antibodies (ELISA). The percentage of normal smears was identical in the 2 areas (95%). The total HPV 16/18 infection rate was 13% in Denmark and 8.8% in Greenland, and the age-adjusted prevalence rate in Greenland was only 67% of that in Denmark (95% CI: 0.05-0.89). The proportion of HPV 6/11 positivity was the same in Greenland and in Denmark (6.7% vs. 7.5%). A significantly higher proportion of the Greenlandic women had HSV-2 antibodies (68.2%) in comparison with Danish women (30.9%) (p less than 0.01). The prevalence of HSV-1 was also higher in Greenland, especially in women aged 20 to 24. Our finding of a higher HPV infection rate in Denmark than in Greenland, opposed to cervical cancer rates, does not support a role for these viruses as determinants of cervical cancer incidence. In contrast, the rate of HSV-2 infection co-varies with the observed incidence of cervical cancer. This is in line with the notion that differences in cervical cancer incidence between Denmark and Greenland are determined by aspects of sexual behavior.

Adult↗
PubMed2006

Usage of veterinary therapeutic antimicrobials in Denmark, Norway and Sweden following termination of antimicrobial growth promoter use.

Antimicrobial growth promoters (AGPs) were phased out in Denmark, Norway and Sweden in 1998-1999, 1995 and 1986, respectively. The annual usage of therapeutic antimicrobials in animals in Denmark almost doubled during the period when AGPs were phased out (1988-1999) and in the subsequent 2 years. The increase was mainly due to an increased consumption of therapeutic antimicrobials in weaning pigs. The annual increase in usage of therapeutic antimicrobials and the annual increase in numbers of slaughter-swine produced in Denmark correlates well, except for 1999 when AGP use was discontinued in weaning pigs, and the following year. In Norway, the usage of therapeutic antimicrobials in animals decreased by 39% from 1995 to 2000. During 2001-2003 the annual usage remained at the 2000-level. The annual numbers of slaughter-swine produced in Norway increased gradually by 10% after the AGP discontinuation (from 1995 to 2003). In Sweden, the usage of therapeutic antimicrobials in animals increased by 21% the first 2 years subsequent to the AGP ban (1986-1988), remained then constant until 1994; from 1994 to 2003 this usage declined by 47%. The initial increase was caused by increased use in broilers and in weaning piglets. The amounts used in animals in Sweden in 2003 were half of the amounts used in 1994. The annual numbers of slaughter-swine produced in Sweden declined gradually by 16% in the study period, although fluctuating. In Denmark, Norway and Sweden the number of dairy cattle and beef cattle declined only slightly in the various study periods while numbers of broilers produced increased notably, especially in Norway and Sweden. Following the termination of AGPs the total usage of antimicrobials (AGPs and therapeutic antimicrobials) in animals in Denmark declined 36% (from 1996 to 2003): in Norway this figure was 45% (from 1995 to 2003). In Sweden, the total usage of antimicrobials in animals in 2003 amounted to only one third of the amounts used in 1984 (decreased from 51 to 16 tonnes). Termination of AGPs was only a temporary risk factor for increased usage of therapeutic antimicrobials in food-animals in Sweden and Denmark; however, an exception might be usage in weaning piglets in Denmark. Furthermore, the discontinuation of AGP use has decreased the overall annual usage of antimicrobials in animals in Denmark, Norway and Sweden considerably.

Animal Diseases↗
PubMed2004

Case-fatality rates for myocardial infarction declined in Denmark and Sweden during 1987-1999.

OBJECTIVE: To evaluate trends in prognosis after acute myocardial infarction (AMI) between Denmark and Sweden using routinely collected data and different case-fatality measures. STUDY DESIGN AND SETTING: We compared three case-fatality measures during 1987-1999 using national registries in Denmark and Sweden, and extended these measures with underlying deaths of ischemic heart disease and sudden deaths of unknown cause. RESULTS: Changed coding practice distorted trends of case fatality rates during the day of the event. In general, Denmark had higher case-fatality rates, but trends in hospital-based rates were very similar, except for men 35-64 years old; Denmark declined more steeply. Short- and long-term prognosis improved considerably: the odds ratios for case fatality during days 1-28 for 1999 vs. 1987 were 0.48 among men in Denmark (women 0.58) and 0.53 among men in Sweden (women 0.55) and the odds ratios for case fatality during days 29-365 for 1999 vs. 1987 were 0.56 among men in Denmark (women 0.65) and 0.66 among men in Sweden (women 0.67). CONCLUSION: Short- and long-term prognosis improved considerably during 1987-1999 in Denmark and Sweden. Case fatality during the day of the event is epidemiologically important, but less certain than case-fatality measures defined after the day of the event when comparing countries.

Adult↗
PubMed1972

Salmonella in pigs and animal feeding stuffs in England and Wales and in Denmark.

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0.3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.It is concluded that sterilization of animal raw ingredients in Denmark has reduced pig infections with types other than S. typhimurium that are found in England and Wales, but not with S. typhimurium. It is possible that this is because S. typhimurium once introduced into pigs is able to establish itself more easily than other serotypes.

Animal Feed↗
PubMed2002

Allergen sensitization and allergen exposure in Greenlander Inuit residing in Denmark and Greenland.

The aim of this study was to estimate the prevalence of allergic sensitization and possible risk factors in a genetically homogenous Inuit population living under widely differing climatic and cultural conditions. A written questionnaire and skin prick test for 10 aeroallergens were obtained from 1119 adult Greenlanders residing in Denmark, Nuuk (main city in Southern Greenland) and Uummannaq (rural settlement in Northern Greenland). Allergen exposure was assessed by pollen counts, questions on pet keeping and counts of house dust mites in dust samples. The overall prevalence of at least one positive skin prick test was 22.8% in Denmark, 10.6% in Nuuk, and 6.4% in Uummannaq. In Denmark, the total birch pollen counts were 40-1000 times higher compared to Nuuk, whereas the grass pollen count was 13-30 times higher in Denmark compared to Nuuk. Dogs were held indoor with a similar frequency in Denmark and Nuuk, but much less frequently in Uummannaq. In Denmark, house dust mites were found in 72% of house holds (>10/0.1 g dust). Less than 15% of households in Greenland had measurable levels of house dust mites. The prevalence of sensitization to aeroallergens in Inuit Greenlanders differed significantly between Denmark, Nuuk and Uummannaq. These findings correlated with the observed differences in population allergen exposure in the three regions. Furthermore, differences in lifestyle factors such as educational level, stress and ethnic self-identification seemed to be associated with the risk of allergic sensitization in Greenland.

Adolescent↗
PubMed2000

Associations between the use of antimicrobial agents for growth promotion and the occurrence of resistance among Enterococcus faecium from broilers and pigs in Denmark, Finland, and Norway.

This study compares the susceptibility of Enterococcus faecium isolated from pigs and poultry in Denmark, Finland, and Norway to antimicrobial agents used for growth promotion. E. faecium was isolated from 211 broilers and 55 pigs in Denmark in 1997, from Norwegian 55 poultry farms (turkey and broiler farms) and 4 swine farms between 1995 and 1997, and Finnish poultry (52) and swine (43) in 1996 and examined for susceptibility to avilamycin, avoparcin, bacitracin, flavomycin, monensin, salinomycin, spiramycin, tylosin, and virginiamycin. Only a limited number of isolates were categorized as resistant to monensin or salinomycin. In general, an association between the usage of antimicrobial agents in the respective countries and the occurrence of associated resistance was observed. Resistance to avilamycin was frequently observed among isolates from broilers in Denmark, where avilamycin has been used, whereas all isolates from Finland and Norway, where these drugs have not been used, were susceptible. The same phenomenon could be observed for avoparcin, bacitracin, tylosin, and virginiamycin; resistance was frequently observed among isolates from where these antimicrobials have been widely used, but rarely among isolates from where the use has been limited. Also for avoparcin and bacitracin, an association between usage and occurrence of resistance was observed. All isolates categorized as avoparcin resistant contained the vanX gene; isolates from broilers had the T variant in position 8,234 and isolates from pigs the G variant. Three (1%) of the 222 isolates resistant to tylosin contained the ermA gene and 196 (88%) ermB. Sixteen (11%) of the 146 virginiamycin-resistant isolates from broilers and two (7%) of the 27 virginiamycin-resistant isolates from pigs in Denmark contained the satA gene, whereas satA was not observed among any of the virginiamycin-resistant isolates from Finland. A total of 72% of the virginiamycin-resistant E. faecium from broilers in Denmark and all nine virginiamycin-resistant E. faecium from Finland contained satG. This gene was also observed among two (7%) of the virginiamycin-resistant isolates from pigs in Denmark. This study indicates that the use of antimicrobial agents for growth promotion in Denmark, Finland, and Norway have selected for resistance to most of these drugs among E. faecium in food animals.

Animals↗
PubMed1982

Variations between and within countries in hospital care for peptic ulcer. A comparison between Denmark and Sweden.

The present study tries to examine variations in utilization rates for hospital care for ulcer disease between and within Denmark and Sweden. The focus is on how utilization rates differ but an attempt is also made to explain why regional differences occur. Hospital patient statistics from both countries show that ulcer disease accounts for 35% more bed-days per 100000 inhabitants in Denmark than in Sweden. The main source for this difference is duodenal ulcer, where the number of bed-days is 63% higher in Denmark. The differences in length of stay are negligible and the numbers of surgical operations are about the same in the two countries. The greater utilization of hospital resources in Denmark is explained mainly by the fact that more medical cases are treated as in-patients in Denmark than in Sweden. Neither mortality rates nor other data support the hypothesis that the incidence of duodenal ulcer is higher in Denmark than in Sweden. The difference between Denmark and Sweden widens when utilization rates are adjusted for differences in the age structure of the population in the two countries. There are wide variations in utilization rates between regions within both countries. The findings support the hypothesis that the intertemporal change in the technology for management of ulcer disease is one of the main reasons for variations between and within countries.

Denmark↗
PubMed1997

[HIV/AIDS development in Denmark and Sweden. Are there differences?].

National surveillance data from Denmark and Sweden were analyzed for trends in the incidence of HIV and AIDS. By the end of 1995, the cumulative number of AIDS cases was higher in Denmark than in Sweden, but since the annual incidence was still increasing in Sweden and slightly decreasing in Denmark, the Denmark:Sweden ratio of the overall annual AIDS incidence has decreased since 1992, and so has this ratio of incidence among homo/bisexual men. The cumulative number of acquired infections was estimated to be higher in Denmark than in Sweden, although the bi-annual proportional increase in incidence from 1987 to 1993 was higher in Sweden than in Denmark. In both countries, the annual number of new identified HIV infections among homo/bisexual men has become stable, although the Denmark:Sweden ratio has decreased since 1990. In conclusion, the national epidemiological data do not indicate that the Swedish strategy has been more effective than the Danish in preventing new HIV infections.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Reduced mortality for women with mammography-detected breast cancer in east Denmark and south Sweden.

The 5-year relative survival from breast cancer in Denmark is 10 percentage points lower than in Sweden. This difference has been demonstrated previously as being caused partly by more involved lymph nodes and larger tumours in Denmark. Sweden has had nationwide mammography-screening coverage since 1991, whereas this is still in its infancy in Denmark. In the search for an explanation for the remaining survival difference, patient delay was a likely candidate. This study compared patient delay and mammography-detection between two national regions. Data on patient delay and mammography were obtained from hospital records from 1989 and 1994, and analysed using Cox proportional hazard analysis of death within the first 5 years, with the factors age, country, delay/mammography detection and established patho-anatomic variables. A comparison of patient delay and mammography detection in 1989 and 1994 showed more mammography-detected tumours in south Sweden and more women with long delay in east Denmark. Mammography detection, but not long patient delay, had a significant effect on the death hazard when adjusting for patho-anatomic risk factors. The hazard ratio was not eliminated in 1989, but in 1994, the hazard ratio between east Denmark and south Sweden was reduced from 1.3 to 1.1. In conclusion, patient delay did not appear to have any effect on 5-year survival when adjusting for patho-anatomic factors, but tumour detection by mammography affected survival favourably and partly explained the survival difference between east Denmark and south Sweden.

Adult↗
PubMed2004

Respiratory symptoms in greenlanders living in Greenland and Denmark: a population-based study.

BACKGROUND: Knowledge of respiratory diseases in an arctic population with increasingly westernized lifestyles provides the opportunity to obtain new information in this field. OBJECTIVE: To investigate the influence of environment and lifestyle on the presence of respiratory symptoms in a genetically homogenous population sample living under widely differing conditions. METHODS: Greenland is a part of Denmark, but its climate is mainly arctic, as opposed to the temperate climate of southern Denmark. A random sample of Inuits who had immigrated to Denmark and Inuits from 3 towns and 4 remote settlements in Greenland were studied. Of the 6,695 invited Inuits, 4,162 (62%) completed a questionnaire concerning respiratory symptoms and risk factors. RESULTS: Of the 4,162 Inuits, 847 (20%) had respiratory symptoms. Bronchitis was more frequent in the areas of Greenland than in Denmark (26% and 20% vs 13%; P < .001), whereas the pattern of asthma was contradictory (6% and 9% vs 10%; P = .057). Bronchitis was associated with living area (P = .01), tobacco consumption (P < .001), and asthma (P = .001), whereas asthma was related to living area (P = .03), hay fever (P < .001), low intake of whale (P = .04), years in Denmark (P = .09), and bronchitis (P < .001). CONCLUSIONS: Inuits' prevalence of bronchitis and asthma differed, with a higher frequency of bronchitis and a lower frequency of asthma in Inuits living in Greenland compared with Denmark. Living conditions or areas, diet, tobacco use, climate, and atopy are important for the presence of symptoms.

Adult↗
PubMed1993

Human papillomavirus, herpes simplex virus and other potential risk factors for cervical cancer in a high-risk area (Greenland) and a low-risk area (Denmark)--a second look.

The prevalence of human papillomavirus (HPV) infection and other risk factors were studied in a high risk area for cervical cancer (Greenland) and in a low risk area (Denmark). From Nuuk (Greenland) and Nykøbing Falster (Denmark), random samples of 150 women aged 20-39 years were drawn. A total of 129 and 126 women were included in Greenland and Denmark, respectively. The proportion of HPV infected women assessed by ViraPap was similar in Denmark and Greenland (4.8 vs 3.9%). When type specific polymerase chain reaction (PCR) was used, the total HPV detection rate was 38.9% in the Danish population and 43.4% in the Greenlandic. A similar interrelationship between Greenland and Denmark applied to the HPV types 11, 16, 18 and 33. No relationship was observed between HPV detection and number of partners for any of the diagnostic methods. Significantly more Greenlandic than Danish women had antibodies to HSV 2, 76.0% and 26.2%, respectively. The prevalence of self-reported histories of selected venereal diseases was also highest among Greenlanders, except for genital warts where the prevalence was similar in the two areas. Greenlandic women had significantly more sexual partners, earlier age at first intercourse, more current smokers and less use of barrier contraceptives compared to the Danish women. This study confirms the results of our previous population-based cross-sectional comparison study in these areas, corroborating the conclusion that the prevalence of detectable HPV infection does not seem to be a determinant of cervical cancer incidence. However, by using DNA hybridisation techniques, temporal virus shedding is only measured at one point in time. Detectable virus shedding may not correlate with the risk of cervical cancer. In fact, HPV DNA detection may have different implications in different populations. In Denmark, HPV DNA detection may reflect transient, recently acquired infection, whereas in Greenland, it is more indicative of chronic persistent infection.

Adult↗
PubMed2005

Total hip arthroplasty in Denmark: incidence of primary operations and revisions during 1996-2002 and estimated future demands.

BACKGROUND: The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs. METHODS: We calculated the incidence rates (IR) of primary THA and revision in Denmark between 1996 and 2002 and estimated the demands for primary THA in Denmark until 2020. We used data from the Danish Hip Arthroplasty Registry, a nationwide and population-based clinical database, to identify patients who had undergone primary THA (n = 37,144) or revision arthroplasties (n = 6446). Age and sex-specific data on the Danish population were obtained from the StatBank Denmark. All IRs were standardized according to two standards, i.e. the Danish population in 1996 and the European standard population (18 age groups). The future demands for primary THA were estimated using the age and sex-specific incidence of primary THA for 2002 as a reference, and taking into account the expected changes in the age distribution of the population and the trend in IRs seen in Denmark between 1996 and 2002. RESULTS: The annual overall standardized IRs of primary THAs and revisions increased from 101 (95% confidence interval (CI): 97.6-104) to 134 (CI: 131-138) and from 19.2 (CI: 17.9-20.5) to 21.1 (CI: 19.8-22.4) per 100,000 inhabitants from 1996 to 2002, respectively (IRs adjusted to the Danish population in 1996). The IRs of primary THAs and revisions increased by 30% and 10% during this period. The relative increase in IRs of primary THAs was found to be similar in both women and men. The increase was higher among patients aged 50-59 years, however. Furthermore, a decrease in IRs was seen in patients who underwent primary THA due to rheumatoid arthritis. IRs of primary THAs have been estimated to increase by 22% in 2020 compared with 2002, based only on the expected changes in the age distribution of the population. However, assuming that the annual age and sex-independent increase in the IRs seen in the period 1996-2002 will continue, the IR of primary THA is estimated to increase by as much as 210% in 2020. INTERPRETATION: The overall annual standardized IRs of primary THAs and revisions in Denmark increased during the period from 1996 to 2002. Moreover, the demands for THA procedures in the coming decades may exceed the current capacity due to the ageing population and a continued age and sex-independent increase in surgical activity.

Adolescent↗
PubMed2004

Features of the development of a welfare system for visually disabled people in Denmark.

PURPOSE: To describe the development of a formal system of welfare for blind and partially sighted people in Denmark. METHODS: The principal laws in Denmark relating to a formal system of welfare for blind and partially sighted people are noted and commented on. No such collection of laws has been found in the literature. The history of aid to visually disabled people in Denmark is described, as are the Danish classifications of visual impairment. DEVELOPMENT: Formalized welfare for blind and partially sighted people was started in Denmark in 1811, as a private initiative by the Kjaede Order. Later, the Danish state took over responsibility, and in 1858 the Royal Danish Institute for the Blind was established. Since then a series of laws concerning welfare for blind and partially sighted people have been issued in accordance with economic and social development in Denmark. In 1858 the Braille writing system for blind people was introduced. The Danish Association of the Blind was founded in 1911 and has profoundly influenced subsequent legislation. During the last 10 years, several visual centres have been established. Since 1968 prevention of blindness has also played a prominent role in Denmark. CONCLUSION: Great steps have been taken towards improving the welfare of blind and partially sighted people. However, being blind is still very difficult. Modern technologies and hectic lifestyles have created new problems for blind people. The obligations of the Danish state towards visually disabled people have, therefore, increased in recent years.

Blindness↗