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K. Agergaard, M. Mau-Sørensen, T.B. Stage, T.L. Jørgensen, R.E. Hassel, K.D. Steffensen, J.W.Pedersen, M.L.H. Milo, S.H. Poulsen, A. Pottegård, J. Hallas, K. Brøsen, T.K. Bergmann
Clopidogrel paclitaxel drug-drug interaction: a pharmacoepidemiologic study
Clin Pharmacol Ther 2017: doi: 10.1002/cpt.674.
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Background: Our study indicates that clopidogrel is associated with a clinically relevant increased risk of neuropathy in patients treated with high dose paclitaxel.
Alex Kappel Kørup, René dePont Christensen, Connie Thurøe Nielsen, Jens Søndergaard , Nada A Alyousefi, Giancarlo Lucchetti, Klaus Baumann, Eunmi Lee, Azimatul Karimah, Parameshwaran Ramakrishnan, Eckhard Frick, Arndt Büssing, Esther Schouten and Niels Christian Hvidt
The International NERSH Data Pool — A Methodological Description of a Data Pool of Religious and Spiritual Values of Health Professionals from Six Continents
Religions 2017;8:24; doi:10.3390/rel8020024.
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Background: Collaboration within the recently established Network for Research on Spirituality and Health (NERSH) has made it possible to pool data from 14 different surveys from six continents. All surveys are largely based on the questionnaire by Curlin “Religion and Spirituality in Medicine, Perspectives of Physicians” (RSMPP). This article is a methodological description of the process of building the International NERSH Data Pool. The larger contours of the data are described using frequency statistics. 5 subscales in the data pool (including the already established DUREL scale) were tested using Cronbach’s alpha and Principal Component Analysis (PCA) in an Exploratory Factor Analysis (EFA). 5724 individuals were included, of which 57% were female and the mean age was 41.5 years with a 95% confidence interval (CI) ranging from 41.2 to 41.8. Most respondents were physicians (n = 3883), nurses (n = 1189), and midwives (n = 286); but also psychologists (n = 50), therapists (n = 44), chaplains (n = 5), and students (n = 10) were included. The DUREL scale was assessed with Cronbach’s alpha (α = 0.92) and PCA confirmed its reliability and unidimensionality. The new scales covering the dimensions of “Religiosity of Health Professionals (HPs)” (α = 0.89), “Willingness of Physicians to Interact with Patients Regarding R/S Issues” (α = 0.79), “Religious Objections to Controversial Issues in Medicine” (α = 0.78), and “R/S as a Calling” (α = 0.82), also proved unidimensional in the PCAs. We argue that the proposed scales are relevant and reliable measures of religious dimensions within the data pool. Finally, we outline future studies already planned based on the data pool, and invite interested researchers to join the NERSH collaboration.
Jacob K. Pedersen, Irma T. Elo, Nicole Schupf, Thomas T. Perls, Eric Stallard, Anatoliy I. Yashin, and Kaare Christensen.
The Survival of Spouses Marrying Into Longevity-Enriched Families.
Journals of Gerontology: Medical Sciences cite as: J Gerontol A Biol Sci Med Sci, 2017
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Background: Studies of longevity-enriched families are an important tool to gain insight into the mechanisms of exceptionally long and healthy lives. In the Long Life Family Study, the spouses of the members of the longevity-enriched families are often used as a control group. These spouses could be expected to have better health than the background population due to shared family environment with the longevityenriched family members and due to assortative mating.
Graff RE, Möller S, Passarelli MN, Witte JS, Skytthe A, Christensen K, Tan Q, Adami H-O, Czene K, Harris JR, Pukkala E, Kaprio J, Giovannucci E, Mucci LA, Hjelmborg JB.
Familial Risk and Heritability of Colorectal Cancer in the Nordic Twin Study of Cancer.
Clinical Gastroenterology and Hepatology 2017
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Background: We analyzed data from twins to determine how much the familial risk of colorectal cancer can be attributed to genetic factors vs environment. We also examined whether heritability is distinct for colon vs rectal cancer, given evidence of distinct etiologies.
Tina Broby Mikkelsen, Bente Sørensen, Karin B. Dieperink.
Prediction of rehabilitation needs after treatment of cervical cancer: what do late adverse effects tell us?
Support Care Cancer (2017) 25:823–831.
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Karin B. Dieperink, Christoffer Johansen, Steinbjørn Hansen, Lis Wagner, Klaus K. Andersen, Lisbeth R. Minet & Olfred Hansen.
Male coping through a long-term cancer trajectory. Secondary outcomes from a RTC examining the effect of a multidisciplinary rehabilitation program (RePCa) among radiated men with prostate cancer.
Acta Oncologica 2017. DOI: 10.1080/0284186X.2016.1267395.
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Background: The objective of this study was to examine if rehabilitation influenced self-reported male coping styles during and up to three years after treatment with radiotherapy for prostate cancer.
Thing RS, Bernchou U, Mainegra-Hing E, Hansen O, Brink C.
Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy.
Phys Med Biol 2016;61:5781-5802.
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Background: This study shows the first clinical results on how sophisticated body scatter corrections do not suffice in realising the best image quality. To realise the best HU correspondence, all the proposed corrections must be applied in conjunction. No patient specific optimisation of the artefact corrections was applied, and the artefact correction methods work as retrospective processing of the clinical projection data already available. With the improved CBCT image quality, CBCT images might have the potential to be used for dose calculation and accumulation, plan adaptation, and biomarker extraction in the same way as CT images.
Hazell I, Bzdusek K, Kumar P, Hansen CR, Bertelsen A, Eriksen JG, Johansen J, Brink C.
Automatic planning of head and neck treatment plans.
J Appl Clin Med Phys 2016;17:272-282.
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Background: Comparison of autoplans and previous delivered clinical plans showed only small dosimetric differences in target coverage, but significant reduction in dose to OAR for the autoplans. The blinded clinical evaluation of the plans showed that, for 94% of the evaluations, the autoplans were similar to or better than the clinical plans. Auto-Planning software will be able to reduce the manual time spend per treatment plan since the most of the plans could potentially be used clinically without further optimization. Perhaps more importantly, Auto-Planning could be used as a high quality starting point for further plan optimization. This could increase the overall quality of the treatments and reduce the interobserver variation present in manually created treatment plans.
Maria B. Lyng, Annette R. Kodahl, Harald Binder, Henrik J. Ditzel.
Prospective validation of a blood-based 9-miRNA profile for early detection of breast cancer in a cohort of women examined by clinical mammography.
Molecular Oncology 2016;10:1621-1626
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Background: Mammography is the predominant screening method for early detection of breast cancer, but has limitations and could be rendered more accurate by combination with a bloodbased biomarker profile.
Michail Ignatiadis, Hatem A. Azim Jr, Christine Desmedt, Isabelle Veys, Denis Larsimont, Roberto Salgado, Maria B. Lyng, Giuseppe Viale, Brian Leyland-Jones, Anita Giobbie-Hurder, Rosita Kammler, Patrizia Dell’Orto, Françoise Rothé, Ioanna Laïos, Henrik J. Ditzel, MD, Meredith M. Regan, Martine Piccart, Stefan Michiels, Christos Sotiriou.
The Genomic Grade Assay Compared With Ki67 to Determine Risk of Distant Breast Cancer Recurrence.
JAMA Oncology 2016;2:217-224.
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Background: Either the GG assay or centrally reviewed Ki67 significantly improves clinicopathological models to determine distant recurrence of breast cancer. Compared with the histological grade, the GG assay can identify a higher proportion of endocrine-only treated patients with very low risk of distant recurrence at 10 years.
Carla L. Alves, Daniel Elias, Maria Lyng, Martin Bak, Tove Kirkegaard, Anne E. Lykkesfeldt, and Henrik J. Ditzel.
High CDK6 Protects Cells from Fulvestrant-Mediated Apoptosis and is a Predictor of Resistance to Fulvestrant in Estrogen Receptor–Positive Metastatic Breast Cancer.
Clin Cancer Res 2016;22:5514-5526.
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Background: Resistance to endocrine therapy in estrogen receptor–positive (ERþ) breast cancer remains a major clinical problem. Recently, the CDK4/6 inhibitor palbociclib combined with letrozole or fulvestrant was approved for treatment of ERþ advanced breast cancer. However, the role of CDK4/6 in endocrine resistance and their potential as predictive biomarkers of endocrine treatment response remains undefined.
Stefan S. Jeppesen, Niels-Chr. G. Hansen, Tine Schytte, Morten Nielsen, Olfred hansen & on behalf of the Academy of Geriatric Cancer Research (AgeCare)
Comparison of survival of Chronic obstructive pulmonary disease patients with or without a localized non-small lung cancer
Lung Cancer 2016;100:90-95
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Background: Chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) are often co-existing diseases with poor prognosis. The main reasons for inoperability in patients with localized NSCLC are advanced age, poor performance status, and comorbidity. The aim of this study was to compare survival in COPD patients with localized NSCLC treated with stereotactic body radiotherapy with COPD patients without a malignant diagnosis.
Stine Braendegaard Winther, Kanita Zubcevic, Camilla Qvortrup, Lene Weber Vestermark, Helle Anita Jensen, Merete Krogh, Halfdan Sorbye, Per Pfeiffer & on behalf of the Academy of Geriatric Cancer Research (AgeCare)
Experience with S-1 in older Caucasian patientswith metastatic colorectal cancer (mCRC): Findings from an observational chart review.
Acta Oncologica 2016;55:881–885
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Background: The oral fluoropyrimidine S-1 is associated with a lower rate ofadverse events than capecitabine and may therefore be a suitable drug for elderly. However, data on the use of S-1 in Caucasian mCRC patients are lacking/scarce. The study evaluated safety and the efficacy of S-1 alone or in combination with oxaliplatin (SOx) or irinotecan (IRIS) in older mCRC patients. S-1monotherapy, SOx and IRIS were well tolerated for older patients with mCRC and could become alternative regimens in older mCRC patients.
Stine Braendegaard Winther, Trine Lembrecht Jørgensen, Per Pfeiffer, Camilla Qvortrup, on behalf of the Academy of Geriatric Cancer Research (AgeCare)
Can we predict toxicity and efficacy in older patients with cancer? Older patients with colorectal cancer as an example.
ESMO Open 2016;1:e000021. doi:10.1136/esmoopen-2015-000021
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As older and frail patients are under-represented in clinical trials, most of the evidence available on treatment of older metastatic colorectal patients with cancer originates from pooled analyses of the older patients included in large prospective clinical trials and from community-based studies. The aging process is highly individual and cannot be based on the chronological age alone. It is characterised by a decline in organ function with an increased risk of comorbidity and polypharmacy. These issues can result in an increased susceptibility to the complications of both the disease and treatment. Therefore, evaluation of performance status and the chronological age alone is not sufficient, and additionally assessment must be included in the treatment decision process. In the present review, we will focus on clinical aspects of treating older and frail metastatic colorectal patients with cancer, but also on the present knowledge on how to select and tailor therapy for this particular group of patients.
Lise Hoejberg, Dorte Gad, Niels Gyldenkerne, Lars Bastholt & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in melanoma in the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):52-58.
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Background: The incidence of melanoma is rising in Denmark. In the present paper we describe incidence, mortality and survival in Denmark from 1980 to 2012 focusing on age, comparing persons aged 70 years or more with those aged less than 70 years.
Marianne Ewertz, Kaare Christensen, Gerda Engholm, Anne Mette T. Kejs, Lars Lund, Lars E. Matzen, Per Pfeiffer, Hans H. Storm, Jørn Herrstedt & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in cancer in the elderly population in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):1-6.
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Background: Age is the strongest risk factor for developing cancer. The aim of the present analysis is to give an overview of the trends in cancer incidence, mortality, prevalence, and relative survival in Denmark from 1980 to 2012 focusing on age, comparing persons aged 70 years or more with those aged less than 70 years.
Jeanette D. Jensen, Søren Cold, Mette H. Nielsen, Anne Marie B. Jylling, Katrine L. Søe, Lisbet B. Larsen, Marianne Ewertz & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in breast cancer in the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):59-64.
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Background: Breast cancer is the most frequent malignancy among women worldwide and the second most common cause of cancer-related death in developed countries. The aim of the present analysis is to describe trends in incidence, mortality, prevalence, and relative survival in Denmark from 1980 to 2012 focusing on age, comparing persons aged 70 years or more with those aged less than 70 years.
Anja Ør Knudsen, Doris Schledermann, Gitte-Bettina Nyvang, Ole Mogensen, Jørn Herrstedt & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in gynecologic cancer among elderly women in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):65-73.
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Background: The aim of this analysis was to describe trends in incidence, mortality, prevalence, and survival in Danish women with gynecologic cancer from 1980–2012 comparing women aged 70 years or more with younger women.
Mads Hvid Poulsen, Lars Dysager, Oke Gerke, Lars Lund & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in prostate cancer in elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):74-78.
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Backgound The purpose of the study is to elucidate the epidemiology of elderly patients with prostate cancer in Denmark and identify the differences between younger (57 years) and elderly (≥70 years) patients.
Nessn H. Azawi, Simon Moeller Joergensen, Niels Viggo Jensen, Peter E. Clark, Lars Lund & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in kidney cancer among the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):79-84.
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Background: The purpose of this study is to elucidate incidence, mortality, survival, and prevalence of kidney cancer in elderly persons compared with younger persons in Denmark.
Thor Knak Jensen, Niels Viggo Jensen, Simon Møller Jørgensen, Peter Clark, Lars Lund & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in cancer of the urinary bladder and urinary tract in elderly in Denmark, 2008–2012
Acta Oncologica 2016;55(suppl 1):85-90.
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Background: The aim of this study was to examine the trends in incidence, mortality, survival, and prevalence of cancers of the urinary bladder and urinary tract in Denmark from 1980 to 2012 with particular focus on elderly patients over age 70 years.
Rikke H. Dahlrot, Frantz R. Poulsen, Nina N.T.T. Nguyen, Bjarne W. Kristensen, Steinbjørn Hansen, Niels V. Holm & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in tumors in the central nervous system in elderly in Denmark, 2008–2012
Acta Oncologica 2016;55(suppl 1):91-97.
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Background: Tumors in the central nervous system (CNS) comprise a heterogeneous group of tumors with different treatment strategies and prognoses. Current treatment regimens are based on studies on patients mainly younger than 70 years. The aim of the present study was to analyze and describe trends in incidence, mortality, prevalence, and relative survival in Denmark from 1980 to 2012 focusing on patients older than 70 years.
Lukas F. Ocias, Thomas S. Larsen, Hanne Vestergaard, Lone S. Friis, Niels Abildgaard, Henrik Frederiksen & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in hematological cancer in the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):98-107.
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Background: The number of hematological malignancies is expected to increase as the Danish population ages within the next few decades. Despite this, data on the course of hematological cancers among the oldest patients are sparse with many intervention studies focusing on younger age groups. The aim of this study is to present Danish incidence and mortality rates among older patients with non-Hodgkin lymphomas (NHL), multiple myeloma (MM), chronic lymphocytic leukemia (CLL), and acute myeloid leukemia (AML).
Jon Kroll Bjerregaard, Michael Bau Mortensen, Per Pfeiffer & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in cancer of the liver, gall bladder, bile duct, and pancreas in elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):40-45.
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Background: Cancers of the liver, bile duct, gall bladder and pancreas (HPB-c) are a heterogeneous group, united almost exclusively by a poor prognosis. As the number of elderly in the Western world continues to rise and HPB-c are associated with age, we wanted to examine changes in incidence, mortality, prevalence and relative survival for these cancers.
Charlotte Kristiansen, Tine Schytte, Karin Holmskov Hansen, Eva Holtved, Olfred Hansen & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in lung cancer in elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):46-51.
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Background: Lung cancer is an increasing problem in the older patient population due to the improvement in life expectation of the Western population. In this study we examine trends in lung cancer incidence and mortality in Denmark from 1980 to 2012 with special focus on the elderly.
Katrine R. Schønnemann, Michael B. Mortensen, Merete Krogh, Eva Holtved, Mette Maia S. Andersen, Per Pfeiffer & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in upper gastro-intestinal cancer among the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):23-28.
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Background: Upper gastro-intestinal cancer (UGIC) includes malignancies in esophagus, stomach and small intestine, and represents some of the most frequent malignancies worldwide. The aim of the present analysis was to describe incidence, mortality and survival in UGIC patients in Denmark from 1980 to 2012 according to differences in age and time periods.
Stine Brændegaard Winther, Gunnar Baatrup, Per Pfeiffer, Camilla Qvortrup & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in colorectal cancer in the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):29-39.
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Background: Colorectal cancer (CRC) is a disease of the older population. The current demographic ageing leads to more elderly patients and is expected to further increase the number of patients with CRC. The objective of the present paper is to outline incidence, mortality and prevalence from 1980 to 2012 and survival data from 1968 to 2012 in Danish CRC patients focusing on the impact of ageing.
Jørgen Johansen, Jesper Grau Eriksen & On behalf of the Academy of Geriatric Cancer Research (AgeCare)
Trends in cancer of the head and neck in the elderly in Denmark, 1980–2012
Acta Oncologica 2016;55(suppl 1):13-18.
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Background: Squamous cell carcinoma of the head and neck (HNSCC) comprises a variety of malignant tumors. Due to the rarity of each individual malignant entity, knowledge of epidemiological changes and trends over time may be derived from data compiled in regional and national registries. This study analyzed the development in incidence rates and mortality in elderly HNSCC patients in Denmark between 1980 and 2012 with specific attention to compliance to radiotherapy, the main treatment modality of HNSCC in Denmark.
Jacob K. Pedersen, Gerda Engholm, Axel Skytthe, Kaare Christensen & on behalf of the Academy of Geriatric Cancer Research (AgeCare)
Cancer and aging: Epidemiology and methodological challenges
Acta Oncologica 2016;55(suppl 1):7-12.
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Epidemiological cancer data shed light on key questions within basic science, clinical medicine and public health. For decades, Denmark has had linkable health registers that contain individual level data on the entire population with virtually complete follow-up. This has enabled high quality studies of cancer epidemiology and minimized the challenges often faced in many countries, such as uncertain identification of the study base, age misreporting, and low validity of the cancer diagnoses.
Kristine Bjørndal, Stine R. Larsen, Marianne H. Therkildsen, Claus A. Kristensen, Birgitte Charabi, Elo Andersen, Jens Overgaard, Sten Schytte, Henrik B. Pedersen, Lisbeth J. Andersen, Jørgen Johansen, Christian Godballe & On behalf of The Danish Head and Neck Cancer Group (DAHANCA) and Academy of Geriatric Cancer Research (AgeCare)
Does age affect prognosis in salivary gland carcinoma patients? A national Danish study
Acta Oncologica 2016;55(suppl 1):19-22.
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Aim To compare incidence, histology, treatment modalities, disease stages, and outcome in elderly patients (_70 years) compared to younger (570 years).
Mucci LA, Hjelmborg JB, Harris JR, Czene K, Havelick DJ, Scheike T, Graff RE, Holst K, Möller S, Unger RH, McIntosh C, Nuttall E, Brandt I, Penney KL, Hartman M, Kraft P, Parmigiani G, Christensen K, Koskenvuo M, Holm NV, Heikkilä K, Pukkala E, Skytthe A, Adami HO, Kaprio J; Nordic Twin Study of Cancer (NorTwinCan) Collaboration
Familial Risk and Heritability of Cancer Among Twins in Nordic Countries.
JAMA. 2016;315:68-76.
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A total of 27,156 incident cancers were diagnosed in 23,980 individuals, translating to a cumulative incidence of 32%. Cancer was diagnosed in both twins among 1383 monozygotic (2766 individuals) and 1933 dizygotic (2866 individuals) pairs. Of these, 38% of monozygotic and 26% of dizygotic pairs were diagnosed with the same cancer type. There was an excess cancer risk in twins whose co-twin was diagnosed with cancer, with estimated cumulative risks that were an absolute 5% (95% CI, 4%-6%) higher in dizygotic (37%; 95% CI, 36%-38%) and an absolute 14% (95% CI, 12%-16%) higher in monozygotic twins (46%; 95% CI, 44%-48%) whose twin also developed cancer compared with the cumulative risk in the overall cohort (32%). For most cancer types, there were significant familial risks and the cumulative risks were higher in monozygotic than dizygotic twins. Heritability of cancer overall was 33% (95% CI, 30%-37%). Significant heritability was observed for the cancer types of skin melanoma (58%; 95% CI, 43%-73%), prostate (57%; 95% CI, 51%-63%), nonmelanoma skin (43%; 95% CI, 26%-59%), ovary (39%; 95% CI, 23%-55%), kidney (38%; 95% CI, 21%-55%), breast (31%; 95% CI, 11%-51%), and corpus uteri (27%; 95% CI, 11%-43%).
In this long-term follow-up study among Nordic twins, there was significant excess familial risk for cancer overall and for specific types of cancer, including prostate, melanoma, breast, ovary, and uterus. This information about hereditary risks of cancers may be helpful in patient education and cancer risk counseling.
Möller S, Mucci LA, Harris JR, Scheike T, Holst K, Halekoh U, Adami HO, Czene K, Christensen K, Holm NV, Pukkala E, Skytthe A, Kaprio J, Hjelmborg JB.
The Heritability of Breast Cancer among Women in the Nordic Twin Study of Cancer.
Cancer Epidemiol Biomarkers Prev. 2015;25:1-6.
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Family history is an established risk factor for breast cancer. Although some important genetic factors have been identified, the extent to which familial risk can be attributed to genetic factors versus common environment remains unclear. From 1943 through 2010, 3,933 twins were diagnosed with breast cancer. The cumulative lifetime incidence of breast cancer taking competing risk of death into account was 8.1% for both zygosities, although the cumulative risk for twins whose co-twins had breast cancer was 28% among monozygotic and 20% among dizygotic twins. The heritability of liability to breast cancer was 31% [95% confidence interval (CI), 10%-51%] and the common environmental component was 16% (95% CI, 10%-32%). For premenopausal breast cancer these estimates were 27% and 12%, respectively, and for postmenopausal breast cancer 22% and 16%, respectively. The relative contributions of genetic and environmental factors were constant between ages 50 and 96. Our results are compatible with the Peto-Mack hypothesis. Our findings indicate that familial factors explain almost half of the variation in liability to develop breast cancer, and results were similar for pre- and postmenopausal breast cancer IMPACT: We estimate heritability of breast cancer, taking until now ignored sources of bias into account. Cancer Epidemiol Biomarkers Prev; 25(1); 1-6. ©2015 AACR
Karin B. Dieperink, Karen Mark and Tina Broby Mikkelsen
Marital rehabilitation after prostate cancer – a matter of intimacy.
International Journal of Urological Nursing doi:10.1111/ijul.12091.
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Prostate cancer is the most frequent male cancer disease in the western world. Sexual dysfunction is common after prostate cancer with radiation therapy and androgen deprivation therapy, but further research is needed to determine the lived experience of couples struggling with sexual dysfunction after treatment. The purpose of this study was to explore the lived experience of men and their partners experiencing sexual side effects after radiation therapy and androgen deprivation therapy for prostate cancer. In addition, to understand the role of a structured rehabilitation program on the couple’s experience.
Holmström MO, Gimsing P, Abildgaard N, Andersen NF, Helleberg C, Clausen NA, Klausen TW, Frederiksen M, Kristensen DL, Larsen H, Pedersen PT, Andersen KT, Pedersen RS, Jensen BA, Gregersen H, Vangsted AJ.
Causes of early death in multiple myeloma patients who are ineligible for high-dose therapy with hematopoietic stem cell support: A study based on the nationwide Danish Myeloma Database.
Am J Hematol. 2015 Apr;90(4):E73-4.
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To establish intervention strategies to improve survival, we studied the causes of early death in elderly or frail MM patients ineligible for high-dose chemotherapy in an unselected nationwide population. All medical records from myeloma patients who died within 30 and 180 days of diagnosis were thoroughly analyzed. Since 2005 all newly diagnosed MM patients have been registered in the Danish nationwide population-based database (DMMD). The DMMD includes clinical data, laboratory data, and symptoms at diagnosis [7]. We used the DMMD to identify patients ineligible for high-dose therapy (HDT) who died early. SPSS statistical software was used for all calculations (SPSS for Windows, 19.0.0. 2010, Armonk, NY: IBM Inc). All tests were two-sided and P-values <0.05 were regarded as statistically significant. Fisher's exact test or Pearson's χ2-test were used to compare categorical variables. Continuous variables were analyzed using independent samples t-test. Multivariable analysis was performed using a binary logistic regression and right skewed variables (beta 2 microglobulin(B2M), CRP, and lactate dehydrogenase(LDH)) were log-transformed.
Ahrenfeldt LJ, Skytthe A, Möller S, Czene K, Adami HO, Mucci LA, Kaprio J, Petersen I, Christensen K, Lindahl-Jacobsen R
Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden.
Cancer Epidemiol Biomarkers Prev. 2015; 24:1622-8.
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Increasing evidence shows that some cancers originate in utero. It is hypothesized that elevated exposure to some steroid hormones might increase cancer risk and that hormone transfer between twin fetuses could result in different prenatal exposure to testosterone.
This large-scale prospective twin study compared opposite-sex (OS) and same-sex (SS) twins to test the impact of intrauterine exposures on cancer risk. On the basis of the Danish and Swedish twin and cancer registries, we calculated incidence rate ratios for OS and SS twins, whereas standardized incidence ratios (SIR) with 95% confidence intervals (CI) were calculated for OS/SS twins compared with the general population.
Our data suggest that having a male co-twin-which may entail higher exposure to prenatal testosterone-does not increase the risk of sex-specific cancers in OS females. Furthermore, the study supports that twinning per se is not a risk factor of cancer.
Karina G. Thomsen, Mikkel G. Terp, Rikke R. Lund, Rolf Søkilde, Daniel Elias, Martin Bak, Thomas Litman, Hans C. Beck, Maria B. Lyng, Henrik J. Ditzel.
miR-155, identified as anti-metastatic by global miRNA profiling of a metastasis model, inhibits cancer cell extravasation and colonization in vivo and causes significant signaling alterations
Oncotarget. 2015;6:29224-39.
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To gain insight into miRNA regulation in metastasis formation, we used a metastasis cell line model that allows investigation of extravasation and colonization of circulating cancer cells to lungs in mice. Using global miRNA profiling, 28 miRNAs were found to exhibit significantly altered expression between isogenic metastasizing and non-metastasizing cancer cells, with miR-155 being the most differentially expressed. Highly metastatic mesenchymal-like CL16 cancer cells showed very low miR-155 expression, and miR-155 overexpression in these cells lead to significantly decreased tumor burden in lungs when injected intravenously in immunodeficient mice. Our experiments addressing the underlying mechanism of the altered tumor burden revealed that miR-155-overexpressing CL16 cells were less invasive than CL16 control cells in vitro, while miR-155 overexpression had no effect on cancer cell proliferation or apoptosis in established lung tumors.
Jacob K. Pedersen MSc, Axel Skytthe PhD, Matt McGue PhD, Lawrence S. Honig MD, PhD, Claudio Franceschi PhD, Thomas B.L. Kirkwood PhD, Giuseppe Passarino PhD, P. Eline Slagboom PhD, James W. Vaupel PhD, Kaare Christensen MD, DMSc
Low tobacco-related cancer incidence in offspring of long-lived siblings: a comparison with Danish national cancer registry data
Annals of Epidemiology 25 2015;25:569-574.
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Purpose: Familial clustering of longevity is well documented and includes both genetic and other familial factors, but the specific underlying mechanisms are largely unknown. We examined whether low incidence of specific cancers is a mechanism for familial clustering of longevity. Methods: The study population of individuals from longevity-enriched families consisted of 3267 offspring from 610 Danish long-lived families defined by two siblings attaining an age of 90 years or more. The offspring of the long-lived siblings were followed from 1968 to 2009. Using high-quality registry data, observed numbers of cancers were compared with expected numbers based on gender-, calendar period-, and age-specific incidence rates in the general population. Results: During the 41-year-follow-up period, a total of 423 cancers occurred in 397 individuals. The standardized incidence ratios (95% confidence interval) for offspring of long-lived individuals were 0.78 (0.70e0.86) for overall cancer; 0.66 (0.56e0.77) for tobacco-related cancer; 0.34 (0.22e0.51) for lung cancer; 0.88 (0.71e1.10) for breast cancer; 0.91 (0.62e1.34) for colon cancer. Conclusions: The low incidence of tobacco-related cancers in long-lived families compared with non etobacco-related cancers suggests that health behavior plays a central role in lower early cancer incidence in offspring of long-lived siblings in Denmark.
Hansen O, Schytte T, Nielsen M, Brink C.
Age dependent prognosis in concurrent chemo-radiation of locally advanced NSLCL
Acta Oncologica 2015;54:333-339.
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Background: Clinical trials indicate that the benefit of adding concurrent chemotherapy to radiotherapy of locally advanced non-small cell lung cancer (NSCLC) for fi t elderly is similar to the benefit for younger patients. However, since elderly patients are under-represented in most trials, the results might be due to selection bias, thus reports from a cohort of consecutively treated patients are warranted. The current single institution study reports on the influence of age on survival of locally advanced NSCLC patients treated with radiotherapy combined with or without concurrent chemotherapy.
Material and methods. Altogether, 478 patients completed radical radiotherapy in doses of 60 – 66 Gy/30 – 33 fractions from 1995 to June 2012; 137 of the patients had concurrent chemotherapy. The data was analyzed in age groups - 60,60 – 69, and - 70 years.
Conclusion. Use of concurrent chemotherapy to radiotherapy of locally advanced NSCLC was associated with a survival benefit in patient younger than 70 years which was not the case for patients older than 70 years, indicating the need to be careful when selecting elderly patients for concurrent chemo-radiation.
Birte Østergaard, RN, PhD, and Lis Wagner, RN, DrPH
The Development of Family Nursing in Denmark: Current Status and Future Perspectives
Journal of Family Nursing 2014,20:487–500.
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Over the past 12 years, a strong foundation for family nursing has been built in Denmark, with rapid growth in the past 3 years. A review of nursing research conducted in Denmark and published between 2002 and 2013 found 15 studies that examined family phenomena. The majority of the studies used descriptive methods with data collected from surveys and interviews involving family members either together or individually. Only five of the studies examined interventions that included families’ perspectives about the intervention being evaluated. Several current research projects lead by Danish nurses examine the implementation of family nursing knowledge to clinical settings. Integration of family nursing theory has begun in Denmark in undergraduate and graduate nursing curricula and in May 2013, the Danish Family Nursing Association was officially established.
Gunnar Baatrup and Niels Qvist
Local resection of early rectal cancer.
APMIS 2014;122:715-722.
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The introduction of a national screening programme for colorectal cancer will lead to the detection of more early rectal cancers where local excision by TEM must be considered due to the significantly lower risk of morbidity and mortality compared to conventional surgery with total mesorectal excision. However, it should be achieved without compromising oncological control. There are certainly groups of old patients and patients with co-morbidities who will also profit from TEM in terms of long-term survival and reduced treatment- related risks in high risk T1 and >T1 cancers.
Morten F. Gjerstorff, Mette Marie Relster, Katrine B.V. Greve, Jesper B. Moeller, Daniel Elias, Jonas N. Lindgreen, Steffen Schmidt, Jan Mollenhauer, Bjørn Voldborg, Christina B. Pedersen, Nadine Heidi Brückmann, Niels Erik Møllegaard and Henrik Jørn Ditzel
SSX2 is a novel DNA-binding protein that antagonizes polycomb group body formation and gene repression
Nucleic Acids Res. 2014;42:11433-46.
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Polycomb group (PcG) complexes regulate cellular identity through epigenetic programming of chromatin. Here, we show that SSX2, a germline-specific protein ectopically expressed in melanoma and other types of human cancers, is a chromatin-associated protein that antagonizes BMI1 and EZH2 PcG body formation and derepresses PcG target genes. SSX2 further negatively regulates the level of the PcGassociated histone mark H3K27me3 in melanoma cells, and there is a clear inverse correlation between SSX2/3 expression and H3K27me3 in spermatogenesis. However, SSX2 does not affect the overall composition and stability of PcG complexes, and there is no direct concordance between SSX2 and BMI1/H3K27me3 presence at regulated genes. This suggests that SSX2 antagonizes PcG function through an indirect mechanism, such as modulation of chromatin structure. SSX2 binds double-stranded DNA in a sequence non-specific manner in agreement with the observed widespread association with chromatin. Our results implicate SSX2 in regulation of chromatin structure and function.
Jacob B. Hjelmborg, Thomas Scheike, Klaus Holst, Axel Skytthe, Kathryn L. Penney, Rebecca E. Graff, Eero Pukkala, Kaare Christensen, Hans-Olov Adami, Niels V. Holm, Elizabeth Nuttall, Steinbjorn Hansen, Mikael Hartman, Kamila Czene, Jennifer R. Harris, Jaakko Kaprio, and Lorelei A. Mucci
The Heritability of Prostate Cancer in the Nordic Twin Study of Cancer
Cancer Epidemiol Biomarkers Prev 2014;23:2303-2310.
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Background: Prostate cancer is thought to be the most heritable cancer, although little is known about how this genetic contribution varies across age.
Methods: To address this question, we undertook the world’s largest prospective study in the Nordic Twin Study of Cancer cohort, including 18,680 monozygotic (MZ) and 30,054 dizygotic (DZ) same-sex male twin pairs. We incorporated time-to-event analyses to estimate the risk concordance and heritability while accounting for censoring and competing risks of death, essential sources of biases that have not been accounted for in previous twin studies modeling cancer risk and liability.
Results: The cumulative risk of prostate cancer was similar to that of the background population. The cumulative risk for twins whose co-twin was diagnosed with prostate cancer was greater for MZ than for DZ twins across all ages. Among concordantly affected pairs, the time between diagnoses was significantly shorter forMZthan DZpairs (median, 3.8 versus 6.5 years, respectively). Genetic differences contributed substantially to variation in both the risk and the liability [heritability = 58% (95% confidence interval, 52%–63)%] of developing prostate cancer. The relative contribution of genetic factors was constant across age through late life with substantial genetic heterogeneity even when diagnosis and screening procedures vary. Conclusions: Results from the population-based twin cohort indicate a greater genetic contribution to the risk of developing prostate cancer when addressing sources of bias. The role of genetic factors is consistently high across age.
Impact: Findings affect the search for genetic and epigenetic markers and frame prevention efforts. Cancer Epidemiol Biomarkers Prev; 1–8.
Brygger L & Herrstedt J on behalf of the Academy of Geriatric Cancer Research (AgeCare)
5-Hydroxytryptamine3 receptor antagonists and cardiac side effects
Expert Opin Drug Safe 2014;13:1407-22
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Introduction: 5-Hydroxytryptamine3-receptor antagonists (5-HT3-RA) are the most widely used antiemetics in oncology, and although tolerability is high, QTC prolongation has been observed in some patients.
Areas covered: The purpose of this article is to outline the risk of cardiac adverse events (AEs) from 5-HT3-RAs, with focus on the three most commonly used, ondansetron, granisetron and palonosetron.
Expert opinion: Most of the studies analyze electrocardiogram (ECG) changes after 5-HT3-RA administrations in healthy, young adults, or in noncancer patients to treat postoperative nausea and vomiting (PONV). Only a few studies have addressed ECG changes in cancer patients treated for chemotherapyinduced nausea and vomiting (CINV). Investigations in cancer patients are essential, because these patients are older and have a higher incidence of comorbidity, than those usually included in clinical trials. Furthermore, polypharmacy is frequent and drug--drug interactions between chemotherapy and other QTc-prolonging drugs may influence the pharmacokinetics and pharmacodynamics of the 5-HT3-RAs. During the next 10 -- 15 years a huge increase in the number of cancer patients is expected, primarily in the group of 65-plus-year old. Therefore it will be crucial to address the incidence of cardiac AEs in cancer patients with known heart disease receiving chemotherapy and a 5-HT3 RA for the prophylaxis of CINV.
Brink C, Bernchou U, Bertelsen A, Hansen O, Schytte T, Bentzen S.M.
Locoregional Control of Non-Small Cell Lung Cancer in Relation to Automated Early Assessment of Tumor Regression on Cone Beam Computed Tomography
Int J Rad Oncol Biol Phys 2014;89:916-923
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Large interindividual variations in volume regression of non-small cell lung cancer (NSCLC) are observable on standard cone beam computed tomography (CBCT) during fractionated radiation therapy. Here, a method for automated assessment of tumor volume regression is presented and its potential use in response adapted personalized radiation therapy is evaluated empirically.
Methods and Materials: Automated deformable registration with calculation of the Jacobian determinant was applied to serial CBCT scans in a series of 99 patients with NSCLC. Tumor volume at the end of treatment was estimated on the basis of the first one third and two thirds of the scans. The concordance between estimated and actual relative volume at the end of radiation therapy was quantified by Pearson’s correlation coefficient. On the basis of the estimated relative volume, the patients were stratified into 2 groups having volume regressions below or above the population median value. Kaplan-Meier plots of locoregional disease-free rate and overall survival in the 2 groups were used to evaluate the predictive value of tumor regression during treatment. Cox proportional hazards model was used to adjust for other clinical characteristics.
Conclusions: Evaluation of routinely acquired CBCT images during radiation therapy provides biological information on the specific tumor. This could potentially form the basis for personalized response adaptive therapy.
Updated on February 28, 2017, UHK