As Time Goes By: The Long-Term Psychological Impact of either Regular Surveillance or Prophylactic Mastectomy in Women at Risk for Hereditary Breast Cancer

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in women worldwide. In the Netherlands, approximately 13000 new breast cancer cases are diagnosed annually, mostly occurring in women older than 50 years. In total 12-13% (one in eight) of the women in the Netherlands will be diagnosed with breast cancer during lifetime, and population screening for breast cancer therefore is being offered to women as of 50 years of age. While the population risk of ovarian cancer is 1.5% in the Netherlands, population screening is not offered. It is estimated that 5-10% of all cancer cases are due to a genetic predisposition. One of the first recognised entities was the clustering of breast and/or ovarian cancer in families. A strong family history of breast (and/or ovarian) cancer in combination with family members affected at a young age (below 50 years of age) may be suggestive of a cancer susceptibility gene in the family. As of the beginning of the nineteen nineties it became possible for women from families with clustering of breast (and/or ovarian) cancer cases to opt for genetic counselling and testing, and subsequently to receive a personal life time risk estimation. Depending on the risk estimation, decisions have to be made for either regular surveillance or prophylactic surgery. Both options are associated with pros and cons regarding on the one hand anxiety that cancer might develop or be detected (at an advanced stage) during surveillance versus on the other hand irreversible consequences after preventive surgery of either breasts and/or ovaries, potentially affecting physical and psychological functioning. As of the beginning of the availability of genetic testing, it became clear that more data on the (dis)advantages of the different strategies was needed. More knowledge about the psychosocial consequences of adhering to regular surveillance as well as prophylactic mastectomy and/or salpingo-ovariectomy was essential, in order to adequately inform and support women considering these options. In 1999, two studies were initiated at the Erasmus University Medical Centre-Daniel den

Dutch EU-policies with regard to legal migration - 28

Political Science; European Unio

Dwang, verbod en grootse verwachtingen: over het falende Europese asielbeleid

April liet een spectaculaire daling zien van het aantal Syriërs dat in Nederland asiel vroeg: 101 tegen meer dan 5000 in oktober vorig jaar. Het lijkt erop dat de dichte grenzen in de Balkanlanden en het akkoord met Turkije over de terugname van asielzoekers de komst van Syrische vluchtelingen sterk hebben afgeremd. Is de vluchtelingen‘crisis’ opgelost? Allerminst: de deal met Turkije is kwetsbaar en bovendien juridisch kwestieus. Belangrijker is dat het Europese asielbeleid heeft aangetoond slecht te functioneren. Het is nu vooral zaak de gemeenschappelijke asielregels crisisbestendig te maken. Daarvoor lijkt echter de politieke steun te ontbreken

The RISC-KIT storm impact database: A new tool in support of DRR

This paper presents a new storm impact database for European coastlines that facilitates the upload, browsing and download of a broad range of physical and impact information related to historical and recent marine storm events. The database is transparent in terms of open access to raw data and metadata, makes use of version control systems through the OpenEarth repository and promotes the use of international standards. A total of 298 storm events are currently stored in the database from the ten RISC-KIT case study sites, including historical events dating back to the sixteenth century. To demonstrate the application of the tool, examples of typical event data contained within the database as well as the ability of the database to identify impacts of events across regions are presented. It is envisaged that this database will expand beyond the ten case study sites, with the aim of promoting and greatly improving the collection and reporting of extreme hydro-meteorological events across Europe into the future