45 research outputs found
Cervical cancer in women under 30 years of age in Norway: a population-based cohort study
Background
We compared women with incident cervical cancer under the age of 30 with older women with regard to stage, morphology, screening history and cervical cancer mortality in a population-based cohort study.
Methods
We included data from the Cancer Registry of Norway. Incidence rates (per 100,000 women-years) were calculated and joinpoint regression was used to analyse trends. The Nelson-Aalen cumulative hazard function for risk of cervical cancer death during a 15-year follow-up was displayed. The hazard ratios (HRs) of cervical cancer mortality with 95% confidence intervals (CIs) were derived from Cox regression models.
Results
The incidence of cervical cancer in women under the age of 30 has almost tripled since the 1950s, with the steepest increase during 1955â80 (with an annual percentage change (APC) of 7.1% (95%CI 4.4â9.8)) and also an increase after 2004 (3.8% (95%CI -1.3â9.2)). Out of 21,160 women with cervical cancer (1953â2013), 5.3% were younger than 30 years. A lower proportion of younger women were diagnosed at more advanced stages and a slightly higher proportion were diagnosed with adenocarcinoma and adenosquamous carcinoma comparing women above 30 years. The cumulative risk of cervical cancer death was lower for patients under the age of 30. However, the difference between the age groups decreased over time. The overall adjusted HR of cervical cancer mortality was 0.69 (95% CI 0.58â0.82) in women diagnosed under the age of 30 compared to older women.
Conclusion
There has been an increase in cervical cancer incidence in women under the age of 30. Cervical cancer in younger women was not more advanced at diagnosis compared to older women, and the cervical cancer mortality was lower.publishedVersio
Optimisation in strategies in diffusion tensor MR imaging
With diffusion MR imaging, the Brownian motion (or self-diffusion) of
water molecules is measured. In the corresponding ADC (Apparent Diffusion
Coefficient) image, each image element (voxel) represents the average
diffusion. In MRI, the diffusion is measured with diffusion gradients
along certain directions in space. The diffusion-weighting gradients are
often incorporated in an echo planar imaging (EPI) pulse sequence.
Depending on the type of tissue being imaged, the measured diffusion may
be isotropic, i.e. equal for an directions of the diffusion gradient, as
Seen, e.g., in grey matter and the cerebrospinal fluid (CSF). In
contrast, in white matter, the diffusion is higher along the nerve fibres
than across because water molecules moving along fibres are not hindered
- this is referred to as anisotropic diffusion. In diffusion tensor
imaging (DTI), the diffusion, for each voxel, is represented by an
ellipsoid with a certain shape and orientation. For e.g. grey matter the
ellipsoid is a sphere, whereas for white matter it is elongated in one
direction like a cigar. From the diffusion tensor the mean diffusion
(size of the ellipsoid) and the degree of anisotropy (shape of the
ellipsoid) may be calculated.
In this thesis different strategies to improve the image quality and
reliability of the DTI data and diffusion anisotropy maps are presented.
These include simulation studies to determine 1) which anisotropy index
is most insensitive to noise and 2) which diffusion scheme (i.e. which
set of diffusion gradients to use in the scanning process) minimises the
variance and bias of the calculated DTI data. The simulation results were
also complemented with data from phantoms and volunteers. Additionally,
two major types of image artefacts in diffusion weighted single-shot echo
planar imaging (DW SS-EPI) and means of correcting them have been
investigated. The first artefact is signal dropout, predominantly in the
mid-lower part of the brain, due to brain motion. The second is eddy
currents induced by the diffusion gradients that cause the DW images to
be distorted differently depending on the direction of the diffusion
gradient. The distortions are translation, scaling and shear effects in
the phase encoding direction of the image. These distortions, together
with patient motion, result in anatomical mismatch between the different
DW images used for the calculation of the diffusion tensor data. A new
distortion correction method that corrects for this mismatch has been
developed. DTI has been performed in a study comparing schizophrenic
patients and normal controls with respect to diffusion anisotropy, mean
diffusion and morphological differences
Kostnader ved Masseundersøkelsen mot livmorhalskreft
Bakgrunn: Forebygging stĂĽr sentralt i norsk helsepolitikk, og observasjonsstudier tyder pĂĽ at organisert screening har redusert forekomsten av livmorhalskreft i Norge. Samfunnets ressurser er imidlertid knappe.
Hensikt: Vür hensikt var ü estimere de ürlige kostnadene av Masseundersøkelsen mot livmorhalskreft.
Metode: Vi beregnet statens direkte utgifter og de ürlige samfunnsøkonomiske kostnader av dagens screeningprogram for livmorhalskreft pü grunnlag av opplysninger fra Kreftregisteret om antall utførte undersøkelser under Masseundersøkelsen for livmorhalskreft og enhetskostnadene for disse. De samfunnsøkonomiske enhetskostnadene er basert pü ulike beregninger av faktiske kostnader, mens statens utgifter er basert pü de ulike takstsystemer.
Resultater: I 2011 ble det utført i alt 360 704 primÌrscreeningprøver, som med vüre beregninger ville medføre 21 783 nye etterundersøkelser. Det ble innsendt biopsier for omtrent 9000 kvinner, og 3057 kvinner fikk utført konisering. De samlete samfunnsøkonomiske kostnader ved screeningprogrammet var 730 millioner kroner, hvorav 52 prosent utgjorde indirekte kostnader i form av reisekostnader og fravÌr fra arbeid. Statens direkte utgifter utgjorde 163 millioner kroner.
Konklusjon: Det norske screeningprogrammet for livmorhalskreft har betydelige kostnader, der kvinnenes tids- og reisekostnader og legekonsultasjoner veier mest
Cervical cancer in women under 30 years of age in Norway: a population-based cohort study
Cervical cancer in women under 30 years of age in Norway: a population-based cohort study
Background
We compared women with incident cervical cancer under the age of 30 with older women with regard to stage, morphology, screening history and cervical cancer mortality in a population-based cohort study.
Methods
We included data from the Cancer Registry of Norway. Incidence rates (per 100,000 women-years) were calculated and joinpoint regression was used to analyse trends. The Nelson-Aalen cumulative hazard function for risk of cervical cancer death during a 15-year follow-up was displayed. The hazard ratios (HRs) of cervical cancer mortality with 95% confidence intervals (CIs) were derived from Cox regression models.
Results
The incidence of cervical cancer in women under the age of 30 has almost tripled since the 1950s, with the steepest increase during 1955â80 (with an annual percentage change (APC) of 7.1% (95%CI 4.4â9.8)) and also an increase after 2004 (3.8% (95%CI -1.3â9.2)). Out of 21,160 women with cervical cancer (1953â2013), 5.3% were younger than 30 years. A lower proportion of younger women were diagnosed at more advanced stages and a slightly higher proportion were diagnosed with adenocarcinoma and adenosquamous carcinoma comparing women above 30 years. The cumulative risk of cervical cancer death was lower for patients under the age of 30. However, the difference between the age groups decreased over time. The overall adjusted HR of cervical cancer mortality was 0.69 (95% CI 0.58â0.82) in women diagnosed under the age of 30 compared to older women.
Conclusion
There has been an increase in cervical cancer incidence in women under the age of 30. Cervical cancer in younger women was not more advanced at diagnosis compared to older women, and the cervical cancer mortality was lower
Application of an Improved Empirical Model for Rheology Prediction of Cement Pastes Modified with Filler from Manufactured Sand
Atypical glandular lesions of the cervix and risk of cervical cancer
Introduction
Cytology screening has been effective in reducing risks for cervical squamous cell carcinoma but less so for adenocarcinoma. We explored the association of atypical glandular cells or absence of glandular cells in cytology, and subsequent histological diagnoses and cancer risk.
Material and methods
All women in Norway with atypical glandular cells of undetermined significance (AGUS), adenocarcinoma in situ (ACIS) and normal/benign cells, but absence of endocervical or metaplastic cells (NCâNEC) in their first cytology during 1992â2014 (NCâNEC; 2005â2014), recorded in the Cancer Registry of Norway, were included (n = 142 445). Histology diagnoses (stratified by age) within 1 and 3 years after cytology were examined. The NelsonâAalen cumulative hazard function for gynecological cancer risk was displayed.
Results
The majority of AGUS and particularly ACIS were followed with histology within 1 and 3 years. Cervical intraepithelial neoplasia (CIN) lesions were more common in women <35 than in women âĽ35 years. Cervical adenocarcinoma followed 13% of ACIS after 1 and 3 years. After ACIS and AGUS, cervical adenocarcinoma was the most frequent cancer subtype. Cumulative risks of cervical adenocarcinoma following ACIS, AGUS and NCâNEC were 3.5%, 0.9% and 0.05%, respectively, after 22, 22 and 9 years of followâup.
Conclusions
There was a highârisk of glandular malignancies after AGUS and ACIS in cytology. If effective treatment of preâcancer and early cancer is available, cytology screening provides some level of prevention of adenocarcinoma. Lack of glandular cells did not entail a higher cancer risk