Sociodemographic factors, health indicators and lifestyle factors among participants in BreastScreen Norway 2006-2016 – a cohort profile

Purpose: To collect information on sociodemographic factors, health indicators, and lifestyle factors in women who attended the nationwide breast cancer-screening program, BreastScreen Norway, with the aim of investigating how these factors influence the risk of breast cancer, other cancer types, and cancer-related outcomes. Participants: The cohort data includes self-reported responses to questionnaires from 554,149 women aged 50- 69 years, who attended BreastScreen Norway during the data collection period, 2006-2016. Findings to date: Information about sociodemographic factors, health indicators, and lifestyle factors was collected for the current time and retrospectively back to birth. For the cohort, we have complete mammographic screening data, including information about 24,000 breast cancer cases and other cancer types from the Cancer Registry of Norway. These outcomes are aggregating continuously. Data from the cohort have been utilized in studies related to breast cancer and menopausal status. Future projects: Data will be utilized in studies related to tumour growth and risk of breast cancer as well as other cancer types, in addition to overall and cancer-specific death. Registration: The cohort profile is not registered in Clinical Trials

Muscular performance decreases with increasing complexity of resistance exercises in subjects with chronic obstructive pulmonary disease

Chronic obstructive lung disease (COPD) is associated with impaired muscle functions in addition to the impaired cardiopulmonary capacity inherent to the disease. The purpose of this study was to compare muscular performance between COPD subjects (COPD, n = 11, GOLD grade II/III; FEV1 = 53 ± 14% predicted; 61 ± 7 years) and healthy controls (HC, n = 12, 66 ± 8 years) in three resistance exercises with different complexity: (a) one‐legged knee extension (1KE), and (b) one‐ and (c) two‐ legged leg press (1LP and 2LP, respectively). For each exercise, muscular performance was defined as repetitions to exhaustion at 60% of one‐repetition maximum or overall exercise volume, calculated as the sum of three exercise sets. In HC, muscular performance increased progressively with increasing physiological complexity: 1KE < 1LP 1LP), advocating utilization of one‐legged resistance protocols for rehabilitation purposes.publishedVersio

Effect of invitation letter in language of origin on screening attendance: randomised controlled trial in BreastScreen Norway

Objective To explore attendance at organised mammographic screening among immigrant groups that received an invitation letter and information leaflet (invitation) in their language of origin and Norwegian compared with Norwegian only. Design Randomised controlled trial. Setting Population based screening programme for breast cancer in Norway (BreastScreen Norway), which invites women aged 50-69 to two-view mammographic screening biennially. Participants All women invited to BreastScreen Norway in the study period April 2021 to June 2022 whose language of origin was Arabic (women born in Algeria, Egypt, Lebanon, Iraq, Palestine, Sudan, Syria, Tunisia, or Morocco), English (women born in the Philippines), Polish (women born in Poland), Somali (women born in Somalia), or Urdu (women born in Pakistan) (n=11347). Intervention The study group received an invitation to screening in their language of origin and in Norwegian, whereas the control group received an invitation in Norwegian only during the study period. Main outcome measure Attendance at BreastScreen Norway during the study period. Results Overall attendance was 46.5% (2642/5683) in the study group and 47.4% (2682/5664) in the control group. No statistical differences in attendance were observed after stratification by language of invitation, age at invitation, or years since immigration. Conclusions No difference in attendance was observed between immigrant women invited to BreastScreen Norway in their language of origin and in Norwegian compared with Norwegian only. Several barriers to cancer screening may exist among immigrants, and translating the invitation is probably only a part of a complex explanation

Association between Dietary Fibre Intake, Faecal Microbiome Alpha-Diversity and Colorectal Neoplasia

Background: Studies have shown an inverse relationship between dietary fiber intake and risk of colorectal cancer (CRC). More recent studies suggest that the gut microbiome may also have an impact on CRC risk. The aim of this study was to explore the relationship between fiber intake and colorectal neoplasia on two levels: non-advanced adenoma (NAA) and advanced neoplasia (AN). We also aimed to explore the possible relationship between microbial Alpha diversity in faecal microbiome and AN, and the relationship between dietary fiber and Alpha diversity. Methods: This was a cross-sectional study where we invited men and women aged 50-74 years, who tested positive for faecal occult blood in the Norwegian Bowel Cancer Screening pilot study, to participate in a gut microbiome sub-study. We asked participants to fill out a food frequency questionnaire and a lifestyle questionnaire prior to their follow-up colonoscopy examination. Colonoscopy results were collected from the screening database. Faecal samples in participants without any neoplastic findings and with AN were selected for microbiome analysis using metagenomic shotgun sequencing. Microbiome Alpha diversity in the faecal samples was presented with Shannon index. We used multivariate logistic regression (odds ratio, OR, and 95% confidence intervals, CI) to analyse associations between quartiles of fiber intake, and NAA and AN. We investigated differences in Alpha diversity with Wilcoxon signed rank tests, and explored correlations between fiber intake and Alpha diversity with Pearson correlation analysis. Results: In total, 910 men and women had sufficient data quality for analysis. We had sufficient data quality and metagenome data on 232 participants (131 without neoplastic findings and 101 with AN). The basic regression model showed a significant negative OR in the Q3 of fiber intake for NAA compared to Q1 (OR 0.57, 95% CI 0.37-0.86), but not in Q2 and Q4. The negative association remained significant after multivariate adjustment (OR 0.57, 95% CI 0.34-0.97). No association was observed between fiber intake and AN risk. There was no difference in Alpha diversity between subjects without colorectal neoplasia and AN, and no relationship was found between fiber intake and faecal microbiome Alpha diversity. Conclusions: We did not find an association between dietary fiber intake, colorectal neoplasia and gut microbiome Alpha diversity. Future studies on dietary fiber intake and neoplasia should distinguish more between specific sources of fiber and different stages of neoplasia. Fiber may also be preventative on a secondary level by protecting against metabolic disorders. Finally, more studies are needed to investigate specific bacterial species and the composition of the microbiome, regarding both neoplasia and dietary fiber

Participation and cancer detection after reminders versus ordinary invitations in BreastScreen Norway

Objectives - To compare attendance, recall and cancer detection as well as histopathological tumor characteristics among women attending BreastScreen Norway after a reminder versus an ordinary invitation. Setting - This study was conducted on data from a population-based screening program inviting women aged 50–69 to biennial two-view mammography. Methods - We used de-identified data from 883,020 women invited to BreastScreen Norway, 2004–2020, to analyze invitations, participation, recalls, biopsies, cancer detection, and histopathological tumor characteristics. All results were stratified by reminders and ordinary invitations. Early screening outcomes after reminders versus ordinary invitations were compared using bivariate tests and multivariable logistic regression. Results - Reminders increased overall participation rate by 5.0%. The recall rate was 4.3% for reminded women and 3.3% for the ordinary invited. For reminded women, the rate of screen-detected cancer was 7.3 per 1000 screening examinations compared to 5.8 per 1000 for ordinary attenders. The interval cancer rates were 1.9 and 1.7 per 1000 for reminded and ordinary invited women, respectively. Median tumor diameter was 14 mm (interquartile range (IQR): 10–16) for screen-detected cancers (SDC) among reminded women and 13 mm (IQR: 10–16) for ordinary invited. A higher percentage of histological grade III cancers was observed among the reminded: 25.2% versus 21.7% for the ordinary invited. We also found a higher proportion of lymph node positive cases in those reminded: 23.6% versus 20.9%. Conclusions - Postponing screening examinations affects early screening outcomes, including cancer detection and histopathological tumor characteristics. Women should be encouraged to attend screening at regularly intervals to avoid delays in diagnosis

Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway

Irregular attendance in breast cancer screening has been associated with higher breast cancer mortality compared to regular attendance. Early performance measures of a screening program following regular versus irregular screening attendance have been less studied. We aimed to investigate early performance measures following regular versus irregular screening attendance. Methods We used information from 3,302,396 screening examinations from the Cancer Registry of Norway. Examinations were classified as regular or irregular. Regular was defined as an examination 2 years ± 6 months after the prior examination, and irregular examination >2 years and 6 months after prior examination. Performance measures included recall, biopsy, screen-detected and interval cancer, positive predictive values, and histopathological tumor characteristics. Results Recall rate was 2.4% (72,429/3,070,068) for regular and 3.5% (8217/232,328) for irregular examinations. The biopsy rate was 1.0% (29,197/3,070,068) for regular and 1.7% (3825/232,328) for irregular examinations, while the rate of screen-detected cancers 0.51% (15,664/3,070,068) versus 0.86% (2003/232,328), respectively. The adjusted odds ratio was 1.53 (95% CI: 1.49–1.56) for recall, 1.73 (95% CI: 1.68–1.80) for biopsy, and 1.68 (95% CI: 1.60–1.76) for screen-detected cancer after irregular examinations compared to regular examinations. The proportion of lymph node-positive tumors was 20.1% (2553/12,719) for regular and 25.6% (426/1662) for irregular examinations. Conclusion Irregular attendance was linked to higher rates of recall, needle biopsies, and cancer detection. Cancers detected after irregular examinations had less favorable histopathological tumor characteristics compared to cancers detected after regular examinations. Women should be encouraged to attend screening when invited to avoid delays in diagnosis

Muscular performance decreases with increasing complexity of resistance exercises in subjects with chronic obstructive pulmonary disease

Chronic obstructive lung disease (COPD) is associated with impaired muscle functions in addition to the impaired cardiopulmonary capacity inherent to the disease. The purpose of this study was to compare muscular performance between COPD subjects (COPD, n = 11, GOLD grade II/III; FEV1 = 53 ± 14% predicted; 61 ± 7 years) and healthy controls (HC, n = 12, 66 ± 8 years) in three resistance exercises with different complexity: (a) one‐legged knee extension (1KE), and (b) one‐ and (c) two‐legged leg press (1LP and 2LP, respectively). For each exercise, muscular performance was defined as repetitions to exhaustion at 60% of one‐repetition maximum or overall exercise volume, calculated as the sum of three exercise sets. In HC, muscular performance increased progressively with increasing physiological complexity: 1KE 1LP), advocating utilization of one‐legged resistance protocols for rehabilitation purposes

Muscular performance decreases with increasing complexity of resistance exercises in subjects with chronic obstructive pulmonary disease

Chronic obstructive lung disease (COPD) is associated with impaired muscle functions in addition to the impaired cardiopulmonary capacity inherent to the disease. The purpose of this study was to compare muscular performance between COPD subjects (COPD, n = 11, GOLD grade II/III; FEV1 = 53 ± 14% predicted; 61 ± 7 years) and healthy controls (HC, n = 12, 66 ± 8 years) in three resistance exercises with different complexity: (a) one‐legged knee extension (1KE), and (b) one‐ and (c) two‐legged leg press (1LP and 2LP, respectively). For each exercise, muscular performance was defined as repetitions to exhaustion at 60% of one‐repetition maximum or overall exercise volume, calculated as the sum of three exercise sets. In HC, muscular performance increased progressively with increasing physiological complexity: 1KE 1LP), advocating utilization of one‐legged resistance protocols for rehabilitation purposes

Early screening outcomes among non-immigrants and immigrants targeted by BreastScreen Norway, 2010–2019

Aims: This study aimed to analyse results on early screening outcomes, including recall and cancer rates, and histopathological tumour characteristics among non-immigrants and immigrants invited to BreastScreen Norway. Methods: We included information about 2, 763,230 invitations and 2,087,222 screening examinations from 805,543 women aged 50–69 years who were invited to BreastScreen Norway between 2010 and 2019. Women were stratified into three groups based on their birth country: non-immigrants, immigrants born in Western countries and immigrants born in non-Western countries. Age-adjusted regression models were used to analyse early screening outcomes. A random intercept effect was included in models where women underwent several screening examinations. Results: The overall attendance was 77.5% for non-immigrants, 68% for immigrants from Western countries and 51.5% for immigrants from non-Western countries. The rate of screen-detected cancers was 5.9/1000 screening examinations for non-immigrants, 6.3/1000 for immigrants from Western countries and 5.1/1000 for immigrants from non-Western countries. Adjusted for age, the rate did not differ statistically between the groups (p=0.091). The interval cancer rate was 1.7/1000 screening examinations for non-immigrants, 2.4/1000 for immigrants from Western countries and 1.6/1000 for non-Western countries (p<0.001). Histological grade was less favourable for screen-detected cancers, and subtype was less favourable for interval cancers among immigrants from non-Western countries versus non-immigrants. Conclusions: There were no differences in age-adjusted rate of screen-detected cancer among non-immigrants and immigrants from Western countries or non-Western countries among women attending BreastScreen Norway between 2010 and 2019. Small but clinically relevant differences in histopathological tumour characteristics were observed between the three groups

Muscular performance decreases with increasing complexity of resistance exercises in subjects with chronic obstructive pulmonary disease

Chronic obstructive lung disease (COPD) is associated with impaired muscle functions in addition to the impaired cardiopulmonary capacity inherent to the disease. The purpose of this study was to compare muscular performance between COPD subjects (COPD, n = 11, GOLD grade II/III; FEV1 = 53 ± 14% predicted; 61 ± 7 years) and healthy controls (HC, n = 12, 66 ± 8 years) in three resistance exercises with different complexity: (a) one‐legged knee extension (1KE), and (b) one‐ and (c) two‐ legged leg press (1LP and 2LP, respectively). For each exercise, muscular performance was defined as repetitions to exhaustion at 60% of one‐repetition maximum or overall exercise volume, calculated as the sum of three exercise sets. In HC, muscular performance increased progressively with increasing physiological complexity: 1KE < 1LP 1LP), advocating utilization of one‐legged resistance protocols for rehabilitation purposes