Substantial variation in therapy for colorectal cancer across Europe: EUROCARE analysis of cancer registry data for 1987

To provide a quantitative description of the treatments applied to malignant colorectal cancer across Europe, we analysed all cases (11 333) of colorectal cancer registered in 1987 by 15 Cancer Registries in eight European countries. In a third of cancer registries, therapy was known for all cases, in the others 1-15% of registrations lacked treatment information. Eighty per cent of all patients received surgical resection, ranging from 58% (Estonia) to 92% (Tarn). The proportion of resections decreased with advancing age (85-73% for colon cancer; 85-70% for rectal cancer for 74 years, respectively). Only 4% of colon cancer patients received adjuvant or palliative chemotherapy, range 1-12%. Sixteen per cent of rectal cancer patients received radiotherapy with great inter-registry variability (1-43%). Since the proportion of surgically resected patients correlated positively with the 5-year relative survival probability reported by the recently published EUROCARE study, this may be part of the explanation for the major differences in survival for these cancers among different European populations. The most likely determinant of this correlation is stage at diagnosis, but, quality of, and access to surgery, as well as access to endoscopy, may differ among countries and registry areas, and these may also contribute to inter-country survival differences. Copyrigh

Climatic exposures in childhood and the risk of schizophrenia from childhood to early adulthood

Background: Season of birth is a risk factor of schizophrenia, and it is possible that cumulative exposure to cli-matic factors during childhood affects the risk of schizophrenia. We conducted a cohort study among 365,482 persons born in Finland in 1990-1995 to examine associations of 10-year cumulative exposure to global solar radiation and ambient temperature in childhood with schizophrenia. Methods: Data on schizophrenia diagnoses and sociodemographic factors from the Finnish population register and health care register were linked to daily meteorological data using residential information. The study population was followed from age 10 until the first schizophrenia diagnosis, death, emigration or December 31, 2017, whichever came first. Hazard ratios (HR) for the risk of schizophrenia were estimated using Cox pro-portional hazards model.Results: Compared to the lowest quintile of global solar radiation or ambient temperature, growing up in the second highest quintile (Q4) was associated with greater risk of schizophrenia. These hazard ratios were attenuated after adjustment for parental mental disorder, parental education, parental income, area-level so-cioeconomic characteristics and urbanicity (HR = 1.29, 95 % CI 1.06-1.58 for radiation; HR = 1.24, 95 % CI, 1.02-1.52 for temperature). Continuous linear terms evaluated in secondary models suggested a greater risk of schizophrenia at greater childhood exposure to global radiation and ambient temperature, but these associations did not remain in fully adjusted models.Conclusions: We found no consistent evidence that cumulative exposure to sunlight and ambient temperature in childhood is associated with the risk of developing schizophrenia. Studies in other populations residing in different latitudes are needed.Peer reviewe

Survival of Sami cancer patients

WOS:000308237900001Peer reviewe

Kanta-arkiston käyttökokemuksia työterveyshuollossa

The purpose of the eHealth and eSocial Strategy 2020 by the Finnish Ministry of Social Affairs and Health is to provide health care professionals with access to up-to-date patient data and information systems that support their work. Patient data are exchanged between organizations using the national Patient Data Repository (Kanta repository). The repository is increasingly used by the health care professionals as well as citizens. Presently, patient data of nearly every Finn are stored in it. The purpose of this study was to determine the use of the Kanta repository in Occupational Health Services using an electronic questionnaire in summer 2017. The survey targeted occupational health physicians, nurses, physiotherapists, and psychologists. There was a total of 359 respondents. The results indicate that the Kanta repository is positively viewed but not used extensively. Respondents say that patient data retrieval is slow, the required data cannot be found with certainty and occasionally, there are some delays with saving patient data in the Kanta repository. Furthermore, the dates of patient visits showed in the Kanta repository do not always correspond to the actual dates of the visits. Occupational health professionals believe that other professionals utilize patient data generated in occupational health services. However, they feel that getting an overall status of a patient’s care is not easy with the Kanta repository. Documenting and archiving patient data without delay in the Kanta repository provides patients with the best care possible, as professionals can access the patient’s entire medical history if necessary. Although using the Kanta repository is still somewhat cumbersome and there are difficulties with finding patient data, it fulfils its purpose and supports the occupational health professionals’ work. In the future, the situation will hopefully improve. The national patient data management service of the Kanta repository will start providing professionals with the summaries of patient’s key structural health information.Sosiaali- ja terveysministeriön laatiman Sote-tieto hyötykäyttöön -strategian tarkoituksena on mahdollistaa, että terveydenhuollon ammattilaisella on käytössään ajantasainen potilastieto ja työtä tukevat tietojärjestelmät. Tietojen vaihto yli organisaatiorajojen toteutetaan valtakunnallisen Potilastiedon arkiston (Kanta-arkiston) avulla. Arkistoon on tallennettu tietoja lähes kaikista suomalaisista ja sen käyttö lisääntyy terveydenhuollon ammattilaisten keskuudessa koko ajan. Tutkimuksen tarkoituksena oli selvittää Kanta-arkiston käyttöä työterveyshuollossa. Sähköinen kysely lähetettiin työterveyslääkäreille, työterveyshoitajille, työfysioterapeuteille ja työterveyspsykologeille kesällä 2017 ja siihen vastasi yhteensä 359 henkilöä. Tulokset osoittavat, että Kanta-arkistoa pidetään hyvänä ideana, mutta sitä käytetään vielä vähän. Vastaajat kokevat, että tietojen haku on hidasta, tarvittavan tiedon löytäminen hankalaa ja potilastietojen tallentumisessa Kanta-arkistoon on ajoittain viivettä. Lisäksi Kanta-arkistossa näkyvät potilaskäyntien päivämäärät eivät aina välttämättä vastaa käynnin todellista ajankohtaa. Työterveyshuollon ammattilaiset uskovat muiden ammattilaisten hyödyntävän työterveyshuollossa syntyneitä tietoja, vaikka kokevatkin, että Kanta-arkiston avulla kokonaiskuvan saaminen potilaan hoidon tilanteesta ei onnistu helposti. Tietojen ajantasainen kirjaaminen ja niiden tallentuminen Kanta-arkistoon mahdollistaa potilaalle parhaan mahdollisen hoidon, kun ammattilaiset saavat tarvittaessa esille potilaan koko terveys- ja sairaushistorian. Vaikka Kanta-arkiston käyttö on vielä osin hankalaa ja tietojen löytämisessä on vaikeutta, voidaan kuitenkin sanoa sen täyttävän tarkoituksensa ja hyödyttävän työterveyshuollon ammattilaisen työtä. Tulevaisuudessa tilanne tulee paranemaan, kun Kanta-arkistoon toteutettavan tiedonhallintapalvelun kautta saadaan ammattilaisille käyttöön kooste potilasta koskevista keskeisistä terveystiedoista

Prospective Study of Human Papillomavirus Seropositivity and Risk of Nonmelanoma Skin Cancer

Cutaneous human papillomaviruses (HPVs) have been associated with squamous cell carcinoma (SCC) in case-control studies, but there are limited data from prospective studies assessing whether virus exposure predicts risk of future cancer development. Two major biobanks, the Southern Sweden Microbiology Biobank (1971-2003) and the Janus Biobank (1973-2003) in Norway, containing samples from 850,000 donors, were searched for incident skin cancer for up to 30 years using registry linkages. Altogether, 2,623 donors with samples taken before diagnosis of SCC or basal cell carcinoma (BCC) of the skin were identified. Prediagnostic samples and samples from 2,623 matched controls were tested for antibodies against 33 types of HPV. Baseline seropositivity to HPV types in genus beta species 2 was associated with SCC risk (odds ratio = 1.3, 95% confidence interval: 1.1, 1.7); this was also the case for samples taken more than 18 years before diagnosis (odds ratio = 1.8, 95% confidence interval: 1.1, 2.8). Type-specific persistent seropositivity entailed elevated point estimates for SCC risk for 29 HPV types and decreased point estimates for only 3 types. After multiple hypothesis adjustment, HPV 76 was significantly associated with SCC risk and HPV 9 with BCC risk. In summary, seropositivity for certain HPV types was associated with an increased risk for future development of SCC and BCC

Associations of long-term solar insolation with specific depressive symptoms : Evidence from a prospective cohort study

Publisher Copyright: © 2022 The AuthorsEvidence suggests that sunlight counteracts depression, but the associations of long-term sunlight exposure with specific symptoms of depression are not well known. We evaluated symptom-specific associations of average 1-year solar insolation with DSM-5 depressive symptoms in a representative cohort of Finnish adults. The sample included 1,845 participants from the Cardiovascular Risk in Young Finns Study with data on DSM-5 depressive symptoms, place of residence and covariates. Daily recordings of global solar radiation were obtained from the Finnish Meteorological Institute. Each participant's residential zip code on each day one year prior to the assessment of depressive symptoms was linked to the solar radiation data, and 1-year average daily solar insolation was calculated. Associations of the average 1-year solar insolation with depressive symptoms were assessed with linear and logistic regression analyses adjusting for season, sex, age, as well as individual- and neighborhood-level socioeconomic characteristics. Average daily solar insolation over one year prior to the depressive symptom assessment was not associated with the total number of depressive symptoms reported by participants. In symptom-specific analyses, participants exposed to higher levels of solar insolation in their residential neighborhood were less likely to report suicidal thought (OR = 0.61, 95% CI, 0.39–0.94), and more likely to report changes in appetite (OR = 1.24, 95% CI, 1.00–1.54), changes in sleep (OR = 1.30, 95% CI, 1.06–1.59) and feelings of worthlessness/guilt (OR = 1.33, 95% CI = 1.07–1.65). These findings suggest that solar insolation may contribute to symptom-specific differences in depression. Studies in other populations residing in different geographical locations are needed.Peer reviewe

Long-term residential sunlight exposure associated with cognitive function among adults residing in Finland

Publisher Copyright: © 2022, The Author(s).While sunlight may influence cognitive function through several pathways, associations of residential sunlight exposure with cognitive function are not well known. We evaluated associations of long-term residential sunlight exposure with cognitive function among a representative cohort of 1838 Finnish adults residing in Finland who underwent comprehensive cognitive assessment in midlife. We linked daily recordings of global solar radiation to study participants using residential information and calculated the average daily residential exposure to sunlight for four exposure time intervals: 2 months, 1 year, 2 years and 5 years prior to the date of the cognition assessment. Associations of the residential sunlight exposure with cognitive function were assessed using linear regression analyses adjusting for season, sex, age, and individual- and neighborhood-level socioeconomic characteristics. Greater average residential sunlight exposure over 2 and 5 years prior to the cognitive function assessment was associated with better global cognitive function (b = 0.13, 95% CI = 0.01, 0.25; b = 0.17, 95% CI = 0.05, 0.29, per 1 MJ/m2 difference in sunlight exposure), while no associations with global cognitive function were observed at shorter exposure time intervals. In domain-specific analyses, greater residential exposure to sunlight over 1, 2 and 5 years prior to the cognitive function assessment was associated with better performance on new learning and visual memory (b = 0.10, 95% CI = 0.00, 0.20; b = 0.16, 95% CI = 0.04, 0.28; b = 0.19, 95% CI = 0.08, 0.31) and sustained attention (b = 0.15, 95% CI = 0.05, 0.25; b = 0.18, 95% CI = 0.06, 0.30; b = 0.17, 95% CI = 0.05, 0.29), but worse performance on reaction time (b = − 0.12, 95% CI = − 0.22, − 0.02; b = -0.15, 95% CI = − 0.28, − 0.02; b = − 0.18, 95% CI = − 0.30, − 0.05). Residential sunlight exposure was not associated with executive function. These findings suggest long-term residential sunlight exposure may be an environmental factor influencing cognitive function among a cognitively healthy cohort residing in Northern Europe. Further studies in populations residing in different geographical locations are needed.Peer reviewe