Apart from carpal tunnel syndrome, there are no population based studies of the epidemiology of compressive neuropathies. To provide this information, new presentations of compressive neuropathies among patients regis...Apart from carpal tunnel syndrome, there are no population based studies of the epidemiology of compressive neuropathies. To provide this information, new presentations of compressive neuropathies among patients registered with 253 general practices in the UK General Practice Research Database with 1.83 million patient years at risk in 2000 were analysed. The study revealed that in 2000 the annual age standardised rates per 100 000 of new presentations in primary care were: carpal tunnel syndrome, men 87.8/women 192.8; Morton’s metatarsalgia, men 50.2/women 87.5; ulnar neuropathy, men 25.2/women 18.9; meralgia paraesthetica, men 10.7/women 13.2; and radial neuropathy, men 2.97/women 1.42. New presentations were most frequent at ages 55-64 years except for carpal tunnel syndrome, which was most frequent in women aged 45-54 years, and radial nerve palsy, which was most frequent in men aged 75-84 years. In 2000, operative treatment was undertaken for 31%of new presentations of carpal tunnel syndrome, 3%of Morton’s metatarsalgia, and 30%of ulnar neuropathy.展开更多
Objective. Previous studies have shown a positive association between colorectal cancer and Barrett’s oesophagus, but this association is disputed. No population-based studies have examined the incidence of this canc...Objective. Previous studies have shown a positive association between colorectal cancer and Barrett’s oesophagus, but this association is disputed. No population-based studies have examined the incidence of this cancer in patients with Barrett’s oesophagus. Material and methods. The present study comprised a population-based cohort of patients with Barrett’s oesophagus (constructed using pathology reports of all oesophageal biopsies in Northern Ireland 1993-99; cohort subclassified according to whether specialized intestinal metaplasia (SIM) was present, absent, or not commented on in biopsies). Cases of colorectal cancer were identified by linking with the Northern Ireland Cancer Registry. The comparison group used was the general population in Northern Ireland. Results. A total of 2969 patients with Barrett’s oesophagus were followed for a total of 14,014 person-years (mean 4.7 years). SIM was present in 1670 patients (56.2%), absent in 545 (18.4%) and not commented on in 754 (25.4%). Colorectal cancer was diagnosed in 39 patients; 22 patients had cancer diagnosed at least 6 months after diagnosis of Barrett’s oesophagus. There was no increased risk of colorectal cancer: the standardized incidence ratio (SIR) for cancer diagnosed at least 6 months after entry into the cohort was 0.82 (95%CI, 0.48-1.17); this risk did not alter with SIM status or gender. To assess a possible effect of diagnostic bias, we calculated SIRs for cancers occurring after at least 3 months, after at least 1 month and at any time after diagnosis of Barrett‘s oesophagus. These were 0.94 (0.57-1.30), 1.09 (0.69-1.48) and 1.46 (1.00-1.92), respectively. Conclusions. The incidence of colorectal cancer was not elevated in patients with Barrett’s oesophagus. Diagnostic bias may explain why previous studies have found an association.展开更多
Background: For Greece, no data regarding the incidence of cutaneous melanoma (CM) have been reported. In this report, we present epidemiologic data for CM on Crete, an island in southern Greece, during the years 1999...Background: For Greece, no data regarding the incidence of cutaneous melanoma (CM) have been reported. In this report, we present epidemiologic data for CM on Crete, an island in southern Greece, during the years 1999-2002. We attempt a comparison with corresponding data reported for the Italian population. Methods: One hundred and two CM patients of Cretan origin with primary CM first diagnosed between the years 1999-2002 were interviewed and underwent complete skin examination by the same two experienced dermatologists. Crude and/or age-standardized incidence rates were calculated for Crete as a whole, as well as for each one of the four prefectures of the island. Results: The age-standardized incidence rate according to the Greek population was 4.6 per 100,000 person-years for men and 4.7 per 100,000 person-years for women. The crude incidence rates did not differ significanty between the four prefectures. Significant differences between Cretan and Italian CM patients were found in terms of gender, age at diagnosis, anatomic site and histogenetic type of CM, hair color, skin reaction to sun exposure, history of sunburn before the age of 15 years, presence of solar lentigines, and total common nevus count. Conclusions: The incidence of CM on Crete is higher than that estimated for the whole of Greece and comparable with the incidence reported for other southern European countries.展开更多
Objective: To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. Design: Retrospective cohort study. Setting: University Hospital, Helsinki, Finland. Partici...Objective: To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. Design: Retrospective cohort study. Setting: University Hospital, Helsinki, Finland. Participants: 7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up through the Finnish cancer registry until 2003. Main outcome measures: Standardised incidence ratio for cervical cancer and other cancers. Results: During follow-up 22 cases of invasive cervical cancer occurred in women treated for cervical intraepithelial neoplasia (standardised incidence ratio 2.8, 95%confidence interval 1.7 to 4.2). The highest risk was during the second decade (10 cases observed: 3.1, 1.5 to 5.7). The standardised incidence ratio for cervical intraepithelial cancer type 1 was 3.1 (1.4 to 6.2) and for type 2 was 3.7 (0.9 to 10.7). Conclusions: The risk of cervical cancer in the first 20 years after treatment for cervical intraepithelial neoplasia is higher than in the average population. The risk of smoking related cancers is also increased.展开更多
Objective: To study the distribution of septo-optic dysplasia (SOD) and optic nerve hypoplasia (ONH) in the Greater Manchester and Lancashire (GM&L) region of Northwest England, and to analyze occurrence by locati...Objective: To study the distribution of septo-optic dysplasia (SOD) and optic nerve hypoplasia (ONH) in the Greater Manchester and Lancashire (GM&L) region of Northwest England, and to analyze occurrence by location and over time. Study design: A population-based incidence study was undertaken for cases of SOD/ONH from GM&L. Standardized incidence ratio (SIR) for each district, relationships between SIRs and possible geographically varying risk factors, and spatial and space-time clustering were analyzed. Results: Eighty-seven cases had a confirmed diagnosis of ONH/SOD giving an incidence of 10.9/100,000 per year in GM&L. SIRs ranged widely but were significantly elevated (lower confidence limit > 100) in three districts: 167%, 192%, and 198%, respectively. All three were high population density, inner-city locations. SIRs were significantly correlated with higher rates of unemployment (r=0.49, P= .01), dependent children in nonearning households (r= 0.47, P= .02), underage conceptions (r= 0.46, P= .02), and underage pregnancies (r=0.44, P= .03). There was no evidence of spatial or space-time clustering. Conclusions: The incidence of ONH/SOD in GM&L was higher than that reported elsewhere. Cases were more common in areas that had higher unemployment and teenage pregnancy rates.展开更多
Background: Both increases and decreases in the incidence of subsequent malignancies in melanoma patients have been reported. We examined the database of the Indiana University Cancer Center to determine whether there...Background: Both increases and decreases in the incidence of subsequent malignancies in melanoma patients have been reported. We examined the database of the Indiana University Cancer Center to determine whether there is an association between malignant melanoma and noncutaneous malignancies. Objective: We searched for evidence of noncutaneous malignancies in a cohort of melanoma patients. Methods: Patients with microscopically confirmed malignant melanoma diagnosed between January 1987 and March 2001 were analyzed. This cohort was investigated for noncutaneous malignancies occurring either before or after the diagnosis of melanoma. The standardized incidence ratios (SIR) were calculated as the ratio of the observed to the expected number of patients with second malignancies, and 95% confidence intervals (95% CI) around the SIR were estimated from the cumulative Poisson distribution. Results: A total of 955 patients with melanoma (498 males and 457 females) were documented over the 14-year period. Sixty-nine noncutaneous malignancies were identified in 59 (6.2% ) melanoma patients (39 males and 20 females). There was a higher risk of non-Hodgkin’ s lymphoma (SIR= 1.91;95% CI, 0.88- 3.62) in men and renal cell carcinoma (SIR = 2.41,95% CI, 0.97- 4.97) in men. In female patients, however, there was no higher risk of noncutaneous malignancies. Conclusions: This study did not show a higher risk of prostate cancer, gastrointestinal cancer, leukemia, endometrial cancer, or cancer of the nerve and neuroendocrine systems in melanoma patients. No female patients incurred a higher risk of noncutaneous cancers. The increased risk of non-Hodgkin’ s lymphoma and renal cell carcinoma in men might be attributed to a mutual carcinogenic exposure, an aberration of cell-mediated immunity, a shared genetic susceptibility, increased medical surveillance among cancer patients, a post-therapy effect after cancer management, or factors not as yet clear. Close monitoring of melanoma patients for signs of second malignancy is warranted.展开更多
文摘Apart from carpal tunnel syndrome, there are no population based studies of the epidemiology of compressive neuropathies. To provide this information, new presentations of compressive neuropathies among patients registered with 253 general practices in the UK General Practice Research Database with 1.83 million patient years at risk in 2000 were analysed. The study revealed that in 2000 the annual age standardised rates per 100 000 of new presentations in primary care were: carpal tunnel syndrome, men 87.8/women 192.8; Morton’s metatarsalgia, men 50.2/women 87.5; ulnar neuropathy, men 25.2/women 18.9; meralgia paraesthetica, men 10.7/women 13.2; and radial neuropathy, men 2.97/women 1.42. New presentations were most frequent at ages 55-64 years except for carpal tunnel syndrome, which was most frequent in women aged 45-54 years, and radial nerve palsy, which was most frequent in men aged 75-84 years. In 2000, operative treatment was undertaken for 31%of new presentations of carpal tunnel syndrome, 3%of Morton’s metatarsalgia, and 30%of ulnar neuropathy.
文摘Objective. Previous studies have shown a positive association between colorectal cancer and Barrett’s oesophagus, but this association is disputed. No population-based studies have examined the incidence of this cancer in patients with Barrett’s oesophagus. Material and methods. The present study comprised a population-based cohort of patients with Barrett’s oesophagus (constructed using pathology reports of all oesophageal biopsies in Northern Ireland 1993-99; cohort subclassified according to whether specialized intestinal metaplasia (SIM) was present, absent, or not commented on in biopsies). Cases of colorectal cancer were identified by linking with the Northern Ireland Cancer Registry. The comparison group used was the general population in Northern Ireland. Results. A total of 2969 patients with Barrett’s oesophagus were followed for a total of 14,014 person-years (mean 4.7 years). SIM was present in 1670 patients (56.2%), absent in 545 (18.4%) and not commented on in 754 (25.4%). Colorectal cancer was diagnosed in 39 patients; 22 patients had cancer diagnosed at least 6 months after diagnosis of Barrett’s oesophagus. There was no increased risk of colorectal cancer: the standardized incidence ratio (SIR) for cancer diagnosed at least 6 months after entry into the cohort was 0.82 (95%CI, 0.48-1.17); this risk did not alter with SIM status or gender. To assess a possible effect of diagnostic bias, we calculated SIRs for cancers occurring after at least 3 months, after at least 1 month and at any time after diagnosis of Barrett‘s oesophagus. These were 0.94 (0.57-1.30), 1.09 (0.69-1.48) and 1.46 (1.00-1.92), respectively. Conclusions. The incidence of colorectal cancer was not elevated in patients with Barrett’s oesophagus. Diagnostic bias may explain why previous studies have found an association.
文摘Background: For Greece, no data regarding the incidence of cutaneous melanoma (CM) have been reported. In this report, we present epidemiologic data for CM on Crete, an island in southern Greece, during the years 1999-2002. We attempt a comparison with corresponding data reported for the Italian population. Methods: One hundred and two CM patients of Cretan origin with primary CM first diagnosed between the years 1999-2002 were interviewed and underwent complete skin examination by the same two experienced dermatologists. Crude and/or age-standardized incidence rates were calculated for Crete as a whole, as well as for each one of the four prefectures of the island. Results: The age-standardized incidence rate according to the Greek population was 4.6 per 100,000 person-years for men and 4.7 per 100,000 person-years for women. The crude incidence rates did not differ significanty between the four prefectures. Significant differences between Cretan and Italian CM patients were found in terms of gender, age at diagnosis, anatomic site and histogenetic type of CM, hair color, skin reaction to sun exposure, history of sunburn before the age of 15 years, presence of solar lentigines, and total common nevus count. Conclusions: The incidence of CM on Crete is higher than that estimated for the whole of Greece and comparable with the incidence reported for other southern European countries.
文摘Objective: To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. Design: Retrospective cohort study. Setting: University Hospital, Helsinki, Finland. Participants: 7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up through the Finnish cancer registry until 2003. Main outcome measures: Standardised incidence ratio for cervical cancer and other cancers. Results: During follow-up 22 cases of invasive cervical cancer occurred in women treated for cervical intraepithelial neoplasia (standardised incidence ratio 2.8, 95%confidence interval 1.7 to 4.2). The highest risk was during the second decade (10 cases observed: 3.1, 1.5 to 5.7). The standardised incidence ratio for cervical intraepithelial cancer type 1 was 3.1 (1.4 to 6.2) and for type 2 was 3.7 (0.9 to 10.7). Conclusions: The risk of cervical cancer in the first 20 years after treatment for cervical intraepithelial neoplasia is higher than in the average population. The risk of smoking related cancers is also increased.
文摘Objective: To study the distribution of septo-optic dysplasia (SOD) and optic nerve hypoplasia (ONH) in the Greater Manchester and Lancashire (GM&L) region of Northwest England, and to analyze occurrence by location and over time. Study design: A population-based incidence study was undertaken for cases of SOD/ONH from GM&L. Standardized incidence ratio (SIR) for each district, relationships between SIRs and possible geographically varying risk factors, and spatial and space-time clustering were analyzed. Results: Eighty-seven cases had a confirmed diagnosis of ONH/SOD giving an incidence of 10.9/100,000 per year in GM&L. SIRs ranged widely but were significantly elevated (lower confidence limit > 100) in three districts: 167%, 192%, and 198%, respectively. All three were high population density, inner-city locations. SIRs were significantly correlated with higher rates of unemployment (r=0.49, P= .01), dependent children in nonearning households (r= 0.47, P= .02), underage conceptions (r= 0.46, P= .02), and underage pregnancies (r=0.44, P= .03). There was no evidence of spatial or space-time clustering. Conclusions: The incidence of ONH/SOD in GM&L was higher than that reported elsewhere. Cases were more common in areas that had higher unemployment and teenage pregnancy rates.
文摘Background: Both increases and decreases in the incidence of subsequent malignancies in melanoma patients have been reported. We examined the database of the Indiana University Cancer Center to determine whether there is an association between malignant melanoma and noncutaneous malignancies. Objective: We searched for evidence of noncutaneous malignancies in a cohort of melanoma patients. Methods: Patients with microscopically confirmed malignant melanoma diagnosed between January 1987 and March 2001 were analyzed. This cohort was investigated for noncutaneous malignancies occurring either before or after the diagnosis of melanoma. The standardized incidence ratios (SIR) were calculated as the ratio of the observed to the expected number of patients with second malignancies, and 95% confidence intervals (95% CI) around the SIR were estimated from the cumulative Poisson distribution. Results: A total of 955 patients with melanoma (498 males and 457 females) were documented over the 14-year period. Sixty-nine noncutaneous malignancies were identified in 59 (6.2% ) melanoma patients (39 males and 20 females). There was a higher risk of non-Hodgkin’ s lymphoma (SIR= 1.91;95% CI, 0.88- 3.62) in men and renal cell carcinoma (SIR = 2.41,95% CI, 0.97- 4.97) in men. In female patients, however, there was no higher risk of noncutaneous malignancies. Conclusions: This study did not show a higher risk of prostate cancer, gastrointestinal cancer, leukemia, endometrial cancer, or cancer of the nerve and neuroendocrine systems in melanoma patients. No female patients incurred a higher risk of noncutaneous cancers. The increased risk of non-Hodgkin’ s lymphoma and renal cell carcinoma in men might be attributed to a mutual carcinogenic exposure, an aberration of cell-mediated immunity, a shared genetic susceptibility, increased medical surveillance among cancer patients, a post-therapy effect after cancer management, or factors not as yet clear. Close monitoring of melanoma patients for signs of second malignancy is warranted.
