Search

Abstract Background Patients with many types of autoimmune diseases (AIDs) are at an increased risk of cancer, which may depend on underlying dysregulation of the immune system or treatment. We systematically analyzed myeloma risk and survival in patients diagnosed with 33 different AIDs. Methods Data on patients with AIDs were retrieved from the Swedish Hospital Discharge Register and were linked to myeloma diagnoses from the Cancer Registry. Standardized incidence ratios (SIR) and hazard ratios (HRs) were calculated for subsequent myeloma between 1964 and 2008. Results Among patients with the 33 AIDs analyzed, 457 cases of myeloma were diagnosed. The overall SIR for myeloma was 1.12 and the overall HR was 0.92 and non-significant. SIRs for myeloma were significantly increased after ankylosing spondylitis (2.02) and systemic sclerosis (2.63). Only the HR for myeloma after rheumatic fever (5.27) was significantly increased. The SIR for myeloma before age 60 years was 1.45; the SIR for myeloma was only increased in the period 1964–1990 (1.31) and not later (1.04). Only the SIR for myeloma after ankylosing spondylitis was increased in the period 1991–2008 (2.09); the HRs for myeloma were increased after polymyositis/dermatomyositis (6.44) and rheumatic fever (4.43) but there were only three deaths of myeloma after these AIDs. Conclusions The present data showed an increase in myeloma SIR after two AIDs, ankylosing spondylitis and systemic sclerosis, and in HR after rheumatic fever. The overall myeloma risk after any AID was no longer increased in the latter follow-up period of 1991 through 2008.

Background: Previous studies have found that the incidence of dementia is lower in patients with cancer. However, the impact of survival bias, as well as the confounding by medical treatment, have not been fully addressed. We aimed to explore the subsequent risk of dementia in different follow-up intervals among patients with cancer, as well as the risk before the diagnosis of cancer. Methods: By using the Swedish Cancer Register and the Swedish Hospital Discharge Register, we systematically examined the risk of dementia among patients diagnosed with 35 different types of cancer. Standardized incidence ratios (SIRs) were used to calculate the relative risk. Results: The subsequent risk of dementia in patients with cancer decreased by 21% compared to matched cancer-free controls (SIR = 0.79, 95% CI 0.78–0.80). For specific cancer sites, 21 of them had a significantly lower risk of subsequent dementia. The decreased risk of dementia was also significant before the diagnosis of cancer. However, the risk was higher among patients with cancer who survived for more than 10 years' post-diagnosis (SIR = 1.37, 95% CI 1.32–1.41). Conclusions: In this population-based study, we found that the risk of dementia was lower among patients with cancer, and the risk was also lower before the diagnosis of cancer. This suggests that lower dementia risk is not simply due to bias. However, the underlying mechanisms need to be explored further. [ABSTRACT FROM AUTHOR]

Background It is widely believed that autoimmune diseases affect predominantly in women, but the available evidence came from case control study with potential selection and recall bias. We aimed to examine the gender-specific incidence of autoimmune diseases by using national wide registers in Sweden. Methods Swedish Hospital Discharge Register and Outpatient Register were used to identify a set of autoimmune diseases between 1987 and 2010. Gender-specific incidence rate was standardized directly according to the Swedish age distribution in 2000. Results A total of 403,757 individuals were diagnosed with autoimmune diseases between 1987 and 2010 in Sweden. The overall incidence of 32 autoimmune disease was 60% higher in women than men. Female predominance was noted in 18 specific diseases, whereas the rest of them showed no difference or male predominance. The age of onset was different between men and women in 27 autoimmune diseases. Conclusions Our study suggested that the classical view of female predominance of autoimmune diseases may be far from striking than previously believed. Further studies are needed to examine whether there is true difference between men and women. [ABSTRACT FROM AUTHOR]

Previous studies have shown that patients diagnosed with some autoimmune ( AI) diseases are at an increased risk of leukaemia but limited data are available on survival. We systematically analysed the risks (standardized incidence ratio, SIR) and survival (hazard ratio, HR) in nine types of leukaemia among 402 462 patients hospitalized for any of 33 AI diseases and compared to persons not hospitalized for AI diseases. Risk for all leukaemia was increased after 13 AI diseases and survival was decreased after six AI diseases. SIRs were increased after all AI diseases for seven types of leukaemia, including SIR 1·69 (95% confidence interval ( CI): 1·29-2·19) for acute lymphoblastic leukaemia ( ALL), 1·85 (95% CI: 1·65-2·07) for acute myeloid leukaemia, 1·68 (95% CI: 1·37-2·04) for chronic myeloid leukaemia, 2·20 (95% CI: 1·69-2·81) for 'other myeloid leukaemia', 2·45 (95% 1·99-2·98) for 'other and unspecified leukaemia', 1·81 (95% CI: 1·11-2·81) for monocytic leukaemia, and 1·36 (95% CI: 1·08-1·69) for myelofibrosis. The HRs were increased for four types of leukaemia, most for myelofibrosis (1·74, 95% CI: 1·33-2·29) and ALL (1·42, 95% CI: 1·03-1·95). Some AI diseases, including rheumatoid arthritis, were associated with increased SIRs and HRs in many types of leukaemia. The present data showed increases in risk and decreases in survival for many types of leukaemia after various AI diseases. Leukaemia is a rare complication in AI disease but findings about this comorbidity at the time of leukaemia diagnosis may help to optimize the treatment and improve survival. [ABSTRACT FROM AUTHOR]

Background and aims. The incidence of celiac disease (CD) shows large, worldwide variation. However, whether its causes are environmental (gluten-containing diet) or genetic (specific haplotype) have not been established. The aim of the present study is to examine the incidence of CD among second-generation immigrants and adoptees from abroad to disentangle genetic/ethnic versus environmental influences (assuming that immigrants have similar gluten exposures to native Swedes, and thus differ from them only in terms of their genetic background). Methods. Second-generation immigrants and adoptees from abroad were identified in the MigMed 2 Database and were followed until diagnosis of CD, death, or the end of study. Standardized incidence ratios (SIRs) were calculated among these immigrants with native Swedes as the reference group. Results. A total of 1,050,569 children were defined as second-generation immigrants and the overall SIR of CD (SIR == 0.89, 95% confidence interval 0.84--0.94) was significantly lower than that of native Swedes. The incidence of CD among children with parents from Western, Eastern, and Northern European countries was similar to that in native Swedes, but was lower for those with parents from low-prevalence countries, especially Eastern and Southeast Asian countries. A total of 51,557 children born in foreign countries were adopted by Swedes. Adoptees from Eastern Asia had a significantly decreased SIR of CD. Conclusions. The decreased incidence of CD in second-generation immigrants and some groups of adoptees from abroad strongly suggests that ethnic genetic heterogeneity may contribute to the worldwide variation in CD incidence. [ABSTRACT FROM AUTHOR]

Background. Based on the evidence that vitamin D is involved in the development of immune system and vitamin D receptor gene is associated with asthma, we supposed that vitamin D is related to the development of asthma. Methods. Asthma patients were identified from the Swedish Hospital Discharge Register and the hospitalization rate was examined by different seasons and regions. Standardized incidence ratios (SIRs) for asthma were examined among patients hospitalized for osteoporosis compared with the general population. Results. A total of 172,384 patients were hospitalized for asthma in Sweden during 1965-2007. More patients were hospitalized in winter and North Sweden than in summer and South Sweden. The risk of asthma after osteoporosis was significantly increased, giving an overall SIR of 2.93. The risk was higher in male patients when compared with female subjects. Patients hospitalized for osteoporosis at age younger than 55 showed a high risk. Reversing the analyses and examining the risk of osteoporosis after hospitalization of asthma, SIR was significantly increased (3.54). Conclusion. Our study suggests that vitamin D, as indicated by the high risk of asthma after osteoporosis and the seasonal and regional variations of hospitalization, could play an important role for the development of asthma. [ABSTRACT FROM AUTHOR]

Abstract: Background and goals: Comparing cancer incidence by migrant studies is one of the main approaches to generate hypotheses on the aetiology of cancer. Immigrant studies are most informative when cancer incidence data are available from both the source and the host country. Methods: The age standardised incidence rate (ASR) and standardised incidence ratio (SIR) of cancers among the Iranian immigrants were compared to the native Swedish population as the standard population by using the Swedish Family-Cancer Database (FCD) from 1958 to 2006. We also compared SIRs between Iranian immigrants and Iranian residents for whom the data were derived from the Iranian national cancer registry report of 2006. Results: Among the 65,501 Iranian immigrants, the median age at immigration was 26 years and the median length of stay was 16 years. Their all-cancer ASR was 175.3 and 153.1 per 100,000 person years for males and females, respectively, during the period from 1996 to 2006, higher than for the Iranian residents. The ASRs increased among the male Iranian immigrants during the past two decades but were stable among females. The risk for all-cancers among Iranian immigrants was lower than that for the native Swedish population. The Iranian immigrants had a significantly increased risk for male urinary bladder (SIR=1.40) and thyroid cancers (2.64) compared to the Swedes. Conclusion: The reasons for the decreased risk for all-cancers among the Iranian immigrants remain to be established. The ASR difference between the Iranian immigrants and the Iranian residents may be due to the differences between the registry systems, selected immigrant groups and environmental exposures. [Copyright &y& Elsevier]