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Lina Jansen - One of the best experts on this subject based on the ideXlab platform.
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P12 Socioeconomic differences and Lung Cancer Survival in germany: differences in Cancer therapy and clinical prognostic factors
Oral presentations, 2019Co-Authors: Isabelle Finke, Gundula Behrens, Lars Schwettmann, Michael Gerken, Ron Pritzkuleit, Bernd Holleczek, H. Brenner, Lina JansenAbstract:Background Studies from several countries reported lower Lung Cancer Survival for lower socioeconomic status groups at individual and area level. Assumed reasons are differences in Cancer care or tumor characteristics between these different groups. For Germany, this has not yet been investigated in detail. We examined the association between area-based socioeconomic deprivation and Lung Cancer Survival by emphasizing on demographical factors related to the patient, clinical prognostic factors and utilization of Cancer therapy. Methods Patients registered with a primary tumor of the Lung (ICD-10 C34) between 2000–2015 in three German population-based clinical Cancer registries were eligible for our study. Area-based socioeconomic deprivation on municipality level was measured with the categorized German Index of Multiple Deprivation (GIMD). Our main outcome, Survival after Cancer diagnosis, was analyzed with Cox regression and we repeated the analysis for subgroups receiving chemotherapy, radiotherapy or surgery. Differences in stage and grading at diagnosis were analyzed with logistic regression. The main models included age, sex, histologic subtype, grading and stage at diagnosis. All analyses were conducted in SAS 9.4. Results Overall, 22,905 patients were included of whom 72.9% were male, 23.8% were over 75 years of age, 49.5% were diagnosed with stage IV Cancer and 82.7% with non-small-cell Lung Cancer. Kaplan-Meier five year overall Survival estimates from the least to the most deprived quintile were 17.2% [95%-Confidence Interval (CI): 15.8–18.5], 15.9% [14.8–17.2], 16.7% [15.5–17.9], 15.7% [14.5–16.9], and 14.4% [13.3–15.5], respectively. Our main Cox model showed lower Survival in the most deprived group compared to the most affluent group (Hazard Ratio (HR) 1.06, 95%-CI 1.01–1.11). This association was more pronounced in the later than in the earlier period of diagnosis [2000–2010: HR 1.03, (0.98–1.09); 2011–2015: HR 1.12, (1.03–1.23)]. No associations were seen for subgroups of patients receiving either chemotherapy, radiotherapy or surgery. When excluding patients diagnosed with stage IV, the effect estimate for the most deprived group was considerably larger [HR 1.15, 95%-CI 1.07–1.24]. Conclusion Our preliminary results indicate differences in Lung Cancer Survival according to area-based socioeconomic deprivation on municipality level in Germany.
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Socioeconomic Differences and Lung Cancer Survival-Systematic Review and Meta-Analysis.
Frontiers in oncology, 2018Co-Authors: Isabelle Finke, Hermann Brenner, Gundula Behrens, Linda Weisser, Lina JansenAbstract:Background: The impact of socioeconomic differences on Cancer Survival has been investigated for several Cancer types showing lower Cancer Survival in patients from lower socioeconomic groups. However, little is known about the relation between the strength of association and the level of adjustment and level of aggregation of the socioeconomic status measure. Here, we conduct the first systematic review and meta-analysis on the association of individual and area-based measures of socioeconomic status with Lung Cancer Survival. Methods: In accordance with PRISMA guidelines, we searched for studies on socioeconomic differences in Lung Cancer Survival in four electronic databases. A study was included if it reported a measure of Survival in relation to education, income, occupation, or composite measures (indices). If possible, meta-analyses were conducted for studies reporting on individual and area-based socioeconomic measures. Results: We included 94 studies in the review, of which 23 measured socioeconomic status on an individual level and 71 on an area-based level. Seventeen studies were eligible to be included in the meta-analyses. The meta-analyses revealed a poorer prognosis for patients with low individual income (pooled hazard ratio: 1.13, 95 % confidence interval: 1.08-1.19, reference: high income), but not for individual education. Group comparisons for hazard ratios of area-based studies indicated a poorer prognosis for lower socioeconomic groups, irrespective of the socioeconomic measure. In most studies, reported 1-, 3-, and 5-year Survival rates across socioeconomic status groups showed decreasing rates with decreasing socioeconomic status for both individual and area-based measures. We cannot confirm a consistent relationship between level of aggregation and effect size, however, comparability across studies was hampered by heterogeneous reporting of socioeconomic status and Survival measures. Only eight studies considered smoking status in the analysis. Conclusions: Our findings suggest a weak positive association between individual income and Lung Cancer Survival. Studies reporting on socioeconomic differences in Lung Cancer Survival should consider including smoking status of the patients in their analysis and to stratify by relevant prognostic factors to further explore the reasons for socioeconomic differences. A common definition for socioeconomic status measures is desirable to further enhance comparisons between nations and across different levels of aggregation.
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Pre- and post-diagnostic β-blocker use and Lung Cancer Survival: A population-based cohort study.
Scientific reports, 2017Co-Authors: Janick Weberpals, Lina Jansen, Walter E. Haefeli, Michael Hoffmeister, Martin Wolkewitz, Myrthe P. P. Van Herk-sukel, Pauline A. J. Vissers, Hermann BrennerAbstract:Beta-blockers have been associated with decreased Cancer mortality. However, evidence for Lung Cancer is sparse and reported beneficial effects might be based on biased analyses. In this so far largest study we investigated the association between β-blocker use and Lung Cancer Survival. Therefore, patients with a Lung Cancer diagnosis between April 1998 and December 2011 were selected from a database linkage of the Netherlands Cancer Registry and the PHARMO Database Network. After matching eligible patients on the propensity score, adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were calculated using Cox proportional hazards regression to investigate the association between pre-diagnostic and time-dependent β-blocker use and overall Survival. Duration and dose-response analyses and stratified analyses by β-blocker type, histological subgroups and stage were conducted. Of 3,340 eligible Lung Cancer patients, 1437 (43%) took β-blockers four months prior to diagnosis. Pre-diagnostic β-blocker use was not associated with overall Survival (HR 1.00 (0.92–1.08)) in the adjusted model. Time-dependent post-diagnostic analysis showed similar results with a HR of 1.03 (0.94–1.11). Trend analyses showed no association for cumulative dose (HR 0.99 (0.97–1.02)) and cumulative duration (HR 1.00 (0.96–1.05)). In conclusion, β-blocker use is not associated with reduced mortality among Lung Cancer patients.
Karen M. Linklater - One of the best experts on this subject based on the ideXlab platform.
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national comparisons of Lung Cancer Survival in england norway and sweden 2001 2004 differences occur early in follow up
Thorax, 2010Co-Authors: Lars Holmberg, Fredrik Sandin, Freddie Bray, James Spicer, Mats Lambe, Åsa Klint, M.d. Peake, Trond Eirik Strand, M A Richards, Karen M. LinklaterAbstract:BACKGROUND Countries with a similar expenditure on healthcare within Europe exhibit differences in Lung Cancer Survival. Survival in Lung Cancer was studied in 2001-2004 in England, Norway and Sweden. METHODS Nationwide Cancer registries in England, Norway and Sweden were used to identify 250 828 patients with Lung Cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative Survival times. 5-Year relative Survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model. RESULTS In all subcategories of age, sex and follow-up period, the 5-year Survival was lower in England than in Norway and Sweden. The age-standardised Survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001-2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001-2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden. CONCLUSION Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in Lung Cancer management may be seen early in follow-up.
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National comparisons of Lung Cancer Survival in England, Norway and Sweden 2001–2004: differences occur early in follow-up
Thorax, 2010Co-Authors: Lars Holmberg, Fredrik Sandin, Freddie Bray, Michael Richards, James Spicer, Mats Lambe, Åsa Klint, M.d. Peake, Trond Eirik Strand, Karen M. LinklaterAbstract:BACKGROUND Countries with a similar expenditure on healthcare within Europe exhibit differences in Lung Cancer Survival. Survival in Lung Cancer was studied in 2001-2004 in England, Norway and Sweden. METHODS Nationwide Cancer registries in England, Norway and Sweden were used to identify 250 828 patients with Lung Cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative Survival times. 5-Year relative Survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model. RESULTS In all subcategories of age, sex and follow-up period, the 5-year Survival was lower in England than in Norway and Sweden. The age-standardised Survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001-2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001-2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden. CONCLUSION Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in Lung Cancer management may be seen early in follow-up.
Alberto Ruano-ravina - One of the best experts on this subject based on the ideXlab platform.
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Lung Cancer Survival in never-smokers and exposure to residential radon: Results of the LCRINS study.
Cancer letters, 2020Co-Authors: Ana Casal-mouriño, Alberto Ruano-ravina, María Torres-durán, Isaura Parente-lamelas, Mariano Provencio-pulla, Olalla Castro-añón, Iria Vidal-garcía, Carolina Pena-Álvarez, José Abal-arca, María Piñeiro-lamasAbstract:We aimed to evaluate Lung Cancer Survival in never-smokers, both overall and specifically by sex, exposure to residential-radon, age, histological type, and diagnostic stage. We included Lung Cancer cases diagnosed in a multicentre, hospital-based, case-control-study of never-smoker patients, diagnosed from January-2011 to March-2015 (Lung Cancer Research In Never Smokers study). 369 never-smokers (79% women; median age 71 years; 80% adenocarcinoma; 66% stage IV) were included. Median overall Survival, and at one, 3 and 5 years of diagnosis was 18.3 months, 61%, 32% and 22%, respectively. Higher median Survival rates were obtained for: younger age, adenocarcinoma, actionable mutations, and earlier-stage at diagnosis. Higher indoor radon showed a higher risk of death in multivariate analysis. Median Lung Cancer Survival in never-smokers seems higher than that in ever-smokers. Patients with actionable mutations have a significantly higher Survival. Higher indoor-radon exposure has a negative effect on Survival.
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Lung Cancer Survival among never smokers
Cancer letters, 2019Co-Authors: Ana Casal-mouriño, Luis Valdés, Juan Miguel Barros-dios, Alberto Ruano-ravinaAbstract:Lung Cancer incidence among never smokers has increased in recent decades with 10-30% of all Lung Cancers occurring in never smokers, where exposure to residential radon is the leading cause of this disease. Lung Cancer Survival is low, ranging from 12% to 16% at 5 years of diagnosis. There is scant evidence to date on Survival from this disease in never smokers. We aim to evaluate Lung Cancer Survival in never smokers and ascertain whether there might be differences regarding smokers, through a systematic review applying predefined inclusion and exclusion criteria. 17 Studies were included. Never-smoker Lung Cancer patients seem to experience longer Survival times than do smokers or ex-smokers. Lung Cancer in never smokers displays distinctive clinical characteristics, is more frequent among women, is diagnosed at more advanced stages, and the predominant histologic type is adenocarcinoma. Further studies are necessary to ascertain Lung Cancer Survival among never smokers.
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Deletion of GSTM1 and GSTT1 genes and Lung Cancer Survival: a systematic review.
Tumori, 2017Co-Authors: Cristina Ramos Hernández, Juan Miguel Barros-dios, Cecilia Mouronte-roibás, Alberto Fernández-villar, Alberto Ruano-ravinaAbstract:Purpose The mechanisms of Lung carcinogenesis are not fully understood. Not all smokers develop Lung Cancer, indicating that genetic variations and other environmental factors may play an important role in its development. The human glutathione S-transferases (GSTs) have been associated with an increased risk of Lung Cancer. Glutathione S-transferases are phase II biotransformation enzymes that play a role in detoxifying a wide range of exogenous agents including carcinogens but also anticarcinogenic drugs. Methods We assessed the effect of allelic deletions in the GSTM1 and GSTT1 genotypes on Lung Cancer overall Survival through a systematic review of the scientific literature after applying predefined inclusion and exclusion criteria. Results Most of the included studies found no effect or a tendency to worse Survival for individuals with deletion of GSTs. Conclusions Further studies are necessary to understand the magnitude of the effect of the deletion of both genes on Lung Cancer Survival.
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Lung Cancer Survival and deletion of GSTM1 and GSTT1 genes. A case-series from Spain.
Tumori, 2013Co-Authors: Alberto Ruano-ravina, Alberto L García-basteiro, Mónica Pérez-ríos, Antón Gómez-mosquera, Sara Cerdeira-caramés, Juan Miguel Barros-diosAbstract:AIMS AND BACKGROUND Lung Cancer has a high incidence, and only 15% of all cases are alive 5 years after the diagnosis. Identifying the role of the genes implicated in the success of chemotherapy agents is crucial to predict Survival. The objective of the study was to assess the effect of GSTM1 and GSTT1 gene deletion on Lung Cancer Survival. METHODS AND STUDY DESIGN A consecutive sampling of Lung Cancer cases was performed in 1999-2000 at the University Hospital of Santiago de Compostela, Spain, and GSTM1 and GSTT1 genes were genotyped. The effect of GSTM1 and GSTT1 deletion on Survival was analyzed with the logrank test and with Cox regression. RESULTS A total of 132 individuals were included, and more than half of them had stage IV Lung Cancer at diagnosis. Survival was similar irrespective of the presence or absence of the GSTM1 gene, whereas those with deleted GSTT1 had a significantly shorter Survival. In multivariate Cox regression analysis, no significant effect was observed for the deletion of any of the genes, although there was a tendency towards a worse Survival for those with deletion of GSTT1. The main limitation was that stage at diagnosis could not be considered in the analysis since most of the patients were diagnosed at stage IV. CONCLUSIONS GSTT1 appears to influence Lung Cancer Survival whereas GSTM1 seems to have no effect.
Lars Holmberg - One of the best experts on this subject based on the ideXlab platform.
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national comparisons of Lung Cancer Survival in england norway and sweden 2001 2004 differences occur early in follow up
Thorax, 2010Co-Authors: Lars Holmberg, Fredrik Sandin, Freddie Bray, James Spicer, Mats Lambe, Åsa Klint, M.d. Peake, Trond Eirik Strand, M A Richards, Karen M. LinklaterAbstract:BACKGROUND Countries with a similar expenditure on healthcare within Europe exhibit differences in Lung Cancer Survival. Survival in Lung Cancer was studied in 2001-2004 in England, Norway and Sweden. METHODS Nationwide Cancer registries in England, Norway and Sweden were used to identify 250 828 patients with Lung Cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative Survival times. 5-Year relative Survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model. RESULTS In all subcategories of age, sex and follow-up period, the 5-year Survival was lower in England than in Norway and Sweden. The age-standardised Survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001-2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001-2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden. CONCLUSION Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in Lung Cancer management may be seen early in follow-up.
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National comparisons of Lung Cancer Survival in England, Norway and Sweden 2001–2004: differences occur early in follow-up
Thorax, 2010Co-Authors: Lars Holmberg, Fredrik Sandin, Freddie Bray, Michael Richards, James Spicer, Mats Lambe, Åsa Klint, M.d. Peake, Trond Eirik Strand, Karen M. LinklaterAbstract:BACKGROUND Countries with a similar expenditure on healthcare within Europe exhibit differences in Lung Cancer Survival. Survival in Lung Cancer was studied in 2001-2004 in England, Norway and Sweden. METHODS Nationwide Cancer registries in England, Norway and Sweden were used to identify 250 828 patients with Lung Cancer from England, 18 386 from Norway and 24 886 from Sweden diagnosed between 1996 and 2004, after exclusion of patients registered through death certificate only or with missing, zero or negative Survival times. 5-Year relative Survival was calculated by application of the period approach. The excess mortality between the countries was compared using a Poisson regression model. RESULTS In all subcategories of age, sex and follow-up period, the 5-year Survival was lower in England than in Norway and Sweden. The age-standardised Survival estimates were 6.5%, 9.3% and 11.3% for men and 8.4%, 13.5% and 15.9% for women in the respective countries in 2001-2004. The difference in excess risk of dying between the countries was predominantly confined to the first year of follow-up. The relative excess risk ratio during the first 3 months of follow-up comparing England with Norway 2001-2004 varied between 1.23 and 1.46, depending on sex and age, and between 1.56 and 1.91 comparing England with Sweden. CONCLUSION Access to healthcare and population awareness are likely to be major reasons for the differences, but it cannot be excluded that diagnostic and therapeutic activity play a role. Future improvements in Lung Cancer management may be seen early in follow-up.
Curtis C. Harris - One of the best experts on this subject based on the ideXlab platform.
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Serum estrogen and tumor-positive estrogen receptor-alpha are strong prognostic classifiers of non-small cell Lung Cancer Survival in both men and women
Carcinogenesis, 2010Co-Authors: Susan E. Olivo-marston, Elise D Bowman, Leah E. Mechanic, Yun-ling Zheng, Steen Mollerup, Alan T. Remaley, Michele R. Forman, Vidar Skaug, Aage Haugen, Curtis C. HarrisAbstract:The role of tumor estrogen receptors (ERs) and serum estrogen in Lung Cancer is inconclusive. We investigated the hypothesis that ERs and functional single-nucleotide polymorphisms in the estrogen biosynthesis pathway are associated with poorer Lung Cancer Survival. Lung Cancer patients (n = 305) from a National Cancer Institute-Maryland (NCI-MD) case–case cohort in the Baltimore metropolitan area were used as a test cohort. To validate, 227 cases from the NCI-MD case–control cohort and 293 cases from a Norwegian Lung Cancer cohort were studied. Information on demographics, tobacco and reproductive histories was collected in an interviewer-administered questionnaire. Serum estrogen, progesterone, tumor messenger RNA expression of hormone receptors and germ line DNA polymorphisms were analyzed for associations with Lung Cancer Survival. Patients in the highest tertile of serum estrogen had worse Survival in all three cohorts (P combined
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Serum Concentrations of Cytokines and Lung Cancer Survival in African Americans and Caucasians
Cancer epidemiology biomarkers & prevention : a publication of the American Association for Cancer Research cosponsored by the American Society of Pre, 2009Co-Authors: Lindsey Enewold, Elise D Bowman, Leah E. Mechanic, Yun-ling Zheng, G. E. Trivers, Anthony J. Alberg, Curtis C. HarrisAbstract:Accumulating evidence suggests a role for inflammation in the development and progression of Cancer. Our group recently identified a cytokine gene signature in Lung tissue associated with Lung Cancer prognosis. Therefore, we hypothesized that concentrations of circulating cytokines in serum may be associated with Lung Cancer Survival. Ten serum cytokines, namely, interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, granulocyte macrophage colony-stimulating factor, interferon (IFN)-γ, and tumor necrosis factor-α, were assessed in 353 non–small cell Lung Cancer cases from a case-control study of Lung Cancer in the greater Baltimore, Maryland area. Cytokines were measured using an ultrasensitive electrochemiluminescence immunoassay. IL-6 serum concentrations (≥4.0 pg/mL) were associated with significantly poorer Survival in both African Americans [hazard ratio (HR), 2.71; 95% confidence interval (CI), 1.26-5.80] and Caucasians (HR, 1.71; 95% CI, 1.22-2.40). IL-10 (HR, 2.62; 95% CI, 1.33-5.15) and IL-12 (HR, 1.98; 95% CI, 1.14-3.44) were associated with Lung Cancer Survival only in African Americans. Some evidence for an association of tumor necrosis factor-α levels with Survival in Caucasians was observed, although these results were not significant. These hypothesis-generating findings indicate that selected serum cytokine concentrations are associated with Lung Cancer Survival, and indicate that further research is warranted to better understand the mechanistic underpinnings of these associations. (Cancer Epidemiol Biomarkers Prev 2009;18(1):215–22)
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Lung Cancer Survival and Functional Polymorphisms in MBL2, an Innate-Immunity Gene
Journal of the National Cancer Institute, 2007Co-Authors: Sharon R. Pine, Elise D Bowman, Stephen J. Chanock, Leah E. Mechanic, Stefan Ambs, Christopher A. Loffredo, Peter G. Shields, Curtis C. HarrisAbstract:Background The relationship among chronic inflammation, innate immunity, and Cancer is well established. Mannosebinding lectin (MBL) is a key player in innate immunity. Five polymorphisms in the promoter and first exon of the MBL2 gene alter the expression and function of MBL in humans and are associated with inflammationrelated disease susceptibility. These five polymorphisms create six well-characterized haplotypes that result in lower (i.e., LYB, LYC, HYD, and LXA) or higher (i.e., HYA and LYA) serum MBL concentrations. We investigated whether Survival of patients with Lung Cancer was associated with these polymorphisms. Methods We used a multivariable Cox proportional hazards model to study the association between MBL2 polymorphisms and their haplotypes and diplotypes in 558 white and 173 African American patients with non – small-cell Lung Cancer in the Baltimore, MD, area and Lung Cancer mortality. Smoking history and race were obtained from interviews, tumor stage was obtained from medical records, and cause of death was obtained from the National Death Index. All statistical tests were two-sided. Results We found a statistically significant association between the X allele of the promoter Y/X polymorphism (which results in a lower serum MBL concentration) and improved Lung Cancer Survival among white patients (risk ratio [RR] of death from Lung Cancer with X/X or X/Y genotype compared with Y/Y genotype = 0.61, 95% confidence interval [CI] = 0.46 to 0.81) but not among African American patients (RR = 1.11, 95% CI = 0.69 to 1.77). The associations among white patients were strongest in heavy smokers and were independent of stage. We also found a statistically significant interaction between the Y/X polymorphism and race for Lung Cancer Survival ( P interaction = .019). The MBL2 LXA haplotype and XA/B diplotype, which are also associated with low serum MBL levels, were statistically significantly associated with improved Lung Cancer Survival among white patients. Conclusion The functional Y/X polymorphism of the innate-immunity gene MBL2 and MBL2 haplotypes and diplotypes appear to be associated with Lung Cancer Survival among white patients.
