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Akimov AM, Gakova AA, Kuznetsov VA. Comparative analysis of tobacco smoking intensity among young and middle-aged women of one administrative district of Tyumen in 1996-2016. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study the changes of tobacco smoking intensity among young and middle-aged women of one administrative district of Tyumen in 1996-2016.Material and methods. Cross-sectional epidemiological studies were conducted on representative samples of women aged 25-64 years in 1996 and 2016. The category of smokers was ranked by age group and depending on the number of cigarettes smoked per day. The analysis included women of two categories — young age (25-44 years old) and middle age (45-64 years old). Women were considered high-intensity smokers if they smoked >10 cigarettes per day. According to this parameter, all smokers were divided into those with low and high smoking intensity.Results. According to the results, a negative 20-year dynamics was revealed — an increase in the tobacco smoking intensity in the population due to the category of young women. In young women over a 20-year period with a stable prevalence of tobacco smoking, a redistribution from low to high intensity of tobacco smoking was established — the prevalence of high-intensity smokers over low-intensity ones in 2016 with inverse proportions at the first screening. In middle-aged women, over a 20-year period, with a tendency towards an increase in tobacco smoking prevalence from the first to the second screening, the prevalence of low-intensity smokers over high-intensity smokers remains.Conclusion. Within the large-scale federal programs, it is necessary to direct efforts to reduce the intensity of tobacco smoking among women in middle-urbanized Siberian cities, focusing mainly on the category of young age.
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Affiliation(s)
- A. M. Akimov
- Tyumen Cardiology Research Center — branch of Tomsk National Research Medical Center
| | - A. A. Gakova
- Tyumen Cardiology Research Center — branch of Tomsk National Research Medical Center
| | - V. A. Kuznetsov
- Tyumen Cardiology Research Center — branch of Tomsk National Research Medical Center
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2
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Gallus S, Lugo A, Liu X, Behrakis P, Boffi R, Bosetti C, Carreras G, Chatenoud L, Clancy L, Continente X, Dobson R, Effertz T, Filippidis FT, Fu M, Geshanova G, Gorini G, Keogan S, Ivanov H, Lopez MJ, Lopez-Nicolas A, Precioso J, Przewozniak K, Radu-Loghin C, Ruprecht A, Semple S, Soriano JB, Starchenko P, Trapero-Bertran M, Tigova O, Tzortzi AS, Vardavas C, Vyzikidou VK, Colombo P, Fernandez E. Who Smokes in Europe? Data From 12 European Countries in the TackSHS Survey (2017-2018). J Epidemiol 2021; 31:145-151. [PMID: 32249267 PMCID: PMC7813769 DOI: 10.2188/jea.je20190344] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/21/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Population data on tobacco use and its determinants require continuous monitoring and careful inter-country comparison. We aimed to provide the most up-to-date estimates on tobacco smoking from a large cross-sectional survey, conducted in selected European countries. METHODS Within the TackSHS Project, a face-to-face survey on smoking was conducted in 2017-2018 in 12 countries: Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain, representing around 80% of the 432 million European Union (EU) adult population. In each country, a representative sample of around 1,000 subjects aged 15 years and older was interviewed, for a total of 11,902 participants. RESULTS Overall, 25.9% of participants were current smokers (31.0% of men and 21.2% of women, P < 0.001), while 16.5% were former smokers. Smoking prevalence ranged from 18.9% in Italy to 37.0% in Bulgaria. It decreased with increasing age (compared to <45, multivariable odds ratio [OR] for ≥65 year, 0.31; 95% confidence interval [CI], 0.27-0.36), level of education (OR for low vs high, 1.32; 95% CI, 1.17-1.48) and self-rated household economic level (OR for low vs high, 2.05; 95% CI, 1.74-2.42). The same patterns were found in both sexes. CONCLUSIONS These smoking prevalence estimates represent the most up-to-date evidence in Europe. From them, it can be derived that there are more than 112 million current smokers in the EU-28. Lower socio-economic status is a major determinant of smoking habit in both sexes.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Xiaoqiu Liu
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Panagiotis Behrakis
- Institute of Public Health of the American College of Greece, Athens, Greece
| | - Roberto Boffi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giulia Carreras
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
| | - Liliane Chatenoud
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health), Madrid, Spain
- Institut d’investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
| | | | - Tobias Effertz
- University of Hamburg, Hamburg Business School, Institute for Law & Economics, Hamburg, Germany
| | | | - Marcela Fu
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | | | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
| | - Sheila Keogan
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | | | - María J. Lopez
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health), Madrid, Spain
- Institut d’investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
| | | | - José Precioso
- Instituto de Educação, Universidade do Minho, Braga, Portugal
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Foundation “Smart Health - Health in 3D”, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
| | | | - Ario Ruprecht
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Joan B. Soriano
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
- Hospital Universitario La Princesa, Madrid, Spain
| | | | - Marta Trapero-Bertran
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Olena Tigova
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Anna S. Tzortzi
- Institute of Public Health of the American College of Greece, Athens, Greece
| | | | | | | | - Esteve Fernandez
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - the TackSHS Project Investigators
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Institute of Public Health of the American College of Greece, Athens, Greece
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health), Madrid, Spain
- Institut d’investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
- University of Stirling, Stirling, Scotland
- University of Hamburg, Hamburg Business School, Institute for Law & Economics, Hamburg, Germany
- Department of Primary Care and Public Health, Imperial College, London, UK
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
- Smoke Free Life Coalition, Sofia, Bulgaria
- Universidad Politécnica de Cartagena, Cartagena, Spain
- Instituto de Educação, Universidade do Minho, Braga, Portugal
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Foundation “Smart Health - Health in 3D”, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
- European Network for Smoking Prevention, Bruxelles, Belgium
- Hospital Universitario La Princesa, Madrid, Spain
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- DOXA Institute, Milan, Italy
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3
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Forjaz G, Bastos J, Castro C, Mayer A, Noone AM, Chen HS, Mariotto AB. Regional differences in tobacco smoking and lung cancer in Portugal in 2018: a population-based analysis using nationwide incidence and mortality data. BMJ Open 2020; 10:e038937. [PMID: 33099497 PMCID: PMC7590355 DOI: 10.1136/bmjopen-2020-038937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study aims to estimate the proportion of lung cancer cases and deaths attributable to tobacco smoking in Portugal in 2018, complemented by trends in incidence and mortality, by sex and region. DESIGN Cancer cases for 1998-2011 and cancer deaths for 1991-2018 were obtained from population-based registries and Statistics Portugal, respectively. We projected cases for 2018 and used reported deaths for the same year to estimate, using Peto's method, the number and proportion of lung cancer cases and deaths caused by tobacco smoking in 2018. We calculated the age-adjusted incidence and mortality rates in each year of diagnosis and death. We fitted a joinpoint regression to the observed data to estimate the annual percentage change (APC) in the rates. SETTING Portugal. RESULTS In 2018, an estimated 3859 cases and 3192 deaths from lung cancer were attributable to tobacco smoking in Portugal, with men presenting a population attributable fraction (PAF) of 82.6% (n=3064) for incidence and 84.1% (n=2749) for mortality, while in women those values were 51.0% (n=795) and 42.7% (n=443), respectively. In both sexes and metrics, the Azores were the region with the highest PAF and the Centre with the lowest. During 1998-2011, the APC for incidence ranged from 0.6% to 3.0% in men and 3.6% to 7.9% in women, depending on region, with mortality presenting a similar pattern between sexes. CONCLUSION Exposure to tobacco smoking has accounted for most of the lung cancer cases and deaths estimated in Portugal in 2018. Differential patterns of tobacco consumption across the country, varying implementation of primary prevention programmes and differences in personal cancer awareness may have contributed to the disparities observed. Primary prevention of lung cancer remains a public health priority, particularly among women.
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Affiliation(s)
- Gonçalo Forjaz
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
- Azores Oncological Centre, Azores, Portugal
| | - Joana Bastos
- Centre Region Cancer Registry, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
| | - Clara Castro
- Northern Region Cancer Registry, Francisco Gentil Portuguese Institute for Oncology of Porto, Porto, Portugal
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Alexandra Mayer
- Southern Region Cancer Registry, Francisco Gentil Portuguese Institute for Oncology of Lisbon, Lisboa, Portugal
| | - Anne-Michelle Noone
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Huann-Sheng Chen
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Angela B Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
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4
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Oliveira D, Jun Otuyama L, Mabunda D, Mandlate F, Gonçalves-Pereira M, Xavier M, Laks J, Ferri CP. Reducing the Number of People with Dementia Through Primary Prevention in Mozambique, Brazil, and Portugal: An Analysis of Population-Based Data. J Alzheimers Dis 2020; 70:S283-S291. [PMID: 30664504 PMCID: PMC6700611 DOI: 10.3233/jad-180636] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Most people with dementia live in low- and middle-income countries and little is known about the potential for reducing these numbers by reducing key risk factors. Objective: To investigate the potential for dementia incidence reduction in Brazil, Mozambique, and Portugal (a culturally related, high-income country). Methods: We replicated previously published methods and based on the relative risks from previous studies, we estimated the population-attributable risk (PAR) of dementia in Mozambique, Brazil, and Portugal for seven modifiable risk factors associated with dementia (low educational attainment, physical inactivity, midlife hypertension, midlife obesity, depression, smoking, and diabetes mellitus). The combined PAR was calculated and adjusted for associations between risk factors. The potential for risk factor reduction was assessed by examining the effect of relative reductions of 10% and 20% per decade for each of the risk factors on projections for dementia cases for each decade until 2050. Results: After adjusting for non-independence of risk factors, 24.4%, 32.3%, and 40.1% of dementia cases could be related to seven potentially modifiable risk factors in Mozambique, Brazil, and Portugal, respectively. Reducing the prevalence of each risk factor by 20% per decade could, by 2050, potentially reduce the prevalence of dementia in Mozambique, Brazil, and Portugal by 12.9%, 16.2%, and 19.5%, respectively. Conclusion: There is a substantial difference between the countries in the percentage of dementia cases that could be attributable to the seven potentially modifiable risk factors. The proportion of cases that could be prevented by 2050 if measures were taken to address these main risk factors was higher in Portugal than in Brazil and Mozambique. Each country or region should consider their unique risk factor profile when developing dementia risk reduction programs.
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Affiliation(s)
- Deborah Oliveira
- Universidade Federal de Sao Paulo, Departments of Psychobiology and Department of Psychiatry Sao Paulo, Brazil
| | - Leonardo Jun Otuyama
- Universidade Federal de Sao Paulo, Departments of Psychobiology and Department of Psychiatry Sao Paulo, Brazil.,Universidade de Sao Paulo - Hospital das Clinicas da Faculdade de Medicina, Sao Paulo, Brazil
| | - Dirceu Mabunda
- Eduardo Mondlane University, Faculty of Medicine, Maputo, Mozambique
| | - Flavio Mandlate
- Eduardo Mondlane University, Faculty of Medicine, Maputo, Mozambique
| | - Manuel Gonçalves-Pereira
- Universidade Nova de Lisboa, Nova Medical School/Faculdade de Ciências Médicas, Lisboa, Portugal
| | - Miguel Xavier
- Universidade Nova de Lisboa, Nova Medical School/Faculdade de Ciências Médicas, Lisboa, Portugal
| | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Brazil; Universidade do Grande Rio, Duque de Caxias, Rio de Janeiro, Brazil
| | - Cleusa P Ferri
- Universidade Federal de Sao Paulo, Departments of Psychobiology and Department of Psychiatry Sao Paulo, Brazil.,Hospital Alemao Osvaldo Cruz - Health Technology Assessment Unit, Sao Paulo, Brazil
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5
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Pereira AM. Smoking in Portugal: Where do we stand today? Rev Port Cardiol 2019; 38:595-597. [PMID: 31703972 DOI: 10.1016/j.repc.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Ana Margarida Pereira
- CINTESIS, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal; Allergy Unit, CUF-Porto Instituto & Hospital, Porto, Portugal; MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
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6
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Pereira AM. Smoking in Portugal: Where do we stand today? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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7
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Trends in gastric cancer mortality and in the prevalence of Helicobacter pylori infection in Portugal. Eur J Cancer Prev 2018; 25:275-81. [PMID: 26186469 DOI: 10.1097/cej.0000000000000183] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Portugal has the highest gastric cancer mortality rates in Western Europe, along with high prevalences of Helicobacter pylori infection. Monitoring their trends is essential to predict the burden of this cancer. We aimed to quantify time trends in gastric cancer mortality in Portugal and in each administrative region, and to compute short-term predictions, as well as to describe the prevalence of H. pylori infection, through a systematic review. Joinpoint analyses were used to identify significant changes in sex-specific trends in gastric cancer age-standardized mortality rates (ASMR) and to estimate annual percent changes (APC). The most recent trends were considered to compute estimates up to 2020 by adjusting Poisson regression models. We searched PubMed and IndexRMP to identify studies carried out in Portugal reporting the prevalence of H. pylori. Gastric cancer mortality has been decreasing in Portugal since 1971 in men (from ASMR=55.3/100 000; APC=-2.4, 95% confidence interval: -2.5 to -2.3) and since 1970 in women (from ASMR=28.0/100 000; APC=-2.8, 95% confidence interval: -2.9 to -2.7), although large regional differences were observed. Predicted ASMR for 2015 and 2020 were 18.8/100 000 and 16.7/100 000 for men and 8.5/100 000 and 7.4/100 000 for women, respectively. The prevalence of H. pylori varied from almost 5% at 0.5-2 years to just over 90% at 70 years or more. No consistent variation was observed since the 1990s. The downward trends in mortality rates are expected to remain in the next decades. The high prevalence of H. pylori infection across age groups and studies from different periods shows a large potential for decrease in the burden of gastric cancer in Portugal.
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8
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Song EM, Lee HS, Park SH, Kim GU, Seo M, Hwang SW, Yang DH, Kim KJ, Byeon JS, Myung SJ, Yang SK, Ye BD. Clinical characteristics and long-term prognosis of elderly onset ulcerative colitis. J Gastroenterol Hepatol 2018; 33:172-179. [PMID: 28543366 DOI: 10.1111/jgh.13826] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/02/2017] [Accepted: 05/16/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM The aim of this study was to investigate the clinical characteristics and prognosis of patients with elderly onset ulcerative colitis (EOUC), a new growing subgroup of UC. METHODS This study retrospectively analyzed 3060 South Korean UC patients diagnosed between 1977 and 2014. The clinical characteristics and prognosis of EOUC, defined as UC in those aged ≥ 60 years at diagnosis, were compared with those of non-EOUC (NEOUC). RESULTS Among the 3060 patients, 226 were diagnosed with EOUC (7.4%, median age at diagnosis 65.9 years [interquartile range, 62.9-68.7 years], 58.4% male). The frequency of EOUC increased from 3.9% in the interval 1977-1999 to 9.7% in the interval 2008-2014 (P < 0.001). There were more ex-smokers in the EOUC than in the NEOUC group (44.2% vs 19.9%, P < 0.001). In the EOUC group, extensive colitis at diagnosis, and the maximum extent thereof, was less than in the NEOUC group (13.7% vs 22.6%, P = 0.002, and 34.5% vs 42.5%, P = 0.011, respectively). The 10-year cumulative colectomy rate was significantly higher in the EOUC than in the NEOUC group (12.6% vs 7.7%, P = 0.015). UC-related and all-cause mortality were higher in the EOUC than in the NEOUC group (3.5% vs 0.6%, P < 0.001, and 12.4% vs 1.8%, P < 0.001, respectively). CONCLUSION Elderly onset ulcerative colitis patients are likely to exhibit distinct features both at diagnosis and during follow-up. It is necessary to pay more attention to, and to conduct further studies on, this particular group of patients.
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Affiliation(s)
- Eun Mi Song
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho-Su Lee
- Health Screening and Promotion Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Gwang-Un Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Myeongsook Seo
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung-Jo Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Byong Duk Ye
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Risk of second primary cancers among patients with a first primary gastric cancer: A population-based study in North Portugal. Cancer Epidemiol 2017; 50:85-91. [PMID: 28843176 DOI: 10.1016/j.canep.2017.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/12/2017] [Accepted: 08/10/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The growing number of incident cases of gastric cancer along with improved survival result in a rising population of survivors at risk of second primary cancers (SPC). We estimated the cumulative incidence of metachronous (diagnosed >2months after first primary cancer [FPC]) SPC in gastric FPC patients and compared the incidence of metachronous SPC with that expected in the general population. METHODS A cohort of gastric FPC patients from the North Region Cancer Registry of Portugal, diagnosed in 2000-2006 (n=7427) was followed to 31 December 2010 for synchronous and metachronous SPCs. Cumulative incidence of metachronous SPCs taking into account death as a competing event and standardized incidence ratios (SIR) of metachronous SPCs were estimated. RESULTS Overall, 331 (4.5%) patients developed an SPC (26.9% synchronous and 73.1% metachronous). Over half of the SPCs occurred in digestive organs. Among men, the most frequent were colon, prostate, and trachea, bronchus and lung; in women, colon, breast and thyroid were the most common. The 10-year cumulative incidence of metachronous SPC for males was 5.7% and for females 3.5%. The SIR for all cancers was 1.30 in males and 1.20 in females. Among both sexes, significantly higher SIRs were observed for cancers of the oesophagus (males: 4.99; females: 8.03), small intestine (males: 11.04; females: 13.09) and colon (males: 2.42; females: 2.58). CONCLUSIONS Patients with a gastric FPC were found to be at increased risk of developing SPC, mainly in digestive organs, when compared to the general population. Close surveillance of these patients may allow early detection of SPC.
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10
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Kana MA, Correia S, Peleteiro B, Severo M, Barros H. Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis. BMJ Glob Health 2017; 2:e000147. [PMID: 28589009 PMCID: PMC5435250 DOI: 10.1136/bmjgh-2016-000147] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/14/2016] [Accepted: 10/24/2016] [Indexed: 11/14/2022] Open
Abstract
Background The 2007–2008 global financial crisis had adverse consequences on population health of affected European countries. Few contemporary studies have studied its effect on perinatal indicators with long-lasting influence on adult health. Therefore, in this study, we investigated the impact of the 2007–2008 global financial crisis on low birth weight (LBW) in Portugal. Methods Data on 2 045 155 singleton births of 1995–2014 were obtained from Statistics Portugal. Joinpoint regression analysis was performed to identify the years in which changes in LBW trends occurred, and to estimate the annual per cent changes (APC). LBW risk by time period expressed as prevalence ratios were computed using the Poisson regression. Contextual changes in sociodemographic and economic factors were provided by their trends. Results The joinpoint analysis identified 3 distinct periods (2 jointpoints) with different APC in LBW, corresponding to 1995–1999 (APC=4.4; 95% CI 3.2 to 5.6), 2000–2006 (APC=0.1; 95% CI −050 to 0.7) and 2007–2014 (APC=1.6; 95% CI 1.2 to 2.0). For non-Portuguese, it was, respectively, 1995–1999 (APC=1.4; 95% CI −3.9 to 7.0%), 2000–2007 (APC=−4.2; 95% CI −6.4 to −2.0) and 2008–2014 (APC=3.1; 95% CI 0.8 to 5.5). Compared with 1995–1999, all specific maternal characteristics had a 10–15% increase in LBW risk in 2000–2006 and a 20–25% increase in 2007–2014, except among migrants, for which LBW risk remained lower than in 1995–1999 but increased after the crisis. The increasing LBW risk coincides with a deceleration in gross domestic product growth rate, reduction in health expenditure, social protection allocation on family/children support and sickness. Conclusions The 2007–2008 global financial crisis was associated with a significant increase in LBW, particularly among infants of non-Portuguese mothers. We recommend strengthening social policies aimed at maternity protection for vulnerable mothers and health system maintenance of social equity in perinatal healthcare.
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Affiliation(s)
- Musa Abubakar Kana
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal.,Department of Community Medicine, Faculty of Medicine, Kaduna State University, Kaduna, Nigeria
| | - Sofia Correia
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal
| | - Barbara Peleteiro
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal
| | - Milton Severo
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Henrique Barros
- Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit, ISPUP), Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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Regional variation in coronary heart disease mortality trends in Portugal, 1981–2012. Int J Cardiol 2016; 224:279-285. [DOI: 10.1016/j.ijcard.2016.09.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/07/2016] [Accepted: 09/15/2016] [Indexed: 11/19/2022]
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Abstract
The increasing number of new cases of cancer highlights the relevance of primary prevention for cancer control, which is influenced, among other factors, by the population’s health-related knowledge. Therefore, we aimed to describe cancer-related knowledge in Portugal, including perception of risk, awareness of cancer causes and preventive behaviours. We evaluated 1624 Portuguese-speaking dwellers, aged between 16 and 79 years, through face-to-face interviews conducted using a structured questionnaire. We computed adjusted (sex, age, education) regression coefficients and prevalence ratios, using linear and Poisson regression, respectively, to quantify associations with cancer-specific knowledge. The proportions of nonresponse ranged from 13.4 to 63.5% for the most frequent cancer in Portugal and the leading cause of cancer, respectively. The mean of the estimated lifetime risk of cancer in the Portuguese population was 37.0%. A total of 47.5% of the respondents identified breast cancer as the most frequent in Portugal, 72.0% named lifestyles as the leading cause of cancer and 40.2% selected not smoking as the most important preventive behaviour. Lower levels of education were associated with higher proportions of nonresponse, but not consistently with inaccurate knowledge. Men provided lower estimates of the lifetime risk of cancer, indicated breast cancer less frequently and more often lung cancer as the most frequent, and were more likely to select not smoking as the most important preventive behaviour. The present study provides relevant data on knowledge of cancer prevention, which may be used for the planning and evaluation of awareness-raising and primary prevention interventions in Portugal.
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Cancer incidence predictions in the North of Portugal: keeping population-based cancer registration up to date. Eur J Cancer Prev 2016; 25:472-80. [DOI: 10.1097/cej.0000000000000199] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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14
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Trends in Gastric and Esophageal Cancer Incidence in Northern Portugal (1994-2009) by Subsite and Histology, and Predictions for 2015. TUMORI JOURNAL 2016; 103:155-163. [DOI: 10.5301/tj.5000542] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2016] [Indexed: 11/20/2022]
Abstract
Introduction Gastric cancer (GC) and esophageal cancer (EC) share risk factors, and the incidence trends reflect differences in etiology according to their subtypes. We aimed to describe the incidence trends of GC (by topography) and EC (by histological type) in northern Portugal for 1994-2009 and to estimate the incidence for 2015. We further analyzed exposure to the main risk factors for these cancers in the region over the last decades. Methods GC and EC data were obtained from the North Region Cancer Registry of Portugal (RORENO). Joinpoint regression was used to compute annual percent changes (APC) in incidence trends. Poisson regression yielded estimates for 2015. A literature review up to 2014 provided data on exposure to risk factors. Results GC rates decreased in 1994-2009 (men, APC = −1.3; women, APC = −1.6); GC, unspecified subtype, had the steepest decline since the early 2000s (men, APC = −4.9; women, APC = −6.3). The incidence for 2015 will increase for EC in men (up to ≈190 cases) and stabilize in women (≈30) and for GC (≈730 men, ≈500 women). Increasing prevalence of tobacco smoking among women and overweight/obesity, fairly stable prevalence of alcohol, fruit and vegetable consumption, and no trend for Helicobacter pylori infection were observed. Conclusions The declining incidence of GC unspecified subtype indicated an improvement in cancer registration accuracy, but precluded a sound assessment of trends by subtype. Variations in the prevalence of exposure to some risk factors were consistent with observed incidence trends, and future studies should aim to quantify their contribution to the GC and EC burden in the region.
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Vieira R, Fonseca JA, Lopes F, Freitas A. Trends in hospital admissions for obstructive lung disease from 2000 to 2010 in Portugal. Respir Med 2016; 116:63-9. [PMID: 27296823 DOI: 10.1016/j.rmed.2016.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/13/2016] [Accepted: 05/17/2016] [Indexed: 11/28/2022]
Abstract
The burden of hospitalisations for obstructive lung diseases (OLD) has not been sufficiently studied. We aimed to characterise the hospitalisations for OLD from 2000 to 2010 in all Portuguese public hospitals. We analysed hospital discharges with a diagnosis of OLD regarding the patients' gender, age, residence and comorbidities. Of the 120 399 hospital admissions with a principal diagnosis of OLD, COPD (ICD-9-CM 491.x, 492.x, 496) was responsible for 81%. The change in patients discharged with OLD as a principal diagnosis was only 1% from 2000 to 2010 and did not change for COPD. Hospital admissions and deaths for COPD and other OLD increased with age and were more common in men than women. In-hospital mortality for COPD decreased 34.1% from 2000 to 2010, while the median length of stay was fairly constant at 8 days. Respiratory failure, insufficiency and/or arrest, and pneumonia, are the principal diagnoses often associated with COPD. When both pneumonia and COPD were diagnosed there was an increasing trend to classify pneumonia as the principal diagnosis (64.4%-72.9%), a sign that may lead to underestimation of COPD hospitalisations. In summary, a considerable decrease in in-hospital COPD mortality was observed while hospital admissions and the length of stay did not change substantially. These results suggest that better healthcare or other factors may be counteracting the expected increase of the burden of COPD.
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Affiliation(s)
- Rafael Vieira
- Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.
| | - João Almeida Fonseca
- Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Fernando Lopes
- Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Alberto Freitas
- Department of Health Information and Decision Sciences (CIDES), Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
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Pacheco-Figueiredo L, Antunes L, Bento MJ, Lunet N. Incidence of second primary cancers in North Portugal—a population-based study. J Cancer Surviv 2015; 10:142-52. [DOI: 10.1007/s11764-015-0460-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 05/22/2015] [Indexed: 12/24/2022]
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Alves J, Kunst AE, Perelman J. Evolution of socioeconomic inequalities in smoking: results from the Portuguese national health interview surveys. BMC Public Health 2015; 15:311. [PMID: 25884673 PMCID: PMC4391133 DOI: 10.1186/s12889-015-1664-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Southern European countries were traditionally characterized by a higher prevalence of smoking among high socioeconomic groups. Though, recent studies show a reversal of inequalities in Italy and Spain, for example. We investigated whether this evolution also applied to Portugal by describing the evolution of socioeconomic inequalities in smoking between 1987 and 2006. METHODS We used data from the four Portuguese national health interview surveys (N = 120,140) carried out so far. Socioeconomic status was measured by the educational and income levels of respondents. Socioeconomic inequalities were measured through Odds Ratios (OR), Relative Inequality Indexes (RII), and Concentration Indexes (CI) on being current, ever, and former smoker, adjusting for sex and age. Analyses were performed separately for men and women, and for different birth cohorts. RESULTS Among men, smoking was initially more concentrated in high-socioeconomic status individuals (RII = 0.84, 95% Confidence Intervals [95% CI] 0.76-0.93, 1987) but this pattern reversed in the last survey (RII = 1.49, 95% CI 1.34-1.65, 2005/6). Indeed, higher cessation rates were observed among high-socioeconomic groups among all respondents (RII = 0.89, 95% CI 0.84-0.95), coupled with higher initiation rates among the worse-off in younger cohorts (RII = 1.18, 95% CI 1.05-1.31, for youngest generation, 2005/6). Among women, the richer and more educated smoked more in all surveys (RII = 0.21, 95% CI 0.16-0.27, 2005/6), despite being also more likely to quit (RII = 0.41, 95% CI 0.30-0.55). The pattern among women evolved towards a reduction of inequality, which however remained favourable to the worse-off. CONCLUSIONS Inequalities have been increasingly unfavourable to the worse-off in Portugal, although better-off women are still more likely to smoke. Worrisome inequality trends have been observed among the youngest generations, which call for the rapid implementation of equity-oriented tobacco control policies.
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Affiliation(s)
- Joana Alves
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Room J2-207, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Julian Perelman
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
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Wagner GA, Rocha FMMD, Lebrão ML, Duarte YADO, Zanetta DMT. Trends in tobacco consumption in three different birth cohorts of elderly of São Paulo, Brazil. Drug Alcohol Depend 2015; 147:53-9. [PMID: 25575653 DOI: 10.1016/j.drugalcdep.2014.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 11/26/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The effects of birth cohorts reflect the historical differences in physical and social environments. The objectives of the present study were to describe the tobacco consumption and to evaluate the behavioral trends with respect to smoking in three different birth cohorts of a population-based sample of elderly individuals. METHODS A series of three cross-sectional studies conducted with elderly individuals of 60-64 years of age interviewed in 2000 (birth cohort 1936-1940; n=427), 2006 (birth cohort 1942-1946; n=298) and 2011 (birth cohort 1947-1951; n=355) in a population-based sample from the city of São Paulo, Brazil. The interviewees were participating in a prospective cohort study entitled Health, Well-Being and Aging (Saúde, Bem-Estar e Envelhecimento [SABE]). Data on tobacco consumption were self-reported and interviewees were then classified as never smokers, former smokers or current smokers. Linear model for categorical data was used to test differences on tobacco consumption between three birth elderly cohorts. FINDINGS Men were more likely than women to be smokers. Being evangelical and having more schooling constituted protective factors against smoking. Regarding trends, the tobacco consumption of the men did not change in any of the three cohorts studied (p=0.7454), whereas there was an increase in the number of women smokers, principally former smokers, over the periods evaluated (p=0.0189). CONCLUSIONS These results suggest that the anti-smoking policies implemented in Brazil were effective in women of this age group; however, different prevention strategies are required to target elderly men.
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Affiliation(s)
- Gabriela Arantes Wagner
- Department of Epidemiology, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, 01246-904 São Paulo, SP, Brazil.
| | - Francisco Marcelo Monteiro da Rocha
- School of Politics, Economy and Business, Federal University of São Paulo, Rua Angélica 100, Jardim das Flores, 06110-295 Osasco, SP, Brazil
| | - Maria Lúcia Lebrão
- Department of Epidemiology, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, 01246-904 São Paulo, SP, Brazil
| | - Yeda Aparecida de Oliveira Duarte
- Department of Epidemiology, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, 01246-904 São Paulo, SP, Brazil; Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar 419, Cerqueira César, 05403-000 São Paulo, SP, Brazil
| | - Dirce Maria Trevisan Zanetta
- Department of Epidemiology, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, 01246-904 São Paulo, SP, Brazil
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Pereira M, Azevedo A, Lunet N, Carreira H, O’Flaherty M, Capewell S, Bennett K. Explaining the Decline in Coronary Heart Disease Mortality in Portugal Between 1995 and 2008. Circ Cardiovasc Qual Outcomes 2013; 6:634-42. [DOI: 10.1161/circoutcomes.113.000264] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marta Pereira
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
| | - Ana Azevedo
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
| | - Nuno Lunet
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
| | - Helena Carreira
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
| | - Martin O’Flaherty
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
| | - Simon Capewell
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
| | - Kathleen Bennett
- From the Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal (M.P., A.A., N.L., H.C.); Institute of Public Health, University of Porto (ISPUP), Porto, Portugal (M.P., A.A., N.L., H.C.); Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom (M.O.’F., S.C.); and Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland (K.B.)
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Pereira M, Peleteiro B, Capewell S, Bennett K, Azevedo A, Lunet N. Changing patterns of cardiovascular diseases and cancer mortality in Portugal, 1980-2010. BMC Public Health 2012; 12:1126. [PMID: 23273040 PMCID: PMC3560231 DOI: 10.1186/1471-2458-12-1126] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 12/27/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cardiovascular diseases and cancer are jointly responsible for more than half all deaths in Portugal. They also share some important risk factors and act as mutual competing risks. We aimed firstly to describe time trends in death rates and years of life lost due to cardiovascular diseases and cancer in the Portuguese population from 1980 to 2010; and secondly to quantify the contribution of the variation in population and age structure, and age-independent "risk" by cardiovascular or oncological causes to the change in the corresponding number of deaths. METHODS We estimated the annual percent change in age-standardized mortality rates from cardiovascular diseases and cancer, in each sex. The specific contribution of demographic changes (due to changes in population size and in population age structure) and the variation in the age-independent "risk" of dying from the disease to the observed trends in the number of deaths was quantified using the tool RiskDiff. Years of life lost were computed using the Global Burden of Disease method. RESULTS Among men, the mortality rate from all cardiovascular diseases was more than two-fold higher than cancer mortality in 1980. However, three decades later mortality from cancer surpassed cardiovascular diseases. After 2005, the years of life lost from cancer were also higher than from cardiovascular diseases. Among women, despite the decrease in death rates, cardiovascular diseases remained the leading cause of death in 2010 and their absolute burden was higher than that of cancers across the whole period, mainly due to more events in older women. CONCLUSIONS In Portugal, the 20th century witnessed a dramatic decrease in the cardiovascular disease mortality and YLL, and the transition towards cancer. In more recent years, the highest burdens of disease came from cancers in men and from cardiovascular diseases in women.
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Affiliation(s)
- Marta Pereira
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School and Institute of Public Health of the University of Porto (ISPUP), Al. Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Bárbara Peleteiro
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School and Institute of Public Health of the University of Porto (ISPUP), Al. Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Kathleen Bennett
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James’s Hospital, Dublin, Ireland
| | - Ana Azevedo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School and Institute of Public Health of the University of Porto (ISPUP), Al. Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Nuno Lunet
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School and Institute of Public Health of the University of Porto (ISPUP), Al. Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
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