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Alves-Cabratosa L, Elosua-Bayés M, Martí-Lluch R, Blanch J, Tornabell-Noguera È, Garcia-Gil M, Ponjoan A, Grau M, Ribas-Aulinas F, Zacarías-Pons L, Marrugat J, Ramos R. Cardiovascular Risk Age Reflects Arterial Status: Middle-Aged People Showed Equivalent Arterial Stiffness to Older People in the Same Risk Category. J Atheroscler Thromb 2024; 31:626-640. [PMID: 38171907 PMCID: PMC11079498 DOI: 10.5551/jat.64541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/13/2024] [Accepted: 11/08/2023] [Indexed: 01/05/2024] Open
Abstract
AIM The concept of risk age may help overcome an excessive weight of age in cardiovascular risk functions. This study aimed to evaluate the equivalence of risk age with arterial stiffness by comparing people with increased risk age and individuals with the same chronological and risk age. In order to materialize this aim, we categorized individuals based on cardiovascular risk and compared groups with increased risk factors (other than age) and groups with normal levels. METHODS This is a cross-sectional population-level study carried out in Girona province within the context of the REGICOR study (Girona Heart Registry). In this study, individuals aged 35-90 years who had a brachial-ankle pulse wave velocity measurement and with no previous cardiovascular disease or peripheral arterial disease were included. Cardiovascular risk was estimated with the FRESCO (in 35-79 year-olds), SCORE2 (in 35-69 year-olds), and SCORE2-OP (in 70-90 year-olds) functions and categorized to calculate and compare (in each category) the median chronological age in the group with increased risk factors and the reference. Arterial stiffness was assessed with the brachial-ankle pulse wave velocity (baPWV). The analyses were carried out separately by sex. RESULTS In this study, 2499 individuals were included, with a mean age of 59.7 and 46.9% of men. Men presented worse health condition, including a higher mean cardiovascular disease risk score. Both men and women with increased levels of risk factors showed worse health condition than the respective men and women with optimal levels. In each risk category, the groups with higher risk age than chronological age (increased risk factors) were similar in baPWV values to the groups with the same chronological and risk ages (reference), who were consistently older. CONCLUSIONS In categories with the same cardiovascular risk, the arterial stiffness of participants with a higher risk factor burden (increased risk age) matched that of older participants with the rest of the risk factors at optimal levels (same chronological and risk age). These results support the guidelines on the utilization of risk age to explain heightened cardiovascular risk, particularly among individuals in middle age.
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Affiliation(s)
- Lia Alves-Cabratosa
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
| | - Marc Elosua-Bayés
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
| | - Ruth Martí-Lluch
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
- Institut d’Investigacio Biomedica de Girona (IdIBGi)
| | - Jordi Blanch
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
| | - Èric Tornabell-Noguera
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
| | - Maria Garcia-Gil
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
| | - Anna Ponjoan
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
- Institut d’Investigacio Biomedica de Girona (IdIBGi)
| | - Maria Grau
- Serra Hunter Fellow, Department of Medicine, University of Barcelona
- Biomedical Research Consortium in Epidemiology and Public Health (CIBERESP)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
| | - Francesc Ribas-Aulinas
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
| | - Lluís Zacarías-Pons
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
| | - Jaume Marrugat
- Registre Gironi del Cor (REGICOR) Grupo de investigacion en epidemiologia y genetica cardiovascular (EGEC), Institut Hospital del Mar d’Investigacions Mediques (IMIM)
- CIBER Enfermedades Cardiovasculares
| | - Rafel Ramos
- Grup Investigacio en Salut Cardiovascular de Girona (ISV-Girona). Institut Universitari d’Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
- Institut d’Investigacio Biomedica de Girona (IdIBGi)
- Departament de Ciencies Mediques, Universitat de Girona
- Serveis d’Atencio Primaria, Girona. Institut Catala de Salut (ICS)
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Ponjoan A, Blanch J, Fages-Masmiquel E, Martí-Lluch R, Alves-Cabratosa L, Garcia-Gil MDM, Domínguez-Armengol G, Ribas-Aulinas F, Zacarías-Pons L, Ramos R. Sex matters in the association between cardiovascular health and incident dementia: evidence from real world data. Alzheimers Res Ther 2024; 16:58. [PMID: 38481343 PMCID: PMC10938682 DOI: 10.1186/s13195-024-01406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/31/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Cardiovascular health has been associated with dementia onset, but little is known about the variation of such association by sex and age considering dementia subtypes. We assessed the role of sex and age in the association between cardiovascular risk and the onset of all-cause dementia, Alzheimer's disease, and vascular dementia in people aged 50-74 years. METHODS This is a retrospective cohort study covering 922.973 Catalans who attended the primary care services of the Catalan Health Institute (Spain). Data were obtained from the System for the Development of Research in Primary Care (SIDIAP database). Exposure was the cardiovascular risk (CVR) at baseline categorized into four levels of Framingham-REGICOR score (FRS): low (FRS < 5%), low-intermediate (5% ≤ FRS < 7.5%), high-intermediate (7.5% ≤ FRS < 10%), high (FRS ≥ 10%), and one group with previous vascular disease. Cases of all-cause dementia and Alzheimer's disease were identified using validated algorithms, and cases of vascular dementia were identified by diagnostic codes. We fitted stratified Cox models using age parametrized as b-Spline. RESULTS A total of 51,454 incident cases of all-cause dementia were recorded over a mean follow-up of 12.7 years. The hazard ratios in the low-intermediate and high FRS groups were 1.12 (95% confidence interval: 1.08-1.15) and 1.55 (1.50-1.60) for all-cause dementia; 1.07 (1.03-1.11) and 1.17 (1.11-1.24) for Alzheimer's disease; and 1.34 (1.21-1.50) and 1.90 (1.67-2.16) for vascular dementia. These associations were stronger in women and in midlife compared to later life in all dementia types. Women with a high Framingham-REGICOR score presented a similar risk of developing dementia - of any type - to women who had previous vascular disease, and at age 50-55, they showed three times higher risk of developing dementia risk compared to the lowest Framingham-REGICOR group. CONCLUSIONS We found a dose‒response association between the Framingham-REGICOR score and the onset of all dementia types. Poor cardiovascular health in midlife increased the onset of all dementia types later in life, especially in women.
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Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain.
- Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital. Parc Hospitalari Martí I Julià, (Ed. M2), C/Dr. Castany S/N, Salt (Girona), Catalonia, 17190, Spain.
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), C/ Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain.
| | - Jordi Blanch
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - Ester Fages-Masmiquel
- Atenció Primària, Gerència Territorial de Girona, Institut Català de la Salut. C/Mossèn Joan Pons S/N, Girona, 17001, Spain
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
- Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital. Parc Hospitalari Martí I Julià, (Ed. M2), C/Dr. Castany S/N, Salt (Girona), Catalonia, 17190, Spain
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), C/ Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - María Del Mar Garcia-Gil
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - Gina Domínguez-Armengol
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), C/ Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - Francesc Ribas-Aulinas
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), C/ Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - Lluís Zacarías-Pons
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), C/ Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain
| | - Rafel Ramos
- Vascular Health Research Group (ISV-Girona), Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), C/Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain.
- Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital. Parc Hospitalari Martí I Julià, (Ed. M2), C/Dr. Castany S/N, Salt (Girona), Catalonia, 17190, Spain.
- Network for Research On Chronicity, Primary Care, and Health Promotion (RICAPPS), C/ Maluquer Salvador nº11, Girona, Catalonia, 17002, Spain.
- Atenció Primària, Gerència Territorial de Girona, Institut Català de la Salut. C/Mossèn Joan Pons S/N, Girona, 17001, Spain.
- Translab Research Group, Department of Medical Sciences, University of Girona, C/Emili Grahit, 77, Girona, Catalonia, 17071, Spain.
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Zacarías-Pons L, Turró-Garriga O, Saez M, Garre-Olmo J. Multimorbidity patterns and disability and healthcare use in Europe: do the associations change with the regional socioeconomic status? Eur J Ageing 2024; 21:1. [PMID: 38170397 PMCID: PMC10764705 DOI: 10.1007/s10433-023-00795-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Multimorbidity, the concurrence of several chronic conditions, is a rising concern that increases the years lived with disability and poses a burden on healthcare systems. Little is known on how it interacts with socioeconomic deprivation, previously associated with poor health-related outcomes. We aimed to characterize the association between multimorbidity and these outcomes and how this relationship may change with socioeconomic development of regions. 55,915 individuals interviewed in 2017 were drawn from the Survey of Health, Ageing and Retirement in Europe, a population-based study. A Latent Class Analysis was conducted to fit multimorbidity patterns based on 16 self-reported conditions. Physical limitation, quality-of-life and healthcare utilization outcomes were regressed on those patterns adjusting for additional covariates. Those analyses were then extended to assess whether such associations varied with the region socioeconomic status. We identified six different patterns, labelled according to their more predominant chronic conditions. After the "healthy" class, the "metabolic" and the "osteoarticular" classes had the best outcomes involving limitations and the lowest healthcare utilization. The "neuro-affective-ulcer" and the "several conditions" classes yielded the highest probabilities of physical limitation, whereas the "cardiovascular" group had the highest probability of hospitalization. The association of multimorbidity over physical limitations appeared to be stronger when living in a deprived region, especially for metabolic and osteoarticular conditions, whereas no major effect differences were found for healthcare use. Multimorbidity groups do differentiate in terms of limitation and healthcare utilization. Such differences are exacerbated with socioeconomic inequities between regions even within Europe.
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Affiliation(s)
- Lluís Zacarías-Pons
- Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.
| | - Oriol Turró-Garriga
- Glòria Compte Research Institute, Fundació Salut Empordà, Figueres, Girona, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Josep Garre-Olmo
- Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
- Serra-Húnter Professor, Department of Nursing, University of Girona, Girona, Spain
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Zacarías-Pons L, Vilalta-Franch J, Turró-Garriga O, Saez M, Garre-Olmo J. Multimorbidity patterns and their related characteristics in European older adults: A longitudinal perspective. Arch Gerontol Geriatr 2021; 95:104428. [PMID: 33991948 DOI: 10.1016/j.archger.2021.104428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/20/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The concurrence of several chronic conditions is a rising concern that poses a serious burden on ageing populations. Analysing how these conditions appear together and how they change through time may provide useful information to design successful multimorbidity-management programs. OBJECTIVE To identify multimorbidity patterns and their related characteristics from a longitudinal perspective. SUBJECTS 25,931 older adults aged 50+ drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), a population-based longitudinal European study. METHODS A sex-stratified Latent Transition Analysis was conducted to fit latent classes based on 15 self-reported chronic conditions across three time points. Health-related and socioeconomic variables were assessed as covariates of those patterns. RESULTS We identified 4 time-constant latent classes for each sex. A "severely impaired" class (with a weighted prevalence percentage of 7.24% for females and 3.30% for males at the first time point), a "metabolic" class (26.15% and 23.82%) and a "healthy" class (50.92% and 54.32%). The fourth class was named "osteoarticular" for females (15.70%) and "articular-COPD-ulcer" for males (18.56%). Age, smoke, material deprivation and a high body mass index were associated with worse health patterns, whereas education, being employed and physical activity were related to less multimorbid classes. Few class changes were detected when modelling transitions. CONCLUSIONS We reported information of multimorbidity classes and their characteristics that may help to develop targeted health strategies. Within a time window of four years, the identified latent classes were consistent between time points.
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Affiliation(s)
- Lluís Zacarías-Pons
- Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain.
| | - Joan Vilalta-Franch
- Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain
| | - Oriol Turró-Garriga
- Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain; Institut d'Assistència Sanitària, Catalonia, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Josep Garre-Olmo
- Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain; Institut d'Assistència Sanitària, Catalonia, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain
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Garre-Olmo J, Turró-Garriga O, Martí-Lluch R, Zacarías-Pons L, Alves-Cabratosa L, Serrano-Sarbosa D, Vilalta-Franch J, Ramos R. Changes in lifestyle resulting from confinement due to COVID-19 and depressive symptomatology: A cross-sectional a population-based study. Compr Psychiatry 2021; 104:152214. [PMID: 33186837 PMCID: PMC7574785 DOI: 10.1016/j.comppsych.2020.152214] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/07/2020] [Accepted: 10/16/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The measures adopted to control the spread of the COVID-19 pandemic in several countries included mobility and social restrictions that produced an immediate impact on the lifestyle of their inhabitants. METHODS We assessed the association between the consequences of these measures and depressive symptomatology using a population-based sample of 692 individuals aged 18 or over from an ongoing study in the province of Girona (Catalonia, Spain). Participants responded to a telephone-based survey that included questions related to the consequences of confinement and the Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptomatology. Multivariate logistic and linear regressions were used to identify which changes in lifestyle resulting from confinement were independently associated with a possible depression episode and depressive symptomatology. RESULTS The prevalence of a possible depressive episode during the confinement was 12.7% (95% CI = 10.3-15.4). An adverse work situation, expected economic distress, self-reported worsening of the mental health and of the dietary pattern, and worries about a relative's potential infection were variables related to an increased risk of having a possible depressive episode. The changes in lifestyle accounted for 32% of the variance of the PHQ-9 score. CONCLUSION The findings indicate an association of the job situation, the expected negative economic consequences, the perceived worsening of health and habits, and the worries about COVID-19 infection with depressive symptomatology during the confinement.
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Affiliation(s)
- Josep Garre-Olmo
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain; Institut d'Assistència Sanitària, Catalonia, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain.
| | - Oriol Turró-Garriga
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Institut d'Assistència Sanitària, Catalonia, Spain
| | - Ruth Martí-Lluch
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Catalonia, Spain
| | | | - Lia Alves-Cabratosa
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Catalonia, Spain
| | - Domènec Serrano-Sarbosa
- Institut d'Assistència Sanitària, Catalonia, Spain,Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain
| | | | - Rafel Ramos
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain,Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Catalonia, Spain
| | - on behalf of the Girona Healthy Region Study GroupMantéXavier Aldeguer1CasedevallJudit Bassols2GinestaJordi Barretina3TerradellasRamon Brugada4PerxasLaia Calvó5ColomJordi Cid6RealJosé Manuel Fernández7QuiciosJaume Heredia8BermejoAbel López9GrageraRafael Marcos10del RioAna Molina11NavarreteJosé Maria Moreno7NicolauJosep Lluís11MartinezPascual Ramon Orriols12ComptaAna Prada11GutierrezSalvador Pedraza13AlcántaraJosep Puig13TorrentàLluís Ramió14GarcíaGlòria Reig15SerenaJoaquin14RelatMontse Vendrell12VilanovaJoan C.13Department of Gastroenterology, Dr. Josep Trueta University Hospital, Girona, SpainPediatrics Research Group, Girona Biomedical Research Institute, Girona, SpainGirona Biomedical Research Institute, Girona, SpainDepartment of Cardiology, Dr. Josep Trueta University Hospital, Girona, SpainTechnical Office, Institut d'Assistència Sanitaria, Girona, SpainMental Health Network, Institut d'Assistència Sanitaria, Girona, SpainDepartment of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital, Girona, SpainHospital d'Olot, Girona, SpainDepartment of Pediatrics, Dr. Josep Trueta University Hospital, Girona, SpainEpidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, SpainPrimary Care, Institut Català de la Salut, Girona, SpainDepartment of Pneumology, Dr. Josep Trueta University Hospital, Girona, SpainDepartment of Radiology (IDI), Dr. Josep Trueta University Hospital, Girona, SpainDepartment of Neurology, Dr. Josep Trueta University Hospital, Girona, SpainPrimary Care, Institut d'Assistència Sanitària, Girona, Spain
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García-Velasco A, Zacarías-Pons L, Teixidor H, Valeros M, Liñan R, Carmona-Garcia MC, Puigdemont M, Carbajal W, Guardeño R, Malats N, Duell E, Marcos-Gragera R. Incidence and Survival Trends of Pancreatic Cancer in Girona: Impact of the Change in Patient Care in the Last 25 Years. Int J Environ Res Public Health 2020; 17:ijerph17249538. [PMID: 33352812 PMCID: PMC7766657 DOI: 10.3390/ijerph17249538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/24/2022]
Abstract
(1) Background: We investigated the incidence and survival trends for pancreatic cancer (PC) over the last 25 years in the Girona region, Catalonia, Spain; (2) Methods: Data were extracted from the population-based Girona Cancer Registry. Incident PC cases during 1994–2015 were classified using the International Classification of Diseases for Oncology Third Edition (ICD-O-3). Incidence rates age-adjusted to the European standard population (ASRE) and world standard population (ASRW) were obtained. Trends were assessed using the estimated annual percentage of change (EAPC) of the ASRE13. Observed and relative survivals (RS) were estimated with the Kaplan–Meier and Pohar Perme methods, respectively; (3) Results: We identified 1602 PC incident cases. According to histology, 44.4% of cases were exocrine PC, 4.1% neuroendocrine, and 51.1% malignant-non-specified. The crude incidence rate (CR) for PC was 11.43 cases-per-100,000 inhabitants/year. A significant increase of incidence with age and over the study period was observed. PC overall 5-year RS was 7.05% (95% confidence interval (CI) 5.63; 8.84). Longer overall survival was observed in patients with neuroendocrine tumours (5-year RS 61.45%; 95% CI 47.47; 79.55). Trends in 5-year RS for the whole cohort rose from 3.27% (95% CI 1.69–6.35) in 1994–1998 to 13.1% (95% CI 9.98; 17.2) in 2010–2015; (4) Conclusions: Incidence rates of PC in Girona have increased in the last two decades. There is a moderate but encouraging increase in survival thorough the study period. These results can be used as baseline for future research.
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Affiliation(s)
- Adelaida García-Velasco
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
- Correspondence:
| | - Lluís Zacarías-Pons
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Helena Teixidor
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Marc Valeros
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Raquel Liñan
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
| | - M. Carmen Carmona-Garcia
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
| | - Montse Puigdemont
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
| | - Walter Carbajal
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
| | - Raquel Guardeño
- Medical Oncology Department, Josep Trueta Universitary Hospital, Catalan Institute of Oncology, Av de França, 17007 Girona, Spain; (R.L.); (M.C.C.-G.); (W.C.); (R.G.)
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research (CNIO) and CIBERONC, 28029 Madrid, Spain;
| | - Eric Duell
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 08908 Barcelona, Spain;
| | - Rafael Marcos-Gragera
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), C/Dr. Castany, s/n, 17190 Salt, Spain; (M.P.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Av. França, s/n, 17004 Girona, Spain; (L.Z.-P.); (H.T.); (M.V.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), 28029 Madrid, Spain
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