Browsing by Subject "cause of death"

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  • Schmidt, Eeva-Kaisa; Atula, Sari; Tanskanen, Maarit; Nikoskinen, Tuuli; Notkola, Irma-Leena; Kiuru-Enari, Sari (Helsingfors universitet, 2016)
    Background: Finnish type of hereditary gelsolin amyloidosis (AGel amyloidosis) is an autosomal dominant disorder. Until recently, there has only been little knowledge of fatal complications of the disease and its possible impact on the patients' life span. Methods: We identified 272 deceased patients based on patient interviews and genealogical data. After collecting their death certificates we recorded the patients' underlying and immediate causes of death (CoD) and life span and compared them to the general Finnish population. We then calculated proportional mortality ratios (PMR), standardised for age and sex, for the CoDs. Results: The underlying CoD in 20% of the patients was AGel amyloidosis (PMR=114.2; 95% CI 85.6-149.4). The frequency of fatal cancers (10%) was significantly diminished (PMR=0.47; 95% CI 0.31-0.69). Renal complications were overrepresented as the immediate CoD in female patients (PMR=2.82 95% CI 1.13-5.81). The mean life span for male patients was 73.9 years (95% CI 72.0-75.6) and 78.0 years for female patients (95% CI 76.4-79.5) compared to 72.1 and 80.1 years for the general population. Conclusions: Our results suggest that the disease increases the risk for fatal renal complications, but does not substantially shorten the life span, possibly due to the significantly lower frequency of fatal cancers.
  • Global Burden of Disease Cancer Collaboration; Fitzmaurice, C.; Doku, D.T.; Hadkhale, K.; Meretoja, T.J.; Neupane, S. (2019)
    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.
  • Halonen, Pia; Jakobsson, Maija; Heikinheimo, Oskari; Gissler, Mika; Pukkala, Eero (2020)
    The incidence pattern of lichen planus (LP) and LP-related mortality are unknown. The aim of this study was to assess these factors, based on Finnish nationwide registry data including 13,378 women with LP diagnosed during 1969 to 2012. The incidence rate for LP in 2003 to 2012 was 28 per 100,000 woman-years age-adjusted to the European Standard Population. Mortality was assessed using the standardized mortality ratio (SMR) with national mortality rates as the reference. All-cause mortality was increased (SMR 1.07, 95% confidence interval (95% CI) 1.02-1.11), with excess mortality from Hodgkin lymphoma (SMR 6.73, 95% CI 1.83-17.2), non-Hodgkin lymphoma (SMR 1.68, 95% CI 1.11-2.44), cancer of the oral cavity (SMR 10.5, 95% CI 5.99-17.0), cancer of the tongue (SMR 7.25, 95% CI 3.13-14.3), infections (SMR 1.78, 95% CI 1.14-2.64), respiratory diseases (SMR 1.31, 95% CI 1.07-1.57), and diseases of the digestive system (SMR 1.39, 95% CI 1.09-1.75). In conclusion, LP is a common disease and patients seem to have an impaired long-term prognosis.
  • Halonen, Pia; Jakobsson, Maija; Heikinheimo, Oskari; Gissler, Mika; Pukkala, Eero (2020)
    Abstract Objective To assess the incidence of lichen sclerosus (LS) in women and all-cause and cause-specific mortality of women with LS. Design Population-based descriptive study. Setting Finland. Population All Finnish women, including 7,790 women diagnosed with LS during 1969-2012. Methods Information gathered from the national Hospital Discharge Registry on women with LS is combined with dates and causes of death from Statistics Finland and Finnish Cancer Registry. Population statistics are from Statistics Finland. Main Outcome Measures Crude and age-adjusted incidence rates of LS and standardized mortality ratios (SMR). Results The incidence rate of LS adjusted for age (European Standard Population) increased from 14 per 100,000 woman-years in 2003 to 22 per 100,000 woman-years in 2010-2012. The age-specific incidence rate was highest in postmenopausal women (24-53 per 100,000), and was also elevated in girls in ages of 5-9 (7 per 100,000). All-cause mortality of women with LS was lower than in the general female population (SMR 0.84, 95% confidence interval [95% CI] 0.78-0.90), mostly due to decreased mortality from circulatory diseases (SMR 0.80, 95% CI 0.72-0.89), and dementia and Alzheimer?s disease (SMR 0.75, 95% CI 0.62-0.88). Cancer mortality equaled that of the population, but vulvar cancer mortality was increased (SMR 28.1, 95% CI 19.3-39.4). Conclusions LS is a common disease of elderly women. The overall mortality is decreased whereas mortality due to vulvar cancer is increased.
  • Raissadati, Alireza; Nieminen, Heta; Haukka, Jari; Sairanen, Heikki; Jokinen, Eero (2016)
    BACKGROUND Comprehensive information regarding causes of late post-operative death following pediatric congenital cardiac surgery is lacking. OBJECTIVES The study sought to analyze late causes of death after congenital cardiac surgery by era and defect severity. METHODS We obtained data from a nationwide pediatric cardiac surgery database and Finnish population registry regarding patients who underwent cardiac surgery at RESULTS Overall, 10,964 patients underwent 14,079 operations, with 98% follow-up. Early mortality ( CONCLUSIONS CHD-related deaths have decreased markedly but remain a challenge after surgery for severe cardiac defects. Premature deaths are generally more common among patients than the control population, warranting long-term follow-up after congenital cardiac surgery. (C) 2016 by the American College of Cardiology Foundation.
  • Tanaka, Hirokazu; Nusselder, Wilma J.; Bopp, Matthias; Bronnum-Hansen, Henrik; Kalediene, Ramune; Lee, Jung Su; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Kobayashi, Yasuki; Mackenbach, Johan P. (2019)
    Background We compared mortality inequalities by occupational class in Japan and South Korea with those in European countries, in order to determine whether patterns are similar. Methods National register-based data from Japan, South Korea and eight European countries (Finland, Denmark, England/Wales, France, Switzerland, Italy (Turin), Estonia, Lithuania) covering the period between 1990 and 2015 were collected and harmonised. We calculated age-standardised all-cause and cause-specific mortality among men aged 35-64 by occupational class and measured the magnitude of inequality with rate differences, rate ratios and the average inter-group difference. Results Clear gradients in mortality were found in all European countries throughout the study period: manual workers had 1.6-2.5 times higher mortality than upper non-manual workers. However, in the most recent time-period, upper non-manual workers had higher mortality than manual workers in Japan and South Korea. This pattern emerged as a result of a rise in mortality among the upper non-manual group in Japan during the late 1990s, and in South Korea during the late 2000s, due to rising mortality from cancer and external causes (including suicide), in addition to strong mortality declines among lower non-manual and manual workers. Conclusion Patterns of mortality by occupational class are remarkably different between European countries and Japan and South Korea. The recently observed patterns in the latter two countries may be related to a larger impact on the higher occupational classes of the economic crisis of the late 1990s and the late 2000s, respectively, and show that a high socioeconomic position does not guarantee better health.
  • Borchers, Joonatan; Pukkala, Eero; Mäkitie, Outi; Laakso, Saila (2020)
    Context: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is an autoimmune endocrinopathy with severe and unpredictable course. The impact of APECED on mortality has not been determined. Objective: To assess overall and cause-specific mortality of patients with APECED. Design and Setting: A follow-up study of Finnish patients with APECED from 1971 to 2018. Causes and dates of death were collected from Finnish registries. Patients: Ninety-one patients with APECED. Main Outcome Measure: Overall and cause-specific standardized mortality ratios (SMRs) determined by comparing the observed numbers of death and those expected on the basis of respective population death rates in Finland. Results: The overall disease mortality was significantly increased (29 deaths, SMR 11; 95% confidence interval [CI] 7.2-16; P <0.001). The relative risk (SMR) was highest in the youngest age groups but the absolute excess risk was similar (about 10 per 10 000 person-years) in all age categories. The highest SMRs were seen for endocrine and metabolic diseases (SMR 570; 95% CI, 270-1000; P <0.001) and for oral and esophageal malignancies (SMR 170; 95% CI, 68-360; P<0.001). Mortality was also increased for infections, diseases of digestive system, alcohol-related deaths, and for accidents. Due to the small number of cases we were unable to evaluate whether mortality was affected by disease severity. Conclusions: Patients with APECED have significantly increased mortality in all age groups. Highest SMRs are found for causes that are directly related to APECED but also for infections. Increased alcohol- and accident-related deaths may be influenced by psychosocial factors.
  • Zheng, Guoqiao; Hemminki, Akseli; Försti, Asta; Sundquist, Jan; Sundquist, Kristina; Hemminki, Kari (2019)
    Background With continuous increases in survival rates following breast cancer (BC) diagnosis, the challenge of multiple primary cancers has become an issue. The data on familial risk of SPCs after BC diagnosis and the related mortality in BC patients are scarce. Methods A total of 87 752 female BC patients were followed for SPC diagnoses and records of death. Relative risks (RRs) of SPC in BC patients who had first-degree relatives (parents or siblings) affected by the same cancer were compared to the patients without family history. Causes of death were compared between patients with and without SPC. Results After a median follow-up of 5 years, 14 952 BC patients developed SPCs, among which 10 280 (68.8%) had first-degree relatives diagnosed with cancer. Familial risks were significant for 14 site-specific SPCs, and the highest risk was for second ovarian cancer (RR = 6.28, 95%CI: 4.50-8.75), compared to those without family history (1.49, 1.34-1.65). In patients with SPC, SPC was the main cause of death, including diverse cancers and BC in approximately equal proportions. Conclusions Family history contributed to the excess number of patients with SPCs, and SPC was the leading cause of death in patients with SPC. Taking family history at diagnosis of BC may provide warning signs with regard to possible subsequent SPCs and may offer possibilities for counseling, intervention and management.
  • Rautalin, Ilari; Korja, Miikka; Kaprio, Jaakko (2020)
    Background and Purpose: One of the largest twin studies to date suggested that subarachnoid hemorrhage (SAH) is mainly of nongenetic origin, but the causal effect of environmental factors on SAH is yet unknown. We hypothesized that if only one of the twins experience fatal SAH, they do not share the most important environmental risk factor for SAH, namely smoking. If true, such finding would suggest that smoking causes SAH. Methods: Through the nationwide cause-of-death register, we followed 16 282 same-sex twin pairs of Finnish origin from the older Finnish Twin Cohort between 1976 and 2018 and identified all participants who died from SAH. For the baseline, we collected risk factor information about smoking, hypertension, physical activity, body mass index, alcohol consumption, and education. We classified the pairs as monozygotic, dizygotic, or of unknown zygosity. We examined the within-pair risk factor differences in the pairs discordant for SAH, that is, where one twin died from SAH and the other did not. We computed both individual (whole cohort) and pairwise (discordant pair) hazard ratios and 95% CIs. Results: During the 869 469 person-years of follow-up, we identified 116 discordant and 2 concordant (both died from SAH) twin pairs for fatal SAH. Overall, 25 of the discordant twin pairs were monozygotic. For the whole cohort, smoking (occasional/current) was associated with increased risk of SAH death (hazard ratio, 3.33 [CI, 2.24-4.95]) as compared with nonsmokers (never/former). In the pairwise analyses for discordant twin pairs, we found that the twin who smoked had an increased risk of fatal SAH (hazard ratio, 6.33 [CI, 1.87-21.4]) as compared with the nonsmoking twin. The association remained consistent regardless of the twin pairs' zygosity or sex. Conclusions: Our results provide strong evidence for a causal, rather than associative, role of smoking in SAH.
  • Ketola, Raimo A.; Ojanperä, Ilkka (2019)
    Concentration distributions for 183 drugs and metabolites frequently found in post-mortem (PM) femoral venous blood were statistically characterized based on an extensive database of 122 234 autopsy cases investigated during an 18-year period in a centralized laboratory. The cases represented all causes of death, with fatal drug poisonings accounting for 8%. The proportion of males was 74% with a median age of 58 years compared with 26% females with a median age of 64 years. In 36% of these cases, blood alcohol concentration was higher than or equal to 0.2 parts per thousand, the median being 1.6 parts per thousand. The mean, median, and upper percentile (90th, 95th, 97.5th) drug concentrations were established, as the median PM concentrations give an idea of the "normal" PM concentration level, and the upper percentile concentrations indicate possible overdose levels. A correspondence was found between subsets of the present and the previously published PM drug concentrations from another laboratory that grouped cases according to the cause of death. Our results add to the knowledge for evidence-based interpretation of drug-related deaths.