European Journal of Public Health最新文献

{"title":"Improving cervical screening risk stratification through extended human papillomavirus genotyping and age-specific data.","authors":"Aarno Leino, Eero Numminen, Veronika Fonagy, Minna Paloniemi, Tapio Seiskari, Ivana Kholová, Saara Kares, Karolina Louvanto","doi":"10.1093/eurpub/ckag139","DOIUrl":"10.1093/eurpub/ckag139","url":null,"abstract":"<p><p>High-risk human papillomavirus (HR-HPV) screening effectively reduces cervical cancer incidence, but limited specificity leads to excessive colposcopy referrals. Extended HR-HPV genotyping improves triage by accounting for genotype-specific oncogenic risks, offering a more precise framework for patient management than traditional pooled testing. This study analysed real-world screening data from a Finnish cohort of 2368 HR-HPV-positive women (Tampere region, 2017-2019) with up to 6.5 years of follow-up. Extended genotyping was performed using the Seegene Anyplex™II HPV28 Detection assay. Genotype-specific prevalence and cumulative incidence of histology-confirmed High-grade Squamous Intraepithelial Lesions or worse (HSIL+) were assessed and stratified by reflex cytology. Among 3099 detected HR-HPV genotypes, HPV16 was most prevalent (14.3%) and carried the highest HSIL+ risk (35.7%), followed by HPV33 (24.6%) and HPV18 (20.8%). A clear risk hierarchy emerged: the lowest-risk group (HPV59/39/68/51/56/66) had an HSIL+ incidence below 4.2%. Notably, HPV16-positive women with NILM/ASC-US cytology faced a 23.9% HSIL+ risk, exceeding the 21.1% risk seen in the lowest-risk genotype group even when accompanied by LSIL+ cytology. For those with both NILM/ASC-US and the lowest-risk genotypes, HSIL+ incidence was only 3.4%. A distinct hierarchy of oncogenic risk exists within this population-based cohort. Incorporating genotype-specific data into national screening algorithms is strongly supported. This allows for immediate colposcopy for high-risk groups (e.g. HPV16 with mild cytology) while justifying extended follow-up for lower-risk types, optimizing clinical resources and reducing unnecessary procedures.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic differences in the intensity of end-of-life care among patients with cancer: a population-based study in the Lazio region, Italy.","authors":"Arianna Bellini, Alessandro Cesare Rosa, Michela Servadio, Paola Michelozzi, Antonio Addis, Valeria Belleudi","doi":"10.1093/eurpub/ckag148","DOIUrl":"10.1093/eurpub/ckag148","url":null,"abstract":"<p><p>The importance of assessing end-of-life (EoL) care has grown due to increased life expectancy and chronic disease prevalence. Despite awareness of holistic care, cancer patients often receive aggressive treatments that may reflect disparities influenced by socioeconomic factors. This study investigates EoL care among cancer patients in Italy, focusing on the impact of socioeconomic position (SEP). A retrospective observational study was conducted using Italian health databases, focusing on cancer patients aged 35 years and older who died between 2015 and 2019 in Lazio, Italy. SEP was assessed using educational attainment and a composite deprivation indicator at the census-section level. EoL care intensity was measured using hospitalization rates, emergency department visits, medication use, and place of death. Logistic regression models [OR (95% CI)] were used to explore socioeconomic associations with care intensity. The study included 84 936 subjects, predominantly aged over 75, with lung, colorectal, and breast cancers being the most common. During the last month of life, individuals with middle to higher educational levels (upper-middle, university degrees) had increased risks of hospitalization (OR 1.06; 95% CI: 1.02-1.10; OR 1.09; 95% CI: 1.03-1.15), anti-neoplastic therapies (OR 1.29; 95% CI: 1.21-1.38; OR 1.48; 95% CI: 1.36-1.61), and in-hospital death (OR 1.08; 95% CI: 1.03-1.12; OR 1.16; 95% CI: 1.10-1.23) and lower risks of ED admissions (OR 0.91; 95% CI: 0.87-0.94; OR 0.76; 95% CI: 0.71-0.80) and opioid therapy (OR 0.90; 95% CI: 0.86-0.94; OR 0.87; 95% CI: 0.82-0.92). Similar results were observed when using the area-based SEP indicator. Socioeconomic differences influence EoL care pathways for patients with cancer in Italy. These findings suggest complex interactions between socioeconomic factors and care preferences, highlighting the need for tailored and equitable EoL care strategies.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide loss of a close family member in childhood and suicide later in life-a nationwide study among Inuit youth in Kalaallit Nunaat.","authors":"Ivalu K Seidler, Janne S Tolstrup, Allison Crawford, Christina V L Larsen","doi":"10.1093/eurpub/ckag172","DOIUrl":"10.1093/eurpub/ckag172","url":null,"abstract":"<p><p>Suicide-related loss in close relations may lead to complicated grief and increase individual suicide risk. In Kalaallit Nunaat (Greenland), 60% of the population has lost a family member or a close friend to suicide. The study aimed to investigate the association between suicide-related loss of a close family member before the age of 10 and later suicide incidence. The study was a nationwide study using data from the central population register and register of causes of death including 25 663 individuals born between 1983 and 2012. Exposure was the loss of a mother, father, or one or more siblings before the age of 10 and outcome was suicide. Follow-up started at age 10 until the time of death, 40th birthday, or the study termination on 31 December 2022. Incidence rates and incidence rate ratios (IRR) were calculated using Poisson regression. Suicide-related loss of a mother was associated with the highest IRR of 3.4 (95% CI: 1.6-7.2). Suicide-related loss of a father was associated with an IRR of 1.9 (95% CI: 1-3.4), while suicide-related loss of one or more siblings was associated with an IRR of 2.4 (95% CI: 1.3-4.3). Transgenerational suicide transmission was identified in individuals who lost a close relative before the age of 10, with the highest IRR for loss of a mother. The high prevalence of suicide-related loss survivors stresses the need for public health strategies to ensure culturally relevant support.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to 99 abstracts to correct the PDF versions.","authors":"","doi":"10.1093/eurpub/ckag145","DOIUrl":"10.1093/eurpub/ckag145","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying drinking patterns in a middle-aged population and their association with coronary heart disease, stroke, and all-cause mortality risk: the Danish Health Examination Survey.","authors":"Marta Trius-Soler, Marta Guasch-Ferré, Cristina Valle-Hita, Majken K Jensen, Janne S Tolstrup","doi":"10.1093/eurpub/ckag162","DOIUrl":"10.1093/eurpub/ckag162","url":null,"abstract":"<p><p>Alcohol drinking patterns encompass various dimensions of consumption. However, most studies have focused narrowly on the quantity of alcohol consumed. This study aimed to identify alcohol-drinking patterns in middle-aged population using alcohol-related variables and to examine their relationship with coronary heart disease (CHD), stroke, and all-cause-mortality risk. The present population-based study included adults from the Danish Health Examination Survey (DANHES) cohort who were ≥40 years old and free of CHD and stroke at baseline (n = 46 141). Latent Class Analysis (LCA) was used to identify distinct subpopulations based on six alcohol-related variables (amount, frequency, binge episodes, type, within meals, at home and alone). Cox proportional hazard models were used to estimate hazard ratios (95% confidence interval) between drinking patterns and CHD, stroke, and all-cause mortality during a median follow-up of 11.8 years. Four classes of drinking patterns were identified in both sexes (labeled as \"low drinkers,\" \"low-to-moderate drinkers,\" \"moderate-regular drinkers,\" and \"frequent-heavy drinkers\"). The more frequent drinking pattern was a median of 3 (2-5) drinks per week. Frequent heavy drinking was associated with a higher risk of stroke. Individuals in the low-to-moderate male drinking class and the moderate-regular female drinking class not under heart medication had a lower risk of all-cause mortality than low-level drinkers. Four distinct drinking patterns were identified. Among individuals 40 years and older, frequent-heavy drinking was associated with a higher risk of stroke, while low-to-moderate regular drinking might be associated with a lower all-cause mortality risk compared to low drinkers.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and implementation insights from implementing the health navigator model for cancer prevention among people experiencing homelessness across Europe.","authors":"Katerina Belogianni, Alejandro Gil-Salmerón, Tobias Fragner, Julia Gawronska, Rosa Trenado Gomez, Ioanna Tabaki, Maria Moudatsou, Lee Smith, Tamara Alhambra-Borras, Vicent Blanes Selva, Archontoula Dalma, Matina Kouvari, Igor Grabovac","doi":"10.1093/eurpub/ckag119","DOIUrl":"10.1093/eurpub/ckag119","url":null,"abstract":"<p><p>Cancer-related mortality among People Experiencing Homelessness (PEH) is twice as high as in the housed population, with one-third of deaths in this community linked to conditions preventable through timely healthcare. The Health Navigator Model (HNM) is a person-centred approach to improve healthcare access for PEH. This study assessed the feasibility of implementing the HNM across four European countries. A non-randomised, single-arm pilot study was conducted from June 2022 to December 2023 in Austria, Spain, Greece, and the UK. Trained Health Navigators supported adult PEH-excluding those with cancer diagnoses or cognitive impairments-through tailored guidance, education, and referrals. Feasibility indicators (demographics, recruitment, retention, engagement) were collected at baseline and follow-up points. Health Navigators' experiences were explored via qualitative interviews. Out of 1981 individuals approached, 652 PEH participated. The average age was 47.4 years; 64.1% were male, 41.6% relied on state benefits and 62.4% had experienced homelessness for over a year. Nineteen Health Navigators (mean age 34.95 years) were involved. Engagement included cancer education (N = 494), health consultations (N = 286), specialist referrals (N = 212), and screening tests (N = 169). Follow-up rates were 69% at the first time point and 42.5% at the second. Low cancer awareness, prioritisation of subsistence needs over health, and system-level barriers were identified as challenges, while building trust with individuals and stakeholders emerged as facilitators. Health Navigators reported increased empathy, awareness of PEH's needs, and confidence in empowering them as key benefits of their role. Training skilled Health Navigators, building trust and fostering strong inter-organisational collaborations are key to successfully implementing the HNM among PEH.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persisting disparities in hepatitis B diagnoses, associated risk factors, and time to diagnosis among migrants compared with Danish-born populations: a matched cohort study.","authors":"Anna Deal, Farah Seedat, Jessica Carter, Kristina Langholz Kristensen, Sally E Hayward, Kenneth Kabagambe, Jørgen Holm Petersen, Nina Weis, Philippa Matthews, Maria Wessman, Jon S Friedland, Sally Hargreaves, Marie Norredam","doi":"10.1093/eurpub/ckag167","DOIUrl":"10.1093/eurpub/ckag167","url":null,"abstract":"<p><p>Hepatitis B virus (HBV) remains a major public health concern globally despite the availability of an effective vaccine. In Europe, HBV risk is particularly high among those originating from areas with high prevalence rates. We investigated diagnosis rates and risk factors for HBV infections among migrants compared to Danish-born populations. Our matched cohort study included migrants matched 1:6 with Danish-born individuals over a 23-year period. We calculated HBV diagnosis rates per 10 000 person-years. A multivariate quasi-Poisson regression analysis was done across the entire cohort, to compare adjusted incidence rate ratios (aIRRs) between the Danish-born and migrant cohorts. A further multivariate analysis was done in the migrant cohort only, to examine factors associated with diagnosis. Time to diagnosis was also compared within the migrant cohort. 179 110 migrants and 1 049 345 Danish-born individuals were included in the study cohort, among whom there were 1362 HBV diagnoses (migrants: 1118; Danish-born: 244). Migrants had a higher HBV diagnosis rate compared to Danish-born (aIRR 30.6; 95% CI: 26.7-35.2). A higher rate of substance use disorders, hepatitis C, and HIV co-infection were observed among Danish-born cases. Within the migrant cohort, hepatitis C diagnosis, region of origin (Southeast Asia and Pacific, African region), and migrant status were associated with HBV diagnosis and the average time from arrival to diagnosis was 5.4 years. Migrants are at increased risk for HBV and may experience diagnostic delays, particularly those who fall outside of routine screening processes for pregnant women and on-arrival health assessments. At-risk migrant groups should be engaged early in culturally competent screening programs to increase health equity and meet WHO 2030 HBV elimination goals.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 5","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Don't give up on politics.","authors":"Scott Burris","doi":"10.1093/eurpub/ckag070","DOIUrl":"10.1093/eurpub/ckag070","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 4","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Europe must act: rethinking global health preparedness without the United States.","authors":"Anja Schreijer, Tiago Correia, Martin McKee, Tit Albreht, Aura Timen, Maria Ganczak, Tony Holohan","doi":"10.1093/eurpub/ckag098","DOIUrl":"10.1093/eurpub/ckag098","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 4","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomous clinical Artificial Intelligence and the validation gap: structural risks and regulatory priorities for European health systems.","authors":"Răzvan Cherecheș","doi":"10.1093/eurpub/ckag068","DOIUrl":"10.1093/eurpub/ckag068","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 4","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}