Lancet Regional Health-Europe最新文献

筛选
英文 中文
Correction to “Utilization of colorectal cancer screening tests across European countries: a cross-sectional analysis of the European health interview survey 2018–2020” [The Lancet Regional Health—Europe Volume 41, June 2024, 100920]
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-26 DOI: 10.1016/j.lanepe.2025.101287
Idris Ola , Rafael Cardoso , Michael Hoffmeister , Hermann Brenner
{"title":"Correction to “Utilization of colorectal cancer screening tests across European countries: a cross-sectional analysis of the European health interview survey 2018–2020” [The Lancet Regional Health—Europe Volume 41, June 2024, 100920]","authors":"Idris Ola , Rafael Cardoso , Michael Hoffmeister , Hermann Brenner","doi":"10.1016/j.lanepe.2025.101287","DOIUrl":"10.1016/j.lanepe.2025.101287","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101287"},"PeriodicalIF":13.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety and efficacy of immunoguided prophylaxis for cytomegalovirus disease in low-risk lung transplant recipients in Spain: a multicentre, open-label, randomised, phase 3, noninferiority trial
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-26 DOI: 10.1016/j.lanepe.2025.101268
Aurora Páez-Vega , José M. Vaquero-Barrios , Elisa Ruiz-Arabi , David Iturbe-Fernández , Rodrigo Alonso , Piedad Ussetti-Gil , Victor Monforte , Amparo Pastor , Raquel Fernández-Moreno , Victor M. Mora , Marta Erro-Iribarren , Carlos A. Quezada , Cristina Berastegui , José M. Cifrian-Martínez , Angela Cano , Juan J. Castón , Isabel Machuca , Maria A. Lobo-Acosta , Belén Gutiérrez-Gutiérrez , Sara Cantisán , Virginia Pérez
{"title":"Safety and efficacy of immunoguided prophylaxis for cytomegalovirus disease in low-risk lung transplant recipients in Spain: a multicentre, open-label, randomised, phase 3, noninferiority trial","authors":"Aurora Páez-Vega , José M. Vaquero-Barrios , Elisa Ruiz-Arabi , David Iturbe-Fernández , Rodrigo Alonso , Piedad Ussetti-Gil , Victor Monforte , Amparo Pastor , Raquel Fernández-Moreno , Victor M. Mora , Marta Erro-Iribarren , Carlos A. Quezada , Cristina Berastegui , José M. Cifrian-Martínez , Angela Cano , Juan J. Castón , Isabel Machuca , Maria A. Lobo-Acosta , Belén Gutiérrez-Gutiérrez , Sara Cantisán , Virginia Pérez","doi":"10.1016/j.lanepe.2025.101268","DOIUrl":"10.1016/j.lanepe.2025.101268","url":null,"abstract":"<div><h3>Background</h3><div>The standard prophylaxis treatment for cytomegalovirus (CMV) disease in CMV-seropositive lung transplant recipients is six months of prophylaxis with valganciclovir followed by six months of pre-emptive therapy. This protocol is associated with adverse events and risk of resistance. We have previously shown that prophylaxis can be suspended in CMV-seropositive kidney transplant recipients receiving thymoglobulin without increasing the risk of CMV disease and reducing the incidence of neutropenia. The objective of the current study is to demonstrate that immunoguided prophylaxis is effective and safe in seropositive lung transplant recipients.</div></div><div><h3>Methods</h3><div>A phase III, multicentre, randomised, open-label, noninferiority clinical trial was conducted in adult lung transplant recipients. Patients were randomised (1:1) to two groups: (1) immunoguided prophylaxis (IP), consisting of 3 months of universal prophylaxis followed by CMV-specific cell-mediated immunity-guided discontinuation, or (2) standard prophylaxis (SP), consisting of 6 months of prophylaxis followed by pre-emptive therapy, both for a total of 12 months. The noninferiority margin was 7%. The primary and secondary efficacy endpoints were CMV disease and asymptomatic CMV replication at month 18. The primary and secondary safety endpoints were incidence of neutropenia (defined as neutrophil count <1500 cells/μL), incidence of rejection and number of days of valganciclovir prophylaxis. This trial was registered in EudraCT (2018-003300-39) and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT03699254</span><svg><path></path></svg></span>). This trial has been completed.</div></div><div><h3>Findings</h3><div>Patients were recruited between April 2019 and December 2021 in seven Spanish centres. A total of 150 patients were randomised (75 patients per group). Incidence of CMV disease at month 18 did not differ among groups (18·7% [14 patients] vs. 16·0% [12 patients]; risk difference [RD] −0·03 [95% CI −0·15% to 0·06%]; <em>P</em> = 0·620) but occurred earlier in the IP group compared to the SP group. The proportion of patients who developed CMV disease at ≤180 days after transplant was higher in the IP group compared with the SP group (8% [6 patients] vs. 0% [0 patients]; RD −0·08 [95% CI −0·14 to −0·02; <em>P</em> = 0·009]). Asymptomatic CMV replication was reduced in the IP group vs. the SP group (4·0% [3 patients] vs. 16·0% [12 patients]; adjusted RD 0·12 [95% CI 0·03–0·21; <em>P</em> = 0·009]). A total of 30 patients (40%) in the IP group did not require prophylaxis from month 4 to 12. No significant difference was observed in the proportion of patients with neutropenia during months 4 to 7 (14·7% [11 patients] vs. 25·3% [19 patients]; RD 0·11 [95% CI −0·02 to 0·23]; <em>P</em> = 0·090) or rejection (33·3% [25 patients] vs. 30·7% [23 patients]; RD −0·03 [95% CI −0·18 to 0·12; <em>P</em> = 0·690]). T","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101268"},"PeriodicalIF":13.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A call to action to address the steatotic liver disease public health threat in Barcelona
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-22 DOI: 10.1016/j.lanepe.2025.101272
Jeffrey V. Lazarus , J. Emilio Miralles-Sanchez , Leire Agirre-Garrido , Nicolai Brachowicz , Aina Nicolàs , Anthony Armenta Jr. , Delfina Boudou , Lisa Rice-Duek , Juan M. Pericàs , Joan Benach , Christopher J. Kopka , Dana Ivancovsky Wajcman
{"title":"A call to action to address the steatotic liver disease public health threat in Barcelona","authors":"Jeffrey V. Lazarus ,&nbsp;J. Emilio Miralles-Sanchez ,&nbsp;Leire Agirre-Garrido ,&nbsp;Nicolai Brachowicz ,&nbsp;Aina Nicolàs ,&nbsp;Anthony Armenta Jr. ,&nbsp;Delfina Boudou ,&nbsp;Lisa Rice-Duek ,&nbsp;Juan M. Pericàs ,&nbsp;Joan Benach ,&nbsp;Christopher J. Kopka ,&nbsp;Dana Ivancovsky Wajcman","doi":"10.1016/j.lanepe.2025.101272","DOIUrl":"10.1016/j.lanepe.2025.101272","url":null,"abstract":"<div><div>Despite their high prevalence worldwide, steatotic liver diseases (SLDs) are largely excluded from most non-communicable disease (NCD) guidelines and strategies. We propose policies and strategies to achieve the United Nations Sustainable Development Goal of reducing NCD premature mortality by one-third by 2030. To assess this gap—the exclusion of SLDs from NCD policies—in urban areas, we reviewed Barcelona’s strategies for NCD risks (e.g., alcohol, tobacco, healthy food access). We then explored applications of geo-spatial visualisation and whole-of-society approaches (e.g., citizen science engagement) aligned with the World Health Organization (WHO) Best Buys to provide recommendations to address NCDs, generally, and SLDs specifically.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101272"},"PeriodicalIF":13.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Maternal and neonatal outcomes of pregnancies after metabolic bariatric surgery: a retrospective population-based study
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-22 DOI: 10.1016/j.lanepe.2025.101263
Pierre Bel Lassen , Anne-Isabelle Tropeano , Armelle Arnoux , Estelle Lu , Louis Romengas , Sandrine Katsahian , Bérénice Ségrestin , Bénédicte Lelièvre , Delphine Mitanchez , Géraldine Gascoin , Tigran Poghosyan , Andrea Lazzati , Barbara Heude , Jacky Nizard , Sébastien Czernichow , Cécile Ciangura , Claire Rives-Lange
{"title":"Maternal and neonatal outcomes of pregnancies after metabolic bariatric surgery: a retrospective population-based study","authors":"Pierre Bel Lassen ,&nbsp;Anne-Isabelle Tropeano ,&nbsp;Armelle Arnoux ,&nbsp;Estelle Lu ,&nbsp;Louis Romengas ,&nbsp;Sandrine Katsahian ,&nbsp;Bérénice Ségrestin ,&nbsp;Bénédicte Lelièvre ,&nbsp;Delphine Mitanchez ,&nbsp;Géraldine Gascoin ,&nbsp;Tigran Poghosyan ,&nbsp;Andrea Lazzati ,&nbsp;Barbara Heude ,&nbsp;Jacky Nizard ,&nbsp;Sébastien Czernichow ,&nbsp;Cécile Ciangura ,&nbsp;Claire Rives-Lange","doi":"10.1016/j.lanepe.2025.101263","DOIUrl":"10.1016/j.lanepe.2025.101263","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The incidence of post metabolic bariatric surgery (BS) pregnancies is rising. Previous studies provided conflicting results regarding the risk of prematurity, stillbirth, perinatal death and the optimal time from BS to conception. This study examined maternal and neonatal outcomes of post-BS pregnancies and influencing factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Nationwide retrospective study of all post-BS pregnancies in France from January 1st 2013 to December 31st 2022. We compared 55,941 post-BS pregnancies with 223,712 controls matched on delivery date, parity, age, obesity, hypertension, diabetes, and socio-economic status (1:4 ratio) using generalized estimating equations. We also compared 11,777 post-BS pregnancies with 11,777 pre-BS pregnancies in the same women, using conditional logistic regression. Maternal outcomes included gestational hypertension, preeclampsia, and gestational diabetes. Neonatal outcomes included small-for-gestational-age (SGA), prematurity, stillbirth, and perinatal death. We tested for interactions with BS type, BS to pregnancy time interval and malnutrition.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Post-BS pregnancies were associated with reduced risk of gestational hypertension (odds ratio [OR] 0.57 [95% CI 0.53–0.62]), preeclampsia (OR 0.59 [0.55–0.64]), and gestational diabetes (OR 0.64 [0.62–0.66]) as compared with control. Similar but stronger risk reductions were observed compared with pre-BS pregnancies. Risk of SGA was increased (OR 1.74 [1.68–1.79]) as compared with controls and pre-BS pregnancies (OR 1.88 [1.64–2.16]). Risk of prematurity was increased (OR 1.27 [1.22–1.31]) as compared with controls but not pre-BS pregnancies (OR 0.95 [0.85–1.06]). Compared with controls, risk of stillbirth was increased (OR 1.2 [1.06–1.35]), mediated by SGA, as was perinatal death (OR 1.5 [1.13–1.99]), mediated by both prematurity and SGA. Increased SGA risk compared to controls was higher with malnutrition (OR: 2.38 [1.96, 2.88], p&lt;sub&gt;interaction&lt;/sub&gt; &lt;0.0001), with &lt;6 months (OR: 1.95 [1.72, 2.21], p&lt;sub&gt;interaction&lt;/sub&gt; = 0.01) or 6–12 months between BS and pregnancy (OR: 1.86 [1.70, 2.04], p&lt;sub&gt;interaction&lt;/sub&gt; = 0.02) and with gastric bypass (OR: 1.88 [1.77–2.00], p&lt;sub&gt;interaction&lt;/sub&gt; = 0.027). Increased prematurity risk compared to controls was higher with malnutrition (2.45 [1.99, 3.00], p&lt;sub&gt;interaction&lt;/sub&gt; &lt;0.0001) and gastric bypass (OR: 1.46 [1.36–1.57], p&lt;sub&gt;interaction&lt;/sub&gt; = 0.0003).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Post-BS compared with pre-BS or control pregnancies were associated with reduced risk of maternal adverse outcomes but increased risk of neonatal adverse events. The risks of SGA and prematurity are higher with shorter intervals between BS and conception, gastric bypass, and malnutrition. Post-BS pregnancies could be considered high risk, requiring close nutritional and obstetrical monitoring.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;Su","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101263"},"PeriodicalIF":13.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New opportunities for accessing promising non-oncological orphan drugs
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-21 DOI: 10.1016/j.lanepe.2025.101275
Carla E.M. Hollak , Carelle C. Reparon-Schuijt , Kathelijn Verdeyen , Lisa J. Deesker , Jaap W. Groothoff , Josephine M.I. Vos , Atse H. Huisman , Silvia van der Flier , Anke A.M.G. Pisters-van Roy
{"title":"New opportunities for accessing promising non-oncological orphan drugs","authors":"Carla E.M. Hollak ,&nbsp;Carelle C. Reparon-Schuijt ,&nbsp;Kathelijn Verdeyen ,&nbsp;Lisa J. Deesker ,&nbsp;Jaap W. Groothoff ,&nbsp;Josephine M.I. Vos ,&nbsp;Atse H. Huisman ,&nbsp;Silvia van der Flier ,&nbsp;Anke A.M.G. Pisters-van Roy","doi":"10.1016/j.lanepe.2025.101275","DOIUrl":"10.1016/j.lanepe.2025.101275","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101275"},"PeriodicalIF":13.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PCR and biomarker algorithms to guide antibiotics in lower respiratory tract infections—is the future now?
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-21 DOI: 10.1016/j.lanepe.2025.101277
Werner C. Albrich , Noémie Boillat-Blanco
{"title":"PCR and biomarker algorithms to guide antibiotics in lower respiratory tract infections—is the future now?","authors":"Werner C. Albrich ,&nbsp;Noémie Boillat-Blanco","doi":"10.1016/j.lanepe.2025.101277","DOIUrl":"10.1016/j.lanepe.2025.101277","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101277"},"PeriodicalIF":13.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metabolic bariatric surgery and pregnancy: balancing maternal benefits with neonatal risks
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-21 DOI: 10.1016/j.lanepe.2025.101280
Antonio Iannelli , Sergio Carandina
{"title":"Metabolic bariatric surgery and pregnancy: balancing maternal benefits with neonatal risks","authors":"Antonio Iannelli ,&nbsp;Sergio Carandina","doi":"10.1016/j.lanepe.2025.101280","DOIUrl":"10.1016/j.lanepe.2025.101280","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101280"},"PeriodicalIF":13.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-20 DOI: 10.1016/j.lanepe.2025.101270
Catherine Quantin , Jonathan Cottenet , Colleen Chambers , Natasha Kennedy , Sadhbh Whelan , Geoff Debelle , Diogo Lamela , Ulugbek Nurmatov , Donna O'Leary , Christian Torp-Pedersen , Sinéad Brophy , Marcella Broccia , Ruth Gilbert , Troels Græsholt-Knudsen , Laura Elizabeth Cowley
{"title":"Hospitalisations for physical abuse in infants and children less than 5 years, 2013–2021: a multinational cohort study using administrative data from five European countries","authors":"Catherine Quantin ,&nbsp;Jonathan Cottenet ,&nbsp;Colleen Chambers ,&nbsp;Natasha Kennedy ,&nbsp;Sadhbh Whelan ,&nbsp;Geoff Debelle ,&nbsp;Diogo Lamela ,&nbsp;Ulugbek Nurmatov ,&nbsp;Donna O'Leary ,&nbsp;Christian Torp-Pedersen ,&nbsp;Sinéad Brophy ,&nbsp;Marcella Broccia ,&nbsp;Ruth Gilbert ,&nbsp;Troels Græsholt-Knudsen ,&nbsp;Laura Elizabeth Cowley","doi":"10.1016/j.lanepe.2025.101270","DOIUrl":"10.1016/j.lanepe.2025.101270","url":null,"abstract":"<div><h3>Background</h3><div>Child physical abuse (CPA) is a global public health problem associated with lifelong negative consequences, yet reliable epidemiologic data are lacking. This multinational cohort study analyses trends in CPA hospitalisations from 2013 to 2021.</div></div><div><h3>Methods</h3><div>We used medico-administrative databases to identify children aged one month to five years hospitalised in Denmark, England, France, Ireland, and Wales. We identified CPA using a validated algorithm based on ICD-10 codes. We calculated the number, proportion, and incidence rate of children hospitalised for CPA, and the number and proportion of total hospitalisations for CPA, by year and age group (&lt;1 and &lt;5). We determined the proportion of CPA hospitalisations recorded using different ICD-10 codes, by country.</div></div><div><h3>Findings</h3><div>The pooled incidence rate of infants &lt;1 year hospitalised for CPA was stable over time (around 42/100,000 per year), ranging on average from 33 to 48/100,000 between countries. The pooled proportion of infant hospitalisations for CPA was around 0.17% (N = 750) per year (range 0.15–0.21%, N range 674–785), increasing significantly during the COVID-19 pandemic in 2020 (0.21%, N = 674). In children &lt;5, the incidence rate (around 18/100,000 per year) and proportion of CPA hospitalisations (around 0.11% per year (N = 1600), range 0.10–0.14% (N range 1341–1657) were lower than in infants, but also increased in 2020 (0.14%, N = 1341). There were national differences in the distribution of ICD-10 codes used to record CPA and differences in year-on-year trends between countries.</div></div><div><h3>Interpretation</h3><div>Comparing temporal trends in CPA hospitalisations between countries is feasible. Hospital data are one of several valuable sources for CPA surveillance.</div></div><div><h3>Funding</h3><div>European COST Action EURO-CAN. <span>European Union</span> (HORIZON Europe SERENA project).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101270"},"PeriodicalIF":13.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Socioeconomic inequalities in diagnostics, care and survival outcomes for hepatocellular carcinoma in Sweden: a nationwide cohort study
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-20 DOI: 10.1016/j.lanepe.2025.101273
Juan Vaz , Hannes Hagström , Malin Sternby Eilard , Magnus Rizell , Ulf Strömberg
{"title":"Socioeconomic inequalities in diagnostics, care and survival outcomes for hepatocellular carcinoma in Sweden: a nationwide cohort study","authors":"Juan Vaz ,&nbsp;Hannes Hagström ,&nbsp;Malin Sternby Eilard ,&nbsp;Magnus Rizell ,&nbsp;Ulf Strömberg","doi":"10.1016/j.lanepe.2025.101273","DOIUrl":"10.1016/j.lanepe.2025.101273","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. This study evaluates how strongly socioeconomic factors associate with diagnostics, treatment, and survival among patients with HCC in Sweden.</div></div><div><h3>Methods</h3><div>All adult patients registered with a diagnosis of HCC in the Swedish quality register for liver cancer between 2011 and 2021 were included. Household income was classified as low (first quartile; poorest), medium (second or third quartile), or high (in fourth quartile; wealthiest) based on the overall distribution of household income across all household in Sweden. Outcomes included likelihood of diagnosis under surveillance, early-stage diagnosis (Barcelona Clinic Liver Cancer [BCLC] staging 0-A), and receipt of curative treatment (ablation, resection or liver transplantation), as well as mortality risk.</div></div><div><h3>Findings</h3><div>Among 5490 patients, a significant association was found between low household income and decreased likelihood of diagnosis while under surveillance (adjusted odds ratio [aOR] 0·63; 95% confidence interval [CI]: 0·50–0·80), early-stage diagnosis (aOR 0·58; 95% CI: 0·51–0·67), and curative treatment receipt (aOR 0·65; 95% CI: 0·50–0·85). After adjustments for all variables in the BCLC, other sociodemographic variables, comorbidities, and cirrhosis status, patients with low household income had an adjusted hazard ratio for mortality of 1·29 (95% CI: 1·15–1·45) compared to patients with high household income.</div></div><div><h3>Interpretation</h3><div>Socioeconomic disparities associate markedly with more advanced stage at HCC diagnosis, less curative treatment, and poorer survival in Sweden. Addressing these disparities through targeted public health interventions may improve HCC care and outcomes in socioeconomically disadvantaged populations.</div></div><div><h3>Funding</h3><div>The <span>Swedish Cancer Society</span>—<span>Cancerfonden</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101273"},"PeriodicalIF":13.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sex-specific associations between sleep apnoea and lung cancer risk in patients with COPD: a nationwide prospective cohort study
IF 13.6
Lancet Regional Health-Europe Pub Date : 2025-03-20 DOI: 10.1016/j.lanepe.2025.101269
Kristiaan Proesmans , Annemarie I. Luik , Lies Lahousse
{"title":"Sex-specific associations between sleep apnoea and lung cancer risk in patients with COPD: a nationwide prospective cohort study","authors":"Kristiaan Proesmans ,&nbsp;Annemarie I. Luik ,&nbsp;Lies Lahousse","doi":"10.1016/j.lanepe.2025.101269","DOIUrl":"10.1016/j.lanepe.2025.101269","url":null,"abstract":"<div><h3>Background</h3><div>COPD is an established risk factor for lung cancer. Sleep apnoea is prevalent in COPD and the inflammation caused by intermittent hypoxaemia may increase this lung cancer risk. Females have more systemic inflammation for a similar apnoea-hypopnoea index than males. Therefore, this study aims to investigate sex-specific associations between sleep apnoea and lung cancer in COPD.</div></div><div><h3>Methods</h3><div>The sex-specific absolute and relative risk of sleep apnoea on newly diagnosed lung cancer was estimated in a nationwide observational study of Belgian patients with COPD (≥55 years), between 2017 and 2022, using an Aalan-Johanson estimator and a cause-specific Cox regression model adjusted for age, socioeconomic status, smoking status, alcoholism, frailty, comorbidities, and comedication.</div></div><div><h3>Findings</h3><div>The study consisted of 62,903 COPD patients (42·80% female), of whom 2898 (4·60%) developed lung cancer. We found a significant sex interaction of sleep apnoea on lung cancer hazard (<strong><em>χ</em></strong>-squared: 13·239, P-interaction &lt; 0·01). In females, sleep apnoea was associated with a higher lung cancer risk (cumulative incidence: 1545 vs 1350 per 100,000 PY; aHR: 1·31 (95% CI: 1·05–1·63)). For males, sleep apnoea patients had a lower lung cancer risk (cumulative incidence: 1632 and 2305 per 100,000 PY; aHR: 0·82 (95% CI: 0·70–0·95)). The impact of sleep apnoea on lung cancer development was especially strong in female COPD patients with hypoxia-related comorbidities e.g., with a history of emphysema (aHR: 2·65 (95% CI: 1·11–6·34)).</div></div><div><h3>Interpretation</h3><div>Sleep apnoea was associated with a higher risk of lung cancer in female COPD patients while, in males, there was a lower risk. Especially in female COPD patients with hypoxia, sleep apnoea is strongly associated with an increased lung cancer risk.</div></div><div><h3>Funding</h3><div>Emmanuel van der Schueren cancer research fellowship “<span>Kom Op Tegen Kanker</span>”.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101269"},"PeriodicalIF":13.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信