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  • 1.
    Agreus, Lars
    et al.
    Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Hellström, Per M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Gastroenterologi/hepatologi.
    Talley, Nicholas J.
    Univ Newcastle, Fac Hlth & Med, Newcastle, NSW, Australia..
    Wallner, Bengt
    Umea Univ, Dept Surg, Umea, Sweden..
    Forsberg, Anna
    Karolinska Inst, Mol Med & Surg, Stockholm, Sweden..
    Vieth, Michael
    Klinikum Bayreuth, Inst Pathol, Bayreuth, Germany..
    Veits, Lothar
    Klinikum Bayreuth, Inst Pathol, Bayreuth, Germany..
    Björkegren, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Engstrand, Lars
    Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden..
    Andreasson, Anna
    Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.;Stockholm Univ, Stress Res Inst, Stockholm, Sweden..
    Towards a healthy stomach?: Helicobacter pylori prevalence has dramatically decreased over 23 years in adults in a Swedish community2016Inngår i: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414, Vol. 4, nr 5, s. 686-696Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background In Western countries the prevalence of Helicobacter pylori (H. pylori) infection may be declining but there is a lack of recent longitudinal population studies. We evaluated the changing epidemiology over a 23-year period in Sweden.

    Materials and methods In 1989, the validated Abdominal Symptom Questionnaire (ASQ) was mailed to a random sample of inhabitants (ages 22-80 years) in a Swedish community, and 1097 (87%) responded. H. pylori serology was analysed in a representative subsample (n=145). Twenty-three years later, the ASQ was mailed again using similar selection criteria, and 388 out of 1036 responders had an upper endoscopy with assessment of H. pylori and corpus atrophy status.

    Results The prevalence of positive H. pylori serology decreased from 37.9% (1989) to 15.8% (2012), corresponding to a decrease in odds of 75% per decade (odds ratio (OR): 0.25; 95% confidence interval (CI): 0.11-0.59, p=0.001) independent of age, gender, body mass index (BMI) and level of education, with a pattern consistent with a birth cohort effect. The prevalence increased with increasing age (p=0.001). The prevalence of H. pylori on histology in 2012 was 11.4% (95% CI 8.6-15.0). The prevalence of corpus atrophy on serology and/or histology in 2012 was 3.2% (95% CI 1.8-5.5); all cases were 57 years old.

    Conclusion The stomach is healthier in 2012 compared with 1989. H. pylori prevalence in adults has decreased over the last two decades to a level where clinical management might be affected.

  • 2.
    Andreasson, Anna
    et al.
    Karolinska Inst, Dept Med, Unit Clin Med, Stockholm, Sweden;Stockholm Univ, Stress Res Inst, Stockholm, Sweden;Macquarie Univ, Dept Psychol, N Ryde, NSW, Australia.
    Hagström, Hannes
    Karolinska Inst, Dept Med, Clin Epidemiol Unit, Stockholm, Sweden;Karolinska Univ Hosp, Dept Upper GI, Unit Hepatol, Stockholm, Sweden.
    Sköldberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kolorektalkirurgi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Gastrointestinalkirurgi.
    Onnerhag, Kristina
    Skane Univ Hosp, Dept Gastroenterol & Hepatol, Malmo, Sweden.
    Carlsson, Axel C.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden.
    Schmidt, Peter T.
    Karolinska Inst, Dept Med, Unit Clin Med, Stockholm, Sweden.
    Forsberg, Anna M.
    Karolinska Inst, Dept Med, Clin Epidemiol Unit, Stockholm, Sweden.
    The prediction of colorectal cancer using anthropometric measures: A Swedish population-based cohort study with 22 years of follow-up2019Inngår i: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414, Vol. 7, nr 9, s. 1250-1260Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Obesity is a risk factor for colorectal cancer (CRC). Objective The objective of this article is to investigate whether anthropometric measures reflecting visceral obesity are better predictors of CRC than body mass index (BMI). Methods Data were analysed from the Malmo Diet and Cancer study in Sweden, comprising 16,669 women and 10,805 men (median age 56.6 and 59.1 years) followed for a median 21.5 years. Diagnoses of CRC were identified using Swedish national registers. Cox regression was used to test the associations of BMI, waist circumference (WC), waist-hip ratio, waist-to-height ratio, waist-to-hip-to-height ratio, A Body Shape Index (ABSI) and percentage body fat with the development of CRC adjusted for age, alcohol consumption, smoking, education and physical activity in men and women. Results None of the measures were significantly associated with an increased risk for CRC in women. WC was the strongest predictor of colon cancer (CC) in men and the only measure that was independent of BMI. ABSI was the only measure significantly associated with the risk of rectal cancer in men. Conclusions Visceral obesity, best expressed as WC, is a risk factor for CC in men but a poor predictive marker for CRC in women.

  • 3.
    Sadr-Azodi, Omid
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, T2 Karolinska Univ Hosp, Stockholm, Sweden.; Eskilstuna Cty Hosp, Dept Surg, Eskilstuna, Sweden..
    Konings, Peter
    Karolinska Inst, Dept Mol Med & Surg, Upper Gastrointestinal Res, Stockholm, Sweden..
    Brusselaers, Nele
    Karolinska Inst, Dept Mol Med & Surg, Upper Gastrointestinal Res, Stockholm, Sweden..
    Menopausal hormone therapy and pancreatic cancer risk in women: a population-based matched cohort study2017Inngår i: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414, Vol. 5, nr 8, s. 1123-1128Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background The role of menopausal hormone therapy (MHT) in the development of pancreatic cancer is inconclusive owing to small studies and lack of proper study design. Methods This population-based matched cohort study included all Swedish women who used systemic MHT between 1 July 2005 and 31 December 2012. For each user of MHT, three never-users of MHT were randomly selected, matched for childbirth, history of thromboembolic events, and previous hysterectomy, as well as for year of birth, diabetes, obesity, and smoking- or alcohol-related disorders. Multivariable conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between MHT use and pancreatic cancer. The effect of MHT duration on pancreatic cancer development was calculated using multivariable Poisson regression. Results There were 290,186 ever-users of MHT and 870,165 matched never-users. During the follow-up, 311 (0.0011%) ever-users of MHT and 1220 (0.0014) never-users developed pancreatic cancer. In a multivariable adjusted model, ever-users had a 23% reduced risk (OR 0.77; 95% CI: 0.68-0.87) of pancreatic cancer. This risk decreased by 35% (incidence rate ratio (IRR) 0.65; 95% CI: 0.33-1.27) in women who used MHT 1-2 years and by 60% (IRR 0.40; 95% CI: 0.18-0.88) in women who used MHT3 years compared to women with <1 year of MHT use. The type of MHT did not change the results. Conclusion Systemic MHT use might reduce the risk of pancreatic cancer.

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