Central nervous system drugs, especially psychotropics, seem to be associated with an increased risk of falls. The quality of observational studies needs to be improved, for many appear to lack even a clear definition of a fall, target medicines, or prospective follow-up. Many drugs commonly used by older persons are not systematically studied as risk factors for falls.
Of the 28,857 cancer cases registered by the Finnish Cancer Registry in 1955, 1960 and 1965, 63 patients had committed suicide by the end of 1970. The suicide rate among males was 1.3 times higher (p less than 0.01) and among females 1.9 times higher (p less than 0.05) than the rate in the general population. The highest suicide risk (relative risk 2.5, p less than 0.001) was associated with gastrointestinal cancer. Patients with a non-localized tumor at diagnosis had a two-fold risk of suicide and the rate was higher among patients undergoing no treatment, or treatment with chemotherapy or hormones only. It was estimated that 23% of all suicides among male cancer patients and 46% among female cancer patients was associated with the patients having cancer.
Background. A cohort of women enrolled in the Mama breast self‐examination‐(BSE) containing breast screening program in Finland from 1973 through 1975 (with BSE used for screening and mammography for diagnosis) was studied. Methods. Twenty‐eight thousand seven hundred eighty‐five women who returned calendars recording their practice of BSE over a 2‐year period have been followed by linkage with the records of the Finnish Cancer Registry through 1986. The incidence of and mortality from breast cancer was compared with that expected in the Finnish population based on a model incorporating Finnish national data for breast cancer incidence and case fatality. Results. Breast cancer incidence was higher than expected (a rate ratio of 1.19 over all ages). The stage distribution of cases was not different from that expected from Finnish cancer registry data for 1980, but the breast cancer mortality was lower than expected (a rate ratio of 0.75). The latter difference occurred mainly in Years 3–6 of the follow‐up period. The effect seemed similar in women under and over the age of 50 years. The cohort was of higher educational status than the Finnish population, and the mortality from all causes was lower than the general Finnish population, an effect seen in previous studies of compliers with breast screening. Conclusions. The reduction in mortality from breast cancer in the study cohort is consistent with an effect of the BSE‐containing Mama program, though selection bias, inherent in any observational study of screening, provided an alternative explanation for the findings.
Summary A nationwide mammographic screening for breast cancer was started in Finland in 1987. During the first 2 years of the organised screening programme, 126,000 women were invited. Most of them (103,000) belonged to the birth year cohort in the 50-59 years' age groups. Among the 112,000 screenees, 418 cancers (0.4%) were found. Specificity of the test was about 96%. The screening prevalance was 2.4 times the annual incidence and a minimum estimate for the detection rate among those invited was 1.6 times that among those not invited. These estimates indicate a relatively low test and programme sensitivity. The final effectiveness of a public health policy cannot be predicted on the basis of limited preventive trials, and there is need to evaluate also a public health policy by experimental means.
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