Hospital contacts for endocrine disorders in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): a population-based cohort study

Licht, Sofie de Fine; Winther, Jeanette Falck; Guðmundsdóttir, Þorgerður; Holmqvist, Anna Sällfors; Bonnesen, Trine Gade; Asdahl, Peter H.; Tryggvadóttír, Laufey; Anderson, Harald; Wesenberg, Finn; Malila, Nea; Holm, Kirsten; Hasle, Henrik; Olsen, Jørgen H.

doi:10.1016/s0140-6736(13)62564-7

Cited by 74 publications

(62 citation statements)

References 23 publications

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“…7 They also call attention to the challenges and deficiencies in the medical care provided to these individuals as they age. 4 Interactions between pituitary dysfunction, sex, and ethnicity and the impact of untreated GHD and LH/FSHD on cardiovascular health, body composition, and physical fitness deserve further investigation. …”

Section: ‫ء‬mentioning

confidence: 99%

“…1,2 Recent reports have highlighted the increase in their prevalence with time and a relatively high proportion of diagnoses uncovered by systematic risk-based screening. 1,3,4 The risk of anterior pituitary dysfunction in CCS treated with cranial radiotherapy (CRT) is known to increase in a time-and dose-dependent fashion. [5][6][7] Nevertheless, extended long-term follow-up data are scarce, 1 and the impact of potentially undiagnosed and/or untreated deficiencies on overall health is unknown.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anterior Hypopituitarism in Adult Survivors of Childhood Cancers Treated With Cranial Radiotherapy: A Report From the St Jude Lifetime Cohort Study

Chemaitilly

Huang

et al. 2015

JCO

217

180

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Purpose To estimate the prevalence of and risk factors for growth hormone deficiency (GHD), luteinizing hormone/follicle-stimulating hormone deficiencies (LH/FSHD), thyroid-stimulatin hormone deficiency (TSHD), and adrenocorticotropic hormone deficiency (ACTHD) after cranial radiotherapy (CRT) in childhood cancer survivors (CCS) and assess the impact of untreated deficiencies. Patients and Methods Retrospective study in an established cohort of CCS with 748 participants treated with CRT (394 men; mean age, 34.2 years [range, 19.4 to 59.6 years] observed for a mean of 27.3 years [range, 10.8 to 47.7 years]). Multivariable logistic regression was used to study associations between demographic and treatment-related risk factors and pituitary deficiencies, as well as associations between untreated deficiencies and cardiovascular health, bone mineral density (BMD), and physical fitness. Results The estimated point prevalence was 46.5% for GHD, 10.8% for LH/FSHD, 7.5% for TSHD, and 4% for ACTHD, and the cumulative incidence increased with follow-up. GHD and LH/FSHD were not treated in 99.7% and 78.5% of affected individuals, respectively. Male sex and obesity were significantly associated with LH/FSHD; white race was significant associated with LH/FSHD and TSHD. Compared with CRT doses less than 22 Gy, doses of 22 to 29.9 Gy were significantly associated with GHD; doses ≥ 22 Gy were associated with LH/FSHD; and doses ≥ 30 Gy were associated with TSHD and ACTHD. Untreated GHD was significantly associated with decreased muscle mass and exercise tolerance; untreated LH/FSHD was associated with hypertension, dyslipidemia, low BMD, and slow walking; and both deficits, independently, were associated with with abdominal obesity, low energy expenditure, and muscle weakness. Conclusion Anterior pituitary deficits are common after CRT. Continued development over time is noted for GHD and LH/FSHD with possible associations between nontreatment of these conditions and poor health outcomes.

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Section: ‫ء‬mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anterior Hypopituitarism in Adult Survivors of Childhood Cancers Treated With Cranial Radiotherapy: A Report From the St Jude Lifetime Cohort Study

Chemaitilly

Huang

et al. 2015

JCO

217

180

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“…1 It has long been known that the side effects which can occur include late thyroid complications, such as thyroid dysfunction [2][3][4][5][6][7][8][9] and thyroid cancer. [10][11][12][13] Thyroid dysfunction is rather frequent and has been mostly reported as a complication of irradiation, particularly for solid tumors, such as brain cancers 10,14 and Hodgkin lymphoma.…”

Section: Introductionmentioning

confidence: 99%

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Oudin¹,

Auquier²,

Bertrand³

et al. 2016

Haematologica

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T hyroid complications are known side effects of irradiation. However, the risk of such complications in childhood acute leukemia survivors who received either central nervous system irradiation or hematopoietic stem cell transplantation is less described. We prospectively evaluated the incidence and risk factors for thyroid dysfunction and tumors in survivors of childhood acute myeloid or lymphoid leukemia. A total of 588 patients were evaluated for thyroid function, and 502 individuals were assessed for thyroid tumors (median follow-up duration: 12.6 and 12.5 years, respectively). The cumulative incidence of hypothyroidism was 17.3% (95% CI: 14.1-21.1) and 24.6% (95% CI: 20.4-29.6) at 10 and 20 years from leukemia diagnosis, respectively. Patients who received total body irradiation (with or without prior central nervous system irradiation) were at higher risk of hypothyroidism (adjusted HR: 2.87; P=0.04 and 2.79, P=0.01, respectively) as compared with transplanted patients who never received any irradiation. Patients transplanted without total body irradiation who received central nervous system irradiation were also at higher risk (adjusted HR: 3.39; P=0.02). Patients irradiated or transplanted at older than 10 years of age had a lower risk (adjusted HR: 0.61; P=0.02). Thyroid malignancy was found in 26 patients (5.2%). Among them, two patients had never received any type of irradiation: alkylating agents could also promote thyroid cancer. The cumulative incidence of thyroid malignancy was 9.6% (95% CI: 6.0-15.0) at 20 years. Women were at higher risk than men (adjusted HR: 4.74; P=0.002). In conclusion, thyroid complications are frequent among patients who undergo transplantation after total body irradiation and those who received prior central nervous system irradiation. Close monitoring is thus warranted for these patients.

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“…For eksempel er det ikke uvanlig at eldre pasienter kan ha både kardiovaskulaer sykdom, diabetes og lungesykdom, og i tillegg ha psykisk sykdom som depresjon eller demens. Legemiddelbruk, behandling og sykdommer bør studeres i sammenheng, og dette er noe registerdata kan bidra til 46 . Registerdata kan også gi oss økt innsikt i immunologiske tilstanders betydning i utvikling av andre sykdommer 47 .…”

Section: Generasjonsstudier Livsløpsstudier Og Komorbiditetunclassified

Nasjonale registerkilder i epidemiologisk forskning

Håberg

Ebbing²,

Stoltenberg³

2017

Nor J Epidemiol

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This is an open access article distributed under the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. INTRODUKSJONI Norge har vi nasjonale personregistre med informasjon om demografi, familier, sosiale forhold, helseopplysninger og helsetjenester. I tillegg er nesten en million personer med i befolkningsbaserte helseundersøkelser, og mange hundre tusen blodprøver er lagret til forskningsformål. De nasjonale registrene er opprettet for mange ulike formål, og er verdifulle datakilder for forskning. Fødselsnummeret inngår i nesten alle registre, og data fra de ulike registrene kan derfor kobles. Vi har dermed nasjonale data som kan brukes til å beskrive og studere helse og sykdom for hele befolkningen, og gjennom hele livsløpet. Utenom Norden er det få land som har tilsvarende muligheter. I helseundersøkelser og andre typer studier er man avhengig av å rekruttere deltagere. Det kan vaere vanskelig å oppnå utvalg med samme demografiske og sosioøkonomiske sammensetning som befolkningen ellers. Enkelte grupper kan vaere spesielt vanskelige å rekruttere, og noen problemstillinger vil vaere uetiske å studere. Dette gjelder for eksempel studier av legemiddelvirkninger og bivirkninger, og sikkerhet av vaksiner hos gravide og barn. Kobling av informasjon fra nasjonale registre har vist seg svaert nyttige i studier som bidrar til slik kunnskap [1][2][3] . Alvorlig psykisk syke personer, personer med utviklingshemning, sosialt usatte grupper og eldre med funksjonsnedsettelse kan også vaere vanskelige å rekruttere til helseundersøkelser og forskningsprosjekter som forutsetter informert samtykke. I registerbasert forskning kan vi bruke informasjon som er hentet rutinemessig fra helsetjenestene og samfunnet til nasjonale registre, og kombinere opplysninger om helse og sykdom gjennom livsløpet med data om demografiske og sosioøkonomiske forhold som landbakgrunn, sivil status, familieforhold, og utdanning. Landsdekkende registre med helsedata fra fødsel til død, oversikt over familiaere relasjoner og muligheten til å bruke registerinformasjon sammen med data fra helseundersøkelser eller andre kohortstudier og tilknyttede biobanker, gir unike forskningsmuligheter 4-11 . Slike koblinger gir mulighet til å studere risikofaktorer som ikke registreres i nasjonale registre, som for eksempel genetikk, miljø-og livsstilsfaktorer, og lettere symptomer og tilstander som ikke behandles eller registreres i helsetjenestene. Mulighetene vi har i Norge gjør at vi kan bidra til å øke kunnskapsgrunnlaget internasjonalt, og de gjør at vi er attraktive samarbeidspartnere for verdensledende forskningsmiljøer. MEDISINSK FØDSELSREGISTER -ET UNIKT UTGANGPUNKTMedisinsk fødselsregister (MFR) er det eldste fødsels-registeret i verden -og vi mener det også er et av de beste i verden. Kobling av MFR med andre datakilder gir mulighet til å studere forhold knyttet til graviditet, fødsel, barsel og barn som ellers er vanskelig eller umulig. Randomis...

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Hospital contacts for endocrine disorders in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): a population-based cohort study

Cited by 74 publications

References 23 publications

Anterior Hypopituitarism in Adult Survivors of Childhood Cancers Treated With Cranial Radiotherapy: A Report From the St Jude Lifetime Cohort Study

Anterior Hypopituitarism in Adult Survivors of Childhood Cancers Treated With Cranial Radiotherapy: A Report From the St Jude Lifetime Cohort Study

Late thyroid complications in survivors of childhood acute leukemia. An L.E.A. study

Nasjonale registerkilder i epidemiologisk forskning

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