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  • 1
    Electronic Resource
    Electronic Resource
    Maintained bone density at advanced ages after long term treatment with low dose oestradiol implants (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate whether the bone preserving effect of low dose oestrogen replacement therapy (20 mg oestradiol implanted subcutaneously every six months) persists during continuous long term treatment through advanced ages.Design Cross sectional clinical study of postmenopausal women treated with oestradiol implants as compared with nonusers matched for age.Setting Outpatient research unit at a university hospital.Subjects Thirty-five women with a mean age of 67 years (range 47–83 years) at the time of investigation who, after a prior hysterectomy, had been treated with oestradiol implants for climacteric symptoms for a mean period of 16 years (range 5.5–31 years). The results were compared with those in women matched for age and without any diseases or medications known to affect the bone metabolism.Main outcome measures Bone mineral densities (BMD) in the distal forearm, vertebrae and hip analysed by study group, age and duration of treatment.Results Implant users had a median serum oestradiol concentration in the luteal range, 313 (range 126–1711) pmol/1, and premenopausal levels of follicle stimulating hormone (FSH). All women except one who were given the standard dose at the standard intervals had serum oestradiol levels below 650 pmol/1. Compared with nonusers, women treated with oestradiol implants had 20 to 25% higher BMD at all measurement sites: distal radius (P〈0.0001), lumbar vertebrae (P〈0.0002) and femoral neck (P〈0.0001). These differences also remained after adjustment for potential confounders (height, age at menarche, parity, smoking habits, physical exercise and education) (P〈0.01 at all sites). In a multiple regression analysis the negative effect of advancing age was more than compensated by the positive effect of increasing treatment duration with a higher BMD at all measurement sites in women with a longer as compared with shorter, duration of treatment; the regression coefficients were significant (P〈0.05) in the spine and hip measurements.Conclusions Continuous long term treatment with low dose oestradiol implants yielding physiological levels of serum oestradiol preserves both compact and cancellous bone and the effect seems to persist into advanced ages without any inevitable age related bone loss.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb15271.x
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  • 2
    Electronic Resource
    Electronic Resource
    The risk of acute myocardial infarction after oestrogen and oestrogen-progestogen replacement (1992)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine the relative risk of developing a first acute myocardial infarction after treatment with oestrogens alone or oestrogen-progestogen combinations.Design Prospective cohort study utilizing a prescription-based and record linkage System for a follow-up period from 1977 to 1983. Average individual observation time was 5–8 years.Setting The entire female population of the Uppsala Health Care Region (14 million inhabitants), one-sixth of the total Swedish population.Subjects 23 174 women aged 35 years and older, identified from pharmacy records as having been prescribed non-contraceptive oestrogens during 1977–1980.Outcomes Admissions to hospitals for first acute myocardial infarctions.Results Overall, 227 cases of a first acute myocardial infarction were observed as against 281–l expected, RR=0.81 (95% confidence limits 0.71 to 0.92). Women who were younger than 60 years at entry into the study and prescribed oestradiol com-pounds (1–2 mg) or conjugated oestrogens (0.625–1.25 mg) showed a significant 30% reduction of the relative risk (RR=0.69,0.54 to 0.86). Those prescribed a com-bined oestradiol-levonorgestrel brand also demonstrated a significantly lowered relative risk (RR=0.53, 0.30 to 0.87). The risk estimates were near unity during the first year of follow-up but decreased during subsequent years. Exposure to the weak oestrogen oestriol did not alter the risk.Conclusion Hormonal replacement therapy with oestrogens alone, and maybe also when cyclically combined with progestogens, can reduce the risk of acute myocardial infarction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb14414.x
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  • 3
    Electronic Resource
    Electronic Resource
    Fracture of the distal forearm as a forecaster of subsequent hip fracture: A population-based cohort study with 24 years of follow-up (1993)
    Springer
    Calcified tissue international 52 (1993), S. 269-272 
    Details
    ISSN: 1432-0827
    Keywords: Colles' fracture ; Hip fracture ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary Objective: To determine the long-term risk of hip fracture following fracture of the distal forearm. Design: Registry-based cohort study comparing patients with a fracture of the distal forearm with a population-based cohort. Fracture cohort: All women and men above 40 years of age with a radiologically verified fracture of the distal forearm during a 5-year period. 1968–1972, in all 1,126 women and 212 men. Control cohort: An equal number of population-based, age-and sex-matched control persons selected from a population register. Measurements: All cohort members were followed up individually through record linkage until the first hip fracture, emigration, death, or the end of 1991. The cohort members contributed a total of 40,832 person-years of observation, and altogether 365 cases of hip fractures were observed. Results: Both women and men with a fracture of the distal forearm ran an increased risk of sustaining a subsequent hip fracture. The overall relative hazard for the women was 1.54 and for men 2.27. The increased risk in the women was independent of age at inclusion, but that in the men was more pronounced in the younger age groups. Conclusions: Patients with a fracture of the distal forearm run an increased risk of sustaining a subsequent hip fracture. They therefore appear to constitute a group in which appropriate prophylactic measures against osteoporosis and fractures should be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296650
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  • 4
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    Unknown
    Symposium "sprache und pragmatik" in Lund (Schweden). 16. bis 18. Mai 1978 (1979)
    Berlin : Periodicals Archive Online (PAO)
    Zeitschrift für germanistische Linguistik. 7 (1979) 62 
    Details
    ISSN: 0301-3294
    Topics: German, Dutch and Scandinavian Studies
    Notes: BERICHTE
    URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pao:&rft_dat=xri:pao:article:r201-1979-007-00-000021
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  • 5
    Electronic Resource
    Electronic Resource
    Association of Family History and Other Risk Factors with Breast Cancer Risk (Sweden) (1998)
    Springer
    Cancer causes & control 9 (1998), S. 259-267 
    Details
    ISSN: 1573-7225
    Keywords: Breast neoplasms ; family history ; risk factors ; Sweden ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Women with a family history of breast cancer have an increased risk for the disease. However, the combined impact of family history and other risk factors on breast cancer risk is unclear. We conducted a large epidemiologic study to examine this issue. Methods. In a population-based case-control study in all of Sweden, 3,345 women aged 50 to 74 years with invasive breast cancer (84 percent of all eligible), and 3,454 controls of similar age (82 percent of all selected) were included. Mailed questionnaires and telephone interviews were used to collect detailed information on potential breast cancer risk factors. Odds ratios (OR) and 95 percent confidence intervals (CI) were estimated through multiple logistic regression. Results: Women with a history of breast cancer in any first-degree relative had an increased risk of breast cancer compared with those without such a history (OR = 1.96, CI = 1.67-2.30). There was no clear indication of a differential impact of hormonal risk factors (age at menarche, parity, age at first birth, age at menopause, use of exogenous hormones, and weight gain) or body build at age seven among women with and without a positive family history. Yet, benign breast disease and height clearly were related to breast cancer risk in subjects without a family history, whereas seemingly not so in women with a family history. Formal tests for interaction between family history and these factors, however, did not prove statistically significant. Conclusions: Our findings indicate that established risk factors entail similar associations with breast cancer risk among women with and without family history of the disease. Cancer Causes and Control 1998, 9, 259-267
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008817018942
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  • 6
    Electronic Resource
    Electronic Resource
    Risks of breast and endometrial cancer after estrogen and estrogen–progestin replacement (1999)
    Springer
    Cancer causes & control 10 (1999), S. 253-260 
    Details
    ISSN: 1573-7225
    Keywords: breast neoplasms ; cohort ; endometrial neoplasms ; estrogens ; hormone replacement therapy ; progestins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: We studied the risk of breast and endometrial cancer in a cohort of 11,231 Swedish women prescribed different replacement hormone regimens. Methods: All 10,472 women at risk of developing breast cancer and 8,438 women at risk of endometrial cancer were followed up from the time of the questionnaire in 1987–88 through 1993, by record-linkages to the National Swedish Cancer Registry. Using data from a questionnaire we analyzed the relationships between hormone exposures and cancer risk, with non-compliers and users of less than 1 year as a reference group. Results: For breast cancer, women reporting use of estrogens combined with progestins had evidence of an increased risk relative to women denying intake or taking hormones for less than 1 year; relative risk (RR) = 1.4 (95% confidence interval 0.9–2.3) after 1–6 years of intake, and RR=1.7 (95% CI 1.1–2.6) after more than 6 years. This excess risk seemed confined to recent exposure. We found no association with intake of estrogens alone using non-compliers and short-term takers as the reference group. The risk of invasive endometrial cancer was increased four-fold in women using medium-potency estrogens alone for 6 years or longer, RR = 4.2 (95% CI 2.5–8.4). Women on such long-term progestin-combined treatment had a lower, non-significant, excess risk (RR = 1.4; 95% CI 0.6–3.3). Conclusions: We conclude that long-term recent use of estrogen–progestin combined replacement therapy may increase the risk of breast cancer. Exposure to estrogen alone substantially elevates the risk of endometrial cancer, an increase that can be reduced or perhaps avoided by adding progestins.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008909128110
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  • 7
    Electronic Resource
    Electronic Resource
    Breast cancer risk and lifetime leisure-time and occupational physical activity (Sweden) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 523-531 
    Details
    ISSN: 1573-7225
    Keywords: breast neoplasm ; exercise ; leisure activities ; occupations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To clarify whether type and timing of physical activity affect postmenopausal breast cancer risk. Methods: In a population-based case–control study within the Swedish female population 50–74 years of age, 3347 women with invasive, postmenopausal breast cancer (84% of all eligible) and 3455 controls (82% of all selected) reported on past leisure-time physical activity. Record linkage to decennial census data (1960–1990) provided estimates of their occupational physical activity. Odds ratios with 95% confidence intervals were estimated by multivariate logistic regression. Results: After adjustment for potential confounders, women in sedentary occupations during their reproductive years (25–44 years of age) had a 50% higher risk for postmenopausal breast cancer, compared to those with the physically most demanding jobs. Only the most recent leisure-time physical activity was associated with a significant risk reduction. Women with the combination of sedentary jobs and lack of leisure-time exercise had a three-fold higher risk of breast cancer, compared to the physically most active both inside and outside the workplace. Conclusion: Effects of occupational and leisure-time physical activity on breast cancer risk appear to have different latency times, and/or to be effect-modified by age or reproductive status. Although chance might explain our findings, it is advisable to consider type and timing of physical activity in future studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008900512471
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  • 8
    Electronic Resource
    Electronic Resource
    Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden) (2000)
    Springer
    Cancer causes & control 11 (2000), S. 185-192 
    Details
    ISSN: 1573-7225
    Keywords: diabetes mellitus Types 1 and 2 ; endometrial neoplasms ; hypertension ; obesity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To measure the association between endometrial cancer risk and obesity at age 18 and recently, adult weight gain, diabetes mellitus and hypertension. Methods: We performed a population-based, nationwide case–control study among postmenopausal women aged 50–74 years in Sweden, including 709 incident cases with histopathologically verified endometrial cancer and 3368 controls. Results: Compared to lean women (recent body mass index (BMI), i.e. kg/m2 below 22.5), overweight women (recent BMI 28–29.99) had a 50% increase in risk for endometrial cancer (OR 1.5, 95% CI 1.0–2.1). Obese women (recent BMI 30–33.99) had a 3-fold increased risk (OR 2.9, 95% CI 2.0–4.0), and markedly obese women (recent BMI ≥ 34) a 6-fold increased risk (OR 6.3, 95% CI 4.2–9.5). The OR for Type 2 diabetes mellitus was 1.5 (95% CI 1.0–2.1) and for Type 1 diabetes mellitus it was 13.3 (3.1–56.4). The effect of recent BMI was similar for tumors having different degrees of differentiation and myometrial invasion, and did not vary with age, time since menopause, smoking status, diabetes mellitus, and use of contraceptives. Hypertension increased risk only among obese women. BMI at age 18, height, and adult weight change were not independent risk factors. Conclusions: Recent overweight/obesity and diabetes mellitus (Types 1 and 2) are associated with endometrial cancer risk. Hypertension increases risk among obese women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008946825313
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  • 9
    Electronic Resource
    Electronic Resource
    Trends in endometrial cancer incidence and mortality in Sweden, 1960–84 (1990)
    Springer
    Cancer causes & control 1 (1990), S. 201-208 
    Details
    ISSN: 1573-7225
    Keywords: Endometrial cancer ; incidence ; mortality ; trends
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Trends in incidence of and mortality from invasive endometrial cancer in Sweden in 1960–84 were analyzed. The study was based on virtually all 20,371 patients given this diagnosis and 4,887 patients who died of the disease in that period. Only minor changes occurred in age-standardized incidence in pre-menopausal women, in whom the rates declined consistently during the last 15 years, especially in the youngest age groups. Among post-menopausal women, an early increase was followed by stable rates in women over 60 and decreasing rates at ages 50–59 years. In contrast, mortality rates decreased consistently over the study period. Multivariate regression analyses indicated that birth cohort was a more important determinant of incidence and mortality than was time period. The relative risk of developing endometrial cancer increased by about 20 percent in women born around 1900 as compared with 1880, and by an additional 40 percent from the 1910 cohort to the maximum risk attained in those born around 1930. In successively younger birth cohorts, the risk markedly and continuously declined. These strong birth-cohort effects after 1910 may be reasonably explained by the change from the risk-increasing estrogen-only replacement therapy introduced in the 1960s to the less harmful use, starting about 10 years later, of combined estrogen—progestogen regimens; and further, by the protective exposure of a large proportion of pre-menopausal women to oral contraceptives. Mortality, however, decresed steadily in successive cohorts from those born in 1890, indicating that the increase in incidence was referable mainly to non-lethal cancers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00117471
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  • 10
    Electronic Resource
    Electronic Resource
    Use of oral contraceptives and endometrial cancer risk (Sweden) (1999)
    Springer
    Cancer causes & control 10 (1999), S. 277-284 
    Details
    ISSN: 1573-7225
    Keywords: combined oral contraceptives ; endometrial neoplasms ; Sweden
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To estimate the magnitude and persistence of the protective effect of use of combined oral contraceptives (COCs) and endometrial cancer risk. Methods: We performed a nation-wide, population-based case–control study among postmenopausal women aged 50–74 years in Sweden, which included 709 subjects with incident, histopathologically verified endometrial cancer, and 3,368 controls with an intact uterus. We used unconditional logistic regression to calculate odds ratios as estimates of relative risks. Results: Use of any sort of oral contraceptive decreased risk for endometrial cancer by 30%, while progestin-only pills reduced risk more markedly. For COCs the reduction in risk was noticeable following 3 or more years of use (OR 0.5, 95% CI 0.3–0.7), and increased with duration of intake, reaching 80% lower risk after 10 years of use. The protective effect of COC use was similar for all degrees of tumor differentiation and invasiveness, and remained for at least 20 years after cessation of use. Subsequent use of hormone replacement did not modify these protective effects. Conclusions: We conclude that COC use confers a long-lasting protection against endometrial cancer risk which is particularly marked for long-term users.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008945721786
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