ORGAN EQUIVALENT DOSE AND LIFETIME ATTRIBUTABLE RISK OF CANCER INCIDENCE AND MORTALITY ASSOCIATED WITH CARDIAC CT ANGIOGRAPHY

2020 ◽  
Vol 189 (2) ◽  
pp. 213-223
Author(s):  
Seyed Mohammad Bagher Hosseini Nasab ◽  
Mohammad Reza Deevband ◽  
Ali Shabestani-Monfared ◽  
Seyed Ali Hoseini Amoli ◽  
Seyed Hasan Fatehi Feyzabad
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Ct Angiography ◽  
Cancer Incidence ◽  
Organ Dose ◽  
Attributable Risk ◽  
Lifetime Attributable Risk ◽  
Incidence And Mortality ◽  
Males And Females ◽  
Risk Of Cancer

Abstract The aim of this study is the calculation of equivalent organ dose and estimation of lifetime attributable risk (LAR) of cancer incidence and mortality related to cardiac computed tomography angiography (CCTA) because the use of CT angiography as a noninvasive diagnostic method has increased. The organ dose has been calculated by ImPACT software based on the volumetric CT dose index (CTDIvol), and LAR of cancer risk incidence and mortality from CCTA has estimated according to the BEIR VII report. The median value of the effective dose was 13.78 ± 6.88 mSv for both genders. In all scanners, the highest median value for LAR of cancer incidence in males and females for lung cancer was 44.20 and 109.17 per 100 000, respectively. And in infants was 5.89 and 12 for lung cancer in males and breast cancer in females, respectively. Also, the median value of LAR of all cancer incidence from single CCTA in adult patients for males and females was 122 and 238 cases, respectively. Maximum LAR of cancer mortality in adults for lung cancer was 40.28 and 91.84 and in pediatrics was 5.69 and 8.50 in males and females, respectively. Despite many benefits of CTA in the heart disease evaluation, according to a high radiation dose in CCTA, to reduce the cancer risk: CCTA should be used cautiously, especially for pediatric and females.

scholarly journals Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 614-614
Author(s):  
Suzanne Orchard ◽  
Jonathan Broder ◽  
Jessica Lockery ◽  
Peter Gibbs ◽  
Robyn Woods ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Risk ◽  
Cancer Incidence ◽  
Community Dwelling ◽  
Uncontrolled Diabetes ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Significant Difference ◽  
Risk Of Cancer ◽  
Related Mortality

Abstract Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and cancer-related mortality in older adults. ASPirin in Reducing Events in the Elderly (ASPREE) was a primary prevention trial of daily aspirin vs placebo which enrolled community-dwelling adults from Australia (70+ years) and the US (65+ years for minorities) followed for a median of 4.7 years. Invasive cancer was adjudicated by an expert panel. Cox proportional-hazards models, controlling for age at randomization and known cancer risk factors, were used to analyse the relationship between baseline metformin use, randomized treatment arm, cancer incidence (first in-trial cancer) and mortality. For participants with controlled diabetes, there was a significant reduction in cancer mortality in metformin users compared to nonusers (Adjusted [Adj] HR=0.24, 95%CI=0.07, 0.80), but not for cancer incidence (Adj HR=0.61, 95%CI=0.29, 1.27). For participants with uncontrolled diabetes, there was no significant difference in cancer incidence (Adj HR=0.95, 95%CI=0.66, 1.38) or mortality (Adj HR=1.18, 95%CI=0.62, 2.26) between metformin and non-metformin users. Uncontrolled diabetes, irrespective of metformin use, increased risk of cancer incidence and mortality compared to non-diabetics. Aspirin did not modify the effect of metformin on cancer incidence or mortality. Our findings show that metformin may have protective effects against cancer-related mortality for those older persons whose diabetes is well-controlled, and underscores the importance of diabetes control to minimise cancer risk.

A 5-Year Continued Follow-up of Cancer Risk and All-Cause Mortality Among Norwegian Military Peacekeepers Deployed to Kosovo During 1999–2016

2019 ◽  
Author(s):  
Leif Aage Strand ◽  
Jan Ivar Martinsen ◽  
Einar Kristian Borud
Keyword(s):  
Cancer Risk ◽  
Cancer Incidence ◽  
News Media ◽  
Brain Cancer ◽  
Poisson Regression ◽  
Length Of Service ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Risk Of Cancer

Abstract Introduction In 2012, Norwegian news media reported on cases of brain cancer among Norwegian peacekeeping troops who served in Kosovo, allegedly caused by exposure to depleted uranium fired during airstrikes before the peacekeepers arrived in 1999. A first study followed 6076 military men and women with peacekeeping service in Kosovo during 1999–2011 for cancers and deaths throughout 2011. The study did not support to the idea that peacekeeping service in Kosovo could lead to increased risk of brain cancer or other cancers. However, the average time of follow-up (10.6 years) was rather short for cancer development; therefore the aim of the present study was to evaluate cancer risk and general mortality in an updated cohort after 5 years of additional follow-up. Materials and Methods The updated cohort consisted of 6,159 peacekeepers (5,884 men and 275 women) who served in Kosovo during 1999–2016 and were followed for cancer incidence and mortality from all causes combined throughout 2016. We calculated standardized incidence ratios (SIR) for cancer and standardized mortality ratios (SMR) from national population rates. Poisson regression was used to assess the effect of length of service (<1 year vs. ≥1 year) on cancer risk. Results We observed 149 cancer cases and 75 deaths in the updated cohort. Observed cancer incidence did not exceed national rates. In men, the SIR for brain cancer was 0.73 (95% confidence interval (CI) 0.32–1.44), based on eight cases, while the risk of colon cancer was lowered (SIR = 0.14, 95% CI 0.00–0.79). The Poisson regression showed no effect of service duration on all-site cancer incidence. Mortality from all causes combined was lower than expected (SMR = 0.62, 95% CI 0.49–0.78) and in accordance with a “healthy soldier effect”. Conclusion The extended follow-up did not give support to the suggestion that peacekeeping service in Kosovo could lead to increased risk of cancer.

scholarly journals Cancer Risk Assessment of Patients Undergoing Computed Tomography Examination at the Korle-Bu Teaching Hospital

2018 ◽  
pp. 861-868
Author(s):  
T. A. Sackey ◽  
C. Schandorf ◽  
J. J. Fletcher ◽  
Y. B. Mensah ◽  
I. Shirazu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cancer Risk ◽  
Effective Dose ◽  
Teaching Hospital ◽  
Cancer Incidence ◽  
Attributable Risk ◽  
Cancer Risk Assessment ◽  
Dose Length Product ◽  
Effective Doses ◽  
Risk Of Cancer

The aim of this study is to estimate the effective dose and assess the lifetime attributable risk of cancer incidence of patients undergoing computed tomography scan at the Korle-Bu Teaching Hospital in the Greater Accra Region of Ghana. Data on Volume CT Dose Index ( ) and Dose Length Product ( ) displayed on the scanner control console was recorded after confirmation of the results by performing independent checks on a phantom. The effective doses were estimated using the  displayed and the anatomic region specific conversion factors ( ). The average effective dose for the head, abdomen, chest, neck, and pelvis were 3.63± 2.39mSv, 15.37±8.49 mSv, 12.72 ± 13.97 mSv, 4.04 ± 1.47 mSv and 15.8 ± 3.59 mSv respectively. Effective doses for the head and neck were within the typical range of (1-10mSv) for CT examinations whilst abdomen, chest and pelvis were above 10mSv. The average life attributable risk of cancer incidence for each region of examination were determined from the effective dose, sex and age using  the model proposed in BEIR VII Report . The average cancer risk incidence for head, neck, chest, abdomen and pelvis examinations were low in the range 1 in 10,000 to 1 in 1,000. There were wide variations in the effective dose values obtained for the same region under examination. This trend calls for the optimization of CT examination protocols to be established to ensure that patient doses are as low as reasonably achievable, economic and social factors being taken into account especially for chest examinations.

scholarly journals Estimating the current and future cancer burden in Canada: methodological framework of the Canadian population attributable risk of cancer (ComPARe) study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022378 ◽  
Author(s):  
Darren R Brenner ◽  
Abbey E Poirier ◽  
Stephen D Walter ◽  
Will D King ◽  
Eduardo L Franco ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cancer Risk ◽  
Cancer Incidence ◽  
Population Attributable Risk ◽  
Attributable Risk ◽  
Population Exposure ◽  
Cancer Society ◽  
National Network ◽  
Canadian Population ◽  
Risk Of Cancer

IntroductionThe Canadian Population Attributable Risk of Cancer project aims to quantify the number and proportion of cancer cases incident in Canada, now and projected to 2042, that could be prevented through changes in the prevalence of modifiable exposures associated with cancer. The broad risk factor categories of interest include tobacco, diet, energy imbalance, infectious diseases, hormonal therapies and environmental factors such as air pollution and residential radon.Methods and analysisUsing a national network, we will use population-attributable risks (PAR) and potential impact fractions (PIF) to model both attributable (current) and avoidable (future) cancers. The latency periods and the temporal relationships between exposures and cancer diagnoses will be accounted for in the analyses. For PAR estimates, historical exposure prevalence data and the most recent provincial and national cancer incidence data will be used. For PIF estimates, we will model alternative or ‘counterfactual’ distributions of cancer risk factor exposures to assess how cancer incidence could be reduced under different scenarios of population exposure, projecting incidence to 2042.DisseminationThe framework provided can be readily extended and applied to other populations or jurisdictions outside of Canada. An embedded knowledge translation and exchange component of this study with our Canadian Cancer Society partners will ensure that these findings are translated to cancer programmes and policies aimed at population-based cancer risk reduction strategies.

Prediction of 10-year and lifetime risk of cancer in individual patients with established cardiovascular disease, results from UCC-SMART and CANTOS

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Van 't Klooster ◽  
P.M Ridker ◽  
N.R Cook ◽  
J.G.J.V Aerts ◽  
J Westerink ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Lung Cancer ◽  
Cancer Risk ◽  
Prediction Models ◽  
Funding Source ◽  
Cancer Models ◽  
Total Cancer ◽  
The Cantos ◽  
Risk Of Cancer

Abstract Background As treatment for cardiovascular disease (CVD) has improved substantially over the last decades, more patients survive acute CVD manifestations and are at risk for developing cancer as well as recurrent CVD. Due to similar risk factors, including smoking and obesity, patients with established CVD are at higher risk for cancer. Objectives The aim of this study was to develop and externally validate prediction models for the estimation of 10-year and lifetime risk for total, colorectal, and lung cancer in patients with established CVD. Methods Data from patients with established CVD from the UCC-SMART prospective cohort study (N=7,280) were used for model development, and data from the CANTOS trial (N=9,322) were used for model validation. Predictors were selected based on previously published cancer risk prediction models or cancer risk factors, easy clinical availability, and availability in the derivation dataset (UCC-SMART cohort). A Fine and Gray competing risk-adjusted lifetime model was developed for total, colorectal, and lung cancer. Results Selected predictors were age, sex, smoking status, weight, height, alcohol use, antiplatelet use, diabetes mellitus, and C-reactive protein. External calibration for 4-year risks of the total cancer, colorectal cancer, and lung cancer models was good (Figure 1), and C-statistics were 0.63–0.74 in the CANTOS trial population. Median predicted lifetime risks in CANTOS were 26% (range 1%-52%) for total cancer, 4% (range 0%-13%) for colorectal cancer, and 5% (range 0%-37%) for lung cancer. Conclusions Lifetime and 10-year risk of cancer can be estimated with easy to measure variables in patients with established CVD, showing a wide distribution of predicted lifetime risks for total cancer and lung cancer. Using these lifetime models in clinical practice could increase understanding of cancer risk and aid in emphasizing healthy lifestyle changes. Figure 1. Calibration plots of cancer models Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Medical Center; Additional funding: CANTOS trial was funded by Novartis Pharmaceuticals.

scholarly journals Diabetes, Antidiabetic Medications and Cancer Risk in Type 2 Diabetes: Focus on SGLT-2 Inhibitors

2021 ◽  
Vol 22 (4) ◽  
pp. 1680
Author(s):  
Mariusz Dąbrowski
Keyword(s):  
Type 2 Diabetes ◽  
Cancer Risk ◽  
The European Union ◽  
Sodium Glucose Cotransporter ◽  
Incidence And Mortality ◽  
Increasing Risk ◽  
Risk Of Cancer ◽  
Diabetes And Obesity ◽  
Increased Activity

In the last decade, cancer became the leading cause of death in the population under 65 in the European Union. Diabetes is also considered as a factor increasing risk of cancer incidence and mortality. Type 2 diabetes is frequently associated with being overweight and obese, which also plays a role in malignancy. Among biological mechanisms linking diabetes and obesity with cancer hyperglycemia, hyperinsulinemia, insulin resistance, increased levels of growth factors, steroid and peptide hormones, oxidative stress and increased activity of pro-inflammatory cytokines are listed. Antidiabetic medications can modulate cancer risk through directly impacting metabolism of cancer cells as well as indirectly through impact on risk factors of malignancy. Some of them are considered beneficial (metformin and thiazolidinedions—with the exception of bladder cancer); on the other hand, excess of exogenous insulin may be potentially harmful, while other medications seem to have neutral impact on cancer risk. Inhibitors of the sodium-glucose cotransporter-2 (SGLT-2) are increasingly used in the treatment of type 2 diabetes. However, their association with cancer risk is unclear. The aim of this review was to analyze the anticancer potential of this class of drugs, as well as risks of site-specific malignancies associated with their use.

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