Time trends and educational differences in the incidence of quitting smoking in Spain (1965-2000)

BACKGROUND: To analyze the pattern in the incidence of quitting smoking in Spain from 1965 to 2000 according to gender, age and educational level. METHODS: We used data from 5 Spanish National Health Interview Surveys including 33532 ever smokers>or=20 years old. We reconstructed the history of smoking and the age at smoking cessation. We calculated the biannual incidence of quitting smoking according to sex, age and educational level. We fitted joinpoint regression to identify significant changes in trends. RESULTS: The incidence of quitting smoking at ages 20-50 years has increased from 0.5% in 1965-1966 to 4.9% in 1999-2000 for males and from 1.1% in 1965-1966 to 5.0% in 1999-2000 in females. For those aged>50 years old, the incidence of quitting smoking has increased from 0.4% in 1965-1966 to 8.7% in 1999-2000 for males and from 7.9% in 1973-1974 to 8.8% in 1999-2000 in females. A level-off in cessation rates is observed both in men and women aged 20-50 years old with lower educational level in the last decade, while cessation among those with higher educational level continue to increase. CONCLUSIONS: The different pattern of smoking cessation according to gender, age, and level of education suggests that health promotion actions and tobacco control policies might have had a different effect among different population subgroups.     

Time trends in incidence of cervical cancer in Lithuania from 1983 to 1997

This report examines time trends in both age-specific and age-standardized cervical cancer (ICD9-180) incidence rates among Lithuanian women. The study covers the period from 1983 to 1997. In case of the age-specific rates Poisson regression revealed the controversial results for the different age groups. The incidence rates increased ( > 0) for the women below 50 years and decreased ( < 0) for the women above 50 years. The average annual percentage changes were estimated using the age-drift model. In the age groups from 30 to 49 years old the incidence rate increased by 3.3% per year with the 95% confidence interval (CI) being 2.2–4.4. In the age groups from 50 to 69 years old the incidence rate decreased by 2.9% (95% CI: 1.9–3.8). In case of the age-standardized rates during the last few years some increase was observed, although no strict conclusions could be drawn. This observation together with the results of the age-specific rate studies predicts that in the near future the age-standardized rate will start growing.     

Time trends in incidence of myocardial infarction in male and female dominated occupations in Stockholm, Sweden

AIMS: To investigate time trends in first acute myocardial infarction (MI) incidence in male and female dominated occupations in Stockholm during 1977-1996. METHODS: Population-based case-control study, where all first events of acute MI among participants aged 40-69 in Stockholm 1977-1996 were identified, using registers of hospital discharges and deaths. Controls were selected randomly using national population registers. There were 16,531 male and 4382 female cases and 117,015 male and 102,083 female controls. In all, 222 female cases worked in male dominated occupations and 844 male cases worked in female dominated occupations. RESULTS: Both women and men in male dominated occupations showed an elevated relative risk of first MI compared to other employees during the study period. Between 1985-1996, when there was a general decline in MI incidence in Sweden, women in male dominated occupations tended to show an increasing trend. Women in female dominated high and intermediate occupations had a lower relative risk of MI compared to other women in the same socioeconomic group. In male dominated and non-manual female dominated occupations a decline in the incidence of MI was seen during 1985-1996 in men but not in women. CONCLUSIONS: Work in male dominated occupations appears to be associated with an increased risk of MI in both genders. There is a need to investigate possible work related or other factors that may be driving this elevated risk.     

Time trends of spina bifida in Sweden 1947-81.

The spina bifida rate in Sweden from 1947 to 1981 has been studied using various sources of information, including two central computerised registers. During the period the rate approximately halved, but the decline was not smooth and occurred in three "waves." When the geographical location of high risk areas within each wave was studied, they were found to differ. The findings are discussed in the light of an environmental aetiology hypothesis of this malformation.     

Increase of colon and rectal cancer incidence rates in Japan: trends in incidence rates in Miyagi Prefecture, 1959-1997

BACKGROUND: During recent decades, colorectal cancer incidence rates have been rapidly increasing in Japan. To investigate trends in colorectal cancer incidence rates, we analyzed incidence data during 39 years between 1959 and 1997 in Miyagi Prefecture, Japan. METHODS: Using age-period-cohort models, we evaluated the effects of time period and cohort on colon and rectal cancer incidence. Model fitting was based on eleven 5-year age groups (30-34 to 80-84), eight 5-year time periods, and 18 overlapping birth cohorts of 10 years each. RESULTS: The analysis found a significant (p=0.04) and upward period effect on female colon cancer incidence, and a significant (p<0.01) and upward cohort effect on male colon cancer incidence. An upward period effect was also observed for male colon cancer incidence without significance. For rectal cancer incidence, a significant cohort effect was found among both males and females. CONCLUSIONS: In light of known risk factors of colorectal cancer, the effects of period and cohort might be related to the change in the prevalence of risk factors such as high intake of meat and animal fat, and obesity. The improved diagnostic procedures including the spread of cancer screening might be responsible for the period effect. Although the significant cohort effects may give a caution for a continuous increase of colorectal cancer incidence, the future trend may be influenced by the period-related factors. Successive monitoring of cancer incidence and prevalence of risk factors is required.     

Comparison of hip fracture incidence and trends between Germany and Austria 1995-2004: An epidemiological study

Background  

Several studies evaluated variations in hip fracture incidences, as well as trends of the hip fracture incidences. Comparisons of trends are lacking so far. We compared the incidence rates and, in particular, its trends between Austria and Germany 1995 to 2004 analysing national hospital discharge diagnosis register data.     

Cesium-137 body burdens in Norwegian Lapps, 1965-1983

Results of measurements of the whole-body contents of 137Cs during the period 1965-1983 in Lapps from the Kautokeino area in Norway are reported with measurements of 137Cs in reindeer meat during the period 1966-1983. By using available data on 137Cs in precipitation for the period 1950-1980, transfer coefficients from 137Cs in precipitation to reindeer meat have been assessed. A correlation between the 137Cs content in reindeer meat and the 137Cs content in Lapp reindeer breeders has been established. The average whole-body committed dose equivalent, H50, to the reindeer breeders from internally deposited 137Cs from intakes up to year 2000 was assessed to 13 mSv with a peak value of 30 mSv. In comparison, the corresponding committed dose equivalent to the Norwegian population from internally deposited 137Cs has been estimated to be about 1 mSv. The higher intake of 137Cs by reindeer breeders is due to the lichen-reindeer-man exposure pathway.     

Time trends and sex patterns in Hodgkin's disease incidence in Canada, 1970-1995

PURPOSE: To examine time trends and sex patterns in Hodgkin's disease incidence in Canada, from 1970 through 1995. METHOD: In addition to analyses of the secular trends and sex ratio in incidence rates, age-period-cohort models were fitted to estimate the effects on the trends. Age-specific male/female incidence rate ratios were examined for the disease and for its two major histologic subtypes. RESULTS: The overall age-adjusted incidence rate of Hodgkin's disease decreased significantly in males (3.5 per 100,000 in 1970-71 to 2.8 in 1994-95) but only slightly in females (2.4 per 100,000 to 2.3). There was a significant increase in the incidence among females aged 10-29 and among males aged 10-24, but a dramatic decrease among older ages. Age-period-cohort modelling showed that birth cohort and period effects were responsible for the observed trends in males and females, respectively. CONCLUSION: The risk factors responsible for Hodgkin's disease are different in females and males. Reproductive factors are likely to be associated with the occurrence of the disease in young women.     

Time trends in incidence rates of venous thromboembolism in a large cohort recruited from the general population

Changes in the incidence of venous thromboembolism (VTE) during the last two decades have not been extensively studied. Therefore, we studied time trends in the incidence rates (IRs) of deep vein thrombosis (DVT) and pulmonary embolism (PE) in a cohort of 26,855 subjects, aged 25–97 years, enrolled in the Tromsø study in 1994/1995. The subject were followed-up throughout 2012, and all symptomatic, objectively confirmed, incident VTEs were identified using multiple sources (hospital discharge-, radiology procedure- and autopsy registry) and validated by review of medical records. Age-adjusted biennial IR per 100,000 person years (PY) with 95% confidence intervals (CI) were calculated using Poisson regression. Between January 1996 and December 2012, 693 VTEs occurred during 368,150 PY of follow up. The IR of VTE increased from 158 (95% CI 116–199) in 1996/1997 to 201 (95% CI 160–243) in 2010/2011. There was a marked increase in the rates of PE (with/without concurrent DVT) ranging from 45 (95% CI 23–67) in 1996/1997 to 113 (95% CI 82–144) in 2010/2011, whereas the rates of isolated DVT decreased (112, 95% CI 77–146 in 1996/1997 and 88, 95% CI 61–115 in 2010/2011). Despite advances in prophylaxis, the IR of VTE has increased slightly during the last 15 years, mainly due to an increase in PE. Although the introduction of better diagnostic tools to some extent may explain the increase in PE rates, our findings suggest that there is still a need for improvement in risk factor management and prevention strategies of first time VTE.     

Effect of birth cohort on risk of hip fracture: age-specific incidence rates in the Framingham Study

OBJECTIVES: This study examined the effect of birth cohort on incidence rates of hip fracture among women and men in the Framingham Study. METHODS: Age-specific incidence rates of first hip fracture were presented according to tertile of year of birth for 5209 participants of the Framingham Study, a population-based cohort followed since 1948. Sex-specific incidence rate ratios were calculated by Cox regression to assess the relation between birth cohort and hip fracture incidence. RESULTS: An increasing trend in hip fracture incidence rates was observed with year of birth for women (trend, P =.05) and men (trend, P =.03). Relative to those born from 1887 to 1900 (incidence rate ratio [IRR] = 1.0), age-specific incidence rates were greatest in the most recent birth cohort, born from 1911 to 1921 (IRR = 1.4 for women, IRR = 2.0 for men), and intermediate in those born from 1901 to 1910 (IRR = 1.2 for women, IRR = 1.5 for men). CONCLUSIONS: Results suggest risk of hip fracture is increasing for successive birth cohorts. Projections that fail to account for the increase in rates associated with birth cohort underestimate the future public health impact of hip fracture in the United States.     

Time trends in death rates from homicides in the city of Sao Paulo, Brazil, 1979-1994

To study homicide trends by gender and age, 1979-1994, S?o Paulo, Brazil, cubic polynomials were used to determine the best model for adjusting to time trends in homicide mortality rates by age and gender in the city of S?o Paulo, Brazil, 1979-1994. The model best adjusted to each group was selected considering the regression coefficient (Beta) , R2 value, residual analysis, and model's simplicity. The results show linear growth for total rates and rates by gender due to behavior of rates in the 20-29 and 30-39 year age groups. The reciprocal model adjusted best to rates for the 40-49 and 50-59 year age groups, while rates for adolescents followed the multiplicative model. There was no significant relationship between homicide rates and time for the remaining groups (under 10 and over 59 years). Rates for males were considerably higher in all age groups. The remarkably steady growth in homicide rates among adolescents and young adults is consistent with trends observed in other urban areas in developing and developed countries and denotes deteriorating living conditions and increased poverty.     

A comparison of acquired immunodeficiency syndrome and Kaposi''s sarcoma incidence rates, Atlanta, 1983-86.

Recent temporal trends in incidence rates for acquired immunodeficiency syndrome (AIDS) and Kaposi's sarcoma were compared in metropolitan Atlanta, Georgia. From 1983 through 1986 the age-adjusted incidence rate of Kaposi's sarcoma among White males ages 25-49 increased 11-fold (2.2-24.4/100,000 person years). The annual incidence rate of AIDS increased ten-fold (11.3-113.3/100,000). These findings do not support earlier reports that the proportion of AIDS patients with Kaposi's sarcoma has decreased over time.     

Time trends in cancer incidence in Navarra and Zaragoza, spain

BACKGROUND AND OBJECTIVES: The knowledge of time-related changes occurring in cancer incidence and mortality is an essential element for cancer control. This paper aims to describe the time trends of the more important cancer sites in Navarra and Zaragoza. METHODS: The influence of age, diagnosis period and birth cohort on the observed time trend cancer incidence in Navarre and Zaragoza was assessed using a log-linear model. Results are showed graphically, for the different tumour sites by sex and each registry. RESULTS: Among males, a considerable rise in the incidence of lung cancer (5% per year), prostate cancer (> 2% per year) and non-Hodgkin's lymphomas was found. Among females, the highest increases corresponded to non-Hodgkin's lymphomas, with a yearly rise greater than 7%, and ovarian cancer (4% per year). Breast cancer in women increased in both registries (3.5% per year in Navarre and 0.9% per year in Zaragoza), part of the increment in Navarra being explained by a higher case detection rate. Finally, the incidence of colorectal, bladder and kidney cancer rose more than a 3% per year in both registries and sexes. For most types of tumours, cancer risk increased with subsequent generations. CONCLUSION: The substantial cancer increment observed points out the inefficacy of primary prevention policies, the importance of studying cancer incidence for long time periods and the need to increase the population coverage of Spanish cancer registries.     

Time trends in the incidence of myocardial infarction among professional drivers in Stockholm 1977-96

Aims: To investigate time trends in the incidence of first myocardial infarction (MI) among bus, taxi, and lorry drivers in Stockholm.

Methods: In this population based case-control study, all first events of acute MI among men aged 40–69 in Stockholm County 1977–96 were identified using registers of hospital discharges and deaths. Controls were selected randomly from the general population. National censuses were used for information on occupational titles. A total of 20 364 cases and 136 342 controls were included in the study. Among these, 1183 cases and 6072 controls had worked as drivers.

Results: During 1977–84 the MI incidence was higher in all three driver groups than among other manual workers. There was a decline in MI incidence among drivers as well as in the general population during the study period. The decline was greater among drivers than among other manual workers. During 1985–96 the relative risk remained increased compared to other manual workers among taxi and lorry drivers, but not among bus drivers.

Conclusions: Despite a reduced MI incidence for professional drivers in recent years, preventive measures to reduce the risk of MI in these occupational groups, and in particular among taxi and lorry drivers, continue to be of importance.

     

Evaluation of screening for cervical cancer in Sweden: trends in incidence and mortality 1958-1980

Papanicolaou screening for cancer of the uterine cervix was introduced in Sweden in the late 1950's. Screening programmes covering the age groups 30-49 years were organized in various countries between 1965 and 1973. The approximate number of smears rose from 100 000 in 1960 to one million in 1970, in a female population of four million. Almost 60 000 cases of in situ carcinoma and 17 100 invasive carcinomas of the uterine cervix were registered in Sweden between 1958 and 1980. The age-standardized incidence of invasive carcinoma fell in this period by about 40%. Within the screened cohorts and age groups, the incidence was reduced by two-thirds and there was a parallel fall in mortality from the disease. At least part of these reductions seemed to be explained by the intensity of screening.     

Time trends in burdens of cadmium, lead, and mercury in the population of northern Sweden

The time trends of exposure to heavy metals are not adequately known. This is a worldwide problem with regard to the basis for preventive actions and evaluation of their effects. This study addresses time trends for the three toxic elements cadmium (Cd), mercury (Hg), and lead (Pb). Concentrations in erythrocytes (Ery) were determined in a subsample of the population-based MONICA surveys from 1990, 1994, and 1999 in a total of 600 men and women aged 25-74 years. The study took place in the two northernmost counties in Sweden. To assess the effect of changes in the environment, adjustments were made for life-style factors that are determinants of exposure. Annual decreases of 5-6% were seen for Ery-Pb levels (adjusted for age and changes in alcohol intake) and Ery-Hg levels (adjusted for age and changes in fish intake). Ery-Cd levels (adjusted for age) showed a similar significant decrease in smoking men. It is concluded that for Pb and maybe also Hg the actions against pollution during recent decades have caused a rapid decrease of exposure; for Hg the decreased use of dental amalgam may also have had an influence. For Cd, the decline in Ery-Cd was seen only in smokers, indicating that Cd exposure from tobacco has decreased, while other environmental sources of Cd have not changed significantly. To further improve the health status in Sweden, it is important to decrease the pollution of Cd, and actions against smoking in the community are important.