Smallpox and BCG vaccination in childhood and cutaneous malignant melanoma in Danish adults followed from 18 to 49 years

BackgroundEarly smallpox and Bacillus Calmette-Guérin (BCG) vaccinations have been associated with reduced risk of cutaneous malignant melanoma (CMM). We assessed the association between pre-school smallpox vaccination and early-school BCG vaccination and CMM in a young Danish population.MethodsWe conducted a register-based case-cohort study of individuals growing up during the phase-out period of smallpox and BCG vaccination in Denmark (born 1965–1976) utilising the decrease in vaccination during this period. Information on childhood vaccinations and potential confounders from Copenhagen school health records were linked with nationwide registers on cancer (CMM diagnoses), migrations and deaths by personal identification numbers.ResultsThe individuals were followed from age 18 until 31/12/2014 (maximum age at end of follow-up, 49 years). 188 cases of CMM occurred in the background population of 46,239 individuals; 172 CMM cases (91%) had full information and were analysed. The adjusted hazard ratio (HR) for CMM by BCG and/or smallpox vaccination compared with neither vaccine was 1.29 (95% confidence interval (CI) 0.72–2.31). For smallpox vaccination only, HR = 1.23 (95% CI 0.53–2.86) for BCG vaccination only, HR = 1.13 (95% CI 0.61–2.09) and for both smallpox and BCG vaccination, HR = 1.75 (95% CI 0.87–3.48) compared with none of these. Vaccination below the age of one year gave similar results.ConclusionsWe found no strong beneficial effect of smallpox and BCG vaccination against CMM among young adult Danes and with broad confidence intervals our data alone could be compatible with both modest preventive effects, no effects, and modest harmful effects. Our estimates do not contradict a potential modest beneficial effect of neonatal vaccination.     

Prevalence of dental caries in schoolchildren of the province of Granada (Spain)

A sample of 3,347 students between 5 and 14 years of age was selected from the entire student population in the province of Granada (Spain) to study the prevalence of dental caries and several risk factors for the disease. Decay was ascertained in the study population by mean of the following indices: df, DMF, and DMFS. Risk factors considered were the level of oral hygiene, number of between-meal sugar-containing food, and flouride concentration in drinking water. The indices mentioned showed a clear relationship to the age of the participants in the study. The level of oral hygiene did not show a clear association with dental caries measured through the df and DMF indices. Curiously, a higher correlation was noted between the disease in deciduous teeth and fluoride concentration than between the disease in permanent teeth and the latter factor.     

山东省1970-2005年恶性肿瘤死亡率变化趋势分析

目的 分析山东省1970-2005年肿瘤变化趋势.方法 分析山东省1970-1974、1985-1989、1990-1992和2004-2005年全死因回顾调查资料(除1985-1989年为山东省组织的调查外,其余3次都是全国调查资料的一部分),1985-2005年3次抽样调查点的选择依据1970-1974年资料进行评估其代表性,观察指标为死亡率和标化死亡率,采用Joinpoint回归模型分析肿瘤变化速率.结果 山东省肿瘤死亡率2005年比1970年上升了143.15%.标化率分析显示1970-1984年间年增长速率为0.54%,1985-1992年为1.24%,而1992年以后上升速率为0.18%.2004-2005年前8位主要恶性肿瘤位次为:肺癌、胃癌、肝癌、食管癌、肠癌、白血病、乳腺癌和宫颈癌,其中肺癌由第4位上升为首位,宫颈癌由第5位下降为第8位.主要恶性肿瘤中食管癌和宫颈癌呈逐年下降,胃癌呈前期上升后期下降,其余则为逐年上升趋势.城市人群肺癌和乳腺癌高于农村,而胃癌和食管癌低于农村人群.结论 35年中山东省肿瘤死亡率明显上升,主要恶性肿瘤死因谱发生了很大变化.     

Competing risk analysis of mortality from invasive cutaneous melanoma in New South Wales: a population‐based study, 1988–2007

Objective: Accurate estimates of risk of death from melanoma, based on the most recent information, are desirable, especially if secular improvements in survival have occurred. This study aims to investigate prognostic factors and temporal changes in mortality from primary invasive cutaneous melanoma (CM) and to predict cumulative probabilities of death from CM. Methods: Cases of CM from the NSW Central Cancer Registry (NSWCCR) diagnosed in 1988–2007 were analysed. We used Fine and Gray competing risks models to investigate prognostic factors associated with CM mortality, along with period effects of year of diagnosis. Adjusted cumulative probabilities of CM death were then estimated. Results: Of 52,330 CM cases, 5291 (10%) died from CM and 8290 (16%) from other causes. Patients with tumours thicker than 4 mm had 9.5 times the risk of death from CM compared to those with tumours 1 mm or less (subhazard ratio [SHR] 9.52; 95%CI:8.42–10.77). Risk of melanoma death was 31% lower in 2003–2007 compared to 1988–1992 (SHR 0.69; 95%CI: 0.63–0.76). Other risk factors for CM mortality included older age and male gender. Assuming the estimated period effect for a diagnosis in 2003–2007 applies now, the predicted probability of CM death within 10 years of diagnosis of a tumour 4+ mm thick is 26% in males and 19% in females. Conclusion: This study highlights the importance of awareness and early detection and shows a significant improvement in survival from CM since 1988.     

Trends in the use of emergency contraception: an epidemiological study in Barcelona, Spain (1994-2002)

We conducted a retrospective review of the medical records of women requesting emergency contraception (EC) at our emergency department over a 9-year period (1994-2002). EC accounted for 5.9% of all visits (n = 95,288) and increased from 1.26% in 1994 to 9.82% in 2002 (p < 0.001). Reasons for EC were condom problems in 79.5% of cases. EC was used only once by 93% of women. The mean daily number of visits was significantly higher in August (2.46), July (2.01) and September (2.02) than in other months (p < 0.05), and was more frequent on Sunday (3.26), Saturday (2.92) and Monday (2.05) compared to other week days (p < 0.001). New Year's Day and the St. John's Night registered the highest number of visits (mean of 17.2 and 11.7, respectively), with significant differences compared to the remaining days of the year (p < 0.001).