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  • 1.
    Abbas, Hassan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Huzeirovic, Melisa
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    En jämförelse mellan två sjukdomsgrupper med PET/CT som undersökningsmetod: Beräkning av den totala effektiva dosen från PET- och CT-undersökning2019Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Background: Lung cancer and malignant melanoma are diseases investigated by the dual-modality positron emission tomography/computed tomography (PET/CT). There are radiation risks with the examination that can appear as stochastic effects such as cancer. The aim of this study was to compare the radiation doses between the lung cancer group (suspected or verified) and the malignant melanoma group by calculating the total effective radiation dose and to declare the risk with the PET/CT examination. Material and method: The material contained parameters regarding the examination and the sample contained 20 patients from the two groups. The method was retrospective with a quantitative approach. Results: There was a significant difference (p <0,001) between these two groups, were the lung cancer group received 11,95 milliSievert (mSv) and the malignant melanoma group 6,03 mSv and the percentage risk for lethal cancer increased by 0,06% and 0,03%, respectively. Conclusions: The lung cancer group received twice as much effective dose than the malignant melanoma group. However, the effective dose is so low that the risk increase of the lethal cancer is marginal, and the benefit of the examination outweighs the risks.

  • 2. Antoniou, A. C.
    et al.
    Beesley, J.
    McGuffog, L.
    Sinilnikova, O. M.
    Healey, S.
    Neuhausen, S. L.
    Ding, Y. C.
    Rebbeck, T. R.
    Weitzel, J. N.
    Lynch, H. T.
    Isaacs, C.
    Ganz, P. A.
    Tomlinson, G.
    Olopade, O. I.
    Couch, F. J.
    Wang, X.
    Lindor, N. M.
    Pankratz, V. S.
    Radice, P.
    Manoukian, S.
    Peissel, B.
    Zaffaroni, D.
    Barile, M.
    Viel, A.
    Allavena, A.
    Dall'Olio, V.
    Peterlongo, P.
    Szabo, C. I.
    Zikan, M.
    Claes, K.
    Poppe, B.
    Foretova, L.
    Mai, P. L.
    Greene, M. H.
    Rennert, G.
    Lejbkowicz, F.
    Glendon, G.
    Ozcelik, H.
    Andrulis, I. L.
    Thomassen, M.
    Gerdes, A. -M
    Sunde, L.
    Cruger, D.
    Jensen, U. B.
    Caligo, M.
    Friedman, E.
    Kaufman, B.
    Laitman, Y.
    Milgrom, R.
    Dubrovsky, M.
    Cohen, S.
    Borg, A.
    Jernström, H.
    Lindblom, A.
    Rantala, J.
    Stenmark-Askmalm, M.
    Melin, B.
    Nathanson, K.
    Domchek, S.
    Jakubowska, A.
    Lubinski, J.
    Huzarski, T.
    Osorio, A.
    Lasa, A.
    Durán, M.
    Tejada, M. -I
    Godino, J.
    Benitez, J.
    Hamann, U.
    Kriege, M.
    Hoogerbrugge, N.
    Van Der Luijt, R. B.
    Van Asperen, C. J.
    Devilee, P.
    Meijers-Heijboer, E. J.
    Blok, M. J.
    Aalfs, C. M.
    Hogervorst, F.
    Rookus, M.
    Cook, M.
    Oliver, C.
    Frost, D.
    Conroy, D.
    Evans, D. G.
    Lalloo, F.
    Pichert, G.
    Davidson, R.
    Cole, T.
    Cook, J.
    Paterson, J.
    Hodgson, S.
    Morrison, P. J.
    Porteous, M. E.
    Walker, L.
    Kennedy, M. J.
    Dorkins, H.
    Peock, S.
    Godwin, A. K.
    Stoppa-Lyonnet, D.
    De Pauw, A.
    Mazoyer, S.
    Bonadona, V.
    Lasset, C.
    Dreyfus, H.
    Leroux, D.
    Hardouin, A.
    Berthet, P.
    Faivre, L.
    Loustalot, C.
    Noguchi, T.
    Sobol, H.
    Rouleau, E.
    Nogues, C.
    Frénay, M.
    Vénat-Bouvet, L.
    Hopper, J. L.
    Daly, M. B.
    Terry, M. B.
    John, E. M.
    Buys, S. S.
    Yassin, Y.
    Miron, A.
    Goldgar, D.
    Singer, C. F.
    Dressler, A. C.
    Gschwantler-Kaulich, D.
    Pfeiler, G.
    Hansen, T. V. O.
    Jnson, L.
    Agnarsson, B. A.
    Kirchhoff, T.
    Offit, K.
    Devlin, V.
    Dutra-Clarke, A.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E.
    Tihomirova, L.
    Blanco, I.
    Lazaro, C.
    Ramus, S. J.
    Sucheston, L.
    Karlan, B. Y.
    Gross, J.
    Schmutzler, R.
    Wappenschmidt, B.
    Engel, C.
    Meindl, A.
    Lochmann, M.
    Arnold, N.
    Heidemann, S.
    Varon-Mateeva, R.
    Niederacher, D.
    Sutter, C.
    Deissler, H.
    Gadzicki, D.
    Preisler-Adams, S.
    Kast, K.
    Schönbuchner, I.
    Caldes, T.
    De La Hoya, M.
    Aittomäki, K.
    Nevanlinna, H.
    Simard, J.
    Spurdle, A. B.
    Holland, H.
    Chen, X.
    Platte, R.
    Chenevix-Trench, G.
    Easton, D. F.
    Common breast cancer susceptibility alleles and the risk of breast cancer for BRCA1 and BRCA2 mutation carriers: Implications for risk prediction2010In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 70, no 23, p. 9742-9754Article in journal (Refereed)
    Abstract [en]

    The known breast cancer susceptibility polymorphisms in FGFR2, TNRC9/TOX3, MAP3K1, LSP1, and 2q35 confer increased risks of breast cancer for BRCA1 or BRCA2 mutation carriers. We evaluated the associations of 3 additional single nucleotide polymorphisms (SNPs), rs4973768 in SLC4A7/NEK10, rs6504950 in STXBP4/COX11, and rs10941679 at 5p12, and reanalyzed the previous associations using additional carriers in a sample of 12,525 BRCA1 and 7,409 BRCA2 carriers. Additionally, we investigated potential interactions between SNPs and assessed the implications for risk prediction. The minor alleles of rs4973768 and rs10941679 were associated with increased breast cancer risk for BRCA2 carriers (per-allele HR = 1.10, 95% CI: 1.03-1.18, P = 0.006 and HR = 1.09, 95% CI: 1.01-1.19, P = 0.03, respectively). Neither SNP was associated with breast cancer risk for BRCA1 carriers, and rs6504950 was not associated with breast cancer for either BRCA1 or BRCA2 carriers. Of the 9 polymorphisms investigated, 7 were associated with breast cancer for BRCA2 carriers (FGFR2, TOX3, MAP3K1, LSP1, 2q35, SLC4A7, 5p12, P = 7 × 10-11 - 0.03), but only TOX3 and 2q35 were associated with the risk for BRCA1 carriers (P = 0.0049, 0.03, respectively). All risk-associated polymorphisms appear to interact multiplicatively on breast cancer risk for mutation carriers. Based on the joint genotype distribution of the 7 risk-associated SNPs in BRCA2 mutation carriers, the 5% of BRCA2 carriers at highest risk (i.e., between 95th and 100th percentiles) were predicted to have a probability between 80% and 96% of developing breast cancer by age 80, compared with 42% to 50% for the 5% of carriers at lowest risk. Our findings indicated that these risk differences might be sufficient to influence the clinical management of mutation carriers.

  • 3. Antoniou, A. C.
    et al.
    Sinilnikova, O. M.
    McGuffog, L.
    Healey, S.
    Nevanlinna, H.
    Heikkinen, T.
    Simard, J.
    Spurdle, A. B.
    Beesley, J.
    Chen, X.
    Neuhausen, S. L.
    Ding, Y. C.
    Couch, F. J.
    Wang, X.
    Fredericksen, Z.
    Peterlongo, P.
    Peissel, B.
    Bonanni, B.
    Viel, A.
    Bernard, L.
    Radice, P.
    Szabo, C. I.
    Foretova, L.
    Zikan, M.
    Claes, K.
    Greene, M. H.
    Mai, P. L.
    Rennert, G.
    Lejbkowicz, F.
    Andrulis, I. L.
    Ozcelik, H.
    Glendon, G.
    Gerdes, A. -M
    Thomassen, M.
    Sunde, L.
    Caligo, M. A.
    Laitman, Y.
    Kontorovich, T.
    Cohen, S.
    Kaufman, B.
    Dagan, E.
    Baruch, R. G.
    Friedman, E.
    Harbst, K.
    Barbany-Bustinza, G.
    Rantala, J.
    Ehrencrona, H.
    Karlsson, P.
    Domchek, S. M.
    Nathanson, K. L.
    Osorio, A.
    Blanco, I.
    Lasa, A.
    Benítez, J.
    Hamann, U.
    Hogervorst, F. B. L.
    Rookus, M. A.
    Collee, J. M.
    Devilee, P.
    Ligtenberg, M. J.
    van der Luijt, R. B.
    Aalfs, C. M.
    Waisfisz, Q.
    Wijnen, J.
    van Roozendaal, C. E. P.
    Peock, S.
    Cook, M.
    Frost, D.
    Oliver, C.
    Platte, R.
    Evans, D. G.
    Lalloo, F.
    Eeles, R.
    Izatt, L.
    Davidson, R.
    Chu, C.
    Eccles, D.
    Cole, T.
    Hodgson, S.
    Godwin, A. K.
    Stoppa-Lyonnet, D.
    Buecher, B.
    Léoné, M.
    Bressac-de Paillerets, B.
    Remenieras, A.
    Caron, O.
    Lenoir, G. M.
    Sevenet, N.
    Longy, M.
    Ferrer, S. F.
    Prieur, F.
    Goldgar, D.
    Miron, A.
    John, E. M.
    Buys, S. S.
    Daly, M. B.
    Hopper, J. L.
    Terry, M. B.
    Yassin, Y.
    Singer, C.
    Gschwantler-Kaulich, D.
    Staudigl, C.
    Hansen, T. V. O.
    Barkardottir, R. B.
    Kirchhoff, T.
    Pal, P.
    Kosarin, K.
    Offit, K.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E. N.
    Allavena, A.
    Schmutzler, R. K.
    Versmold, B.
    Engel, C.
    Meindl, A.
    Ditsch, N.
    Arnold, N.
    Niederacher, D.
    Deißler, H.
    Fiebig, B.
    Suttner, C.
    Schönbuchner, I.
    Gadzicki, D.
    Caldes, T.
    de la Hoya, M.
    Pooley, K. A.
    Easton, D. F.
    Chenevix-Trench, G.
    Common variants in LSP1, 2q35 and 8q24 and breast cancer risk for BRCA1 and BRCA2 mutation carriers2009In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 18, no 22, p. 4442-4456Article in journal (Refereed)
    Abstract [en]

    Genome-wide association studies of breast cancer have identified multiple single nucleotide polymorphisms (SNPs) that are associated with increased breast cancer risks in the general population. In a previous study, we demonstrated that the minor alleles at three of these SNPs, in FGFR2, TNRC9 and MAP3K1, also confer increased risks of breast cancer for BRCA1 or BRCA2 mutation carriers. Three additional SNPs rs3817198 at LSP1, rs13387042 at 2q35 and rs13281615 at 8q24 have since been reported to be associated with breast cancer in the general population, and in this study we evaluated their association with breast cancer risk in 9442 BRCA1 and 5665 BRCA2 mutation carriers from 33 study centres. The minor allele of rs3817198 was associated with increased breast cancer risk only for BRCA2 mutation carriers [hazard ratio (HR) = 1.16, 95% CI: 1.07-1.25, P-trend = 2.8 × 10-4]. The best fit for the association of SNP rs13387042 at 2q35 with breast cancer risk was a dominant model for both BRCA1 and BRCA2 mutation carriers (BRCA1: HR = 1.14, 95% CI: 1.04-1.25, P = 0.0047; BRCA2: HR = 1.18 95% CI: 1.04-1.33, P = 0.0079). SNP rs13281615 at 8q24 was not associated with breast cancer for either BRCA1 or BRCA2 mutation carriers, but the estimated association for BRCA2 mutation carriers (per-allele HR = 1.06, 95% CI: 0.98-1.14) was consistent with odds ratio estimates derived from population-based case-control studies. The LSP1 and 2q35 SNPs appear to interact multiplicatively on breast cancer risk for BRCA2 mutation carriers. There was no evidence that the associations vary by mutation type depending on whether the mutated protein is predicted to be stable or not. 

  • 4.
    Bergman, Annika
    Department of Medical and Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    On the genetics of hereditary breast/ovarian cancer: BRCA1, BRCA2 and beyond2006Doctoral thesis, comprehensive summary (Other academic)
  • 5.
    Bergman, Annika
    et al.
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Flodin, Anna
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Engwall, Yvonne
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Arkblad, Eva L.
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Berg, Kerstin
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Einbeigi, Zakaria
    Oncology, Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital/östra, Göteborg, Sweden.
    Martinsson, Tommy
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Wahlström, Jan
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    Karlsson, Per
    Oncology, Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital/östra, Göteborg, Sweden.
    Nordling, Margareta
    Department of Clinical Genetics, Göteborg University, Göteborg, Sweden.
    A high frequency of germline BRCA1/2 mutations in western Sweden detected with complementary screening techniques2005In: Familial Cancer, ISSN 1389-9600, E-ISSN 1573-7292, Vol. 4, no 2, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Dominant inheritance is presumed in 6-10% of breast and ovarian cancers. Mutations in BRCA1 and BRCA2 genes are the most commonly identified causative genes in such families. The frequency of mutation carriers with breast/ovarian cancer depends on the population studied, and display considerable variation that coincides with ethnic and geographical diversity. Mutation analyses were performed in 143 families registered at the Cancer Genetic Counseling Clinic of western Sweden. In a thorough mutation screening procedure, the entire BRCA1 and BRCA2 genes were analyzed using a combination of complementary mutation detection techniques. Mutations in either BRCA1 or BRCA2 were detected in 36% (52 out of 143) of all screened families. All families were clinically evaluated regarding age at diagnosis, type of cancer and number of cancer cases in the family. Among high-risk families, the mutation detection rate was 39% (46 out of 117). The detection rate observed among families with cases of ovarian cancer (42 out of 62, 68%), was substantially higher than in families with only breast cancer (10 out of 81, 12%). Age at ovarian cancer did not seem to have an effect on the detection rate. The analyses revealed 11 frameshift mutations, 4 nonsense mutations and 2 large deletions. Notably, the BRCA1 c.3171ins5 mutation accounted for 34 of 52 (65%) identified mutations. Seven mutations are novel: BRCA1c.409_410del; c.1912T>G; c.2228_2229del; c.3029delA; c.3433delA, a large deletion covering exons 1-3 of BRCA1and one BRCA2 mutation; BRCA2c.6287_6290del. We have shown that the founder mutation BRCA1 c.3171ins5 has a great influence on western Swedish breast/ovarian cancer families along with a high number of mutations unique for the region. In order to achieve a high mutation detection rate we suggest a combination of several detection techniques. 

  • 6.
    Bergman, Annika
    et al.
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Karlsson, Per
    Department of Oncology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Berggren, Jonna
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Martinsson, Tommy
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Björck, Karin
    Swegene Bioinformatics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Nilsson, Staffan
    Swegene Bioinformatics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Wahlström, Jan
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Wallgren, Arne
    Department of Oncology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Nordling, Margareta
    Department of Clinical Genetics, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Genome-wide linkage scan for breast cancer susceptibility loci in Swedish hereditary non-BRCA1/2 families: Suggestive linkage to 10q23.32-q25.32007In: Genes, Chromosomes and Cancer, ISSN 1045-2257, E-ISSN 1098-2264, Vol. 46, no 3, p. 302-309Article in journal (Refereed)
    Abstract [en]

    The two breast cancer genes BRCA1 and BRCA2 were identified more than 10 years ago and, depending on population, mutations in these genes are responsible for a varying percentage of familial breast cancer. In more than half the families, the increased risk of breast cancer cannot be explained by mutations in these genes, and the goal of this study was to locate novel susceptibility genes. One of the main difficulties in identifying the cause of hereditary non-BRCA1/BRCA2 breast cancer is genetic heterogeneity, possibly due to multiple, incompletely penetrant susceptibility genes, along with ethnic and geographic differences. In this study, one large family and 13 small to medium-sized families with multiple cases of breast cancer were analyzed by genome-wide linkage analysis. The genome scan was performed by genotype analysis of 10,000 SNP markers on microarrays. The strongest evidence of linkage (HLOD 2.34) was obtained on chromosome region 10q23.32-q25.3. A further two regions were identified, with LOD scores above 2.10 on 12q14-q21 and 19p13.3-q12. In a subset of families of western Swedish origin, two regions generated LOD scores exceeding 1.8: 10q23.32-q25.3 and 19q13.12-q13.32. The large family in the study exceeded LOD 1.5 in three regions: 10q23.32-q25.3, 19q13.12-q13.32, and 17p13. Our results indicate that one or more of the suggested regions may harbor genes that are involved in the development of breast cancer. 

  • 7.
    Bergman, Annika
    et al.
    Lundberg Laboratory for Cancer Research, Department of Pathology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Sahlin, Pelle
    Department of Plastic Surgery, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Emanuelsson, Monica
    Oncology Center, Umeå University Hospital, Umeå, Sweden.
    Carén, Helena
    Department of Clinical Genetics, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Tarnow, Peter
    Department of Plastic Surgery, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Martinsson, Tommy
    Department of Clinical Genetics, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Grönberg, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Stenman, Göran
    Lundberg Laboratory for Cancer Research, Department of Pathology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
    Germline mutation screening of the Saethre-Chotzen-associated genes TWIST1 and FGFR3 in families with BRCA1/2-negative breast cancer2009In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 0284-4311, E-ISSN 1651-2073, Vol. 43, no 5, p. 251-255Article in journal (Refereed)
    Abstract [en]

    Saethre-Chotzen syndrome is one of the most common craniosynostosis syndromes. It is an autosomal dominantly inherited disorder with variable expression that is caused by germline mutations in the TWIST1 gene or more rarely in the FGFR2 or FGFR3 genes. We have previously reported that patients with Saethre-Chotzen syndrome have an increased risk of developing breast cancer. Here we have analysed a cohort of 26 women with BRCA1/2-negative hereditary breast cancer to study whether a proportion of these families might have mutations in Saethre-Chotzen-associated genes. DNA sequence analysis of TWIST1 showed no pathogenic mutations in the coding sequence in any of the 26 patients. MLPA (multiplex ligation-dependent probe amplification)-analysis also showed no alterations in copy numbers in any of the craniofacial disorder genes MSX2, ALX4, RUNX2, EFNB1, TWIST1, FGFR1, FGFR2,FGFR3, or FGFR4. Taken together, our findings indicate that mutations in Saethre-Chotzen-associated genes are uncommon or absent in BRCA1/2-negative patients with hereditary breast cancer.

  • 8.
    Browall, Maria
    et al.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Oncology, Division of Selected Clinical Specialties, Sahlgrenska University Hospital, Göteborg, Sweden.
    Ahlberg, Karin
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Karlsson, Per
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Oncology, Southern Älvsborg Hospital, Borås, Sweden.
    Danielson, Ella
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Health Science, Mid Sweden University, Östersund, Sweden.
    Persson, Lars-Olof
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Gaston-Johansson, Fannie
    School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
    Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women2008In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, no 3, p. 180-189Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (>= 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.

  • 9.
    Browall, Maria
    et al.
    Department of Oncology, Sahlgrenska University Hospital, Gothenburg 413 45, Sweden.
    Carlsson, Maria
    Department of Public Health and Caring Sciences, Döbelnsgatan 2, Uppsala 752 37, Sweden.
    Horvath, György
    Department of Oncology, Sahlgrenska University Hospital, Gothenburg 413 45, Sweden.
    Information needs of women with recently diagnosed ovarian cancer - A longitudinal study2004In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 8, no 3, p. 200-207Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the information needs among patients with ovarian cancer and whether these information needs change over time. The information needs were evaluated three times, through structured interviews, and were based on the paired comparison approach developed by Degner and colleagues. A consecutive sample of patients (n=82) with recently diagnosed ovarian cancer was asked to participate.Sixty-four patients (78%) chose to participate. The three different measurements of participants' information needs revealed only small changes in these needs. The three most important information needs, in all measurements, were information about the likelihood of cure, information about the stage and spreading of the disease, and information about different treatment options. Information regarding sexual attractiveness was the lowest ranked item in all measurements. Regarding subgroups (age, education) the only significant difference throughout all measurements was that younger patients rated issues of sexual attractiveness higher than older patients (p=0.005).In this longitudinal study patients with ovarian cancer ranked information about the disease and its treatment (i.e. likelihood of cure, stage of disease, and treatment options) highest, and information about psychosocial aspects and self-care lowest. These findings are in accordance with the results from studies of women diagnosed with other types of cancer, which used the same methodology. © 2004 Elsevier Ltd. All rights reserved.

  • 10.
    Browall, Maria
    et al.
    Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg, Sweden / Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, SE 405 30 Göteborg, Sweden.
    Gaston-Johansson, Fannie
    Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg, Sweden / Johns Hopkins University, School of Nursing, Baltimore, MD, United States.
    Danielson, Ella
    Sahlgrenska Academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Göteborg, Sweden.
    Postmenopausal women with breast cancer: Their experiences of the chemotherapy treatment period2006In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 29, no 1, p. 34-42Article in journal (Refereed)
    Abstract [en]

    This article illustrates the experience of 20 postmenopausal women with breast cancer who had received chemotherapy treatment. The interviews were of narrative nature and analyzed with content analysis. Four themes, including 12 subthemes, described these women's life during treatment as a journey from the negative experiences of fear of the unknown, affects on body and mind, to the more positive to get by, and a transformed life. The treatment was compared with an assault on the body, and the loss of their hair was experienced more negatively than the loss of a breast. The women described a feeling of imbalance in their relationships due to lack of support from those close to them. The support from healthcare professionals was experienced both positively and negatively, and many of the women revealed variation in the professional's attitude, knowledge, and empathy. The women who chose not to work during the treatment felt pressure from society and healthcare professionals to get back to work as soon as possible. For many, especially those in a leading position, this was experienced as very difficult. The women expressed a feeling of not being afraid of dying but wanted more time to prepare themselves.

  • 11.
    Browall, Maria M.
    et al.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Ahlberg, Karin M.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden / Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Persson, Lars-Olof G.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Karlsson, Per O.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden / Department of Oncology, Southern Älvsborg Hospital, Borås, Sweden.
    Danielson, Ella B.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    The impact of age on Health-Related Quality of Life (HRQoL) and symptoms among postmenopausal women with breast cancer receiving adjuvant chemotherapy2008In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 47, no 2, p. 207-215Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Elderly women with breast cancer are often not given adjuvant chemotherapy (CT). One reason for this is that older women are believed to have more problems in tolerating side-effects of CT. The purpose of this study was to analyze the impact of age on health related quality of life (HRQoL) and symptoms in postmenopausal women with breast cancer undergoing adjuvant CT.

    Patients and methods: Eighty consecutive postmenopausal patients planned for CT were invited. Seventy-five agreed to participate (age 55-77 years). The patients completed two cancer-specific HRQoL questionnaires, The European Organisation for Research and Treatment of cancer (EORTC) EORTC-QLQ-C30, the EORTC-QLQ-BR23, and the Hospital Anxiety and Depression Scale (HADS) before, during, and 4 months after completion of treatment. The design was descriptional and longitudinal. Correlations were examined between age and change in HRQoL variables.

    Results: No significant correlations were found between age and any of the assessed HRQoL domains or symptom scales, except for dyspnoea and sexual functioning. Age was inversely correlated to change in dyspnoea from baseline through follow-up, whereas older women perceived their sexual functioning significantly lower at baseline.

    Conclusion: The results indicate that among postmenopausal patients in the age range 55-77 years consecutively selected for adjuvant CT age was not a predictor of decreased HRQoL. This supports the argument that age should not be used in isolation in decisions about adjuvant CT for breast cancer in elderly women.

  • 12.
    Browall, Maria
    et al.
    Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Persson, L. -O
    Ahlberg, K.
    Karlsson, P.
    Danielson, E.
    Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy: Original article2009In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 18, no 5, p. 507-516Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy. 

  • 13. Chenevix-Trench, G.
    et al.
    Milne, R. L.
    Antoniou, A. C.
    Couch, F. J.
    Easton, D. F.
    Goldgar, D. E.
    An international initiative to identify genetic modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: The Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA)2007In: Breast Cancer Research, ISSN 1465-5411, E-ISSN 1465-542X, Vol. 9, no 2, article id 104Article in journal (Other academic)
    Abstract [en]

    BRCA1 and BRCA2 mutations exhibit variable penetrance that is likely to be accounted for, in part, by other genetic factors among carriers. However, studies aimed at identifying these factors have been limited in size and statistical power, and have yet to identify any convincingly validated modifiers of the BRCA1 and BRCA2 phenotype. To generate sufficient statistical power to identify modifier genes, the Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA) has been established. CIMBA contains about 30 affiliated groups who together have collected DNA and clinical data from approximately 10,000 BRCA1 and 5,000 BRCA2 utation carriers. Initial efforts by CIMBA to identify modifiers of breast cancer risk for BRCA1 and BRCA2 mutation carriers have focused on validation of common genetic variants previously associated with risk in smaller studies of carriers or unselected breast cancers. Future studies will involve replication of findings from pathway-based and genome-wide association studies in both unselected and familial breast cancer. The identification of genetic modifiers of breast cancer risk for BRCA1 and BRCA2 mutation carriers will lead to an improved understanding of breast cancer and may prove useful for the determination of individualized risk of cancer amongst carriers. 

  • 14.
    Darcy, Laura
    et al.
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Björk, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Young children's experiences of living an everyday life with cancer – A three year interview study2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Purpose

    The young child's experiences of living with cancer are crucial to providing evidence based care. This study explores and describes experiences of everyday life of young children with cancer, over a three year period from diagnosis.

    Method

    This is a longitudinal, inductive interview study with young children with cancer, and their parents. Interviews from shortly after diagnosis, six and 12 months after diagnosis have been reanalysed. Interviews with the same children and their parents from 18 to 36 months after diagnosis have been analysed for the first time in the present paper. A longitudinal temporal analysis at category level for five synchronic data sets forms the basis for the results.

    Results

    The child living with cancer over a three year period is described as a child apart, striving to live an everyday life. This description is built on three categories: I want to be a child like any other, I need security and control and I feel lonely and left out. Young children with cancer actively strive to understand their illness, participate in care and live an ordinary everyday life- but with ongoing feelings of social isolation and loneliness.

    Conclusions

    Young children with cancer need access to and ongoing contact with peers and preschool. A structured follow-up throughout the cancer trajectory and not just during active treatment, is necessary. A child-centred philosophy of care would guide the child towards attainment of health and wellbeing.

  • 15.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Hong, Thaitrinh
    Vietnam National University.
    Nguyen, Linh Tu Thi
    Vietnam National University.
    Skarstedt, Marita
    Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Ryhov County Hospital, Jönköping, Sweden.
    Matussek, Andreas
    Ryhov County Hospital, Jönköping, Sweden.
    Common 4977 bp deletion and novel alterations in mitochondrial DNA in Vietnamese patients with breast cancer2015In: SpringerPlus, E-ISSN 2193-1801, Vol. 4, p. 1-7, article id 58Article in journal (Refereed)
    Abstract [en]

    Mitochondrial DNA (mtDNA) has been proposed to be involved in carcinogenesis and ageing. The mtDNA 4977 bp deletion is one of the most frequently observed mtDNA mutations in human tissues and may play a role in breast cancer (BC). The aim of this study was to investigate the frequency of mtDNA 4977 bp deletion in BC tissue and its association with clinical factors.

    We determined the presence of the 4977 bp common deletion in cancer and normal paired tissue samples from 106 Vietnamese patients with BC by sequencing PCR products.

    The mtDNA 4977 bp deletion was significantly more frequent in normal tissue in comparison with paired cancer tissue. Moreover, the incidence of the 4977 bp deletion in BC tissue was significantly higher in patients with estrogen receptor (ER) positive as compared with ER negative BC tissue. Preliminary results showed, in cancerous tissue, a significantly higher incidence of novel deletions in the group of patients with lymph node metastasis in comparison with the patients with no lymph node metastasis.

    We have found 4977 bp deletion in mtDNA to be a common event in BC and with special reference to ER positive BC. In addition, the novel deletions were shown to be related to lymph node metastasis. Our finding may provide complementary information in prediction of clinical outcome including metastasis, recurrence and survival of patients with BC.

  • 16.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Shamoun, Levar
    Department of Laboratory Medicine and Pathology, Region Jönköping County Hospital Ryhov, Jönköping, Sweden.
    Landerholm, Kalle
    Department of Surgery, Jönköping, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Andersson, Roland E.
    Department of Surgery, Jönköping, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Kolodziej, Blanka
    Department of Pathology, Region Jönköping County Hospital Ryhov, Jönköping, Sweden.
    Wågsäter, Dick
    Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
    Genetic variants of the IL2 gene related to risk and survival in patients with colorectal cancer2019In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 39, no 9, p. 4933-4940Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Interleukin 2 (IL2) is a significant factor activating T-cell-mediated immune response by stimulation of natural killer cells, T-cells and in development of regulatory T (Treg) cells. Recent studies have that IL2 participates in cancer development by modifying the local immune response. Based on the suggested role of the single nucleotide polymorphisms (SNPs) rs2069762, rs6822844 and rs11938795 of IL2 in the pathogenesis of certain diseases, the relationship of these SNPs with clinicopathological variables and their possible implication for prognosis and disease outcome were evaluated in a cohort of Swedish patients with colorectal cancer (CRC).

    MATERIALS AND METHODS: TaqMan SNP genotype assays based on polymerase chain reaction were used for analysis of the IL2 SNPs in 467 patients with CRC and 467 healthy controls. Expression analysis of IL2 in plasma and CRC tissue was also performed.

    RESULTS: The allelic variants T in rs11938795 and G in rs6822844 were significantly associated with a higher risk of CRC. Kaplan-Meier analysis showed that cancer-specific survival was worse for individuals with C allele for rs2069762 with stage II CRC and with T allele for rs6822844 with stage III CRC.

    CONCLUSION: SNPs rs2069762, rs6822844 and rs11938795 of the IL2 gene may be helpful as prognostic biomarkers in the follow-up and management of the patients.

  • 17.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Skarstedt, Marita
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Slind Olsen, Renate
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Andersson, Roland E.
    Department of Surgery, Region Jönköping County, Jönköping, Sweden.
    Matussek, Andreas
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Gene polymorphism in DNA repair genes XRCC1 and XRCC6 and association with colorectal cancer in Swedish patients2016In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 124, no 9, p. 736-740Article in journal (Refereed)
    Abstract [en]

    The DNA repair genes XRCC1 and XRCC6 have been proposed to participate in the pathological process of cancer by modulating the DNA repair capacity. This study evaluated the susceptibility of the single-nucleotide polymorphisms (SNPs) XRCC1 (rs25487, G > A) and XRCC6 (rs2267437, C > G) to colorectal cancer (CRC) and their association with clinical parameters in Swedish patients with CRC. Using the TaqMan system, these SNPs were screened in 452 patients and 464 controls. No significant difference in genotype distribution was found between the patients and controls, or any significant association with cancer-specific or disease-free survival in patients. However, we showed that the carriers of allele A in XRCC1 (rs25487, G > A) were connected with a higher risk of disseminated CRC (Odds Ratio = 1.64; 95% Confidence Interval = 1.12–2.41, p = 0.012).

  • 18.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Slind Olsen, Renate
    Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Skarstedt, Marita
    Clinical Microbiology, Ryhov County Hospital, Jönköping.
    Löfgren, Sture
    Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Zar, Niklas
    Ryhov County Hospital, Jönköping.
    Matussek, Andreas
    Department of Laboratory Services, Ryhov County Hospital, Jönköping.
    Polymorphism of the p38 beta gene in patients with colorectal cancer2014In: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 8, p. 1093-1095Article in journal (Refereed)
    Abstract [en]

    The p38 mitogen‑activated protein kinase (MAPK) signaling pathways have been proposed to participate in the pathological process of cancer by affecting inflammation, proliferation, metastasis and cell survival. A single nucleotide polymorphism (SNP; rs2235356, ‑1628A→G) in the promoter region of the p38β gene has been proposed as a genetic modifier for colorectal cancer (CRC) in a Chinese population. The present study evaluated the susceptibility of patients possessing this SNP to CRC, in addition to determining its association with clinical parameters in Swedish patients with CRC. Using the LightSNiP genotyping assay, this SNP was screened in 389 patients with CRC and 517 control subjects. No significant difference in the genotype distribution or in the allelic frequencies was identified between the two groups nor was any association identified with the clinical parameters. These findings indicate that the ‑1628A→G polymorphism of the p38β gene is not significantly associated with a susceptibility to CRC in a Swedish population.

  • 19.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Ström, Karin
    Klinisk Mikrobiologi, Länssjukhuset Ryhov, Jönköping.
    Löfgren, Sture
    Klinisk Mikrobiologi, Länssjukhuset Ryhov, Jönköping.
    Zar, Niklas
    Kirurgkliniken, Länssjukhuset Ryhov, Jönköping.
    Hugander, Anders
    Kirurgkliniken, Länssjukhuset Ryhov, Jönköping.
    Matussek, Andreas
    Laboratoriemedicin, Länssjukhuset Ryhov, Jönköping.
    Expression of the serine protease inhibitor serpinA3 in human colorectal adenocarcinomas2011In: Oncology Letters, ISSN 1792-1074, Vol. 2, no 3, p. 413-418Article in journal (Refereed)
    Abstract [en]

    Proteases facilitate a number of steps in cancer progression. The serine protease inhibitors (serpins) are a protein superfamily with inhibitory activity against proteases. One of these proteases, serpinA3, appears to have a multifaceted role and is associated with inflammatory reactions, Alzheimer's disease, malignant melanoma and gastric cancer. To gain insight into the potential effect of serpinA3 on colorectal cancer (CRC) we determined whether serpinA3 is altered in colorectal tissue or plasma in CRC patients. Collectively, by using ELISA we noted a significantly lower serpinA3 level in cancer tissue compared to paired normal tissue. Moreover, the tumour serpinA3 level tended to be higher in disseminated disease as compared to localised disease. No significant difference in the plasma levels of serpinA3 was noted in the patients when compared to the controls. However, plasma serpinA3 and C-reactive protein (marker of inflammation) in the CRC patients and controls were significantly positively correlated. To confirm and detect localization of serpinA3 expression, immunohistochemistry was performed. Immunohistochemistry showed heterogeneous immunoreactivity in epithelial cells in the cancer and normal tissue and extracellular staining within bands of stroma as well as in some stromal cells. A Taq Man system was used to investigate a single nucleotide polymorphism (rs4934) in the serpinA3 signal sequence gene with supposed effect on serpinA3 secretion and expression. No significant difference was observed between CRC and control subjects regarding genotype and allelic distributions, nor were associations noted between clinical characteristics and serpinA3 levels. In conclusion, an altered serpinA3 concentration in CRC tissue may be a potential biomarker in CRC progression. SerpinA3 concentrations in plasma appear to be correlated with systemic inflammation, but do not appear to be specific to CRC patients. Further studies are warranted to improve our understanding of the role of serpinA3 in CRC.

  • 20.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Ström, Karin
    Dep. of Clinical Microbiology, Ryhov County Hospital Jönköping Sweden.
    Löfgren, Sture
    Dep. of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Zar, Niklas
    Dep. of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Lindh, Mikael
    Department of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Matussek, Andreas
    Dep. of Laboratory Medicin, Ryhov County Hospital, Jönköping, Sweden.
    DNA promoter methylation status and protein expression of interleukin-8 in human colorectal adenocarcinomas2012In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 27, no 6, p. 709-714Article in journal (Refereed)
    Abstract [en]

    Background  Interleukin-8 (IL-8) also referred to as CXCL8, a member of the CXC chemokine family that attracts neutrophils and other leukocytes, has been associated with cancer. Angiogenesis is a prime regulator of tumour expansion and data support that IL-8 is a potent angiogenic factor. Epigenomic instability has been postulated to play a role for the development of multiple neoplasias including colorectal cancer (CRC). DNA methylation of cytosine residues in CpG dinucleotides leads to transcriptional silencing of associated genes.

    Method  In this study, we comparatively analysed the protein expression of IL-8 in plasma, tumour and paired normal tissue and methylation status of the IL-8 gene to evaluate its impact on CRC.

    Results  Collectively, by using Luminex technology, we noted a significantly higher IL-8 level in cancer tissue compared to paired normal tissue and that CRC patients exhibit significantly higher plasma levels than healthy controls. Analysed by methylation-specific polymerase chain reaction, we detected IL-8 hypomethylation in 64% of the cancerous tissue cases but no hypomethylation was found in paired normal tissue. We noted that the CRC patients with IL-8 hypomethylation revealed a significant higher level of IL-8 protein in cancerous tissue, which tended to be associated with distant metastasis. We also observed that patients with distant metastasis showed a significantly higher plasma level of IL-8 in relation to patients without distant metastasis.

    Conclusion  Our results suggest that the predominance of high plasma levels of IL-8 in patients with distant metastasis in combination with the hypomethylation of the IL-8 promoter region might be a useful marker of the disease advancement.

  • 21.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Thai, Trinh Hong
    Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi, Vietnam.
    Skarstedt, Marita
    Department of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Department of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Zar, Niklas
    Department of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Matussek, Andreas
    Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Detection of Cytomegalovirus DNA in Colorectal Tissue from Swedish and Vietnamese Patients with Colorectal Cancer2013In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 33, no 11, p. 4947-4950Article in journal (Refereed)
    Abstract [en]

    Background: Human cytomegalovirus (HCMV) has been implicated as a factor, which might be associated with colorectal cancer (CRC) progression. Data from studies with HCMV-infected tumour cell lines have highlighted an oncomodulatory potential of HCMV. In the present study, we aimed to evaluate the prevalence of HCMV DNA in CRC tissue compared to matched normal tissue, and its association with clinical factors.

    Patients and Methods: We used quantitative real-time polymerase chain reaction assay to detect HCMV DNA in 202 cancerous and paired normal tissue from Swedish (n=119) and Vietnamese (n=83) CRC patients.

    Results: Overall, the HCMV DNA rate was significantly higher in cancerous in relation to paired normal tissue. Furthermore, a significantly higher frequency (39.8%) of HCMV DNA was observed in cancer tissues from the Vietnamese patients compared to the Swedish patients (15.1%). The prevalence of HCMV DNA in CRC tissue of 50% of those with disseminated disease tended to be higher compared to those with localized disease, with a prevalence of 33.3% in Vietnamese patients.

    Conclusion: Our observations indicate that the prevalence of HCMV DNA differs significantly between cancer and matched normal tissues. Thus, these data support a possible role of CMV in CRC. Moreover, we noted differences between Swedish and Vietnamese patients, indicating a role of ethnicity.

  • 22.
    Dimberg, Jan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Thai, Trinh Hong
    Vietnam National University.
    Skarstedt, Marita
    Ryhov County Hospital, Jönköping.
    Löfgren, Sture
    Ryhov County Hospital, Jönköping.
    Zar, Niklas
    Ryhov County Hospital, Jönköping.
    Matussek, Andreas
    Ryhov County Hospital, Jönköping.
    Novel and Differential Accumulation of Mitochondrial DNA Deletions in Swedish and Vietnamese Patients with Colorectal Cancer2014In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 34, no 1, p. 147-152Article in journal (Refereed)
    Abstract [en]

    Background: Mitochondrial DNA (mtDNA) has been proposed to be involved in carcinogenesis and aging. The mtDNA 4977 bp deletion is one of the most frequently observed mtDNA mutations in human tissues and may play a role in colorectal cancer (CRC). In the present study, we aimed to evaluate the frequency of mtDNA 4977 bp deletion in CRC tissues and its association with clinical factors. Patients and Methods: We determined the presence of the 4977 bp common deletion in cancer and normal paired tissue samples from 105 Swedish and 88 Vietnamese patients with CRC using polymerase chain reaction (PCR) assays. Results: The mtDNA 4977 bp deletion was shown to be significantly more frequent in normal tissues in comparison with paired cancer tissues in both Swedish and Vietnamese patients. The 4977 bp common deletion was significantly more frequent in cancer tissues of the Vietnamese patients compared to the Swedish patients, and in Vietnamese cancer tissues, the 4977 bp deletion was significantly over represented in those with localized disease compared to those with disseminated disease. Moreover, we detected nine novel mtDNA deletions and found a significantly higher rate of these in CRC tissues in Swedish in comparison to Vietnamese patients. Conclusion: The mtDNA 4977 bp deletion seems to have an impact on the clinical outcome of CRC in Vietnamese patients, that the Swedish patients accumulate more of the detected novel deletions in CRC tissue compared to Vietnamese patients probably indicates divergent mechanisms in colorectal carcinogenesis.

  • 23.
    Einbeigi, Z.
    et al.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Bergman, Annika
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Kindblom, L.-G.
    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Martinsson, T.
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Meis-Kindblom, J. M.
    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Nordling, M.
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Suurküla, M.
    Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Wahlström, J.
    Department of Clinical Genetics, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Wallgren, A.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    Karlsson, P.
    Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden, Sweden.
    A founder mutation of the BRCA1 gene in Western Sweden associated with a high incidence of breast and ovarian cancer2001In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 37, no 15, p. 1904-1909Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe and characterise a founder mutation of the BRCA1 gene in western Sweden. Of 62 families screened for BRCA mutations, 24 had BRCA1 mutations and two had BRCA2 mutations. Tumours that occurred in family members were histologically reviewed and mutational status was analysed using archival paraffin-embedded tissues. The same BRCA1 mutation, 3171ins5, was found in 16 families who were clustered along the western coast of Sweden. Mutation analysis revealed a maternal linkage in 13 families and a paternal linkage in 3. There was complete agreement between mutation analysis results obtained from blood and archival tissues. The penetrance of breast or ovarian cancer by age 70 years was estimated to be between 59 and 93%. There were no differences in survivals between breast or ovarian cancer patients with the mutation and age-matched controls. Thus, a predominant BRCA1 gene founder mutation associated with a high risk of breast and ovarian cancer has been identified and found to occur in a restricted geographical area, thereby allowing timely and cost-effective mutation screening using blood samples or archival histological material. 

  • 24. Engel, C.
    et al.
    Versmold, B.
    Wappenschmidt, B.
    Simard, J.
    Easton, D. F.
    Peock, S.
    Cook, M.
    Oliver, C.
    Frost, D.
    Mayes, R.
    Evans, D. G.
    Eeles, R.
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    Brewer, C.
    McGuffog, L.
    Antoniou, A. C.
    Stoppa-Lyonnet, D.
    Sinilnikova, O. M.
    Barjhoux, L.
    Frenay, M.
    Michel, C.
    Leroux, D.
    Dreyfus, H.
    Toulas, C.
    Gladieff, L.
    Uhrhammer, N.
    Bignon, Y. -J
    Meindl, A.
    Arnold, N.
    Varon-Mateeva, R.
    Niederacher, D.
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    Kast, K.
    Deissler, H.
    Sutter, C.
    Gadzicki, D.
    Chenevix-Trench, G.
    Spurdle, A. B.
    Chen, X.
    Beesley, J.
    Olsson, H.
    Kristoffersson, U.
    Ehrencrona, H.
    Liljegren, A.
    Van Der Luijt, R. B.
    Van Os, T. A.
    Van Leeuwen, F. E.
    Domchek, S. M.
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    Nathanson, K. L.
    Osorio, A.
    Ramón Y Cajal, T.
    Konstantopoulou, I.
    Benítez, J.
    Friedman, E.
    Kaufman, B.
    Laitman, Y.
    Mai, P. L.
    Greene, M. H.
    Nevanlinna, H.
    Aittomäki, K.
    Szabo, C. I.
    Caldes, T.
    Couch, F. J.
    Andrulis, I. L.
    Godwin, A. K.
    Hamann, U.
    Schmutzler, R. K.
    Association of the variants CASP8 D302H and CASP10 V410I with breast and ovarian cancer risk in BRCA1 and BRCA2 mutation carriers2010In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 19, no 11, p. 2859-2868Article in journal (Refereed)
    Abstract [en]

    Background: The genes caspase-8 (CASP8) and caspase-10 (CASP10) functionally cooperate and play a key role in the initiation of apoptosis. Suppression of apoptosis is one of the major mechanisms underlying the origin and progression of cancer. Previous case-control studies have indicated that the polymorphisms CASP8 D302H and CASP10 V410I are associated with a reduced risk of breast cancer in the general population.

    Methods: To evaluate whether the CASP8 D302H (CASP10 V410I) polymorphisms modify breast or ovarian cancer risk in BRCA1 and BRCA2 mutation carriers, we analyzed 7,353 (7,227) subjects of white European origin provided by 19 (18) study groups that participate in the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). A weighted cohort approach was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI).

    Results: The minor allele of CASP8 D302H was significantly associated with a reduced risk of breast cancer (per-allele HR, 0.85; 95% CI, 0.76-0.97; Ptrend = 0.011) and ovarian cancer (per-allele HR, 0.69; 95% CI, 0.53-0.89; Ptrend = 0.004) for BRCA1 but not for BRCA2 mutation carriers. The CASP10 V410I polymorphism was not associated with breast or ovarian cancer risk for BRCA1 or BRCA2 mutation carriers.

    Conclusions: CASP8 D302H decreases breast and ovarian cancer risk for BRCA1 mutation carriers but not for BRCA2 mutation carriers.

    Impact: The combined application of these and other recently identified genetic riskmodifiers could in the future allow better individual risk calculation and could aid in the individualized counseling and decision making with respect to preventive options in BRCA1 mutation carriers.

  • 25.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Omvårdnad av barn med cancer1999Book (Other academic)
  • 26.
    Enskär, Karin
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ljusegren, Gunilla
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gimbler Berglund, Ingalill
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Eaton, Nicola
    Harding, Rosemary
    Mokoena, Joyce
    Chauke, Motsedisi
    Moleki, Maria
    Attitudes to and knowledge about pain and pain management, of nurses working with children with cancer: A comparative study between UK, South Africa and Sweden2007In: Journal of Research in Nursing, ISSN 1744-9871, Vol. 12, no 5, p. 501-515Article in journal (Refereed)
    Abstract [en]

    Pain is among the most common effects of cancer and its treatment. Children and young people with cancer often consider pain from procedures and treatment to be the worst aspect of their illness. This study aimed to i) identify and describe knowledge and attitudes to pain and pain management amongst nurses working with children with cancer and ii) compare the perspectives on pain and pain management of nurses from UK, South Africa and Sweden. 106 nurses working with children with cancer in UK, South Africa and Sweden completed Salanterä’s (1999) questionnaire on nurses’ attitudes to pain in children. Nurses had good levels of knowledge and positive attitudes to pain management, with Swedish nurses’ having higher levels of knowledge and a more positive attitude to pain management than nurses from UK or South Africa. A high level of knowledge was correlated to a more positive attitude to pain management. Knowledge levels need to be improved to ensure more positive attitudes to pain management, especially for nurses in South Africa. Swedish nurses’ level of knowledge about non-pharmacological pain management strategies has scope for improvement. British nurses may need to focus more on the sociology and psychology of pain.

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    Global Burden of Disease Cancer Collaboration, ,
    Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study2019In: JAMA Oncology, ISSN 2374-2437, E-ISSN 2374-2445Article in journal (Refereed)
    Abstract [en]

    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.

    Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.

    Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.

    Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs).

    Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. 

  • 28. Johnatty, S. E.
    et al.
    Couch, F. J.
    Fredericksen, Z.
    Tarrell, R.
    Spurdle, A. B.
    Beesley, J.
    Chen, X.
    Gschwantler-Kaulich, D.
    Singer, C. F.
    Fuerhauser, C.
    Fink-Retter, A.
    Domchek, S. M.
    Nathanson, K. L.
    Pankratz, V. S.
    Lindor, N. M.
    Godwin, A. K.
    Caligo, M. A.
    Hopper, J.
    Southey, M. C.
    Giles, G. G.
    Justenhoven, C.
    Brauch, H.
    Hamann, U.
    Ko, Y. -D
    Heikkinen, T.
    Aaltonen, K.
    Aittomäki, K.
    Blomqvist, C.
    Nevanlinna, H.
    Hall, P.
    Czene, K.
    Liu, J.
    Peock, S.
    Cook, M.
    Platte, R.
    Gareth Evans, D.
    Lalloo, F.
    Eeles, R.
    Pichert, G.
    Eccles, D.
    Davidson, R.
    Cole, T.
    Cook, J.
    Douglas, F.
    Chu, C.
    Hodgson, S.
    Paterson, J.
    Hogervorst, F. B. L.
    Rookus, M. A.
    Seynaeve, C.
    Wijnen, J.
    Vreeswijk, M.
    Ligtenberg, M.
    Van Der Luijt, R. B.
    Van Os, T. A. M.
    Gille, H. J. P.
    Blok, M. J.
    Issacs, C.
    Humphreys, M. K.
    McGuffog, L.
    Healey, S.
    Sinilnikova, O.
    Antoniou, A. C.
    Easton, D. F.
    Chenevix-Trench, G.
    No evidence that GATA3 rs570613 SNP modifies breast cancer risk2009In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 117, no 2, p. 371-379Article in journal (Refereed)
    Abstract [en]

    GATA-binding protein 3 (GATA3) is a transcription factor that is crucial to mammary gland morphogenesis and differentiation of progenitor cells, and has been suggested to have a tumor suppressor function. The rs570613 single nucleotide polymorphism (SNP) in intron 4 of GATA3 was previously found to be associated with a reduction in breast cancer risk in the Cancer Genetic Markers of Susceptibility project and in pooled analysis of two case-control studies from Norway and Poland (P trend = 0.004), with some evidence for a stronger association with estrogen receptor (ER) negative tumours [Garcia-Closas M et al. (2007) Cancer Epidemiol Biomarkers Prev 16:2269-2275]. We genotyped GATA3 rs570613 in 6,388 cases and 4,995 controls from the Breast Cancer Association Consortium (BCAC) and 5,617 BRCA1 and BRCA2 carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). We found no association between this SNP and breast cancer risk in BCAC cases overall (ORper-allele = 1.00, 95% CI 0.94-1.05), in ER negative BCAC cases (ORper-allele = 1.02, 95% CI 0.91-1.13), in BRCA1 mutation carriers RRper-allele = 0.99, 95% CI 0.90-1.09) or BRCA2 mutation carriers (RRper-allele = 0.93, 95% CI 0.80-1.07). We conclude that there is no evidence that either GATA3 rs570613, or any variant in strong linkage disequilibrium with it, is associated with breast cancer risk in women. 

  • 29.
    Kjellström, Jessica
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Evelina, Karlsson
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Är teknetium-99m DMSA-scintigrafi på barn 0-2 år berättigad vid utredning av njurparenkymskador efter pyelonefrit?: Parenkymskador och komplikationsrisker i förhållande till cancerrisk2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    A dimercaptosuccinic acid (DMSA) scintigraphy is used to test for pyelonephritis, an inflammation of the kidneys with risk of renal scarring. Aiming to investigate if DMSA scan after pyelonephritis in children is justified, we calculated the general cancer risk, the specific increased renal cancer risk, the number of discovered renal scarring and potential differences between the sexes. The method was retrospective and quantitative and data was based on results from DMSA scans of children aged 0-2 years. From the original set of 91 children (52 girls, 39 boys), 16 were excluded. Of the remaining 75, six (8 %) had renal scarring; with an average age of 9,2 months, and there was no significant difference between sex and renal parenchymal damage (p=0,0246). The mean activity from a DMSA scan equaled an effective dose of 0.69 mSv, with general cancer versus renal cancer risk being 0.01-0.014 and 0.00019, respectively. Even though only a few children develop renal scarring, there is still a risk of complications. Renal scarring is therefore important to discover. The increased risk for cancer and renal cancer after a DMSA scan is low. The benefits (discovering renal scarring) are greater than the risk (radiation), making the DMSA scan justified.

  • 30.
    Larsson, Dennis
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Hagberg, Malin
    Högskolan i Skövde, Institutionen för vård och natur.
    Nahren, Malek
    Högskolan i Skövde, Institutionen för vård och natur.
    Kjellberg, Charlotte
    Högskolan i Skövde, Institutionen för vård och natur.
    Senneberg, Edina
    Högskolan i Skövde, Institutionen för vård och natur.
    Tahmasebifar, Neda
    Högskolan i Skövde, Institutionen för vård och natur.
    Johansson, Viktoria
    Karolinska Institutet.
    Membrane Initiated Signaling by 1,25α-dihydroxyvitamin D3 in LNCaP Prostate Cancer Cells2008In: Hormonal Carcinogenesis V / [ed] Jonathan J. Li, Sara A. Li, Suresh Mohla, Henri Rochefort, Thierry Maudelonde, Springer, 2008, p. 573-579Chapter in book (Refereed)
    Abstract [en]

    Prostate cancer (PC) is one of the most common cancers among men, and vitamin D and its metabolites are candidates for prevention and therapy of this disease. The vitamin D metabolites, 1, 25-dihydroxyvitamin D3 (1,25D) and 25-hydroxyvitamin D3, decreases cellular proliferation and invasiveness, and stimulates differentiation of PC cells. However, the underlying mechanisms are not fully clarified, and there is evidence that some of these effects of the vitamin D system are mediated by specific membrane-associated receptors/binding proteins in addition to its nuclear receptor, suggesting multiple regulatory pathways. The aim of the present study was to examine the role of membrane initiated pathways mediating effects of 1,25D on cell invasiveness in LNCaP cells. Treatment with 1,25D evoked a dose-dependent activation of the JNK/SAPK MAPK signaling pathways within 10 min, demonstrating membrane initiated signaling of 1,25D in LNCaP cells. Furthermore, treatment with 1,25D decreased LNCaP cell invasiveness by approximately 20% after 48h. Using an inhibitor (SP600125) for the JNK/SAPK MAPK signaling pathway in combination with 1,25D on LNCaP cells, the inhibitory action of 1,25D on invasiveness was eliminated. In conclusion, 1,25D decrease invasiveness of LNCaP cells by interaction with a putative membrane associated receptor, which activate membrane, initiated signaling via the JNK/SAPK MAPK signaling pathway.

  • 31.
    Larsson, Dennis
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Johansson, Viktoria
    Högskolan i Skövde, Institutionen för vård och natur.
    Karlsson, Sandra
    Högskolan i Skövde, Institutionen för vård och natur.
    Olausson, Josefin
    Högskolan i Skövde, Institutionen för vård och natur.
    Holmén, Jonathan
    Högskolan i Skövde, Institutionen för vård och natur.
    Hagberg, Malin
    Högskolan i Skövde, Institutionen för vård och natur.
    Rapid activation of JNK/SAPK in LNCaP prostate cancer cells by 1α,25-dihydroxyvitamin D3 is independent of PDIA3 (1,25-MARRS)2008In: Current Topics in Steroid Research, ISSN 0972-4788, Vol. 5, p. 17-24Article in journal (Refereed)
    Abstract [en]

    1α,25-dihydroxyvitamin D3 (1,25D3 ) is a highly potential anti-cancerous agent for prevention and treatment of prostate cancer, the most commonly diagnosed cancer type of males in western countries. A recent study by our laboratory, demonstrates that LNCaP cancer cells treated with 1,25D3, evoked dose-dependent activation of the JNK/SAPK MAPK signaling pathway within 10 minutes after hormone treatment, indicative of membrane-initiated steroid signaling (MISS) by 1,25D3. This confirms previous reports on intestinal-, chondrocyte- and osteoblast cells, where 1,25D3 operates through pharmacologically distinct nuclear-initiated mechanisms (NISS) and plasma membrane-initiated mechanisms. NISS is mediated via the vitamin D receptor (nVDR) and MISS is mediated through 1,25D3-MARRS (PDIA3, 1,25D3-membraneassociated rapid response steroid binding protein) or nVDR. The aims of the present study were to investigate the mechanisms of MISS evoked effects on alkaline phosphatase (ALP) and activation of the JNK/SAPK by 1,25D3, and the involvement of PDIA3 in 1,25D3 initiated activation of the JNK/SAPK signaling pathway. Furthermore, 1,25D3-treated LNCaP cells were transfected with siRNA against PDIA3 and phosphorylated JNK/SAPK was estimated by western analysis. Western analysis and ALP-assays demonstrated rapid activation of both JNK/SAPK as well as ALP. Silencing of PDIA3 did not affect 1,25D3 mediated activation of JNK/SAPK, suggesting that PDIA3 is not involved in the 1,25D3-initiated activation of the JNK/SAPK signaling pathway.

  • 32.
    Laytragoon-Lewin, Nongnit
    et al.
    Department of Laboratory Medicine, Ryhov Hospital, SE-55185, Jönköping, Sweden.
    Jonson, Fredrik
    Department of ENT, Ryhov Hospital, Jönköping, Sweden.
    Lundgren, Jan
    Department of ENT, Karolinska University Hospital, Stockholm, Sweden.
    Rutqvist, Lars Erik
    Swedish Match AB, Stockholm, Sweden.
    Wikby, Anders
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Löfgren, Sture
    Department of Laboratory Medicine, Ryhov Hospital, SE-55185, Jönköping, Sweden.
    Lewin, Freddi
    Department of Oncology, Ryhov Hospital, Jönköping, Sweden.
    Perforin, CD28 and CD95 expression in circulating CD4 and CD8 cells as predictors of head and neck (H&N) cancer patient survival2014In: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 31, no 12, p. 290-Article in journal (Refereed)
    Abstract [en]

    Long-term survival of H&N cancer patients has not improved significantly over the last 30 years. The possibility of using circulating blood cell phenotypes as a prognostic biomarker of H&N cancer patient was investigated in this study. Pre-treatment, circulating T lymphocyte subpopulations as well as the survival time of the patients in question were studied. Upregulated CD4+ perforin+ and CD8+ CD95+ but downregulated CD4+ CD28+ (p < 0.001) were detected in H&N cancer patients. With 3 years of follow-up time, an increase in the frequency of the pre-treatment, circulating CD4+ perforin+ cells and CD8+ perforin+ cells was showed to have reverse effects on the survival time in H&N cancer patients (p < 0.01). Detection of perforin? frequency in CD4+ and CD8+ lymphocyte by FACS is fast, simple and cost-effective. A potential role of perforin expression in CD4+ and CD8+ cells as a prognostic biomarker for H&N cancer patient in the clinical setting was suggested.

  • 33.
    Lundgren, Christine
    et al.
    Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
    Lindman, Henrik
    Department of Oncology, Uppsala University Hospital, Uppsala, Sweden.
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.
    Ekholm, Maria
    Department of Oncology, Ryhov County Hospital , Jönköping, Sweden.
    Good adherence to adjuvant endocrine therapy in early breast cancer - a population-based study based on the Swedish Prescribed Drug Register2018In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 57, no 7, p. 935-940Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Adjuvant endocrine therapy improves recurrence-free and overall survival in primary breast cancer. However, not all patients complete their planned treatment, mostly because of side-effects. The aim of this study was to examine the adherence to adjuvant endocrine therapy in a cohort of primary breast cancer patients in Region Jönköping County, Sweden, after 3 and 5 years.

    MATERIAL AND METHODS: The Swedish Breast Cancer Register was used to identify patients diagnosed with hormone receptor positive breast cancer in Region Jönköping County between 2009 and 2012. Adherence was evaluated based on data from the Swedish Prescribed Drug Register, and Medication Possession Ratio (MPR), defined as the days' supply of medication during the period from the first dispensing till the last dispensing in the time period (3 and 5 years), divided by number of days. Adherence was defined as MPR ≥80%. Regression analyses were used to identify subgroups associated with adherence; age, type of endocrine treatment, additional adjuvant therapy, and hospital responsible for the follow-up (Eksjö, Jönköping, and Värnamo).

    RESULTS: We identified 634 patients who were recommended adjuvant endocrine therapy and to be able to estimate adherence after 3 and 5 years, 488 patients were included in the analysis. After 3 years of treatment, 91.2% of the patients (95% confidence interval (CI) 88.7-93.6; n = 445), were found to be adherent. The corresponding figure for the 271 patients who had completed 5 years of treatment was 91.5% (95% CI 88.2-94.8; n = 248). No subgroups (age, endocrine therapy, radio/chemotherapy, or hospital) were significantly associated with adherence in the multiple logistic regression analysis.

    DISCUSSION: This study shows substantially higher adherence to adjuvant endocrine therapy than previously reported. Reasons for this could be differences in routines for therapy information and follow-up, but this needs to be further investigated.

  • 34.
    Mandal, Saumen
    et al.
    Department of Statistics, University of Manitoba, Winnipeg, Canada.
    Arabi Belaghi, Reza
    Department of Statistics, University of Tabriz, Tabriz, Iran.
    Mahmoudi, Akram
    Department of Statistics, University of Tabriz, Tabriz, Iran.
    Aminnejad, Minoo
    Department of Statistics, Razi University, Kermanshah, Iran.
    Stein-type shrinkage estimators in gamma regression model with application to prostate cancer data2019In: Statistics in Medicine, ISSN 0277-6715, E-ISSN 1097-0258, Vol. 38, no 22, p. 4310-4322Article in journal (Refereed)
    Abstract [en]

    Gamma regression is applied in several areas such as life testing, forecasting cancer incidences, genomics, rainfall prediction, experimental designs, and quality control. Gamma regression models allow for a monotone and no constant hazard in survival models. Owing to the broad applicability of gamma regression, we propose some novel and improved methods to estimate the coefficients of gamma regression model. We combine the unrestricted maximum likelihood (ML) estimators and the estimators that are restricted by linear hypothesis, and we present Stein-type shrinkage estimators (SEs). We then develop an asymptotic theory for SEs and obtain their asymptotic quadratic risks. In addition, we conduct Monte Carlo simulations to study the performance of the estimators in terms of their simulated relative efficiencies. It is evident from our studies that the proposed SEs outperform the usual ML estimators. Furthermore, some tabular and graphical representations are given as proofs of our assertions. This study is finally ended by appraising the performance of our estimators for a real prostate cancer data. 

  • 35.
    Molassiotis, A.
    et al.
    School of Nursing, University of Manchester, United Kingdom.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Milovics, L.
    Department of Education, Institute for Oncology and Radiology, Belgrade, Serbia.
    Panteli, V.
    Greek Oncology Nursing Society, Athens, Greece.
    Patiraki, E.
    Greek Oncology Nursing Society, Athens, Greece.
    Fernandez-Ortega, P.
    Institut Català Oncologia ICO, Barcelona, Spain.
    Complementary and alternative medicine use in patients with gynecological cancers in Europe2006In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 16, no Suppl. 1, p. 219-224Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to assess the use of complementary and alternative medicine (CAM) specifically in women with gynecological cancer. The design of the study was of a descriptive cross-sectional survey using a 27-item questionnaire. The study was conducted in 11 countries in Europe as part of a larger project. Data were available from 72 gynecological cancer patients. Among the participants, 40.3% used CAM after the diagnosis with cancer. The most popular CAM modalities used were herbal medicine (34.5%), relaxation techniques (21.4%), and vitamins/minerals (20.7%). A very high level of satisfaction with CAM use was reported. Patients used CAM to increase the body's ability to fight the cancer or to improve physical and emotional well-being. The main sources of information about CAM were informal (friends/ family or the media). It is important to discuss CAM use with gynecological cancer patients, as they frequently use it and such use may have implications for clinical practice.

  • 36.
    Molassiotis, A.
    et al.
    School of Nursing, University of Manchester, Manchester, United Kingdom.
    Fernandez-Ortega, P.
    Institut Català Oncologia ICO, Barcelona, Spain.
    Pud, D.
    Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
    Ozden, G.
    Gazi University Hospital, Ankara, Turkey.
    Scott, J. A.
    Department of Nursing and Midwifery, University of Stirling, Stirling, United Kingdom.
    Pantelil, V.
    Greek Oncology Nursing Society, Ag. Anargiri Hospital, Athens, Greece.
    Margulies, A.
    Zurich University Hospital, Poliklinik Onkologie, Zurich, Switzerland.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Magri, M.
    Università degli Studi di Milano, Istituto Nazionale Tumori, Milan, Italy.
    Selvekerova, S.
    Masaryk Memorial Cancer Institute, Brno, Czech Republic.
    Madsen, E.
    Oncology Department, Aarhus University Hospital, Aarhus, Denmark.
    Milovics, L.
    Department of Education, Institute for Oncology and Radiology, Belgrade, Serbia.
    Bruyns, I.
    Belgian Society of Oncology Nursing, Brussels, Belgium.
    Gudmundsdottir, G.
    Department of Oncology, Lanspitali, Reykjavik, Iceland.
    Hummerston, S.
    Department of Oncology, City Hospital, Nottingham, United Kingdom.
    Ahmad, A. M. A.
    School of Nursing, University of Manchester, Manchester, United Kingdom.
    Platin, N.
    School of Health Sciences, Koc University, Istanbul, Turkey.
    Kearney, N.
    Department of Nursing and Midwifery, University of Stirling, Stirling, United Kingdom.
    Patiraki, E.
    Greek Oncology Nursing Society, Department of Nursing, University of Athens, Athens, Greece.
    Use of complementary and alternative medicine in cancer patients: a European survey2005In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 16, no 4, p. 655-663Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients across a number of European countries.

    Methods: A descriptive survey design was developed. Fourteen countries participated in the study and data was collected through a descriptive questionnaire from 956 patients.

    Results: Data suggest that CAM is popular among cancer patients with 35.9% using some form of CAM (range among countries 14.8% to 73.1%). A heterogeneous group of 58 therapies were identified as being used. Herbal medicines and remedies were the most commonly used CAM therapies, together with homeopathy, vitamins/minerals, medicinal teas, spiritual therapies and relaxation techniques. Herbal medicine use tripled from use before diagnosis to use since diagnosis with cancer. Multivariate analysis suggested that the profile of the CAM user was that of younger people, female and with higher educational level. The source of information was mainly from friends/family and the media, while physicians and nurses played a small part in providing CAM-related information. The majority used CAM to increase the body's ability to fight cancer or improve physical and emotional well-being, and many seemed to have benefited from using CAM (even though the benefits were not necessarily related to the initial reason for using CAM). Some 4.4% of patients, however, reported side-effects, mostly transient.

    Conclusions: It is imperative that health professionals explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.

  • 37.
    Molassiotis, A.
    et al.
    School of Nursing, University of Manchester, Manchester, United Kingdom.
    Ozden, G.
    Gazi University Hospital, Ankara, Turkey.
    Platin, N.
    School of Health Sciences, Koc University, Istanbul, Turkey.
    Scott, J. A.
    Department of Nursing and Midwifery, University of Stirling, Stirling, United Kingdom.
    Pud, D.
    Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
    Fernandez-Ortega, P.
    Institut Català Oncologia ICO, Barcelona, Spain.
    Milovics, L.
    Department of Education, Institute for Oncology and Radiology, Belgrade, Serbia.
    Panteli, V.
    Greek Oncology Nursing Society, Athens, Greece.
    Gudmundsdottir, G.
    Department of Oncology, Landspitali, Reykjavik, Iceland.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Madsen, E.
    Oncology Department, Aarhus University Hospital, Aarhus, Denmark.
    Patiraki, E.
    Greek Oncology Nursing Society, Athens, Greece.
    Kearney, N.
    Department of Nursing and Midwifery, University of Stirling, Stirling, United Kingdom.
    Complementary and alternative medicine use in patients with head and neck cancers in Europe2006In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 15, no 1, p. 19-24Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to examine the patterns of complementary and alternative medicine (CAM) use in a sample of head and neck cancer patients, forming part of a larger study. A cross-sectional survey design was used collecting data through a descriptive 27-item questionnaire in nine countries in Europe. The participants were 75 patients with head and neck cancers. The prevalence rate of CAM use was 22.7%. The most common therapies used were herbal medicine (47%), medicinal teas (23.5%), use of vitamins/minerals (11.8%) and visualization (11.8%). Use of CAM dramatically increased after the diagnosis with cancer (i.e. eightfold increase in the use of herbs). A profile of CAM users was not evident in this sample. Patients used CAM for a variety of reasons together, with counteracting the ill effects from cancer and its treatment being the most common one. Information about CAM was obtained mostly from friends and family. As one in five head and neck cancer patients use CAM it is important that clinicians explore practices with their patients, improve communication about CAM with them and assist those who want to use CAM in using appropriate and safe therapies.

  • 38.
    Molassiotis, Alexander
    et al.
    School of Nursing, University of Manchester, Manchester, United Kingdom.
    Margulies, Anita
    University Hospital Zürich, Klinik und Poliklinik für Onkologie, Zürich, Switzerland.
    Fernandez-Ortega, Paz
    Institut Català Oncologia ICO, Barcelona, Spain.
    Pud, Dorit
    Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
    Panteli, Vassiliki
    Greek Oncology Nursing Society, Athens, Greece.
    Bruyns, Ingrid
    Belgian Society of Oncology Nursing, Brussels, Belgium.
    Scott, Julia A.
    Department of Nursing and Midwifery, University of Stirling, Stirling, Scotland.
    Gudmundsdottir, Gudbjorg
    Department of Oncology, Landspitali, Reykjavik, Iceland.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Madsen, Elin
    Oncology Department, Aarhus University Hospital, Aarhus, Denmark.
    Ozden, Gulten
    Gazi University Hospital, Ankara, Turkey.
    Magri, Miriam
    Università degli Studi di Milano-Istituto Nazionale Tumori, Milan, Italy.
    Selvekerova, Sarka
    Masaryk Memorial Cancer Institute, Brno, Czech Republic.
    Platin, Nurgun
    School of Health Sciences, Koc University, Istanbul, Turkey.
    Kearney, Nora
    Department of Nursing and Midwifery, University of Stirling, Stirling, Scotland.
    Patiraki, Elisabeth
    Greek Oncology Nursing Society, Athens, Greece.
    Complementary and alternative medicine use in patients with haematological malignancies in Europe2005In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 11, no 2, p. 105-110Article in journal (Refereed)
    Abstract [en]

    This study reports upon a descriptive cross-sectional survey assessing the use of complementary and alternative medicine (CAM) in patients with haematological cancers. Twelve European countries contributed data from patients with haematological cancers, as part of a larger study. Sixty-eight patients with haematological cancer participated. Among the participants, 26.5% used some form of CAM after the cancer diagnosis. The most common therapies used were homeopathy (38.9%), herbal medicine (22.2%) various psychic therapies, such as use of mediums, healers, rebirthing or past life regression therapy (22.2%). A particular profile of a CAM user was not evident in the sample. Moderate levels of satisfaction with CAM were reported. Patients commonly used CAM to increase the ability of their body to fight cancer and to improve physical and emotional well-being. Information about CAM was received mainly from friends or family. As CAM use in patients with haematological malignancies is common, clinicians should assist patients who want to use CAM to make an appropriate decision, and improve communication with them about CAM use in an open and non-judgemental dialogue. © 2005 Elsevier Ltd. All rights reserved.

  • 39.
    Molassiotis, Alexander
    et al.
    a School of Nursing, University of Manchester, Manchester, United Kingdom.
    Panteli, Vassiliki
    Greek Oncology Nursing Society, Athens, Greece.
    Patiraki, Elisabeth
    Greek Oncology Nursing Society, Athens, Greece.
    Ozden, Gulten
    Gazi University Hospital, Ankara, Turkey.
    Platin, Nurgun
    School of Health Sciences, Koc University, Istanbul, Turkey.
    Madsen, Elin
    Oncology Department, Aarhus University Hospital, Aarhus, Denmark.
    Browall, Maria
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Fernandez-Ortega, Paz
    Institut Català Oncologia ICO, Barcelona, Spain.
    Pud, Dorit
    Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
    Margulies, Anita
    University Hospital Zürich, Klinik und Poliklinik für Onkologie, Zürich, Switzerland.
    Complementary and alternative medicine use in lung cancer patients in eight European countries2006In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 12, no 1, p. 34-39Article in journal (Refereed)
    Abstract [en]

    This paper presents findings from a cross-sectional survey about the use of complementary and alternative medicine (CAM) in patients with lung cancer, forming part of a larger study. Data from 111 lung cancer patients in 8 countries in Europe were collected through a descriptive 27-item questionnaire. The data suggest that 23.6% of the lung cancer patients used CAM after the diagnosis with cancer. The most popular CAM modalities were herbal medicine (48.1%), medicinal teas (11.5%), homeopathy (11.5%), use of animal extracts (11.5%) and spiritual therapies (11.5%). Herbal use increased by three times after the diagnosis of cancer. Patients seemed quite satisfied with the CAM used. They were also spending on average about 142 Euros monthly on CAM therapies or remedies. The most common motivation to use CAM was to increase the body's ability to fight the cancer. Main sources of information about CAM were friends and family. As CAM is increasingly used by patients with lung cancer, it is important to be able to assist patients make an appropriate decision by discussing the issue of CAM openly, providing reassurance and communicating safe and appropriate information to patients. 

  • 40. Mälarstig, Anders
    et al.
    Wågsäter, Dick
    Löfgren, Sture
    Hugander, Anders
    Zar, Niklas
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Tumour-derived adhesion factor in colorectal cancer2009In: Molecular Medicine Reports, ISSN 1791-2997, Vol. 2, no 6, p. 971-976Article in journal (Refereed)
    Abstract [en]

    Tumour-derived adhesion factor (TAF) has been shown to be associated with breast, prostate and colorectal cancer (CRC), acting as tumour suppressor or tumour promoter by mechanisms not as yet understood. Here, we comparatively analyzed the expression profile of TAF in plasma, tumour and paired normal tissue from patients with CRC. In addition, we investigated the relationship between TAF and systemic inflammation, mirrored by the elevation of interleukin-6 (IL-6) and TAF levels in plasma. Levels of TAF and IL-6 were determined by ELISA. Immunohistochemistry was performed to investigate the site of TAF expression. We also used a TaqMan system to investigate a TAF single nucleotide polymorphism (rs2041437) with a potential effect on CRC. TAF protein levels were significantly (P<0.001) higher in colorectal tumours than in normal tissue, and were increased in patients with Dukes' stages B and C compared to A. Immunohistochemistry revealed heterogeneous TAF expression mainly in the epithelial cells of the cancer and normal tissue. The plasma TAF level was reduced in CRC patients compared with the controls (P=0.002), independent of the inflammatory marker IL-6. Regarding genotype and allelic distributions, significant differences between CRC patients and control subjects or associations between clinical characteristics and TAF levels in tissue and plasma were not observed. In conclusion, altered TAF protein expression in cancer tissue may be a potential biomarker in colorectal carcinogenesis. Further research exploring the regulation of TAF is required to evaluate whether TAF is linked to clinical outcome.

  • 41.
    Nejati, Babak
    et al.
    Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Lin, Chien-Chin
    Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
    Aaronson, Neil K.
    Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands.
    Cheng, Andy S. K.
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma2019In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 7, p. 1490-1497Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To identify determinants of shared decision making in patients with multiple myeloma (MM) to facilitate the design of a program to maximize the effects of shared decision making.

    METHODS: This prospective longitudinal study recruited 276 adult patients (52% male, mean age 62.86 y, SD 15.45). Each patient completed the eHealth Literacy Scale (eHEALS), Multidimensional Trust in Health Care Systems Scale (MTHCSS), Patient Communication Pattern Scale (PCPS), and 9-Item Shared Decision-Making Questionnaire (SDM-Q-9) at baseline and the SDM-Q-9 again 6 months later. One family member of the patient completed the Family Decision-Making Self-Efficacy (FDMSE) at baseline. Structural equation modeling (SEM) was used to investigate the associations between eHealth literacy (eHEALS), trust in the health care system (MTHCSS), self-efficacy in family decision making (FDMSE), patient communication pattern (PCPS), and shared decision making (SDM-Q-9).

    RESULTS: SEM showed satisfactory fit (comparative fit index = 0.988) and significant correlations between the following: eHealth literacy and trust in the health care system (β = 0.723, P < 0.001); eHealth literacy and patient communication pattern (β = 0.242, P < 0.001); trust in the health care system and patient communication pattern (β = 0.397, P < 0.001); self-efficacy in family decision making and patient communication pattern (β = 0.264, P < 0.001); eHealth literacy and shared decision making (β = 0.267, P < 0.001); and patient communication pattern and shared decision making (β = 0.349, P < 0.001).

    CONCLUSIONS: Patient communication and eHealth literacy were found to be important determinants of shared decision making. These factors should be taken into consideration when developing strategies to enhance the level of shared decision making.

  • 42.
    Oliva, Delmy
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Hallingbäck, Anna
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Icke farmakologisk behandling av illamående och kräkningar hos kvinnor med bröstcancer som behandlas med cytostatika2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Illamående och kräkningar hos kvinnor som behandlas med cytostatika mot bröstcancer är ettomfattande problem inom den onkologiska omvårdnaden. Många kvinnor upplever, trots välutvecklade läkemedel för att motverka cytostatika utlöst illamående och kräkningar denna, förmånga fruktade biverkan. Syftet med litteraturöversikten var att finna förebyggande ochlindrande icke farmakologiska metoder som kan hjälpa till att minska det cytostatika utlöstaillamåendet och kräkningarna som kan uppstå hos kvinnor med bröstcancer i samband medcytostatikabehandlingen och effekten av dessa metoder.

    Som teoretiskt stöd användes Orem´s egenvårdsteori och för att identifiera metoderna gjordesen litteraturöversikt med kvantitativa originalartiklar ur vetenskapliga tidskrifter. De ickefarmakologiska metoderna som studerades var akupressur, elektroakupunktur, yoga,fysiskträning, massage och utbildning.Användandet av dessa icke farmakologiska metoder visade på en minskning av cytostatikautlöst illamående och kräkningar, antingen som placeboeffekt eller som faktisk effekt. Sombifynd diskuteras ångest och stress effekt på illamående och kräkningar, eftersom metodernavisat sig kunna inverka och förbättra kvinnornas sinnesstämning genom suggestion.De studerade icke farmakologiska metoderna är förhållandevis lätta att tillämpa och är inte såtidskrävande. Även om metoderna visat en minskning av illamående och kräkningar utlösta av cytostatika, är kunskapsbasen med avseende på effekten inte fullständig och detbehövs mer forskning.

  • 43.
    Oliva, Delmy
    et al.
    Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
    Nilsson, Mats
    Futurum - The Academy for Healthcare, Region Jönköping County, Jönköping, Sweden.
    Strandéus, Michael
    Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
    Andersson, Bengt-Åke
    Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; and Department of Laboratory medicine, Region Jönköping County, Jönköping, Sweden.
    Sharp, Lena
    Regional Cancer Centre, Stockholm-Gotland, Stockholm, Sweden.
    Laytragoon-Lewin, Nongnit
    Department of Laboratory medicine, Region Jönköping County, Jönköping, Sweden.
    Lewin, Freddi
    Department of Oncology, Ryhov County Hospital, Jönköping, Sweden.
    Individual genetic variation might predict acute skin reactions in women undergoing adjuvant breast cancer radiotherapy2018In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 38, no 12, p. 6763-6770Article in journal (Refereed)
    Abstract [en]

    Adverse skin reactions during radiotherapy (RT) are common. The aim of this study was to explore whether genetic variation might be linked to acute radiation skin reactions (ARSR). Materials and Methods: One hundred and nineteen women undergoing adjuvant RT for breast cancer were included. The symptoms of itching, burning and irritation were self-reported twice using the visual analogue scale. Assessments used the Radiation Therapy Oncology Group scoring system for acute RT skin reaction (RTOG scale). Blood-based single nucleotide polymorphism (SNP) analysis was performed. Thirty SNPs of well-defined functional genes were investigated. Results: All women were assessed with ARSR. After RT, the women self-reported itching (n=97), burning (n=64) and irritation (n=96). Two SNPs in X-Ray Repair Cross Complementing 2 gene (XRCC2) rs2040639 and interferon gamma (IFNG) rs2069705 genes were found to be associated with ARSR. Conclusion: An association between two SNPs and ARSR was found. The possibility of using these SNPs as prognostic biomarkers for ARSR as tools to improve the care of patients needs further investigation. 

  • 44.
    Olsen, Renate S.
    et al.
    Ryhov County Hospital, Jönköping, Sweden.
    Andersson, Roland E.
    Ryhov County Hospital, Jönköping, Sweden.
    Zar, Niklas
    Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Ryhov County Hospital, Jönköping, Sweden.
    Wågsäter, Dick
    Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Matussek, Andreas
    Ryhov County Hospital, Jönköping, Sweden.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Prognostic significance of PLA2G4C gene polymorphism in patients with stage II colorectal cancer2016In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, no 4, p. 474-479Article in journal (Refereed)
    Abstract [en]

    Background: Phospholipase A2 Group IV C (PLA2G4C) catalyzes the release of certain fatty acids from phospholipids and plays a role in a range of physiological functions, such as remodeling of cell membranes and the production of prostaglandins. Furthermore, it has been proposed that PLA2G4C plays an important role in breast cancer cell chemotaxis. This study aimed to investigate the effect of a single nucleotide polymorphism (SNP) rs1549637 (T>A) of the PLA2G4C gene on the prognosis of colorectal cancer (CRC).

    Material and methods: Whole blood DNA was extracted from 381 patients with CRC and 618 controls, and a TaqMan SNP genotyping assay was used to determine the distribution of the genotypes. Cancer-specific and disease-free survival was analyzed by Kaplan-Meier graphs and by uni- and multivariable Cox regression.

    Results: The cancer-specific survival differed between the genotypes (p  = 0.019) and the carriers of the A allele were associated with the highest risk of CRC death, with a hazard ratio (HR) of 1.72 [95% confidence interval (CI) 1.17–2.53, p = 0.006] compared with homozygous carriers of the T allele. This increased mortality in the carriers with the allele A was especially marked in stage II with an HR of 3.84 (95% CI 1.51–9.78, p = 0.005).

    Conclusion: The A allele in PLA2G4C SNP (rs1549637) is associated with a worse prognosis in patients with CRC, especially in stage II disease, and it could be a potential prognostic biomarker in the planning of individual adjuvant therapy in stage II patients.

  • 45.
    Olsen, Renate S.
    et al.
    Division of Medical Diagnostics, Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Nijm, Johnny
    Division of Medical Diagnostics, Department of Clinical Physiology, Region Jönköping County, Jönköping, Sweden.
    Andersson, Roland E.
    Department of Surgery, Region Jönköping County, Jönköping, Sweden.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Wågsäter, Dick
    Division of Drug Research, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Circulating inflammatory factors associated with worse long-term prognosis in colorectal cancer2017In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 23, no 34, p. 6212-6219Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate association of circulating inflammatory factors at the time of colorectal cancer (CRC) surgery with survival.

    METHODS: Plasma levels from 174 CRC patients (69 females and 105 men), with median age 70 years (range 29-90), localized in the colon (n = 105) or rectum (n = 69), with stage I (n = 24), stage II (n = 54), stage III (n = 67) and stage IV (n = 29) were measured using commercially available Bio-Plex Pro™ Human Chemokine Panel 40-Plex, including 40 different chemokines, cytokines and interleukins. The prognostic association of each inflammatory factor was analysed as CRC-specific and total mortality.

    RESULTS: Out of 174 patients, 66 died during the follow-up, 40 because of CRC specific mortality. High tertile levels of 8 factors were significantly associated with increased CRC-specific mortality, of which CCL1, CCL20, CCL24, CX3CL1, IL-4 and TNF-α remained significant in a multivariate Cox regression analysis. High tertile levels of 14 factors were associated with increased total mortality, of which CCL1, CCL15, CCL20, CX3CL1, CXCL13, IFN-γ, IL-2, IL-4 and IL-10 remained significant after adjustment for clinical covariates. For most of the inflammatory factors the association between higher tertile levels and an increased mortality in general appeared two years after surgery. High tertile levels of TNF-α and CCL24 were exclusively associated with CRC-specific mortality. The distribution of these factors were not associated with TNM stage with exception for CCL20.

    CONCLUSION: High plasma levels of inflammatory factors are associated with increased risk of mortality among CRC patients and could be potential biomarkers for revealing prognosis.

  • 46.
    Olsen, Renate Slind
    et al.
    Department of Laboratory Medicine, Division of Medical Diagnostics, Region Jönköping County, Jönköping, Sweden.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Geffers, Robert
    Genome Analytics, Helmholtz Centre for Infection Research, Braunschweig, Germany.
    Wågsäter, Dick
    Division of Drug Research, Department of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Possible role and therapeutic target of PDGF-D signalling in colorectal cancer2019In: Cancer Investigation, ISSN 0735-7907, E-ISSN 1532-4192, Vol. 37, no 2, p. 99-112Article in journal (Refereed)
    Abstract [en]

    Platelet-derived growth factor D (PDGF-D) has been shown to mediate cellular processes of importance in cancer progression. This study aimed to investigate the expression and putative involvement of PDGF-D signaling in colorectal carcinogenesis. PDGF-D was expressed in vascular endothelial cells in tumor and normal tissues. PDGF-D stimulation of cells altered genes of importance in carcinogenic processes. In addition, PDGF-D increased the proliferation rate while imatinib inhibited these effects. PDGF-D and its PDGF receptor beta (PDGFR-β) are expressed in colorectal cancer and blockage of PDGF-D/PDGFR-β signaling using tyrosine kinase inhibitors, such as imatinib, might be important in inhibiting tumor-promoting actions.

  • 47.
    Olsson, Maria
    et al.
    Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Steineck, Gunnar
    Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Wilderäng, Ulrica
    Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Jarfelt, Marianne
    Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Self-Perceived physical attractiveness in relation to scars among adolescent and young adult cancer survivors: A population-based study2018In: Journal of Adolescent and Young Adult Oncology, ISSN 2156-5333, Vol. 7, no 3, p. 358-366Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Cancer treatment may result in various effects that last long after treatment has been concluded. The purpose of this study was to explore to what extent scars affect adolescents and young adults postcancer treatment.

    METHODS: In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. Question development involved expert validation by professionals from oncology units, midwives, epidemiologists, and statisticians. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors. The topics covered in the questionnaire were as follows: psychosocial health, body image and sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to teenage and young adult cancer survivors and matched controls in Sweden.

    RESULTS: In this study, the relative risk of feeling less attractive due to scars was higher both for female cancer survivors RR 1.48, CI 1.05-2.08 and male cancer survivors RR 1.90, CI 1.15-3.13 compared to controls. The feeling of attractiveness was negatively related to the size of scars in both cancer and control groups. In a logistic regression analysis, significant associations were found between age, education, exercise, depression, and the feeling of low attractiveness due to scars.

    CONCLUSIONS: The results of this study provide a basis for care interventions for teenage and young adult cancer patients during and after cancer treatment. Further research is needed on care interventions to reduce, if possible, the impact of scars.

  • 48.
    Olsson, Maria
    et al.
    Institute of Clinical Sciences, Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Steineck, Gunnar
    Department of Oncology, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Wilderäng, Ulrica
    Department of Oncology, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Jarfelt, Marianne
    Institute of Clinical Sciences, Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Adolescent and young adult cancer survivors' perceptions of participating in a survey - Ethical and methodological considerations2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 55-61Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to understand patient-reported perception of participation in a population-based web-survey focusing on sensitive issues for adolescent and young adult cancer survivors.

    METHOD: A population-based web survey for adolescent and young adult cancer survivors including a matched control group. Adolescent and young adult cancer survivors from the population-based Swedish National Cancer Registry from four of the six register holders at Regional Cancer Centers in Sweden. Controls were randomly identified from the Swedish National Population registry, from the same register holders.

    RESULT: Of 729 eligible participants, 540 completed the survey i.e. 74% participation rate. The study population included 285 adolescent and young adult cancer survivors and 255 matched controls. None of the participants answered that the survey had a very negative impact on them and a minority of 43 (7.9%) of the 540 responded that they were mildly negatively affected by their participation in the study. There was a no significant difference between patients and controls regarding the negative effect of the participation (p = 0.29). Positive experiences of participating in the study were widely expressed and most participants (95%) found the study valuable.

    CONCLUSIONS: These findings suggest that the benefits clearly outweigh the risks when adolescent and young adult cancer survivors participate in surveys including sensitive and trauma-related aspects, given that the study design is ethically sound and participants are approached carefully. We also present a modified ethical protocol for epidemiological surveys on adolescents and young adult cancer survivors.

  • 49.
    Olsson, Maria
    et al.
    Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Steineck, Gunnar
    Institute of Clinical Sciences, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Wilderäng, Ulrica
    Institute of Clinical Sciences, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Jarfelt, Marianne
    Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Sexual function in adolescent and young adult cancer survivors - a population-based study2018In: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 12, no 4, p. 450-459Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Previous research has established that treatments for cancer can result in short- and long-term effects on sexual function in adult cancer patients. The purpose was to investigate patient-reported physical and psychosexual complications in adolescents and young adults after they have undergone treatment for cancer.

    METHODS: In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors (15-29 years) and validated by professionals from oncology units, midwives, epidemiologists, and statisticians. The topics covered in the questionnaire were psychosocial health, body image, sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to adolescent and young adult cancer survivors and matched controls in Sweden.

    RESULTS: In this study, adolescent and young adult cancer survivors (15-29 years) showed low satisfaction regarding sexual function compared to controls (P < 0.01). Female adolescent and young adult cancer survivors had a statistically significant lower frequency of orgasm during sexual activity than the controls (P < 0.01). Male adolescent and young adult cancer survivors had statistically significant lower sexual desire than the controls (P = 0.04).

    CONCLUSIONS: We found that adolescent and young adult cancer survivors perceived themselves as being less satisfied with their sexual function than matched population-based controls.

    IMPLICATIONS FOR CANCER SURVIVORS: Adolescent and young adult cancer survivors need psychological rehabilitation support from the health care profession during and after cancer treatment to help them to reduce their reported poor sexual function to enhance a good sexual quality of life.

  • 50. Osorio, A.
    et al.
    Milne, R. L.
    Pita, G.
    Peterlongo, P.
    Heikkinen, T.
    Simard, J.
    Chenevix-Trench, G.
    Spurdle, A. B.
    Beesley, J.
    Chen, X.
    Healey, S.
    Neuhausen, S. L.
    Ding, Y. C.
    Couch, F. J.
    Wang, X.
    Lindor, N.
    Manoukian, S.
    Barile, M.
    Viel, A.
    Tizzoni, L.
    Szabo, C. I.
    Foretova, L.
    Zikan, M.
    Claes, K.
    Greene, M. H.
    Mai, P.
    Rennert, G.
    Lejbkowicz, F.
    Barnett-Griness, O.
    Andrulis, I. L.
    Ozcelik, H.
    Weerasooriya, N.
    Gerdes, A. -M
    Thomassen, M.
    Cruger, D. G.
    Caligo, M. A.
    Friedman, E.
    Kaufman, B.
    Laitman, Y.
    Cohen, S.
    Kontorovich, T.
    Gershoni-Baruch, R.
    Dagan, E.
    Jernström, H.
    Askmalm, M. S.
    Arver, B.
    Malmer, B.
    Domchek, S. M.
    Nathanson, K. L.
    Brunet, J.
    Ramón Y Cajal, T.
    Yannoukakos, D.
    Hamann, U.
    Hogervorst, F. B. L.
    Verhoef, S.
    Garcíla, E. B. G.
    Wijnen, J. T.
    Van Den Ouweland, A.
    Easton, D. F.
    Peock, S.
    Cook, M.
    Oliver, C. T.
    Frost, D.
    Luccarini, C.
    Evans, D. G.
    Lalloo, F.
    Eeles, R.
    Pichert, G.
    Cook, J.
    Hodgson, S.
    Morrison, P. J.
    Douglas, F.
    Godwin, A. K.
    Sinilnikova, O. M.
    Barjhoux, L.
    Stoppa-Lyonnet, D.
    Moncoutier, V.
    Giraud, S.
    Cassini, C.
    Olivier-Faivre, L.
    Révillion, F.
    Peyrat, J. -P
    Muller, D.
    Fricker, J. -P
    Lynch, H. T.
    John, E. M.
    Buys, S.
    Daly, M.
    Hopper, J. L.
    Terry, M. B.
    Miron, A.
    Yassin, Y.
    Goldgar, D.
    Singer, C. F.
    Gschwantler-Kaulich, D.
    Pfeiler, G.
    Spiess, A. -C
    Hansen, T. V. O.
    Johannsson, O. T.
    Kirchhoff, T.
    Offit, K.
    Kosarin, K.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E. N.
    Allavena, A.
    Schmutzler, R. K.
    Versmold, B.
    Engel, C.
    Meindl, A.
    Ditsch, N.
    Arnold, N.
    Niederacher, D.
    Deiler, H.
    Fiebig, B.
    Varon-Mateeva, R.
    Schaefer, D.
    Froster, U. G.
    Caldes, T.
    De La Hoya, M.
    McGuffog, L.
    Antoniou, A. C.
    Nevanlinna, H.
    Radice, P.
    Benítez, J.
    Evaluation of a candidate breast cancer associated SNP in ERCC4 as a risk modifier in BRCA1 and BRCA2 mutation carriers. Results from the consortium of investigators of modifiers of BRCA1/BRCA2 (CIMBA)2009In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 101, no 12, p. 2048-2054Article in journal (Refereed)
    Abstract [en]

    Background: In this study we aimed to evaluate the role of a SNP in intron 1 of the ERCC4 gene (rs744154), previously reported to be associated with a reduced risk of breast cancer in the general population, as a breast cancer risk modifier in BRCA1 and BRCA2 mutation carriers. Methods: We have genotyped rs744154 in 9408 BRCA1 and 5632 BRCA2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and assessed its association with breast cancer risk using a retrospective weighted cohort approach. Results: We found no evidence of association with breast cancer risk for BRCA1 (per-allele HR: 0.98, 95% CI: 0.93-1.04, P0.5) or BRCA2 (per-allele HR: 0.97, 95% CI: 0.89-1.06, P0.5) mutation carriers. Conclusion: This SNP is not a significant modifier of breast cancer risk for mutation carriers, though weak associations cannot be ruled out.

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