General Swedish Population Research Articles

Preferences for improvements in attributes associated with basal insulin: a time trade-off and willingness-to-pay survey of a diabetic and non-diabetic population in Sweden

Objective: Apart from improved health outcomes, treatment convenience per se may have a value to individuals. This is sometimes referred to as process utility and can be estimated in terms of willingness-to-pay (WTP) or quality-adjusted life-years (QALYs). Previous research has produced multiple studies on QALY gains and WTP estimates of insulin-related attributes. There are, however, significant variations between studies, and it is not clear to what extent the value is a reflection of the true preferences or a consequence of the methodological approach. The aim of this study is to estimate the preferences for treatment attributes associated with basal insulin (administration frequency, administration flexibility, and treatment-induced weight gain) using both QALYs—elicited using time trade-off (TTO) and WTP—among a sample of the Swedish general population and among a sample of the Swedish diabetes population.Methods: Data was collected using web-based surveys which were distributed to members of internet panels. The WTP survey presented five hypothetical scenarios with an offer to pay the incremental cost to receive basal insulin with improved attributes. The TTO survey presented six hypothetical scenarios where the respondent could choose between living for the rest of his/her life with diabetes and receiving treatment with a basal insulin with certain attributes or live for a shorter time with full health. The scenarios were combined with either a basal or a basal–bolus treatment regimen. Results from the TTO analysis were translated into monetary estimates using a threshold value of SEK500,000 per QALY.Results: In total, 2012 responses were included. The ratings of the attributes were almost identical, irrespective of method for the general population, while it differed to some extent for the diabetes population. The methods produced the same value for flexibility, but the estimates generated with the TTO approach were higher for one less injection and avoided weight gain. The general population assigned a higher utility gain to convenience attributes, while the diabetes population assigned a higher utility gain to avoiding weight gain.Limitations: About a quarter of the respondents did not accept the scenario in the WTP survey, i.e. protesters.Conclusions: The ranking of the attributes was generally independent of evaluation method, but the TTO method resulted in similar or higher values compared to the WTP method.

The Youth Psychopathic Traits Inventory-Short Version in a general population sample of emerging adults.

Prior studies with children and adolescents have shown that Youth Psychopathic Traits Inventory-Short Version (YPI-S) scores are internally consistent and manifest expected relations with external variables of interest. In the present study, the factor structure and the internal consistency of YPI-S scores, and the convergent validity of the interpretation of YPI-S scores were tested in a sample of 2,500 emerging adults from the general population in Sweden (aged 20-24 years; 52.6% women). Results of exploratory and confirmatory factor analyses support a 3-factor structure among both men and women that is similar to prior YPI-S studies conducted with children and adolescents. The YPI-S total score and the 3 factor scores were internally consistent. Correlations with external variables, including aggression and delinquency, support the convergent validity of the interpretation of YPI-S scores. Finally, the strength of these zero-order and partial correlations, overall, was not significantly different across gender. In conclusion, this study provides initial evidence that the YPI-S may hold promise as a brief and time-effective self-report tool for assessing psychopathic traits in emerging adults. The present findings also suggest that the YPI-S performs in a consistent manner across gender. Recommendations for future research with the YPI-S are discussed. (PsycINFO Database Record

ACTN3 Genotype Affects Change in Muscle Fiber Cross-Sectional Area from Adolescence to Adulthood

INTRODUCTION: Alpha-actinin-3 is a Z-disc protein that is expressed only in type II muscle fibers. Common null polymorphism in the ACTN3 gene (R577X) results in lack of this protein in XX-genotypes. In sprint/power oriented elite athletes the prevalence of the X-allele is much lower than in control populations. That implies that lack of alpha-actinin-3 is detrimental for these athletes but a mechanistic link is not fully established. We have previously shown that ACTN3 genotype modulates skeletal muscle hypertrophy signaling in response to sprint exercise in moderately trained subjects. PURPOSE: To examine the impact of ACTN3 genotype on changes in fiber dimensions from adolescence to adulthood. METHODS: 63 male and female subjects (13 XX, 29 RX, 21 RR) from the general Swedish population were studied at 16 and 27 years of age. Their physical activity level was estimated by a questionnaire. Muscle samples were obtained from vastus lateralis muscle by needle biopsy technique. The samples were analyzed histochemically for fiber types (I, IIA, IIB). Cross-sectional area (CSA) of the different fiber types was measured from histological sections by planimetry. DNA was extracted from muscle samples and the genotyping was performed by allelic discrimination. Statistical analyses of the effect of ACTN3 and sex on changes in CSA with age were performed by ANOVA and multiple regression analysis. RESULTS: A significant difference in the relative change of CSA with age, across ACTN3 genotypes was observed in type IIA fibers (ANOVA P=0.02) but not in type I fibers and type IIB fibers. The change, expressed as 27-16 years/16-years value, was in type IIA fibers -4.2%, -2.5% and 7.7% in XX, RX and RR respectively and in type IIB -3.0%, -3.4%, and 9.9% in XX, RX and RR respectively. Multiple regression analysis showed that the change in CSA of type IIA fibers was dependent on ACTN3 genotype, while the change in CSA of type IIB was equally dependent on ACTN3 genotype and sex. No ACTN3 genotype effect was observed for the CSA change in type I fibers where alpha-actinin-3 is not expressed. No significant differences in CSA were detected across ACTN3 genotypes either at 16 or 27 years. CONCLUSION: ACTN3 genotype is strongly suggested to be a determinant of dimensions of type II skeletal muscle fibers in humans which supports the findings in ACNT3 knock out mice.

Screening of Two ADH4 Variations in a Swedish Cluster Headache Case-Control Material.

BackgroundCluster headache (CH) is a severe neurovascular disorder and an increasing amount of evidence points to a genetic contribution to this disease. When CH was first described, it was observed that alcohol may precipitate an attack during the active phase of the disease. The alcohol dehydrogenase 4 (ADH4) gene encodes an enzyme which contributes to the metabolization of alcohol and is, therefore, an interesting candidate gene for CH. Two Italian groups have reported association of the single nucleotide polymorphism (SNP) rs1126671 located in the ADH4 gene with an increased risk of CH in Italy. In addition, one of the groups found an association between the ADH4 SNP rs1800759 and CH.ObjectiveTo perform a replication study on the ADH4 SNPs rs1126671 and rs1800759 in a large homogeneous Swedish case–control cohort in order to further investigate the possible contribution of ADH4 to CH.MethodsA total of 390 unrelated patients diagnosed with CH and 389 controls representing a general Swedish population were recruited to the study. DNA samples from patients and controls were genotyped for the two ADH4 SNPs rs1126671 and rs1800759 using quantitative real‐time polymerase chain reaction. Statistical analyses of genotype, allele and haplotype frequencies for the two SNPs were performed and compared between patients and controls.ResultsFor rs1126671, the minor allele frequency (A allele) was 32.8% (n = 254) in controls compared with 31.9% (n = 249) in CH patients. The minor allele frequency (A allele) of rs1800759 was 42.3% (n = 324) in controls and 41.9% (n = 327) in CH patients. Statistical analysis showed no significant differences in allele as well as in genotype or haplotype frequencies between the patient and control group for either SNP. This was also seen after stratifying the patient group for experiencing alcohol as a trigger factor.ConclusionsThe data did not support an association of the ADH4 SNPs rs1126671 and rs1800759 with CH. A comparison with previous studies revealed variance in genotype, allele, and haplotype frequencies among the different populations which might contribute to the contradictory results. Although a significant association with CH in Swedish case–control group was not found, ADH4 as a candidate gene for CH could not be excluded.

A novel sibling-based design to quantify genetic and shared environmental effects: application to drug abuse, alcohol use disorder and criminal behavior.

Twin studies have been criticized for upwardly biased estimates that might contribute to the missing heritability problem. We identified, from the general Swedish population born 1960-1990, informative sibships containing a proband, one reared-together full- or half-sibling and a full-, step- or half-sibling with varying degrees of childhood cohabitation with the proband. Estimates of genetic, shared and individual specific environment for drug abuse (DA), alcohol use disorder (AUD) and criminal behavior (CB), assessed from medical, legal or pharmacy registries, were obtained using Mplus. Aggregate estimates of additive genetic effects for DA, AUD and CB obtained separately in males and females varied from 0.46 to 0.73 and agreed with those obtained from monozygotic and dizygotic twins from the same population. Of 54 heritability estimates from individual classes of informative sibling trios (3 syndromes × 9 classes of trios × 2 sexes), heritability estimates from the siblings were lower, tied and higher than those from obtained from twins in 26, one and 27 comparisons, respectively. By contrast, of 54 shared environmental estimates, 33 were lower than those found in twins, one tied and 20 were higher. With adequate information, human populations can provide many methods for estimating genetic and shared environmental effects. For the three externalizing syndromes examined, concerns that heritability estimates from twin studies are upwardly biased or were not generalizable to more typical kinds of siblings were not supported. Overestimation of heritability from twin studies is not a likely explanation for the missing heritability problem.

World Gastroenterology Organisation Global Guidelines: GERD Global Perspective on Gastroesophageal Reflux Disease.

PROBIOTICS—THE CONCEPTHistory and DefinitionsA century ago, Elie Metchnikoff (a Russian scientist, Nobel laureate, and professor at the Pasteur Institute in Paris) postulated that lactic acid bacteria (LAB) offered health benefits capable of promoting longevity. He suggested that “intestinal autoint

Mortality Is Not Increased in Recombinant Human Growth Hormone-treated Patients When Adjusting for Birth Characteristics.

This study aimed to investigate whether reported high mortality in childhood recombinant human GH (rhGH)-treated patients was related to birth-characteristics and/or rhGH treatment. We sought to develop a mortality model of the Swedish general population born between 1973 and 2010, using continuous-hazard functions adjusting for birth characteristics, sex, age intervals, and calendar year to estimate standardized mortality ratio (SMR) and to apply this model to assess expected deaths in Swedish rhGH-treated patients with idiopathic isolated GH deficiency (IGHD), idiopathic short stature (ISS) or born small for gestational age (SGA). The general population: Swedish Medical Birth Register (1973-2010: 1 880 668 males; 1 781 131 females) and Cause of Death Register (1985-2010). Intervention Population: Three thousand eight hundred forty-seven patients starting rhGH treatment between 1985 and 2010 and followed in the National GH Register and/or in rhGH trials diagnosed with IGHD (n = 1890), ISS (n = 975), or SGA (n=982). Death. Using conventional models adjusting for age, sex, and calendar-year, the SMR was 1.43 (95% confidence interval, 0.89-2.19), P = .14, observed/expected deaths 21/14.68. The rhGH population differed (P < .001) from the general population regarding birth weight, birth length, and congenital malformations. Application of an Advanced Model: When applying the developed mortality model of the general population, the ratio of observed/expected deaths in rhGH-treated patients was 21/21.99; SMR = 0.955 (0.591-1.456)P = .95. Model Comparison: Expected number of deaths were 14.68 (14.35-14.96) using the conventional model, and 21.99 (21.24-22.81) using the advanced model, P < .001, which had at all ages a higher gradient of risk per SD of the model, 24% (range, 18-42%; P < .001). Compared with the general Swedish population, the ratio of observed/expected deaths (21/21.99) was not increased in childhood rhGH-treated IGHD, ISS, and SGA patients when applying an advanced sex-specific mortality model adjusting for birth characteristics.

Victimized as a child or youth

Being victimized as a child or youth increases the risk of emotional and behavioural problems, and may call for a report to authorities and professional support. This study investigates how often young adult males and females in a randomly selected general population in Sweden ( n = 2,500) reported different types of victimization as a child or youth and to whom, from whom they received professional support, whether it was more common to receive professional support among those victimized multiple times by different types of crime, and whether there was a connection between report and support. Analyses reveal that the participants more often responded that they had not reported their victimization, than that they had reported it. For those who had, the police was the most common institution to which the victimization was reported. It was significantly more common for victimized females to both report and receive professional support than for males. There was a trend towards a greater likelihood of receiving professional support after higher levels of victimization. In all however, of those whose victimization had been reported to the authorities, only 22.4% had received professional support to deal with their experiences of victimization. We conclude that the relatively low prevalence of reporting victimization and receiving support documented in this study calls for reflection upon how well society meets the needs of victims.

Increased Long-Term Cardiovascular Risk After Total Hip Arthroplasty: A Nationwide Cohort Study.

Total hip arthroplasty is a common and important treatment for osteoarthritis patients. Long-term cardiovascular effects elicited by osteoarthritis or the implant itself remain unknown. The purpose of the present study was to determine if there is an increased risk of late cardiovascular mortality and morbidity after total hip arthroplasty surgery.A nationwide matched cohort study with data on 91,527 osteoarthritis patients operated on, obtained from the Swedish Hip Arthroplasty Register. A control cohort (n = 270,688) from the general Swedish population was matched 1:3 to each case by sex, age, and residence. Mean follow-up time was 10 years (range, 7-21).The exposure was presence of a hip replacement for more than 5 years. The primary outcome was cardiovascular mortality after 5 years. Secondary outcomes were total mortality and re-admissions due to cardiovascular events.During the first 5 to 9 years, the arthroplasty cohort had a lower cardiovascular mortality risk compared with the control cohort. However, the risk in the arthroplasty cohort increased over time and was higher than in controls after 8.8 years (95% confidence interval [CI] 7.0-10.5). Between 9 and 13 years postoperatively, the hazard ratio was 1.11 (95% CI 1.05-1.17). Arthroplasty patients were also more frequently admitted to hospital for cardiovascular reasons compared with controls, with a rate ratio of 1.08 (95% CI 1.06-1.11).Patients with surgically treated osteoarthritis of the hip have an increased risk of cardiovascular morbidity and mortality many years after the operation when compared with controls.

Age-Related Differences in Quality of Life in Swedish Women with Endometriosis.

The purpose of this observational study was to evaluate the impact of endometriosis on quality of life (QoL) in different age groups of Swedish women with endometriosis. Recruitment occurred through the Endometriosis Association (Sweden) (n = 400) and five gynecology departments of five Swedish hospitals (n = 400). All voluntary female members of the patient organization and patients attending specialist clinics due to endometriosis (n = 800) were invited by sending them a questionnaire. An age- and gender-matched sample of the general Swedish population was used as a control group when analyzing SF-36 data. A postal questionnaire (including SF-36) was distributed to 800 women. The questionnaire was evaluated by using descriptive statistics, and SF-36 was evaluated according to standard methods. Of the 449 (56%) self-administered questionnaires returned, 431 (96%) contained evaluable answers. Women with endometriosis have significantly lower SF-36 scores than the general female Swedish population, and the score depends on the women's age. Younger women experience more symptoms and have a lower QoL score compared with women in the older age group. Women with endometriosis have significantly lower QoL than the general female Swedish population and it depends on the women's age, where younger women express more symptoms and have a lower QoL compared with women in the older age group. Our results highlight that more healthcare resources should be focused on younger women with endometriosis.

Primary anterior dislocation of the shoulder: long-term prognosis at the age of 40 years or younger

We describe the long-term prognosis in 257 first-time anterior shoulder dislocations (255 patients, aged 12-40 years) registered at 27 Swedish emergency units between 1978 and 1979. Half the shoulders were immobilised for 3-4 weeks after repositioning. Follow-ups were performed after two (questionnaire), five (questionnaire), 10 (questionnaire and radiology) and 25 (questionnaire and radiology) years in 227 patients (229 shoulders). Twenty-eight patients died during the 25 years of observation. Early movement or immobilisation after the primary dislocation resulted in the same long-term prognosis. Recurrences increased up to 10 years of follow-up, but, after 25 years, 29 % of the shoulders with ≥2 recurrences appeared to have stabilised over time. Arthropathy increased from 9 % moderate to severe and 11 % mild at 10 years, to 34 % moderate to severe and 27 % mild after 25 years. Alcoholics had a poorer prognosis with respect to dislocation arthropathy (P < 0.001). Age <25 years and/or bilateral instability represent a poorer prognosis, where stabilising surgery is necessary in every second shoulder. Fracture of the greater tuberosity means a good prognosis, and we have found no evidence that athletic activity, gender, a Hill-Sachs lesion and minor rim fractures had any prognostic impact. During the 25 years in which these patients were followed, 28/255 died (11 %), representing a mortality rate (SMR) that was more than double that of the general Swedish population (P < 0.001). Almost half of all first-time dislocations at the age of <25 years will have stabilising surgery and two-thirds will develop different stages of arthropathy within 25 years.

Sleep disturbances among Swedish soldiers after military service abroad

Aims Since 1956, more than 100,000 Swedish soldiers have served abroad on various international missions. The aim of this paper was to determine whether there was a connection between military service abroad and sleep disorders among Swedish soldiers.Methods The prevalence of sleep disturbances among 1,080 veterans from Kosovo and Afghanistan was compared with almost 27,000 Swedes from a general population sample, using propensity score matching and logistic regression. The sleep disturbances studied were habitual snoring, difficulty inducing sleep (DIS), difficulty maintaining sleep (DMS), early morning awakenings (EMA), and excessive daytime sleepiness (EDS). Insomnia was defined as having at least one of DIS, DMS, or EMA. The covariates used in the matching and adjustments were age, gender, smoking habits, BMI, education, ever having had asthma, moist snuff, and exercise habits.Results The veterans had a significantly lower prevalence of insomnia (26.2% versus 30.4%) and EDS (22.7% versus 29.4%) compared with a matched group from the reference population, using propensity score matching. Analyses with logistic regression showed that belonging to the military population was related to a lower risk of having DMS (adjusted OR (95% CI) 0.77 (0.64–0.91)), insomnia (OR 0.82 (0.71–0.95)), and EDS (OR 0.74 (0.63–0.86)), whereas no significant difference was found for snoring, DIS, and EMA.Conclusion Swedish veterans have fewer problems with insomnia and daytime sleepiness than the general Swedish population. The explanation of our findings may be the selection processes involved in becoming a soldier and when sampling personnel for military assignments abroad.

Causes of death and mortality in hypertrophic cardiomyopathy patients with implantable defibrillators in Sweden.

Implantable defibrillators (ICDs) successfully terminate ventricular arrhythmias in hypertrophic cardiomyopathy (HCM), protect against bradycardia, and monitor atrial arrhythmias. This may alter the natural history and causes of death. This nationwide observational longitudinal retrospective study of all HCM patients implanted during 1995-2012 obtained data from the Swedish ICD Registry, the National Patient Register, the Cause of Death Register, and were validated by review of medical records. Of 342 patients (mean age 51.8 years, 70.8% males), 45 died during a total follow-up of 1847 years (mean 5.4 years). Mean age at death was 68.2 years (range 21-83 years; 12 were ≥75 years). Mean follow-up time among the deceased was 4.9 years (quartiles 1.4-7.4 years). All-cause mortality was higher in HCM patients compared with the age and sex-matched Swedish general population (standardized mortality ratio 3.4; 95% confidence interval 2.4-4.5; P < 0.001). Main cause of death was heart failure (n = 27), stroke (n = 5), cancer (n = 3), myocardial infarction (n = 2), sepsis (n = 2), and others (n = 4). Two patients died suddenly, one after the ICD was turned off because of inappropriate shocks, and one patient whose device system was removed after infection. HCM was the main cause of death in 76% of the cases, mainly because of progressive heart failure. For HCM patients, ICDs almost eliminate premature arrhythmic death and result in a shift to heart failure as the cause of death in the majority of cases. Still, mortality in HCM patients remains elevated and management of heart failure and comorbidities must be improved to increase survival.

SCOFF in a general swedish adolescent population.

BackgroundAlthough Disordered Eating Behaviors (DEB) is an ill-defined concept, multiple studies have examined prevalence of DEB and its relations to other variables in various populations. DEB have been shown to predict more serious eating disorders which in turn can lead to death. Mostly girls seem to suffer from DEB, but the question has been raised whether this, at least, partially is due to the methods used for screening. The SCOFF-questionnaire has been suggested as a quick and easily administered tool to assess DEB. However, the psychometric results regarding SCOFF suggest some inconsistencies, and more research is needed in various countries and age samples.MethodTo validate SCOFF, a total of 1265 Swedish adolescents (51.6 % girls) completed self-report questionnaires using the Eating Disorder Examination Questionnaire (EDE-Q) as a reference standard.ResultsThe factor analyses show inconclusive results as to whether SCOFF should be regarded as a comprehensive scale; furthermore, the results indicate a correlation between SCOFF and the EDE-Q in both girl and boy samples. Girls scored significantly higher on SCOFF and also had a higher total score, indicating more severe problems than boys.ConclusionsThe results raised questions as to whether the SCOFF might be interpreted and responded to in different ways by girls and boys, risking overlooking boys’ DEB and also whether one “yes” answer, instead of the stipulated two, could be sufficient when using SCOFF for screening purposes. In sum, the results challenge the use of SCOFF in a general adolescent population.

Evictions and suicide: a follow-up study of almost 22 000 Swedish households in the wake of the global financial crisis

BackgroundMillions of families across the world are evicted every year. However, very little is known about the impact that eviction has on their lives. This lack of knowledge is also...

Anxiety and depression in adults with cystic fibrosis: a comparison between patients and the general population in Sweden and three other European countries.

BackgroundCystic fibrosis (CF) is the most common autosomal recessive life-shortening disease among Caucasians. Studies exploring the prevalence of anxiety and depression in adult CF patients are few, show inconsistent findings and rarely include comparisons with general populations. Prevalence and degree of anxiety and depression were investigated in adult CF patients in Sweden, Belgium, Germany and the UK, and compared to corresponding general population data.MethodsAdult non-transplanted CF patients from the three largest CF-centres (out of four) in Sweden (N = 129; Age range 18–70 years; 50 % women) completed the Hospital Anxiety and Depression Scale (HADS). Studies using HADS in adult CF populations in the UK, Germany, and Belgium were included, as well as HADS normative data from the corresponding general populations.ResultsNo elevated risk for anxiety and depression was found among the CF patients. However, a Country x Group interaction effect emerged; CF patients experienced a higher degree of anxiety than the general population in Sweden, but not in the other countries, though this finding did not remain significant in a logistic regression analysis. In Sweden the effect was limited to women. A Country x Group interaction effect was also found for Depression; CF patients experienced lower degree of depression than the general population in Sweden, Germany and the UK, but not in Belgium/Netherlands.ConclusionsContrary to earlier outcomes, the present results do not indicate any general elevated risk for anxiety and depression among CF patients. Anxiety was slightly higher in the Swedish CF population, compared to the general population; this finding was not seen in the other countries. Depression among CF patients was lower than or similar to that in the general populations in the studied countries.

Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population-based study.

PurposePotentially inappropriate prescriptions (PIPs) criteria are widely used for evaluating the quality of prescribing in elderly. However, there is limited evidence on their association with adverse drug reactions (ADRs) across healthcare settings. The study aimed to determine the prevalence of PIPs, defined by the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, in the Swedish elderly general population and to investigate the association between PIPs and occurrence of ADRs.MethodPersons ≥65 years old were identified from a random sample of 5025 adults drawn from the Swedish Total Population Register. A retrospective cohort study was conducted among 813 elderly with healthcare encounters in primary and specialised healthcare settings during a 3-month period in 2008. PIPs were identified from the Swedish Prescribed Drug Register, medical records and health administrative data. ADRs were independently identified by expert reviewers in a stepwise manner using the Howard criteria. Multivariable logistic regression examined the association between PIPs and ADRs.ResultsOverall, 374 (46.0 %) persons had ≥1 PIPs and 159 (19.5 %) experienced ≥1 ADRs during the study period. In total, 29.8 % of all ADRs was considered caused by PIPs. Persons prescribed with PIPs had more than twofold increased odds of experiencing ADRs (OR 2.47; 95 % CI 1.65–3.69). PIPs were considered the cause of 60 % of ADRs affecting the vascular system, 50 % of ADRs affecting the nervous system and 62.5 % of ADRs resulting in falls.ConclusionPIPs are common among the Swedish elderly and are associated with increased odds of experiencing ADRs. Thus, interventions to decrease PIPs may contribute to preventing ADRs, in particular ADRs associated with nervous and vascular disorders and falls.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-015-1950-8) contains supplementary material, which is available to authorized users.

Phthalate exposure and reproductive parameters in young men from the general Swedish population

BackgroundIn animals, exposure to certain phthalates negatively affects the male reproductive function. Human results are conflicting and mostly based on subfertile males, in whom the association between exposure and reproductive function may differ from the general population. ObjectivesTo study if levels of phthalate metabolites were associated with semen quality and reproductive hormones in general Swedish men. MethodsWe recruited 314 young men delivering semen, urine and blood samples at the same visit. We analyzed reproductive hormones and several semen parameters including progressive motility and high DNA stainability (HDS)—a marker for sperm immaturity. In urine, we analyzed metabolites of phthalates, including diethylhexyl phthalate (DEHP). We studied associations between urinary levels of the metabolites and seminal as well as serum reproductive parameters, accounting for potential confounders. ResultsDEHP metabolite levels, particularly urinary mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), were negatively associated with progressive sperm motility, which was 11 (95% CI: 5.0–17) percentage points lower in the highest quartile of MECPP than in the lowest. Further, men in the highest quartile of the DEHP metabolite monoethylhexyl phthalate had 27% (95% CI: 5.5%–53%) higher HDS than men in the lowest quartile. ConclusionsDEHP metabolite levels seemed negatively associated with sperm motility and maturation.

Prevalence of children whose parents have a substance use disorder: Findings from a Swedish general population survey

The present study examined the prevalence of Swedish children living with at least one parent whom has a substance use disorder (SUD), i.e. either an alcohol use disorder (AUD) or a drug use disorder (DUD). A 2013 cross-sectional survey of a nationally representative sample (n = 15,576) of the Swedish adult population 17-84 years of age was used. The response rate was 59.3%. SUDs were measured using selected parts of the Mini International Neuropsychiatric Interview (MINI), derived from the 4th edition of the diagnostic and statistical manual of mental disorders (DSM-IV). In total, 3778 parents with 7448 children under the age of 18 years participated. The proportion of children whose parent had a SUD was 4.6%, implying that around 90,000 children in Sweden experience this situation. Having a parent with an AUD was most common (3.7%), while 0.7% and 0.2% had a parent with a DUD and both (AUD plus DUD), respectively. Our results showed that a substantial number of children in Sweden have parents with a SUD and that it is important to consider both alcohol and drugs, when estimating the size of this group. Our findings call for further strategies to support these children and their families.

Abstract 2758: Cancer risk in relatives of nasopharyngeal carcinoma - A register-based cohort study in Sweden

Abstract Background: Little is known about the cancer susceptibility among relatives of patients with nasopharyngeal carcinoma (NPC) in non-endemic areas. We conducted a register-based cohort study to assess the relative risks (RRs) of cancer in families (including both first- and second-degree relatives) of NPC patients, compared with other individuals of the general population in Sweden, a low-incidence area for NPC. Method: The present study included 11,602,616 individuals that were identified from the Swedish Censuses in 1960, 1970, 1980, and 1990, and were born in Sweden (defined as “general population”). Cross-linking this population to the Swedish Cancer Register and the Swedish Multi-Generation Register, we identified 9,157 relatives (3,645 first-degree and 5,512 second-degree) of 1,211 NPC probands that were diagnosed between 1958 and 2009 and were the first NPC cases in their families. The occurrence of incident cancers in these relatives and other individuals of the general population during 1961-2009 was ascertained through the Swedish Cancer Register. RRs of cancer in the relatives of NPC probands, compared with other individuals from the general population were calculated from Poisson regression models. Results: The RR of all cancers combined among the first- or second-degree relatives of NPC probands was 1.03 (95% confidence interval [CI] = 0.95 to 1.11, P = 0.50), compared with other individuals of the general population. First-degree relatives of NPC probands had higher risks of NPC (N = 2, RR = 4.29, 95% CI = 1.07 to 17.17), and cancers of the larynx (N = 5, RR = 2.53, 95% CI = 1.05 to 6.09), prostate (N = 76, RR = 1.35, 95% CI = 1.07 to 1.68), and thyroid (N = 10, RR = 2.44, 95% CI = 1.31 to 4.53). In addition, a higher risk of cancer of the salivary glands was observed among the first-degree relatives of NPC probands with undifferentiated carcinoma (N = 2, RR = 6.64, 95% CI = 1.66 to 26.57). In contrast, a decreased risk of colorectal cancer incidence among relatives of NPC probands has been observed (N = 43, RR = 0.71, 95% CI = 0.53 to 0.96). Conclusion: The increased risk of NPC and some other cancers among the first-degree relatives of NPC patients may potentially be explained by shared genetic and environmental risk factors, the latter including Epstein-Barr virus infection and tobacco smoking. However, interpretation of these findings should be cautious given the small number of cancer cases observed among the relatives of NPC patients. Citation Format: Zhiwei Liu, Fang Fang, Ellen T. Chang, Weimin Ye. Cancer risk in relatives of nasopharyngeal carcinoma - A register-based cohort study in Sweden. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2758. doi:10.1158/1538-7445.AM2015-2758