Unique Personal Identification Number Research Articles

Long-term follow-up for cancer incidence in a cohort of Danish firefighters

ObjectivesTo examine cancer incidence among Danish firefighters using several employment-related exposure subgroups.MethodsA historical cohort of 9061 male Danish firefighters was established from collected personnel and membership records from employers and...

Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer\u2019s disease: a nationwide matched cohort study

BackgroundAntidepressant use has been associated with an increased risk of falling, but no studies have been conducted on whether antidepressant use is associated with an increased risk of head injuries which often result from falling among older persons. The objective of this study was to investigate the risk of head and brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer’s disease.MethodsA matched cohort study was conducted by comparing new antidepressant users (n = 10,910) with two matched nonusers (n = 21,820) in the MEDALZ study cohort. The MEDALZ cohort includes all community-dwelling persons newly diagnosed with Alzheimer’s disease between 2005 and 2011 in Finland. Incident antidepressant users were identified based on register-based dispensing data from the Prescription register with a 1-year washout period for antidepressant use. Nonusers were matched with users based on age, gender, and time since Alzheimer’s disease diagnosis. The outcome events were defined as any head injuries and traumatic brain injuries based on diagnoses in Hospital Discharge and Causes of Death registers. Propensity score adjusted Cox proportional hazard models were utilized. Sensitivity analyses with case-crossover design were conducted. All registers are linkable with unique personal identification numbers assigned for each resident.ResultsAntidepressant use was associated with an increased risk of head injuries (age-adjusted event rate per 100 person-years 2.98 (95% confidence interval (CI) 2.49–3.06) during use and 2.43 (95% CI 2.06–2.35) during nonuse, adjusted hazard ratio (HR) 1.35, 95% CI 1.20–1.52) and traumatic brain injuries (age-adjusted event rate per 100 person-years 1.33 (95% CI 1.13–1.53) during use and 1.10 (95% CI 1.00–1.20) during nonuse, adjusted HR 1.26, 95% CI 1.06–1.50). The risk was highest during the first 30 days of use (HR 1.71, 95% CI 1.10–2.66 for head injuries; HR 2.06, 95% CI 1.12–3.82 for traumatic brain injuries) and remained at an elevated level for head injuries for over 2 years of use. In case-crossover analyses, antidepressant use was consistently associated with a higher risk of head injuries.ConclusionsAntidepressant use was associated with an increased risk of the most severe outcomes, head and brain injuries, in persons with Alzheimer’s disease. Antidepressant use should be carefully considered and the association confirmed in future studies.

Extracting Unique Personal Identification Number from Iris

The aim of this research is to propose an enhanced model that significantly reduces the noise in the iris templates and thus present an efficient and reliable iris recognition system. Accuracy of Iris recognition system significantly depends on reducing noise at every stage of recognition process especially at eye image acquisition and iris segmentation stages. The proposed Iris recognition model combines Canny edge detector and circular Hough transform which yields more rapid and accurate localization of Iris inner and outer boundaries. The eyelid and eyelashes occlusion is also dealt with by applying non maxima radial suppression technique. The segmented Iris area is then normalized and converted from annular shape to fixed-sized rectangular block. In this stage all iris templates converted from circular to rectangular shape will have standard dimensions thus enabling Iris recognition system to perform comparison between them. Fast Fourier Transform function is then applied to normalized Iris image. Input image is viewed as a signal that is converted from time to frequency domain in which the number of frequencies is equal to number of image pixels. The resulting matrix is consisted of real and imaginary part represented by complex numbers. The matrix is encoded according to the pre established encoding pattern that assigns certain sequence of binary numbers to each possible combination of complex numbers thus producing Iris code. In the matching phase the iris codes are compared and if the determined degree of dissimilarity between the two is below the pre-established threshold value than the codes belong to the same user. The proposed Iris recognition method, therefore, successfully treats eyelids and eyelashes noise issues and present the efficient set of algorithms whose performance is superior compared to other existing methods.

AN OVERVIEW OF CREDIT REPORT/CREDIT SCORE MODELS AND A PROPOSAL FOR VIETNAM

Having a national credit database system would help financial institutions (FIs) reduce credit risk and reduce non-recovered bad debts. The government will feel at ease when FIs and the people are protected from bad debts in a sustainably developing and transparent market. On the other hand, borrowers will also receive benefit. Those who have good credit history will be provided with a more favorable interest rate and less requirements, or even without collateral.
 In 2014 the Vietnam National Assembly passed the Citizen Identity Law, which requires the government to issue a unique lifetime personal identification number for each citizen (starting 2016). This will play a crucial role in building a national credit database system. In this article we will give an overview of credit report and credit score models, mainly in the United States. Based on that, we draft a detailed proposal for a national credit database system which can be implemented in Vietnam.

HPV vaccination and risk of chronic fatigue syndrome/myalgic encephalomyelitis: A nationwide register-based study from Norway

BackgroundVaccination has been suggested to be involved in the aetiology of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). HPV vaccine was introduced in the Norwegian Childhood Immunisation Programme and offered 12year old girls from 2009. We studied the association between HPV vaccination and risk of CFS/ME and also assessed medical history in relation to both risk of CFS/ME and HPV vaccine uptake. MethodsIndividual data from national registries, including the Norwegian Population Registry, the Norwegian Patient Registry and the Norwegian Immunisation Registry were linked using the unique personal identification number. Yearly incidence rates of CFS/ME for 2009–2014 were calculated among the 824,133 boys and girls, aged 10–17 living in Norway during these 6years. A total of 176,453 girls born 1997–2002 were eligible for HPV vaccination and included in further analyses. Hazard ratios (HRs) of CFS/ME were estimated using Cox regression. Risk differences (RDs) of vaccine uptake were estimated with binomial regression. ResultsA similar yearly increase in incidence rate of CFS/ME was observed among girls and boys, IRR=1.15 (95% confidence interval (CI) 1.10–1.19) and 1.15 (95% CI 1.09–1.22), respectively. HPV vaccination was not associated with CFS/ME, HR=0.86 (95% CI 0.69–1.08) for the entire follow-up period and 0.96 (95% CI 0.64–1.43) for the first two years after vaccination. The risk of CFS/ME increased with increasing number of previous hospital contacts, HR=5.23 (95% CI 3.66–7.49) for 7 or more contacts as compared to no contacts. Girls with 7 or more hospital contacts were less likely to be vaccinated than girls with no previous hospital contacts, RD=−5.5% (95% CI −6.7% to −4.2%). ConclusionsNo indication of increased risk of CFS/ME following HPV vaccination was observed among girls in the first 6 birth cohorts offered HPV vaccine through the national immunisation programme in Norway.

International comparison of bank fraud reimbursement: customer perceptions and contractual terms

The study presented in this article investigated to what extent bank customers understand the terms and conditions (T&Cs) they have signed up to. If many customers are not able to understand T&Cs and the behaviours they are expected to comply with, they risk not being compensated when their accounts are breached. An expert analysis of 30 bank contracts across 25 countries found that most contract terms were too vague for customers to infer required behaviour. In some cases the rules vary for different products, meaning the advice can be contradictory at worst. While many banks allow customers to write Personal identification numbers (PINs) down (as long as they are disguised and not kept with the card), 20% of banks categorically forbid writing PINs down, and a handful stipulate that the customer have a unique PIN for each account. We tested our findings in a survey with 151 participants in Germany, the USA and UK. They mostly agree: only 35% fully understand the T&Cs, and 28% find important sections are unclear. There are strong regional variations: Germans found their T&Cs particularly hard to understand, and USA bank customers assumed some of their behaviours contravened the T&Cs, but were reassured when they actually read them.

Socioeconomic inequality of diabetes patients\u2019 health care utilization in Denmark

Understanding socioeconomic inequalities in health care is critical for achieving health equity. The aim of this paper is threefold: 1) to quantify inequality in diabetes health care service utilization; 2) to understand determinants of these inequalities in relation to socio-demographic and clinical morbidity factors; and 3) to compare the empirical outcome of using income level and educational level as proxies for Socio Economic Status (SES).Data on the entire Danish population of diabetes patients in 2011 (N = 318,729) were applied. Patients’ unique personal identification number enabled individual patient data from several national registers to be linked. A concentration index approach with decomposition into contributing factors was applied. Differences in diabetes patients’ health care utilization patterns suggest that use of services differ among patients of lower and higher SES, despite the Danish universal health care system. Especially, out-patient services, rehabilitation and specialists in primary care show different utilization patterns according to SES. Comparison of the empirical outcome from using educational level and income level as proxy for patients’ SES indicate important differences in inequality estimates. While income, alike other measures of labor market attachment, to a certain extent is explained by morbidity and thus endogenous, education is more decisive for patients’ ability to take advantage of the more specialized services provided in a universal health care system.

Recurrence of congenital heart defects among siblings-a nationwide study.

Congenital heart defects (CHD) constitute the largest group of congenital malformations. In most families, only one person has CHD; however, the risk of CHD increases for children born into families already affected. In this study, all births from 1994 through 2009 were identified in the Medical Birth Registry of Norway, including supplemental information on CHD from clinical and administrative registers, as part of the CVDNOR project. By using the unique personal identification number of each parent we were able to link 16,078 pairs of twins, 445,584 pairs of full siblings, and 106,840 pairs of half-siblings. Sibling recurrence risk ratio (RRR) was calculated using CHD status in the oldest sibling as exposure and CHD status in the younger sibling as outcome, adjusted for year of birth, maternal age, and maternal diabetes. Among full sibling pairs with CHD in the older sibling, the younger sibling had CHD in 4.1% compared to 1.1% of the pairs without CHD in the older sibling (adjusted RRR 3.6; 95% confidence interval (CI) 3.1-4.1). In same-sex twins the RRR was 14.0 (95% CI 10.6-18.6), and in opposite-sex twins the RRR was 11.9 (95% CI 7.1-19.9). For half-siblings the RRR was 1.5 (95% CI 0.8-2.8). When restricting to severe types of CHD, the RRR was 6.9 (95% CI 4.9-9.8) for full siblings. In 50% of the pairs with recurrent CHD, the siblings had similar types of CHD. The high relative risk of recurrence indicates that familial risk factors are important in the etiology of CHD.

Coronary heart disease incidence and mortality, and all-cause mortality among diabetic and non-diabetic people according to their smoking behavior in Finland

BackgroundAs type 2 diabetes (T2D) patients have a high risk for coronary heart disease (CHD) and all-cause mortality and smoking is a major single risk factor for total and CHD mortality, it is important to understand the impact of smoking to the outcome events in comparison to people without T2D. Studies of excess risk of CHD incidence and mortality, and all-cause mortality in T2D patients related to smoking are controversial. We aimed to assess the risk of CHD incidence and mortality, and all-cause mortality in a large Finnish population cohort consisting of people with and without T2Daccording to smoking status.MethodsProspective follow-up of 28 712 men and 30 700 women aged 25–64 years living in eastern and south-western Finland. The data on mortality were obtained from the nationwide death register using the unique national personal identification number. Follow-up information regarding CHD was based on the Finnish Hospital Discharge Register for non-fatal outcomes. The Cox proportional hazards models were used to estimate the association between diabetes and smoking subgroups and the risk for total and CHD mortality.ResultsT2D patients who were smoking had higher all-cause mortality in both men (HR 3.76; 95% CI 2.95-4.78) and women (HR 4.51; 95% CI 2.91-7.00) than non-smoking diabetic men (HR 2.03; 95% CI 1.51-2.74) and women (HR 2.11; 95% CI 1.71-2.59). The CHD mortality risk for smoking men with T2D was higher (HR 6.15; 95% CI 4.22-8.96) than in non-smoking diabetic men (HR 2.62; 95% CI 1.60-4.29). Similar results were found in women revealing corresponding HR for CHD mortality of 6.92 (95% CI 2.79-17.19) for smoking, T2D women and 4.06 (95% CI 2.83-5.82) for non-smoking T2D women, respectively. Even though the risk of CHD incidence in T2D patients who had stopped smoking was statistically significantly higher than in their non-smoking non-diabetic counterparts, their CHD incidence was lower than in smoking T2D patients (HR in men 3.00; HR in women 2.80).ConclusionIt is important to address tobacco consumption in T2D patients, especially during primary health care contacts in order to reduce their high risk of CHD and all-cause mortality.

Lack of overlap and large discrepancies in the characteristics of the deceased in two sources of drug death. A linkage study of the Cause of Death and the Police Registries in Norway 2007–2009

BackgroundRegistries for drug deaths may include different persons and provide different characteristics of the deceased. The aim of this study was to establish whether a database of drug-induced deaths (Cause of Death Registry (CDR) using the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) definition and the Police registry of drug deaths) included the same persons and provided the same characteristics of the deceased and thus yielded the same information for establishing targeted prevention measures. MethodsNotifications from 2007 to 2009 were drawn from the CDR and the police registry of drug deaths and the unique Norwegian personal identification number was used to match the registrations. ResultsThe two sources of drug deaths yielded 1384 registrations, encompassing 929 individuals of whom only 49% were included in both registries. A large proportion of the deceased (40%) were not listed in the police registry. This group was older (mean age 43 years vs. 35 years); dependence and suicide were listed more often as cause of death (33% vs. 8%); and heroin was listed less often as the type of drug causing death (24% vs. 67%) than those included in both registries. In particular, among women not included in the police registry, the cause of death was identified with much greater frequency as pharmaceuticals with morphine or codeine (47% vs. 16%). ConclusionThe large discrepancies in size, overlap, and characteristics of the deceased included in two sources of drug death imply that prevention measures based on the two sources will differ.

Bullous Pemphigoid: Validation of the National Patient Register in Two Counties in Sweden, 2001 to 2012.

Bullous pemphigoid (BP) is the most common autoimmune blistering disease. Since 2001, data from all specialized outpatient and inpatient care institutions in Sweden, have been registered with the National Patient Register (NPR), based on a unique personal identification number. Previous validations of the register have shown high accuracy for various non-dermatological autoimmune diseases. In order to validate the diagnosis of BP, all residents aged < 20 years in 2 counties in Sweden (539,000 inhabitants) diagnosed with bullous pemphigoid (ICD-10; L12.0, L12.8, L12.9) in the period 2001 to 2012 were identified in the NPR. Medical records, as well as immuno- and histopathological data, were reviewed for this study. A total of 323 patients with BP were identified in the NPR. Of these, 178 patients had a directly confirmed diagnosis of BP from immuno- and histopathological data, reviewed by a dermatopathologist. For the remaining 145 patients medical records were retrieved and further reviewed by 2 dermatologists. Of these, 105 patients had a confirmed diagnosis of BP. The medical records of 16 patients were missing, and 24 patients were not classified as having BP. Overall, a positive predictive value of 92% (283/307) was found for BP in the NPR. In conclusion, the present validation of medical records and immuno- and histopathological data showed high validity for the diagnosis of BP in the Swedish NPR.

Vascular comorbidities in multiple sclerosis: a nationwide study from Denmark.

To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case-control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980-2005 were identified from the Danish Multiple Sclerosis Registry and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique personal identification numbers. To assess the presence of vascular comorbidities before and after MS onset, cases and controls were followed from January 1977 to the index date, and from the index date through December 2012. We used logistic regression to calculate odds ratios (ORs) and Cox regression to calculate hazard ratios (HRs). Before the index date, MS cases had a decreased probability for cerebrovascular comorbidity [OR 0.69 (95% CI 0.48-0.99, p=0.043)], and a numerically but not statistically significant decreased probability for cardiovascular comorbidity [OR 0.87 (95% CI 0.71-1.07, p=0.188)]. After the index date, MS cases had an increased risk for cerebrovascular comorbidity [HR 1.84 (95% CI 1.69-2.00, p<0.0005)], and for cardiovascular comorbidity [HR 1.08 (95% CI 1.02-1.15, p=0.013)]. The lower occurrence of cerebrovascular comorbidities in cases prior to MS onset could be due to protective immune mechanisms, while the higher occurrence of vascular comorbidities in cases after MS onset could be because of converging causal pathways of the coexisting diseases. These findings deserve to be studied closer in a broader spectrum of comorbidities in MS.

Mortality-related risk factors and long-term survival after 4460 liver resections in Sweden\u2014a population-based study

PurposeThe objectives of this study were to analyze the outcome after hepatectomy and to identify contributing factors to mortality and long-term survival in a population-based setting.MethodA retrospective, nationwide register study was performed. All patients who underwent hepatectomy in Sweden between 2002 and 2011 were identified in the Swedish Hospital Discharge Registry using their unique personal identification numbers. This cohort was linked to the National Cancer Registry (cancer diagnosis), the National Registry of Causes of Death, and the Migration Registry. Survival analysis by Kaplan-Meier method was performed to assess long-term outcome. A Cox regression model was used to analyze risk factors affecting long-term survival.ResultsOverall, 4460 hepatectomies were performed. The 30- and 90-day mortalities were 1.8 and 3.1 %, respectively. The overall 5- and 10-year survival rates for all diagnoses were 45 and 38 %, respectively. Independent risk factors for 5-year mortality were as follows: patient age, comorbidity, male gender, intrahepatic/extrahepatic cholangiocarcinoma, gallbladder cancer, extent of hepatectomy, and hepatectomies performed at non-university hospitals. Re-resection (78.1 % with diagnosis “metastasis”) was performed on 374 patients. In these patients, mortality risk decreased by >50 % (HR 0.42; 95 %, CI 0.33–0.53).ConclusionIn a population-based analysis, liver resections are done with a low mortality risk and good long-term outcome. Patients who underwent resection at a University Hospital showed a significant better outcome compared to patients resected at non-University Hospitals. These results support further centralization of liver surgery. Re-resection should be performed if feasible.

Dementia and Traffic Accidents: A Danish Register-Based Cohort Study.

BackgroundAs a consequence of a rapid growth of an ageing population, more people with dementia are expected on the roads. Little is known about whether these people are at increased risk of road traffic-related accidents.ObjectiveOur study aims to investigate the risk of road traffic-related accidents for people aged 65 years or older with a diagnosis of dementia in Denmark.MethodsWe will conduct a nationwide population-based cohort study consisting of Danish people aged 65 or older living in Denmark as of January 1, 2008. The cohort is followed for 7 years (2008-2014). Individual’s personal data are available in Danish registers and can be linked using a unique personal identification number. A person is identified with dementia if the person meets at least one of the following criteria: (1) a diagnosis of the disease in the Danish National Patient Register or in the Danish Psychiatric Central Research Register, and/or (2) at least one dementia diagnosis-related drug prescription registration in the Danish National Prescription Registry. Police-, hospital-, and emergency room-reported road traffic-related accidents occurred within the study follow-up are defined as the study outcome. Cox proportional hazard regression models are used for the main analysis.ResultsOur study protocol has 3 phases including data collection, data analysis, and reporting. The first phase of register-based data collection of 853,228 individual’s personal information was completed in August, 2016. The next phase is data analysis, which is expected to be finished before December 2016, and thereafter writing publications based on the findings. The study started in January 2016 and will end in December 2018.DiscussionThis study covers the entire elderly population of Denmark, and thereby will avoid selection bias due to nonparticipation and loss to follow-up. Furthermore, this ensures that the study results are reliable and generalizable. However, underreporting of traffic-related accidents may occur, which will limit estimation of absolute risks.

The lifelong socioeconomic disadvantage of single-mother background - the Helsinki Birth Cohort study 1934-1944.

BackgroundGrowing up with one parent is associated with economic hardship and health disadvantages, but there is limited evidence of its lifetime consequences. We examined whether being born to an unmarried mother is associated with socioeconomic position and marital history over the lifespan.MethodsWe analysed data from the Helsinki Birth Cohort Study including birth, child welfare clinic and school healthcare records from people born in Helsinki, Finland, between 1934 and 1944. Using a unique personal identification number, we linked these data to information on adult socioeconomic position from census data at 5-year intervals between 1970 and 2000, obtained from Statistics Finland.ResultsCompared to children of married mothers, children of unmarried mothers were more likely to have lower educational attainment and occupational status (odds ratio for basic vs. tertiary education 3.40; 95 % confidence interval 2.17 to 5.20; for lowest vs. highest occupational category 2.75; 1.92 to 3.95). They were also less likely to reach the highest income third in adulthood and more likely to stay unmarried themselves. The associations were also present when adjusted for childhood socioeconomic position.ConclusionBeing born to an unmarried mother, in a society where marriage is the norm, is associated with socioeconomic disadvantage throughout life, over and above the disadvantage associated with childhood family occupational status. This disadvantage may in part mediate the association between low childhood socioeconomic position and health in later life.

Knee Arthrodesis After Failure of Knee Arthroplasty: A Nationwide Register-Based Study.

Arthrodesis is considered a salvage procedure after failure of a knee arthroplasty. Data on the use of this procedure are limited. The purpose of this study was to identify the incidence, causes, surgical techniques, and outcomes of arthrodesis after failed knee arthroplasty in a nationwide population. Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register. A total of 92,785 primary knee arthroplasties performed in Denmark from 1997 to 2013 were identified by linking the data using the unique personal identification number assigned to each patient. Of these arthroplasties, 165 were followed by arthrodesis. Hospital records of all identified cases of arthrodesis were reviewed. A competing risk model was used to estimate the cumulative incidence of arthrodesis in the study period. Differences in cumulative incidence were compared with the Gray test. A total of 164 of the 165 arthrodeses were performed for causes related to failed knee arthroplasty. The 15-year cumulative incidence of arthrodesis was 0.26% (95% confidence interval, 0.21% to 0.31%). The 5-year cumulative incidence decreased significantly (p < 0.0001) from 0.32% for arthroplasties performed from 1997 to 2002 to 0.09% for arthroplasties performed from 2008 to 2013. The most common causes of arthrodesis were periprosthetic infection in 152 patients (93%), extensor mechanism disruption in 46 (28%), soft-tissue deficiency in 25 (15%), and severe bone loss in 11 (7%). In 79 patients (48%), there were 2 or more indications for arthrodesis. Solid fusion was achieved in 65% of the patients. The fusion rate was significantly higher after intramedullary nail fixation compared with external fixation (p = 0.01). A total of 34 patients (21%) underwent repeat arthrodesis, and 23 patients (14%) eventually underwent transfemoral amputation. The cumulative incidence of arthrodesis within 15 years after primary knee arthroplasty was 0.26%. There was a significant decrease in the 5-year cumulative incidence during the study period, suggesting an overall improvement in prevention of this adverse outcome of knee arthroplasty. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Impact of invitation schemes on breast cancer screening coverage: A cohort study from Copenhagen, Denmark.

BackgroundThe purpose of mammography screening is to decrease breast cancer mortality. To achieve this a high coverage by examination is needed. Within an organized screening programme, we examined the impact of changes in the invitation schedule on the interplay between coverage and participation.MethodWe studied nine cohorts aged 50–51 when first targeted by mammography screening in Copenhagen, Denmark. Population data were retrieved from the Danish Civil Registration System; invitation and attendance data from the screening programme database. Data were linked using unique personal identification numbers. Coverage by invitation was defined as (number of invited women/number of targeted women), coverage by examination as (number of screened women/number of targeted women), and participation rate as (number of screened women/number of invited women).ResultsCoverage by invitation was close to or above 95% for all newly recruited cohorts. In subsequent invitation rounds, both technical errors and changes in the invitation scheme affected the coverage by invitation. Coverage by examination at first invitation was 72.5% for the first cohort, but dropped to 64.2% for the latest cohort. Furthermore, coverage by examination dropped by increasing invitation number and with omission of re-invitation of previous non-attenders. Participation rate closely reflected changes in the invitation scheme.ConclusionChanges in the invitation schemes influenced coverage by invitation, coverage by examination, and participation rate. We observed a considerable gap between coverage by examination and participation rate, strongly indicating that the latter cannot without reservations, be taken as an indicator of the first.

Risk of myocardial infarction, ischemic stroke, and cardiovascular death in patients with atopic dermatitis

Risk of myocardial infarction, ischemic stroke, and cardiovascular death in patients with atopic dermatitis

Abstract P1-07-20: The smoking related risk of breast cancer and proportion of avoidable breast cancer cases due to passive and active smoking in middle-aged women in Norway in 2012: The Norwegian women and cancer study 1991-2012

Abstract Background: The burden of smoking on society may be underestimated as previous estimates of cancer due to smoking have generally not included breast cancer. We utilized the Norwegian Women and Cancer Study, a nationally representative prospective cohort study to examine the risk of breast cancer due to passive and active smoking. We also estimated the proportion of breast cancer attributable to passive and active smoking. Material and methods: Our study included 130053 women, aged 34 to 70 years, who completed a baseline questionnaire between 1991 and 2007. We followed the women through linkages to the Cancer Registry of Norway and the Norwegian Central Population Register, to identify all cancer cases, emigrations, and deaths, respectively, using the unique national 11-digit personal identification number. Person-years were calculated from the start of follow-up to the date of any incident cancer diagnosis, emigration, death, or the end of follow-up December 31, 2012, whichever came first. Breast cancer cases were classified according to the original codes in the International Classification of Diseases, Seventh Revision including estrogen and progesterone hormone tumor receptor status. We used Cox proportional hazards models, adjusting for relevant confounders, to estimate multivariate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Never smokers, excluding passive, served as the reference group. We estimated attributable fractions in smokers and in the population with 95% CIs. Results: Ever compared with passive and never smokers were younger at breast cancer diagnosis, at first childbirth and at menopause; they were less likely to have higher education, more likely to have used hormonal contraceptives and postmenopausal hormone therapy and to consume alcohol. The alcohol drinkers were consuming more alcohol. During follow-up 4293 women developed invasive breast cancer confirmed by histology. Compared with never smokers, the multivariate adjusted breast cancer HR was for ever smokers 1.21 (1.08-1.34). Compared with parous never smokers, the HR estimate for breast cancer for ever smokers who had smoked five or more years before giving birth was 1.29 (1.14-1.46) after adjustment. A trend test for number of pack-years and breast cancer risk was significant (ptrend= 0.007). We found similar HR estimates when we stratified by menopausal and parous status at entry. The attributable fraction for breast cancer was 17.3 (7.4-25.4) for active smokers. The population attributable fraction of breast cancer for active smoking was 11.9 (5.3-18.1). Conclusion: In smokers, one in six, and in the population almost one in eight breast cancer cases could have been avoided in the absence of smoking. Citation Format: Gram IT, Little MA, Lund E, Braaten T. The smoking related risk of breast cancer and proportion of avoidable breast cancer cases due to passive and active smoking in middle-aged women in Norway in 2012: The Norwegian women and cancer study 1991-2012. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-20.

Multimodal biometric cryptosystem based on fusion of wavelet and curvelet features in robust security application

The authentication system used at the automated teller machines (ATM) is a unique personal identification number (PIN). This PIN can be easily tapped and misused. In this paper we propose a method in which the PIN is replaced by the biometrics of the individual to have a more secure transaction. A complete hardware system is designed to capture the biometric traits such as face, fingerprint and palm vein. The captured images are pre-processed and then features are extracted which are then fused at feature level. Cryptography is applied on the fused feature vector. Matching is performed using Euclidean distance at the server end. Palm vein is particularly chosen as a biometric trait along with widely used face and fingerprint because it is unique and is impossible to forge the vein pattern of an individual. Curvelet and Wavelet Transforms are used for the feature extraction. Experimental results indicate a good level of security and recognition rate of 91% and 89% is achieved on our own generated database. The results are promising when compared with other existing similar techniques.