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Brain metastases admissions in Sweden between 1987 and 2006.

ABSTRACT: BACKGROUND: Brain metastases (BM) constitute the most common intracranial tumours and are associated with considerable morbidity and mortality. Population-based studies of the epidemiology and time trends of BM are scarce. METHODS: A population-based cohort of patients admitted to hospital with BM in Sweden between 1987 and 2006 (n=15,517) was identified and linked to nationwide registers of cancer incidence and death. Primary cancer types were assessed and time to hospitalisation and death was computed. RESULTS: The annual age-adjusted incidence rate of hospitalisation for BM doubled from 7 to 14 patients per 100,000 between 1987 and 2006. The most common primary tumours among women were lung (33%), breast (33%) and colorectal cancer (7%), and among men lung cancer (44%), malignant melanoma (12%) and colorectal cancer (9%). The increase was most evident for BM patients with lung cancer (both sexes) and breast cancer (women). Survival was short, with a median of 2.7 months. It varied little by cancer type and did not improve over calendar time. CONCLUSION: The number of patients admitted with BM has increased rapidly in Sweden. In spite of recent improvements in the prognosis of common primary cancer types, any parallel improvement among patients with advanced cancer and BM is not indicated.

SUBMITTER: Smedby KE

PROVIDER: S-EPMC2788258 | biostudies-other | 2009 Dec

REPOSITORIES: biostudies-other

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Project description:Increases in a number of psychosocial disorders have been identified among Western youth in the second half of the Twentieth century. However findings are not consistent, trends are complex, and comparisons over time are hampered by methodological problems.Data were drawn from three samples identical in respect of age (15 years), school year (final year of statutory schooling) and geographical location (the West of Scotland). Each sample was administered the 12-item General Health Questionnaire, a measure of self-report psychological distress, in 1987 (N = 505), 1999 (N = 2,196) and 2006 (N = 3,194). Analyses were conducted to examine changes in: GHQ 'caseness'; individual items; and factors, derived via confirmatory factor analysis representing (a) 'negative' and 'positive' items, and (b) 'anxiety and depression', 'loss of confidence or self-esteem' and 'anhedonia and social dysfunction'.Based on the standard (2/3) cut-off, 'caseness' rates in 1987, 1999 and 2006 were 12.7, 15.1 and 21.5% (males) and 18.8, 32.5 and 44.1% (females). Similar increases were observed with more stringent 'caseness' cut-offs. Examination of individual items showed some to have increased much more markedly over time than others. There were larger increases among females for all except two items and some evidence, among both genders, of steeper increases among 'negative' items compared with 'positive' ones. However, the differences in slope were very small compared with the overall increases in both types.Data from three samples identical in respect of age, school year and geographical location, show marked increases in GHQ-12 'caseness' among females between 1987 and 1999 and among both males and females between 1999 and 2006. Although slightly steeper increases in 'negative' items raise the possibility that endorsing such symptoms may have become more acceptable, these were small in comparison with increases in all dimensions of psychological distress. The next step is to identify causal explanations for the increases reported here.

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Brain metastases admissions in Sweden between 1987 and 2006.

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