Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4991
Giske Ursin
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{"title":"Kreftregisteret – full fart fremover. Utviklingen de siste 10 år.","authors":"Giske Ursin","doi":"10.5324/nje.v30i1-2.4991","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4991","url":null,"abstract":"-\u0000 ","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43750475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"70 years of cancer transition in Norway: a comparison of registry incidence profiles 1953-1957 and 2016-2020","authors":"F. Bray","doi":"10.5324/nje.v30i1-2.4972","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4972","url":null,"abstract":"Freddie Bray: 70 years of cancer transition in Norway: a comparison of registry incidence profiles 1953-1957 and 2016-2020","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49273326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4978
T. Bjørge, Birgit Engesæter, G. Skare, A. Tropé
An organised screening programme for cervical cancer (CervicalScreen Norway) was implemented in Norway in 1995. The overall aim of the programme is to reduce the incidence and mortality of cervical cancer, and the screening coverage should exceed 80%. Women in the target age group (25-69 years) are invited for screening every third or fifth year depending on whether the primary screening test is a cytology smear or an HPV (human papillomavirus) test. Since the initiation, there have been major changes within the programme and HPV testing has become increasingly important. The primary screening test has changed from cytology for the whole target age group to primary HPV testing for women from the age of 34, HPV genotype information is directing the follow-up of women in the screening algorithm, and HPV self-sampling will be implemented to increase attendance in under-screened women. CervicalScreen Norway has had a significant impact on reducing the incidence and mortality of the disease. Nevertheless, there has been an increase in incidence in Norway the last decade, in particular among young women. In 2018, the WHO Director-General announced an ambitious global call for action to eliminate cervical cancer through vaccination, screening and treatment. CervicalScreen Norway supports the ambition of the WHO and is working towards this goal.
{"title":"CervicalScreen Norway – A screening programme in transition","authors":"T. Bjørge, Birgit Engesæter, G. Skare, A. Tropé","doi":"10.5324/nje.v30i1-2.4978","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4978","url":null,"abstract":"An organised screening programme for cervical cancer (CervicalScreen Norway) was implemented in Norway in 1995. The overall aim of the programme is to reduce the incidence and mortality of cervical cancer, and the screening coverage should exceed 80%. Women in the target age group (25-69 years) are invited for screening every third or fifth year depending on whether the primary screening test is a cytology smear or an HPV (human papillomavirus) test.\u0000Since the initiation, there have been major changes within the programme and HPV testing has become increasingly important. The primary screening test has changed from cytology for the whole target age group to primary HPV testing for women from the age of 34, HPV genotype information is directing the follow-up of women in the screening algorithm, and HPV self-sampling will be implemented to increase attendance in under-screened women.\u0000CervicalScreen Norway has had a significant impact on reducing the incidence and mortality of the disease. Nevertheless, there has been an increase in incidence in Norway the last decade, in particular among young women. In 2018, the WHO Director-General announced an ambitious global call for action to eliminate cervical cancer through vaccination, screening and treatment. CervicalScreen Norway supports the ambition of the WHO and is working towards this goal.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42159497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4988
F. Langmark
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{"title":"Kreftregisteret i min tid – mine minner og meninger","authors":"F. Langmark","doi":"10.5324/nje.v30i1-2.4988","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4988","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46551790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4977
Y. M. Gjelsvik, T. Johannesen, G. Ursin, T. Myklebust
Background: The Cancer Registry of Norway (CRN) has collected data on all Norwegian cancer patients from health providers since 1952. To assess cancer patients’ self-reported late effects and health related quality of life(HRQoL) after treatment, the CRN started collecting data on Patient Reported Outcomes (PROs) in 2020. Objectives: To present the infrastructure for the CRN’s national health survey collection of PROs and describe some experiences of the first two years of data collection. Methods: In 2021, the CRN invited patients newly diagnosed with prostate cancer, breast cancer, colorectal cancer, or malignant melanoma to participate in the three-year digital health survey “Population survey on health and quality of life”. Patients were invited at least 21 days after diagnosis and within 150 days of the diagnosis. A control group consisting of individuals with no history of the cancer in question was randomly drawn from the National Population Register. Descriptive statistics regarding invitations and participation are presented. Results: A total of 15 641 patients and 15 187 individuals in the control group were identified as eligible for participation in 2021. A total of 12 297 (82%) of the patients and 11 534 (76%) of the controls used one or more of the digital solutions the CRN used to distribute the surveys and received an invitation to the survey. Overall, 6 091 (47%) of the patients and 3 718 (32%) of the controls participated, with variation across the cancer types. Discussion: Self-reported late effects and HRQoL after contemporary cancer treatments can be studied among participants in these nationwide longitudinal surveys which continuously include newly diagnosed patients. The response rates at baseline are still somewhat low and vary between 41% and 51% among the cancer patients. Selection bias may be a challenge, as half of (or less) than the individuals invited in 2021, chose to participate. Conclusions: The infrastructure for a national, prospective survey collection of PROs is in place and in use. The CRN plans to analyse the representativeness and validity of the PROs data. The goals are to include PROs in surveys covering all the clinical registries at the CRN, and that the PROs collected by the CRN can be used in research and quality improvement of the health services offered to cancer patients.
{"title":"A nationwide, prospective collection of patient reported outcomes in the Cancer Registry of Norway","authors":"Y. M. Gjelsvik, T. Johannesen, G. Ursin, T. Myklebust","doi":"10.5324/nje.v30i1-2.4977","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4977","url":null,"abstract":"Background: The Cancer Registry of Norway (CRN) has collected data on all Norwegian cancer patients from health providers since 1952. To assess cancer patients’ self-reported late effects and health related quality of life(HRQoL) after treatment, the CRN started collecting data on Patient Reported Outcomes (PROs) in 2020.\u0000Objectives: To present the infrastructure for the CRN’s national health survey collection of PROs and describe some experiences of the first two years of data collection. Methods: In 2021, the CRN invited patients newly diagnosed with prostate cancer, breast cancer, colorectal cancer, or malignant melanoma to participate in the three-year digital health survey “Population survey on health and quality of life”. Patients were invited at least 21 days after diagnosis and within 150 days of the diagnosis. A control group consisting of individuals with no history of the cancer in question was randomly drawn from the National Population Register. Descriptive statistics regarding invitations and participation are presented.\u0000Results: A total of 15 641 patients and 15 187 individuals in the control group were identified as eligible for participation in 2021. A total of 12 297 (82%) of the patients and 11 534 (76%) of the controls used one or more of the digital solutions the CRN used to distribute the surveys and received an invitation to the survey. Overall, 6 091 (47%) of the patients and 3 718 (32%) of the controls participated, with variation across the cancer types.\u0000Discussion: Self-reported late effects and HRQoL after contemporary cancer treatments can be studied among participants in these nationwide longitudinal surveys which continuously include newly diagnosed patients. The response rates at baseline are still somewhat low and vary between 41% and 51% among the cancer patients. Selection bias may be a challenge, as half of (or less) than the individuals invited in 2021, chose to participate.\u0000Conclusions: The infrastructure for a national, prospective survey collection of PROs is in place and in use. The CRN plans to analyse the representativeness and validity of the PROs data. The goals are to include PROs in surveys covering all the clinical registries at the CRN, and that the PROs collected by the CRN can be used in research and quality improvement of the health services offered to cancer patients.\u0000 \u0000 ","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46554303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4974
Ingrid Stenstadvold Ross, Ole Alexander Opdalshei, Elisabeth Jakobsen
The Cancer Registry of Norway and the Norwegian Cancer Society has a long and strong history of collaboration. The Norwegian Cancer Society was instrumental both political and financial when the Cancer Registry was founded back in 1952. In the following years, the Cancer Registry had major financial contributions from the Norwegian Cancer Society. Throughout the history, the Cancer Registry of Norway and the Norwegian Cancer Society has had a strong collaboration on important areas as cancer research, cancer screening, prevention, and international work. The collaboration has been based on a common desire to reduce the number of cancer patients and to secure the best possible treatment for people affected by cancer. The Norwegian Cancer Society is proud of the high standard the Cancer Registry of Norway has achieved through history, and we are looking forward to continuing our strong collaboration in the years to come.
{"title":"Hva skulle vi gjort uten Kreftregisteret?","authors":"Ingrid Stenstadvold Ross, Ole Alexander Opdalshei, Elisabeth Jakobsen","doi":"10.5324/nje.v30i1-2.4974","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4974","url":null,"abstract":"The Cancer Registry of Norway and the Norwegian Cancer Society has a long and strong history of collaboration. The Norwegian Cancer Society was instrumental both political and financial when the Cancer Registry was founded back in 1952. In the following years, the Cancer Registry had major financial contributions from the Norwegian Cancer Society.\u0000Throughout the history, the Cancer Registry of Norway and the Norwegian Cancer Society has had a strong collaboration on important areas as cancer research, cancer screening, prevention, and international work. The collaboration has been based on a common desire to reduce the number of cancer patients and to secure the best possible treatment for people affected by cancer.\u0000The Norwegian Cancer Society is proud of the high standard the Cancer Registry of Norway has achieved through history, and we are looking forward to continuing our strong collaboration in the years to come.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48328861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4971
I. Larsen, Bjørn Møller, Giske Ursin, Trude Eid Robsahm
Prostatakreft ble den dominerende kreftformen tidlig på 1960-tallet, mens brystkreft har vært den vanligste kreftformen blant kvinner siden Kreftregisteret ble etablert. I 2021 utgjorde prostata-, bryst-, tarm- og lungekreft, nesten halvparten (47%) av alle nye krefttilfeller. Når vi ser på trender over tid, har de aller fleste kreftsykdommene hatt en økning i de aldersstandardiserte insidensratene. Siden 1950-tallet er lungekreft blant kvinner og hudkreftformene melanom og plateepitelkarsinom de kreftformene som har økt mest, mens magesekkreft er den eneste kreftformen som har hatt en jevn og stabil reduksjon i insidensen. Hjerte- og karsykdom var lenge den vanligste dødsårsaken i Norge, men den aldersstandardiserte mortalitetsraten har gått ned siden 1970-tallet. Mortalitetsraten for kreft har sunket de siste 20 årene, men i mye mindre grad enn for hjerte- og karsykdom. Fra 2017 har kreft vært den sykdomsgruppen som har hatt høyest mortalitetsrate. Av spesifikke kreftformer hadde magesekk den høyeste mortalitetsraten (for begge kjønnene samlet) fram til 1970-tallet. Bryst- og prostatakreft lå høyest på 1970-, 80-, og 90-tallet. Fra 2000-tallet har lungekreft hatt den høyeste mortalitetsraten. Overlevelsen har økt for alle kreftformer, og i dag overlever tre av fire sin kreftsykdom i 5 år eller mer. Kreftformer med dårlig langtidsprognose har hatt en betydelig forbedring i overlevelsen de siste 10–20 årene. En tallmessig økende befolkning og en høyere andel av eldre vil føre til et økt antall krefttilfeller i de kommende årene.
{"title":"Krefttrender i Norge i perioden 1953–2021","authors":"I. Larsen, Bjørn Møller, Giske Ursin, Trude Eid Robsahm","doi":"10.5324/nje.v30i1-2.4971","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4971","url":null,"abstract":"Prostatakreft ble den dominerende kreftformen tidlig på 1960-tallet, mens brystkreft har vært den vanligste kreftformen blant kvinner siden Kreftregisteret ble etablert. I 2021 utgjorde prostata-, bryst-, tarm- og lungekreft, nesten halvparten (47%) av alle nye krefttilfeller. Når vi ser på trender over tid, har de aller fleste kreftsykdommene hatt en økning i de aldersstandardiserte insidensratene. Siden 1950-tallet er lungekreft blant kvinner og hudkreftformene melanom og plateepitelkarsinom de kreftformene som har økt mest, mens magesekkreft er den eneste kreftformen som har hatt en jevn og stabil reduksjon i insidensen.\u0000Hjerte- og karsykdom var lenge den vanligste dødsårsaken i Norge, men den aldersstandardiserte mortalitetsraten har gått ned siden 1970-tallet. Mortalitetsraten for kreft har sunket de siste 20 årene, men i mye mindre grad enn for hjerte- og karsykdom. Fra 2017 har kreft vært den sykdomsgruppen som har hatt høyest mortalitetsrate. Av spesifikke kreftformer hadde magesekk den høyeste mortalitetsraten (for begge kjønnene samlet) fram til 1970-tallet. Bryst- og prostatakreft lå høyest på 1970-, 80-, og 90-tallet. Fra 2000-tallet har lungekreft hatt den høyeste mortalitetsraten.\u0000Overlevelsen har økt for alle kreftformer, og i dag overlever tre av fire sin kreftsykdom i 5 år eller mer. Kreftformer med dårlig langtidsprognose har hatt en betydelig forbedring i overlevelsen de siste 10–20 årene. En tallmessig økende befolkning og en høyere andel av eldre vil føre til et økt antall krefttilfeller i de kommende årene.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41489874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4990
Siri Larønningen, Jan F. Nygård
Norsk sammendrag Det har vært en lang reise fra skrivemaskiner, regnemaskiner, hullkort og grafer tegnet på rutepapir til sikre datasentre, skyløsninger, maskinlæring, syntetiske datasett og federerte analyser. Målet med denne artikkelen er å gi et innblikk i behandlingen av data gjennom Kreftregisterets 70 år lange historie, og også si litt om hva vi tror blir viktig i fremtiden. Vi omtaler teknologi for databehandling og deling av data, kodeprosesser, kodeverk og standarder, Kreftregisterets kilder til informasjon, og juss og personvern. Hovedfokuset i artikkelen er databehandling knyttet til Kreftregisterets kjernedata, den såkalte «hoveddatabasen» eller «insidensdatabasen». English summary It has been a long journey from typewriters, calculators, punch cards and graphs drawn on grid paper to secure data centers, cloud-based systems, machine learning, synthetic datasets and federated analysis. The goal of this article is to provide some insight to data management through the 70-year history of the Cancer Registry of Norway. We look into technology for data management and sharing of data, coding, classifications and standards, the Cancer Registry sources of information, and laws, regulations and privacy issues. The main focus of the article is data management related to our core data and variables, the so-called “main database” or “incidence database”.
{"title":"Fra hullkort og strikkepinner til maskinlæring – En reise gjennom Kreftregisterets 70 år med databehandling","authors":"Siri Larønningen, Jan F. Nygård","doi":"10.5324/nje.v30i1-2.4990","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4990","url":null,"abstract":"Norsk sammendrag\u0000Det har vært en lang reise fra skrivemaskiner, regnemaskiner, hullkort og grafer tegnet på rutepapir til sikre datasentre, skyløsninger, maskinlæring, syntetiske datasett og federerte analyser. Målet med denne artikkelen er å gi et innblikk i behandlingen av data gjennom Kreftregisterets 70 år lange historie, og også si litt om hva vi tror blir viktig i fremtiden. Vi omtaler teknologi for databehandling og deling av data, kodeprosesser, kodeverk og standarder, Kreftregisterets kilder til informasjon, og juss og personvern. Hovedfokuset i artikkelen er databehandling knyttet til Kreftregisterets kjernedata, den såkalte «hoveddatabasen» eller «insidensdatabasen».\u0000 \u0000English summary\u0000It has been a long journey from typewriters, calculators, punch cards and graphs drawn on grid paper to secure data centers, cloud-based systems, machine learning, synthetic datasets and federated analysis. The goal of this article is to provide some insight to data management through the 70-year history of the Cancer Registry of Norway. We look into technology for data management and sharing of data, coding, classifications and standards, the Cancer Registry sources of information, and laws, regulations and privacy issues. The main focus of the article is data management related to our core data and variables, the so-called “main database” or “incidence database”.","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43014936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Norsk sammendrag Hovedmålsettingen med organisert mammografiscreening er å oppdage brystkreft i et tidlig stadium og dermed redusere sykelighet og dødelighet av sykdommen. En ulempe er overdiagnostikk. Verdens helseorganisasjons kreftforskningsinstitutt definerer overdiagnostikk i mammografiscreening som brystkreft som ikke ville blitt diagnostisert i kvinnens levetid dersom hun ikke hadde deltatt i screening. Vi kan ikke identifisere hvilke svulster som er overdiagnostiserte eller nøyaktig tallfeste omfanget av overdiagnostikk i mammografiscreening. Dersom vi analyserer data fra store grupper, kan vi gi et anslag på omfanget. Resultatet vil være avhengig av blant annet beregningsmetode, kontrollgruppe, oppfølgingstid, og hva slags type data som benyttes (individdata versus aggregattall). Selv om subtyper av brystkreft med ulik prognose kan defineres, kan vekstmønsteret innenfor samme subtype endres over tid, og det er derfor ikke mulig på diagnosetidspunktet å identifisere hvilke svulster som er overdiagnostiserte og ikke trenger behandling. Alle kvinner som får diagnostisert brystkreft tilbys derfor behandling. Begrepet overdiagnostikk er sammensatt og vanskelig å forstå. I noen sammenhenger brukes det som et paraplybegrep for ulike fenomener som for eksempel feildiagnoser, falskt positive screeningresultater eller overbehandling. Overdiagnostikk i mammografiscreening omfatter ikke feildiagnostikk eller falskt positive screeningresultater. Økt kunnskap i befolkningen og bruk av mer avanserte undersøkelsesteknikker gjør at flere brystkreftsvulster nå oppdages i et tidlig stadium og dermed øker risikoen for overdiagnostikk og overbehandling. Nye behandlingsmetoder reduserer brystkreftdødeligheten, også ved avansert sykdom, men ofte med bi- og seneffekter. Målet er mer presise screening- og diagnosemetoder, og mer persontilpasset behandling enn vi har i dag. Likevel er nok noe overdiagnostikk og overbehandling prisen vi må betale for å redde kvinner fra å dø av brystkreft. English summary The goal of organized mammographic screening is early detection of breast cancer and thereby to reduce disease-specific morbidity and mortality. One disadvantage is overdiagnosis. The World Health Organization's International Agency for Research on Cancer defines overdiagnosis in mammographic screening as the diagnosis of a breast cancer as a result of screening that would not have been diagnosed in the woman’s lifetime if screening had not taken place. We cannot identify which tumors are overdiagnosed or accurately quantify the extent of overdiagnosis in mammographic screening. Analyzing data from large groups will give an estimate, but the result will depend, among other things, on the calculation method, control group, follow-up time, and type of data used (individual data versus aggregate numbers). Although subtypes of breast cancer with different prognosis can be defined, the growth patterns within the same subtype can change over time, and it is therefore n
{"title":"Overdiagnostikk – eksemplifisert ved mammografiscreening","authors":"Solveig Hofvind, Gunhild Mangerud, Åsne Sørlien Holen, Giske Ursin","doi":"10.5324/nje.v30i1-2.4981","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4981","url":null,"abstract":"Norsk sammendrag\u0000Hovedmålsettingen med organisert mammografiscreening er å oppdage brystkreft i et tidlig stadium og dermed redusere sykelighet og dødelighet av sykdommen. En ulempe er overdiagnostikk. Verdens helseorganisasjons kreftforskningsinstitutt definerer overdiagnostikk i mammografiscreening som brystkreft som ikke ville blitt diagnostisert i kvinnens levetid dersom hun ikke hadde deltatt i screening. Vi kan ikke identifisere hvilke svulster som er overdiagnostiserte eller nøyaktig tallfeste omfanget av overdiagnostikk i mammografiscreening. Dersom vi analyserer data fra store grupper, kan vi gi et anslag på omfanget. Resultatet vil være avhengig av blant annet beregningsmetode, kontrollgruppe, oppfølgingstid, og hva slags type data som benyttes (individdata versus aggregattall). Selv om subtyper av brystkreft med ulik prognose kan defineres, kan vekstmønsteret innenfor samme subtype endres over tid, og det er derfor ikke mulig på diagnosetidspunktet å identifisere hvilke svulster som er overdiagnostiserte og ikke trenger behandling. Alle kvinner som får diagnostisert brystkreft tilbys derfor behandling. Begrepet overdiagnostikk er sammensatt og vanskelig å forstå. I noen sammenhenger brukes det som et paraplybegrep for ulike fenomener som for eksempel feildiagnoser, falskt positive screeningresultater eller overbehandling. Overdiagnostikk i mammografiscreening omfatter ikke feildiagnostikk eller falskt positive screeningresultater. Økt kunnskap i befolkningen og bruk av mer avanserte undersøkelsesteknikker gjør at flere brystkreftsvulster nå oppdages i et tidlig stadium og dermed øker risikoen for overdiagnostikk og overbehandling. Nye behandlingsmetoder reduserer brystkreftdødeligheten, også ved avansert sykdom, men ofte med bi- og seneffekter. Målet er mer presise screening- og diagnosemetoder, og mer persontilpasset behandling enn vi har i dag. Likevel er nok noe overdiagnostikk og overbehandling prisen vi må betale for å redde kvinner fra å dø av brystkreft.\u0000English summary\u0000The goal of organized mammographic screening is early detection of breast cancer and thereby to reduce disease-specific morbidity and mortality. One disadvantage is overdiagnosis. The World Health Organization's International Agency for Research on Cancer defines overdiagnosis in mammographic screening as the diagnosis of a breast cancer as a result of screening that would not have been diagnosed in the woman’s lifetime if screening had not taken place. We cannot identify which tumors are overdiagnosed or accurately quantify the extent of overdiagnosis in mammographic screening. Analyzing data from large groups will give an estimate, but the result will depend, among other things, on the calculation method, control group, follow-up time, and type of data used (individual data versus aggregate numbers). Although subtypes of breast cancer with different prognosis can be defined, the growth patterns within the same subtype can change over time, and it is therefore n","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47772475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.5324/nje.v30i1-2.4987
E. Lund
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{"title":"En sen høstdag ved Kreftregisteret, 1979","authors":"E. Lund","doi":"10.5324/nje.v30i1-2.4987","DOIUrl":"https://doi.org/10.5324/nje.v30i1-2.4987","url":null,"abstract":"-\u0000 ","PeriodicalId":35548,"journal":{"name":"Norsk Epidemiologi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43860004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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