Lancet Regional Health-Europe最新文献

{"title":"Rising antimicrobial resistance in Europe: EMA and ECDC outline urgent actions to achieve EU targets","authors":"Emer Cooke , Pamela Rendi-Wagner","doi":"10.1016/j.lanepe.2025.101539","DOIUrl":"10.1016/j.lanepe.2025.101539","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101539"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693684","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":"Economic pressures threaten surgical quality in Germany: immediate policy action required","authors":"Stephan Schorn , Helmut Friess , Ihsan Ekin Demir","doi":"10.1016/j.lanepe.2025.101546","DOIUrl":"10.1016/j.lanepe.2025.101546","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101546"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623530","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":"Announcing the Lancet Migration European Hub and the Lancet Regional Health-Europe Commission on climate change, migration, displacement and health","authors":"Bernadette N. Kumar , Anand S. Bhopal , Sylvia Garry , Rosemary James , Ozge Karadag , Miriam Orcutt , Shilpa Rao , Shervin Shahnavaz , Santino Severoni , Amirhossein Takian , Pooja Jha , Karl Blanchet","doi":"10.1016/j.lanepe.2025.101532","DOIUrl":"10.1016/j.lanepe.2025.101532","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101532"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579111","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":"European Society for Medical Oncology (ESMO) congress 2025","authors":"Ivana Nedic","doi":"10.1016/j.lanepe.2025.101528","DOIUrl":"10.1016/j.lanepe.2025.101528","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101528"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693797","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":"Contraceptive use in France in 2012 and 2022: a descriptive analysis of two repeated nationwide cross-sectional studies","authors":"Lorraine Poncet ,&nbsp;Noémie Roland ,&nbsp;Romain Fortuna ,&nbsp;Karima Hider-Mlynarz ,&nbsp;Rosemary Dray-Spira ,&nbsp;Alain Weill ,&nbsp;Mahmoud Zureik","doi":"10.1016/j.lanepe.2025.101488","DOIUrl":"10.1016/j.lanepe.2025.101488","url":null,"abstract":"<div><h3>Background</h3><div>A decrease in oral contraceptive use, newly available methods, and the emerging role of midwives suggested meaningful changes in contraception use in France. With two repeated cross-sectional studies, we aimed to describe contraception use in France in 2012 and 2022, in the total population and across age groups.</div></div><div><h3>Methods</h3><div>Using the French National Health Data System (SNDS) covering 99% of the population, we identified reimbursed contraceptive use in women 15–49 years in January 2012 and 2022: combined oral contraceptives (COC), progestogen-only pill (POP), injectable progestogen, copper intrauterine device (Cu-IUD), levonorgestrel-releasing intrauterine devices (LNG-IUD), implants, sterilization. Number of users, socio-demographic characteristics and healthcare providers were assessed. Sales data accounted for non-reimbursed OC.</div></div><div><h3>Findings</h3><div>Amid stable prevalence of contraception use (6.67 million users in 01/2012 and 6.73 in 01/2022, or 47%–46% of women aged 15–49 years), COC use decreased by a third from 54% (n = 3,602,803) to 35% of users (n = 2,370,205) while remaining the most popular method. POP and Cu-IUD use doubled, up to 19% (n = 1,293,073) and 21% of users (n = 1,428,837) users, respectively. IUD and POP have become leading methods in women 30–39 years, concerning 44% of users (n = 951,649) and 20% of users (n = 428,138) of users, respectively, while 50% of women ≥40 years (n = 1,051,066) used IUD. From &lt;0.5% in 2012 (n = 16,154), midwives prescriptions reached 13% (n = 859,819) of total prescriptions in 2022. Social disparities in IUD use grew.</div></div><div><h3>Interpretation</h3><div>Our findings displayed profound changes over ten years towards more hormone-free contraceptive methods.</div></div><div><h3>Funding</h3><div>The <span>French National Health Insurance Fund</span> (Cnam) and the <span>French National Agency for Medicines and Health Products Safety</span> (ANSM) via the <span>Scientific Interest Group</span> EPI-PHARE.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101488"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333786","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":"Cardiovascular disease risk and the balance between animal-based and plant-based foods, nutritional quality, and food processing level in the French NutriNet-Santé cohort: a longitudinal observational study","authors":"Clémentine Prioux ,&nbsp;Emmanuelle Kesse-Guyot ,&nbsp;Bernard Srour ,&nbsp;Léopold K. Fézeu ,&nbsp;Julia Baudry ,&nbsp;Sandra Wagner ,&nbsp;Serge Hercberg ,&nbsp;Mathilde Touvier ,&nbsp;Benjamin Allès","doi":"10.1016/j.lanepe.2025.101470","DOIUrl":"10.1016/j.lanepe.2025.101470","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have evaluated the effects of plant-based diets combined with ultra-processed food on cardiovascular diseases (CVD). The objective of this study was to assess associations between CVD risk and novel diet indices that integrate balance between plant-based and animal-based foods, nutritional quality and processing level.</div></div><div><h3>Methods</h3><div>We analyzed data from the French NutriNet-Santé prospective cohort. First, the two original healthy Plant-Based Diet and unhealthy Plant-Based Diet Indices (hPDI and uPDI) were computed. Four new indices were then built, based on the hPDI and uPDI computation, but with a multiplying factor to account for (i) the contribution of unprocessed food (UnPF) and (ii) the contribution of ultra-processed food (UPF), using the NOVA classification, culturally adapted. These two contributions (UnPF and UPF) were estimated using dietary data from 24 h records as percentages of total food consumed (g.day⁻¹). The association between each of the six resulting index scores and cardiovascular disease (cerebrovascular and coronary) was estimated using multivariate Cox proportional hazards models adjusted for confounding factors. Sensitivity analyses were also performed to assess the robustness of these novel indices.</div></div><div><h3>Findings</h3><div>Among 63,835 participants, median follow-up time 9.0 years, IQR: 5–13 years, 76% women, mean age 51.4, SD = 10.2, no statistically significant protective or deleterious association was observed between those adhering to a nutritionally healthy but ultra-processed plant-based diet (hPDI-UPF), and a nutritionally unhealthy but unprocessed plant-based diet (uPDI-UnPF). When comparing participants with the highest adherence to a nutritionally healthy and unprocessed plant-based diet (hPDI-UnPF), to those with the lowest, we observed a 44% lower incidence of coronary heart disease (HR_{D10 vs. D1}: 0.56, 95% CI: [0.42–0.75]) and 32% lower risk for CVD (HR_{D10 vs. D1}: 0.68, 95% CI: [0.53–0.88]). Similarly, participants with the highest adherence to an unhealthy and ultra-processed plant-based diet (uPDI-UPF) had a 46% higher incidence of coronary heart disease (HR_{D10 vs. D1}: 1.46, 95% CI: [1.11–1.93]), and a 38% higher incidence of CVD (HR_{D10 vs. D1}: 1.38, 95% CI: [1.09–1.76]). This was the strongest association observed in our study.</div></div><div><h3>Interpretation</h3><div>The findings of this study mark the importance of considering not only balance between plant-based and animal-based foods, but also nutritional quality and degree of processing when evaluating association between diet and cardiovascular risk.</div></div><div><h3>Funding</h3><div><span>French National Research Agency</span> (ANR, ANR-22-CE36-0012).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101470"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693682","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":"The Gastein prescription: health as Europe's path to renewal","authors":"Martin McKee","doi":"10.1016/j.lanepe.2025.101514","DOIUrl":"10.1016/j.lanepe.2025.101514","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101514"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418068","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":"Unmet supportive care needs among head and neck cancer survivors beyond 5 years after diagnosis: a multinational cohort study","authors":"Femke Jansen ,&nbsp;Simone EJ. Eerenstein ,&nbsp;Katherine J. Taylor ,&nbsp;Cecilie D. Amdal ,&nbsp;Kristin Bjordal ,&nbsp;Guro L. Astrup ,&nbsp;Bente B. Herlofson ,&nbsp;Fréderic Duprez ,&nbsp;Ricardo R. Gama ,&nbsp;Alexandre A. Jacinto ,&nbsp;Eva Hammerlid ,&nbsp;Melissa Scricciolo ,&nbsp;Giuseppe Fanetti ,&nbsp;Orlando Guntinas-Lichius ,&nbsp;Johanna Inhestern ,&nbsp;Tatiana Dragan ,&nbsp;Alexander Fabian ,&nbsp;Andreas Boehm ,&nbsp;Ulrike Wöhner ,&nbsp;Naomi Kiyota ,&nbsp;Irma M. Verdonck-de Leeuw","doi":"10.1016/j.lanepe.2025.101495","DOIUrl":"10.1016/j.lanepe.2025.101495","url":null,"abstract":"<div><h3>Background</h3><div>This study investigates unmet supportive care needs (SCNs) among head and neck cancer (HNC) survivors beyond 5 years after diagnosis and examines the association with sociodemographic, clinical and lifestyle factors, and differences in European and non-European regions and healthcare systems.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 1097 HNC survivors from 11 countries completed the Short-Form Supportive Care Needs Survey (SCNS-SF34) and HNC-specific module (SCNS-HNC), encompassing physical and daily living, psychological, sexuality, HNC-specific and lifestyle domains. Scores were dichotomized per domain and across domains into moderate-high unmet SCNs (yes/no). Logistic regression analyses were used to investigate associated factors.</div></div><div><h3>Findings</h3><div>Half (50%, proportion 100/200) of HNC survivors had unmet SCNs (overall), especially unmet HNC-specific (40%, 40/100), psychological (25%, 25/100), and physical and daily living (22%, 22/100) needs. Personal (women, lower age), lifestyle (smoking, alcohol consumption) and clinical factors (advanced tumor stage, second primary tumor, multimodality treatment [versus single surgery], poor Karnofsky performance score and comorbidities) were associated with unmet SCNs. Physical and daily living, HNC-specific and overall unmet SCNs were more likely among survivors from Northern Europe compared to Southern and Western Europe. Unmet psychological, sexuality and lifestyle needs were more likely among non-European countries. All unmet SCNs (except psychological) were more likely among survivors with a national health system compared to a social and/or etatist health insurance system.</div></div><div><h3>Interpretation</h3><div>Half of HNC survivors have unmet SCNs. Insight into healthcare utilization may provide insights how to improve care.</div></div><div><h3>Funding</h3><div><span>European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Group</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101495"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333707","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":"The effect of disease-modifying therapies on brain volume loss and disability accumulation in multiple sclerosis: a systematic review and network meta-analysis","authors":"Alessandro Cagol ,&nbsp;Sabine Schaedelin ,&nbsp;Roxanne Pretzsch ,&nbsp;Ludwig Kappos ,&nbsp;Maria Pia Sormani ,&nbsp;Cristina Granziera","doi":"10.1016/j.lanepe.2025.101476","DOIUrl":"10.1016/j.lanepe.2025.101476","url":null,"abstract":"<div><h3>Background</h3><div>Multiple treatments have demonstrated efficacy in preventing brain volume loss (BVL) in randomized controlled trials (RCTs) for multiple sclerosis (MS). However, assessing their relative effectiveness remains challenging due to limited head-to-head comparisons. Additionally, the relationship between treatment effects on BVL and disability accumulation is not established for newer therapies. This study aimed to compare the efficacy of approved disease-modifying therapies (DMTs) in reducing BVL in MS and to investigate the association between treatment effects on BVL and disability accumulation.</div></div><div><h3>Methods</h3><div>In this systematic review and network meta-analysis, we included all RCTs enrolling adults with MS that evaluated FDA-approved DMTs and reported BVL outcomes over at least one year. We searched PubMed, Embase, and Cochrane from inception to September 2024. Following PRISMA guidelines, two reviewers independently extracted data on BVL, MRI lesion activity, and disability progression. We conducted a mixed-effects network meta-analysis with placebo as the reference group. Meta-regression analyses examined the association between treatment effects on BVL and disability progression, adjusting for MRI lesion activity.</div><div>The primary outcome was BVL. Secondary outcomes included MRI lesion accumulation and risk of confirmed disability progression. Effect sizes were reported as the ratio of means (ROM) and hazard ratios (HRs), with 95% confidence intervals (CIs). This study is registered with PROSPERO (CRD420251034936).</div></div><div><h3>Findings</h3><div>We included 33 RCTs evaluating 16 DMTs and 26,247 patients. Eight DMTs significantly reduced BVL compared to placebo, including ponesimod (ROM = 0.52; 95%-CI: 0.35–0.77), ofatumumab (ROM = 0.58; 95%-CI: 0.40–0.83), alemtuzumab (ROM = 0.63; 95%-CI: 0.49–0.83), teriflunomide (ROM = 0.71; 95%-CI: 0.52–0.97), ozanimod (ROM = 0.74; 95%-CI: 0.56–0.98), natalizumab (ROM = 0.77; 95%-CI: 0.61–0.96), siponimod (ROM = 0.77; 95%-CI: 0.60–0.98), and fingolimod (ROM = 0.83; 95%-CI: 0.71–0.96). The treatment effect on BVL was associated with the treatment effect on disability accumulation (β = 0.466; p = 0.008), and this association remained significant independently of the treatment effect on MRI activity (β = 0.422; p = 0.005).</div></div><div><h3>Interpretation</h3><div>Several DMTs—including newer therapies—significantly reduce BVL, and this effect correlates with reduced disability accumulation. These findings support BVL as a meaningful treatment target in MS.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101476"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160319","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":"Health and care service utilisation in the last year of life before non-sudden death in Wales, 2014–2023, by palliative care registration: a population-based retrospective cohort study","authors":"Rhiannon K. Owen ,&nbsp;Rowena Bailey ,&nbsp;Helen Daniels ,&nbsp;Athena McBride ,&nbsp;Ashley Akbari ,&nbsp;Elinor Curnow ,&nbsp;Alison Cooper ,&nbsp;Natalie Joseph-Williams ,&nbsp;Adrian Edwards ,&nbsp;Maria Parry ,&nbsp;Idris Baker","doi":"10.1016/j.lanepe.2025.101479","DOIUrl":"10.1016/j.lanepe.2025.101479","url":null,"abstract":"<div><h3>Background</h3><div>End-of-life health and care service provision are complex processes. We aimed to quantify the uptake of health and care services in the last year of life before death from non-sudden causes by palliative care registration.</div></div><div><h3>Methods</h3><div>Population-scale linked administrative and health data in the last year of life for Welsh residents who died of non-sudden causes were modelled using multi-state models between 2014 and 2023. Cox regression were used to estimate hazards for transitions between care settings, including people's homes, care homes with and without nursing, emergency, elective and other hospital admissions, and death. The primary outcome was rate of transition reported as hazard ratios (HR) with corresponding 95% confidence intervals (95% CI) adjusted for age, sex, rurality, area-level deprivation, and palliative care registration. Secondary outcomes included expected length of stay (ELOS).</div></div><div><h3>Findings</h3><div>Our analyses included 267,199 individuals, with 1,845,572 transitions. There were 74,045 (27.7%) individuals registered for palliative care, under-represented groups included men, most-deprived and living alone. Most time was spent at home, with 370,752 (90.3%) of 410,441 emergency admissions from home. There was a 23% (HR 1.23 [95% CI 1.22–1.25]) increased transition rate of emergency admissions from home for palliative care registered compared with unregistered individuals, with a decreased expected length of stay (ELOS 25.34 [95% CI 25.34–25.34] vs 26.87 [26.87–26.87]). Emergency admissions from care homes with and without nursing were 17% (HR 0.83 [95% CI 0.80–0.86]) and 18% (HR 0.82 [95% CI 0.79–0.85]) lower for palliative care registered compared with unregistered individuals, with an increased rate of discharge from emergency hospital settings (HR 2.00 [95% CI 1.92–2.09] and 1.62 [1.54–1.69]).</div></div><div><h3>Interpretation</h3><div>Palliative care status was associated with health and care utilisation at the end-of-life. Efficient identification of individuals needing palliative care and additional support at home should be prioritised for system optimisation.</div></div><div><h3>Funding</h3><div><span>Health and Care Research Wales Evidence Centre</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101479"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269487","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}