Lancet Regional Health-Europe最新文献

{"title":"Are marketing bans on alcoholic beverages a quick buy?","authors":"Jakob Manthey , Carolin Kilian , Jürgen Rehm","doi":"10.1016/j.lanepe.2025.101474","DOIUrl":"10.1016/j.lanepe.2025.101474","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"58 ","pages":"Article 101474"},"PeriodicalIF":13.0,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324591","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":"Longitudinal data on advanced cutaneous squamous cell carcinoma from the Dutch Keratinocyte Cancer Collaborative (DKCC): a nationwide real-world database study","authors":"Loes M. Hollestein ,&nbsp;Celeste J. Eggermont ,&nbsp;Marieke W.J. Louwman ,&nbsp;Kay Schreuder ,&nbsp;Meggie C.M. Drissen ,&nbsp;Olivia F.M. Steijlen ,&nbsp;Antien L. Mooyaart ,&nbsp;Annette H. Bruggink ,&nbsp;Quirinus J.M. Voorham ,&nbsp;Dirk J. Grunhagen ,&nbsp;Mathilde Jalving ,&nbsp;Tamar E.C. Nijsten ,&nbsp;Marlies Wakkee","doi":"10.1016/j.lanepe.2025.101501","DOIUrl":"10.1016/j.lanepe.2025.101501","url":null,"abstract":"<div><h3>Background</h3><div>While Cutaneous Squamous Cell Carcinoma (CSCC) is one of the most common cancers, epidemiological data is scarce. Therefore, the aim of this study was to collect high quality epidemiological data, which is needed to identify differences in outcomes and improve patient care. To achieve this aim, we designed the Dutch Keratinocyte Cancer Collaborative (DKCC), which is a nationwide database, including longitudinal data on locally advanced, recurrent, and metastatic CSCC (advanced CSCC).</div></div><div><h3>Methods</h3><div>Advanced CSCCs were identified from the Dutch nationwide Pathology Databank (Palga) using a validated algorithm. Manual registration of a selection of 500 patients with advanced CSCC per year (all metastatic, all recurrences and a random selection of locally advanced CSCCs) was performed by the Netherlands Cancer Registry to obtain data on tumour characteristics, diagnostics, disease progression and treatment. Data was linked to the Netherland Organ Transplant Registry to obtain information about immunosuppressed patients and to the municipal records for vital status.</div></div><div><h3>Findings</h3><div>We estimated that 8.0% (1846/23,065 CSCC, 95% confidence interval: 7.4–8.6) of all diagnosed CSCC in 2021 were locally advanced CSCC. In 2021–2022, 920 patients with advanced CSCC were registered in the DKCC. A quarter of metastatic patients had recurrent CSCC before developing metastasis (i.e., 13/51 patients with skin metastasis, 63/296 patients with regional lymph node metastasis, 20/72 patients with distant metastasis). The median time to recurrence or metastasis after an American Joint Committee on Cancer (AJCC) T3/T4 primary CSCC was 11 months (Interquartile range [IQR] 6–19) and 9 months (IQR 6–17), respectively. In 6% (4/67, skin metastasis only) to 20% (17/83, distant metastasis) of episodes with metastasis, no treatment was provided.</div></div><div><h3>Interpretation</h3><div>The DKCC is the first nationwide longitudinal data source on advanced CSCC. Its methodology can serve as an example for designing efficient registries for advanced CSCC in other countries or even for other rare cancer outcomes. The high number of locally advanced CSCC puts a large burden on the health care system, as these patients need more extensive work-up and treatment. Data from the DKCC provides essential information to improve clinical guidelines for optimal CSCC patient care.</div></div><div><h3>Funding</h3><div>Funded by <span>Sanofi Genzyme</span>/<span>Regeneron</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101501"},"PeriodicalIF":13.0,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333787","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":"2025-10-16","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":"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":"2025-10-16","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":"Cardioprotective glucose-lowering drugs, statins, and risk of first-time atherosclerotic cardiovascular disease in Denmark: a nationwide cohort study","authors":"Tummas Ternhamar ,&nbsp;Mia Ø. Johansen ,&nbsp;Børge G. Nordestgaard ,&nbsp;Shoaib Afzal","doi":"10.1016/j.lanepe.2025.101490","DOIUrl":"10.1016/j.lanepe.2025.101490","url":null,"abstract":"<div><h3>Background</h3><div>We hypothesized that combining cardioprotective glucose-lowering drugs, i.e. sodium-glucose cotransporter-2 inhibitors or glucagon-like peptide-1 receptor agonists, and statins is associated with lower risk of first-time atherosclerotic cardiovascular disease (ASCVD) than using either drug alone.</div></div><div><h3>Methods</h3><div>We identified and followed individuals in Denmark with type 2 diabetes and without preexisting ASCVD from 2012 to 2021. In an active comparator design, individuals initiating a cardioprotective glucose-lowering drug or a dipeptidyl peptidase-4 inhibitor ± statin were compared: i) dipeptidyl peptidase-4 inhibitor (N = 12,298/59,795; 21%), ii) cardioprotective glucose-lowering drug (N = 16,357/59,795; 27%), iii) dipeptidyl peptidase-4 inhibitor plus statin (N = 14,823/59,795; 25%), and iv) cardioprotective glucose-lowering drug plus statin (N = 16,317/59,795; 27%). Also, in a time-varying design with annually updated covariates we compared: i) no cardioprotective drug (N = 113,669/277,747; 41%), ii) cardioprotective glucose-lowering drug (N = 12,225/277,747; 4%), iii) statin (138,405/277,747; 50%), and iv) cardioprotective glucose-lowering drug plus statin (N = 13,448/277,747; 5%). The primary outcome was ASCVD (myocardial infarction, coronary revascularization, stroke, peripheral arterial disease, or coronary death).</div></div><div><h3>Findings</h3><div>In the active comparator and time-varying cohorts during mean follow-ups of 3.2 and 5.9 years, 2546/59,795 (4%) and 28,044/277,747 (10%) developed ASCVD. In the active comparator cohort, multivariable adjusted hazard ratios of ASCVD were 0.87 (95% confidence interval: 0.76–0.98) for cardioprotective glucose-lowering drug, 0.69 (0.63–0.77) for statin, and 0.64 (0.56–0.73) for combined treatment compared with dipeptidyl peptidase-4 inhibitor. Corresponding values in the time-varying cohort were 0.94 (0.89–1.01), 0.70 (0.68–0.72), and 0.67 (0.64–0.70), respectively.</div></div><div><h3>Interpretation</h3><div>In individuals with type 2 diabetes without preexisting ASCVD, statin was associated with substantially lower risk of ASCVD than cardioprotective glucose-lowering drug, while combination of the two drug classes was associated with similar ASCVD risk as statin alone.</div></div><div><h3>Funding</h3><div><span>Danish Cardiovascular Academy</span> and <span>Danish Heart Foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101490"},"PeriodicalIF":13.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333708","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":"Systematic intensive therapy in addition to continuous glucose monitoring in adults with type 1 diabetes: a multicentre, open-label, randomised controlled trial","authors":"Arndís F. Ólafsdóttir ,&nbsp;Kari-Anne Sveen ,&nbsp;Magnus Wijkman ,&nbsp;Sara Hallström ,&nbsp;Per-Henrik Nilsson ,&nbsp;Sofia Sterner Isaksson ,&nbsp;Helene Holmer ,&nbsp;Marie Ekström ,&nbsp;Henrik Imberg ,&nbsp;Marcus Lind","doi":"10.1016/j.lanepe.2025.101485","DOIUrl":"10.1016/j.lanepe.2025.101485","url":null,"abstract":"<div><h3>Background</h3><div>Although continuous glucose monitor/intermittent scanning continuous glucose monitor (CGM/isCGM) is widely used for glucose monitoring, many adults with type 1 diabetes (T1D) still fail to achieve recommended glycaemic targets. We aimed to evaluate whether digital distance counselling based on CGM data could improve glycaemic control in adults with T1D and suboptimal control.</div></div><div><h3>Methods</h3><div>In this multicentre, open-label, randomised controlled trial, adults with T1D and HbA1c ≥58 mmol/mol, already using CGM/isCGM with insulin therapy (multiple daily injections or pump), were enrolled across eight sites in Sweden and Norway. Participants were allocated (1:1) via a minimisation algorithm to receive either systematic intensive therapy (SIT) or conventional therapy (CT). The SIT group received weekly distance counselling, including CGM interpretation, if mean glucose was ≥8·4 mmol/L, during an 18-week intervention period. The control group attended two clinical visits during this period. The primary outcome was change in HbA1c from baseline to 18 weeks. Adverse events of special interest (AESI; severe hypoglycaemia or diabetic ketoacidosis) were assessed in the safety population. This trial is registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> number <span><span>NCT03474393</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>117 participants were enrolled and randomised (59 SIT, 58 control). At 18 weeks, mean (SD) HbA1c decreased by −10·7 (9·4) mmol/mol (−0·98% [0·86]) in the SIT group compared with −2·4 (8·4) mmol/mol (−0·22% [0·77]) in CT, resulting in an adjusted mean difference of −8·3 mmol/mol (95% CI −11·2 to −5·5), equivalent to −0·76% (95% CI −1·02 to −0·50%; <em>P</em> &lt; 0·0001). No AESI were observed in the SIT group, compared with one event in the control group (1·7%), giving a risk difference of −1·7% (95% CI −5·1 to 1·6%).</div></div><div><h3>Interpretation</h3><div>SIT improves glycaemic control in adults with T1D using CGM/isCGM who are not achieving recommended glycaemic targets, without evidence of safety concerns. These findings highlight the critical role of structured, individualised interventions in addressing persistent glycaemic management deficits and advancing clinical outcomes in this population.</div></div><div><h3>Funding</h3><div>The study was supported by the <span>Swedish state</span>, <span>Region Västra Götaland</span>, and the <span>Swedish Diabetes Foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101485"},"PeriodicalIF":13.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333702","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":"Type 2 diabetes remission after initiation of GLP-1 receptor agonists: frequency, characteristics, and outcomes using multiple definitions in an observational study","authors":"Gian Paolo Fadini ,&nbsp;Andrea Giaccari ,&nbsp;Fabio Broglio ,&nbsp;Laura Nollino ,&nbsp;Bruno Fattor ,&nbsp;Roberto Anichini ,&nbsp;Giancarla Meregalli ,&nbsp;Angelo Avogaro ,&nbsp;Agostino Consoli","doi":"10.1016/j.lanepe.2025.101499","DOIUrl":"10.1016/j.lanepe.2025.101499","url":null,"abstract":"<div><h3>Background</h3><div>Remission of type 2 diabetes (T2D) is becoming feasible with modern treatments, including GLP-1 receptor agonists (GLP-1RA). Here, we explored frequency, characteristics, and outcomes associated with various definitions of remission after initiation of GLP-1RA.</div></div><div><h3>Methods</h3><div>This was an observational study on new-users of GLP-1RA. We explored 4 definitions of remission: (1) HbA1c to &lt;6.5% persisting ≥3 months in the absence of diabetes pharmacotherapy; (2) As in 1, but allowing GLP-1RA therapy; (3) As in 1, but without new diabetes pharmacotherapy; (4) As in 1, but irrespectively of ongoing diabetes pharmacotherapy.</div></div><div><h3>Findings</h3><div>We included 14,141 participants initiating GLP-1RA (60% men, 60-year-old, with a diabetes duration of ∼10 years, BMI 32 kg/m², HbA1c 8.1%). The mean observation was 4 years. Remission frequencies by definition were: (1) 5.8%; (2) 6.2%; (3) 12.2%; (4) 18.3%. Duration was shorter for remission 1–2 (5–6 months) than for remission 3–4 (9–10 months). Factors associated with remission were similar across definitions (shorter diabetes duration, higher BMI, lower burden of complications and medications). Remission was associated with significant and sustained benefits on HbA1c (–1%) and body weight (–2 kg). Microvascular events were reduced by 12–16% in participants with remission 1, 2 or 3. Cardiovascular events were reduced only in remission 3 (HR 0.65; 95% C.I. 0.48–0.88).</div></div><div><h3>Interpretation</h3><div>T2D remission is not rare after initiation GLP-1RA, its frequency and duration varying by definition. When achieved, remission is associated with durable metabolic improvements up to 4 years and fewer incident complications.</div></div><div><h3>Funding</h3><div>Supported by <span>the Italian Diabetes Society (Società Italiana di Diabetologia)</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101499"},"PeriodicalIF":13.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333788","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":"Association between the Dutch Obesogenic Built-environmental CharacterisTics (OBCT) index and 14-year cardiovascular disease incidence: a population-based cohort study of 4.4 million adults","authors":"Paul Meijer ,&nbsp;Thao Minh Lam ,&nbsp;Joline WJ. Beulens ,&nbsp;Diederick E. Grobbee ,&nbsp;Jeroen Lakerveld ,&nbsp;Ilonca Vaartjes","doi":"10.1016/j.lanepe.2025.101494","DOIUrl":"10.1016/j.lanepe.2025.101494","url":null,"abstract":"<div><h3>Background</h3><div>The Dutch Obesogenic Built-environmental CharacterisTics (OBCT) index, which has been previously associated with higher BMI, waist circumference and increased prevalence of obesity, offers a composite measure of such exposures. This study investigated the association between OBCT index scores and 14-year CVD incidence in adults.</div></div><div><h3>Methods</h3><div>This population-based cohort study included 4.4 million Dutch residents aged ≥40 years with no history of CVD as of January 1, 2006. Participants resided at the same address from January 1, 2004, to December 31, 2019, or until death. The OBCT index, ranging from 0 to 100, quantified the obesogenicity of participants' living environments at baseline. CVD outcomes included overall CVD incidence, coronary heart disease (CHD), stroke, and heart failure (HF). Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</div></div><div><h3>Findings</h3><div>A 10-point higher OBCT index score was associated with a 1.1% (HR: 1.011; 95% CI: 1.009–1.013) higher risk of any CVD. Individuals in the highest quintile had a 4.9% (HR: 1.049; 95% CI: 1.038–1.060) higher risk of CVD compared to those in the lowest quintile, corresponding to 37 additional events per 10,000 persons at 10 years. A 10-point higher OBCT index was also associated with CVD mortality (HR: 1.010; 95% CI: 1.006–1.014) and for specific outcomes: CHD (1.1% higher risk), stroke (0.9% higher risk), and HF (1.2% higher risk). Associations were stronger in the highest income group and among individuals exposed to high air pollution levels.</div></div><div><h3>Interpretation</h3><div>Living in a more obesogenic environment is associated with a higher 14-year risk of CVD. Although the effect sizes are modest at the individual level, their significance is amplified by the widespread nature of the exposures studied.</div></div><div><h3>Funding</h3><div>This work is supported by <span>EXPOSOME-NL</span>. EXPOSOME-NL is a Dutch consortium funded through the Gravitation programme of the <span>Dutch Ministry of Education, Culture, and Science</span> and the <span>Netherlands Organization for Scientific Research</span> (NWO grant number <span><span>024.004.017</span></span>).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101494"},"PeriodicalIF":13.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333703","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":"PD-L1 inhibitors combined with chemotherapy for extensive-stage small cell lung cancer: a French nationwide cohort study","authors":"Hugo Jourdain ,&nbsp;Nicolas Albin ,&nbsp;Adrien Monard ,&nbsp;David Desplas ,&nbsp;Mahmoud Zureik ,&nbsp;Nadia Haddy","doi":"10.1016/j.lanepe.2025.101484","DOIUrl":"10.1016/j.lanepe.2025.101484","url":null,"abstract":"<div><h3>Background</h3><div>Immunotherapy with atezolizumab and durvalumab has significantly advanced the treatment of extended-stage small cell lung cancer (esSCLC). We aimed at studying the real-world use and comparative effectiveness and safety of these treatments.</div></div><div><h3>Methods</h3><div>We utilised the French National Health Data System (SNDS) to include all patients treated with atezolizumab or durvalumab for esSCLC from May 1, 2019 to December 31, 2023, with follow-up until June 30, 2024. Baseline characteristics were described. Effectiveness (time to treatment discontinuation and overall survival) and safety (all-cause and cause-specific overnight hospitalisations) were assessed using Cox proportional hazards models.</div></div><div><h3>Findings</h3><div>A total of 8612 patients were included, with 5188 initiating atezolizumab and 3424 initiating durvalumab. The mean age at inclusion was 66·2 years (standard deviation 8·7), and most patients were men (63·8%, n = 5493). The median time to treatment discontinuation was 5·4 months (95% CI, 5·3–5·5) for atezolizumab and 5·5 months (95% CI, 5·4–5·6) for durvalumab, with an adjusted hazard ratio (aHR) of 0·97 (95% CI, 0·92–1·02) for durvalumab vs. atezolizumab. The median overall survival was 11·1 months (95% CI, 10·6–11·4) for atezolizumab and 11·4 months (95% CI, 10·9–11·9) for durvalumab, with an aHR of 0·93 (95% CI, 0·88–0·98) for durvalumab vs. atezolizumab.</div><div>While 61·8% (n = 5323) of patients received systemic steroids, testifying of immune-mediated side effects, no significant safety differences were observed between the groups.</div></div><div><h3>Interpretation</h3><div>Our study found no clinically relevant differences in effectiveness or safety between atezolizumab and durvalumab for first-line esSCLC. Both treatments appearing interchangeable, treatment decision could be based on drug availability, local institutional protocols, administrative organisation, or cost considerations.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101484"},"PeriodicalIF":13.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269994","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":"Association between dietary environmental pressures and major chronic diseases: assessment from the prospective NutriNet-Santé cohort","authors":"Emmanuelle Kesse-Guyot ,&nbsp;Aurélien Chayre ,&nbsp;Elie Perraud ,&nbsp;Sylvaine Berger ,&nbsp;Annabelle Richard ,&nbsp;Justine Berlivet ,&nbsp;Mathilde Touvier ,&nbsp;Benjamin Allès ,&nbsp;Serge Hercberg ,&nbsp;Denis Lairon ,&nbsp;Philippe Pointereau ,&nbsp;Hélène Fouillet ,&nbsp;Julia Baudry ,&nbsp;Christian Couturier ,&nbsp;François Mariotti","doi":"10.1016/j.lanepe.2025.101481","DOIUrl":"10.1016/j.lanepe.2025.101481","url":null,"abstract":"<div><h3>Background</h3><div>Plant-based diets offer co-benefits for human health and the environment, but assessments often consider only specific aspects. This study comprehensively examines the links between diet-related environmental pressures and risk of chronic diseases as well as mortality.</div></div><div><h3>Methods</h3><div>Data from a population study of 34,077 participants to the NutriNet-Santé French cohort were used. Dietary data were collected using a food frequency questionnaire, distinguishing between organic and conventional foods, and were merged with food production environmental indicators. The associations between greenhouse gas emissions (GHGe), energy demand, land occupation (LO), ecological infrastructures (EI), water use, and pesticide treatment frequency and a synthetic environmental pressures index (EPI) and incidence of cancer, cardiovascular diseases (overall, coronary and cerebrovascular diseases), type 2 diabetes and mortality were estimated using weighted multivariable cox proportional risk model.</div></div><div><h3>Findings</h3><div>Over a mean median follow-up of 8.39 years (IQR = 5.62, 256,891 person-year), the diet's overall environmental pressures (EPI) was positively associated with the risk of all tested chronic diseases except stroke. The HR for 1 SD increment ranging from 1.15 (95% CI = 1.03–1.28) for cancer (all locations) to 1.50 (95% CI = 1.29–1.73) for coronary heart disease and type 2 diabetes, but no association with stroke or death was detected.</div></div><div><h3>Interpretation</h3><div>Diets with low overall environmental pressures are associated with important health benefits, suggesting that food systems with lower environmental impacts could be key drivers of both environmental and health sustainability.</div></div><div><h3>Funding</h3><div>Data were collected in the context of the BioNutriNet and TRANSFood projects supported by the <span>French National Research Agency</span> (ANR-13-ALID-0001 and ANR-21-CE21-0011-01).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101481"},"PeriodicalIF":13.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269995","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}