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Risk of skin cancer following phototherapy for neonatal jaundice: retrospective cohort study

Risk of skin cancer following phototherapy for neonatal jaundice: retrospective cohort study. How Scotland compares to other countries.

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Risk of skin cancer following phototherapy for neonatal jaundice: retrospective cohort study

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  1. Risk of skin cancer following phototherapy for neonatal jaundice: retrospective cohort study How Scotland compares to other countries David H Brewster,1,2 Janet S Tucker,3,4 Michael Fleming,1 Carole Morris,1 Diane L Stockton,1 David J Lloyd,3,4 Sohinee Bhattacharya,3,4 James WT Chalmers1,2 Colorectal Cancer Study Day Stirling 13 September 2012 1Information Services Division, NHS National Services Scotland 2University of Edinburgh 3University of Aberdeen 4Aberdeen Maternity Hospital

  2. Outline Risk factors Mortality Incidence Survival

  3. Risk factors / protective factors (1) • Family history and inherited conditions • Familial adenomatous polyposis (FAP) • Hereditary non polyposis colorectal cancer (HNPCC or Lynch syndrome) • Ashkenazi Jewish background • Other medical conditions • Ulcerative colitis • Crohn's disease • Diabetes mellitus • Acromegaly • PMH of large bowel cancer, endometrial cancer, testicular cancer, or lymphoma • PMH of cholecystectomy • PMH of organ transplant

  4. Risk factors / protective factors (2) • Diet • Red and processed meat increase risk • Fruit, vegetable, fibre decrease risk • Calcium may reduce risk • Other factors • Age • Excess weight increases risk • Alcohol probably increases risk • Smoking (long-term) may increase risk • Physical activity decreases risk • Aspirin (and other NSAIDs) probably decrease risk • HRT and OC may decrease risk • Vitamin D may decrease risk • Screening reduces risk of dying from colorectal cancer (and endoscopic screening reduces incidence)

  5. Colorectal cancer (males) Source: Cancer Incidence in Five Continents, Volume IX

  6. Colorectal cancer (females) Source: Cancer Incidence in Five Continents, Volume IX

  7. Age-standardised relative survival from colorectal cancer by survival time and period of diagnosis 1-year 3-year 5-year 10-year

  8. Some factors to consider in population-based survival comparisons Data quality factors Tumour-related factors Population coverage Extent of disease Completeness of ascertainment Site (and sub-site) of tumour Accuracy of registration Tumour morphology Completeness of follow-up Tumour biology ‘Death certificate only’ registrations Host factors Health care-related factors Age Screening Sex Diagnostic facilities Socio-economic status Treatment facilities Race/Ethnicity Quality of treatment Co-morbidity Follow-up care Mortality from other causes Behaviour

  9. Colorectal cancer diagnosed 2002: the delay-survival paradox

  10. The waiting time paradox: the colorectal cancer example… Source: Torring ML et.al. Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care.Br J Cancer 2011;104:934–40.

  11. Risk of skin cancer following phototherapy for neonatal jaundice: retrospective cohort study So how does Scotland compare to other countries, and can we do better? David H Brewster,1,2 Janet S Tucker,3,4 Michael Fleming,1 Carole Morris,1 Diane L Stockton,1 David J Lloyd,3,4 Sohinee Bhattacharya,3,4 James WT Chalmers1,2 Our statistics on incidence, survival, and mortality, and on the prevalence of lifestyle risk factors suggest that we can 1Information Services Division, NHS National Services Scotland 2University of Edinburgh 3University of Aberdeen 4Aberdeen Maternity Hospital

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