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Original Articles
No association between genetically predicted C-reactive protein levels and colorectal cancer survival in Korean: two-sample Mendelian randomization analysis
Chang Kyun Choi, Jung-Ho Yang, Min-Ho Shin, Sang-Hee Cho, Sun-Seog Kweon
Epidemiol Health. 2023;45:e2023039.   Published online March 22, 2023
DOI: https://doi.org/10.4178/epih.e2023039
  • 4,468 View
  • 165 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Elevated C-reactive protein (CRP) levels are associated with an increased risk for colorectal cancer (CRC), as well as a poor prognosis, but it remains unclear whether these associations are causal. This study examined the potential causality between CRP levels and CRC survival using 2-sample Mendelian randomization (MR).
METHODS
From the Korean Genome and Epidemiology Study, a genome-wide association study (n=59,605), 7 single-nucleotide polymorphisms (SNPs) related to log2-transformed CRP levels were extracted as instrumental variables for CRP levels. The associations between the genetically predicted CRP and CRC-specific and overall mortality among CRC patients (n=6,460) were evaluated by Aalen’s additive hazard model. The sensitivity analysis excluded a SNP related to the blood lipid profile.
RESULTS
During a median of 8.5 years of follow-up, among 6,460 CRC patients, 2,676 (41.4%) CRC patients died from all causes and 1,622 (25.1%) died from CRC. Genetically predicted CRP levels were not significantly associated with overall or CRC-specific mortality in CRC patients. The hazard difference per 1,000 person-years for overall and CRC-specific mortality per 2-fold increase in CRP levels was -2.92 (95% confidence interval [CI], -14.05 to 8.21) and -0.76 (95% CI, -9.61 to 8.08), respectively. These associations were consistent in a subgroup analysis according to metastasis and a sensitivity analysis excluding possible pleiotropic SNPs.
CONCLUSIONS
Our findings do not support a causal role for genetically predisposed CRP levels in CRC survival.
Summary
Korean summary
이 연구는 two-sample Mendelian randomization (MR)을 이용하여 대장암에서 C-reactive protein와 사망률 간의 관련성을 평가하였다. Two-sample MR은 한국유전체역학조사사업 (the Korean Genome and Epidemiology Study, KoGES) 참가자 59,605명에서 혈청 C-reactive protein에 대한 전장유전체 분석을 시행하여 7개의 단일염기다형성을 선별하였고, 화순암역학연구-대장암 (thw Hwasun Cancer Epidemiology Study-Colon and Rectum Cancer, HCES-CRC)에 등록된 6,460명 대장암 환자에서 그 7개 단일염기다형성과 사망률 간의 관련성을 평가한 결과를 이용하였다. 그 결과, 높은 혈청 C-reactive protein을 가지는 유전적 성향은 대장암 환자에서 사망률과의 통계적으로 유의한 관련성을 찾을 수 없었다.
Key Message
This study employed a two-sample Mendelian randomization (MR) analysis to investigate the relationship between serum C-reactive protein (CRP) levels and mortality in colorectal cancer. The analysis utilized genome-wide association analysis (GWAS) data from 59,605 participants in the Korean Genome and Epidemiology Study (KoGES) for serum CRP and 6,460 colorectal cancer cases from the Hwasun Cancer Epidemiology Study-Colon and Rectum Cancer for mortality. Our findings suggest that there is no statistically significant association between genetically predisposed serum CRP levels and mortality. Consequently, our study does not support a causal effect of CRP on mortality in colorectal cancer.
The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data
Reza Ebrahimoghli, Hassan Ghobadi, Davoud Adham, Parviz Jangi, Abbas Abbasi-Ghahramanloo, Eslam Moradi-Asl
Epidemiol Health. 2022;44:e2022060.   Published online July 18, 2022
DOI: https://doi.org/10.4178/epih.e2022060
  • 6,457 View
  • 267 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016.
METHODS
This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model.
RESULTS
A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period.
CONCLUSIONS
The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran.
Summary
Key Message
A longitudinal analysis of tuberculosis surveillance data from northwest Iran showed that during the 12-year period from 2005 to 2016, a total of 1,367 tuberculosis cases were registered, of whom 942 patients had a prolonged diagnostic delay (>30 days) and the probability of a delay in tuberculosis diagnosis decreased by 5.0% each year.

Citations

Citations to this article as recorded by  
  • Assessing heterogeneity of patient and health system delay among TB in a population with internal migrants in China
    Ruoyao Sun, Zheyuan Wu, Hongyin Zhang, Jinrong Huang, Yueting Liu, Meiru Chen, Yixiao Lv, Fei Zhao, Yangyi Zhang, Minjuan Li, Jiaqi Yan, Hongbing Jiang, Yiqiang Zhan, Jimin Xu, Yanzi Xu, Jianhui Yuan, Yang Zhao, Xin Shen, Chongguang Yang
    Frontiers in Public Health.2024;[Epub]     CrossRef
Patterns and predictors of smoking relapse among inpatient smoking intervention participants: a 1-year follow-up study in Korea
Seung Eun Lee, Chul-Woung Kim, Hyo-Bin Im, Myungwha Jang
Epidemiol Health. 2021;43:e2021043.   Published online June 9, 2021
DOI: https://doi.org/10.4178/epih.e2021043
  • 10,489 View
  • 414 Download
  • 10 Web of Science
  • 12 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to identify relapse patterns in smokers who participated in an inpatient treatment program and to investigate factors related to relapse.
METHODS
The participants comprised 463 smokers who participated in an inpatient treatment operated by the Daejeon Tobacco Control Center from 2015 to 2018. Participants received high-intensity smoking cessation intervention for 5 consecutive days, including pharmacotherapy and behavioral support, and continued with follow-up for 1 year to determine whether they maintained smoking cessation after discharge from inpatient treatment. Kaplan-Meier and Cox proportional hazard models were used in the analysis.
RESULTS
Participants’ relapse rate within 1 year was 72.8%, and 59.8% of participants smoked again within 6 months after participation. A higher number of counseling sessions was significantly associated with a lower risk of relapse (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.17 to 0.32 for ≥9 vs. ≤5 counseling sessions). Conversely, higher relapse rates were significantly associated with the use of nicotine replacement therapy (NRT) (HR, 1.91; 95% CI, 1.43 to 2.55 for use vs. no use), and higher levels of baseline expired carbon monoxide (CO) (HR, 1.58; 95% CI, 1.21 to 2.06 for expired CO concentrations of 10-19 ppm vs. expired CO concentrations <10 ppm).
CONCLUSIONS
High-intensity smoking cessation interventions in hospital settings can be effective for smoking cessation in smokers with high nicotine dependence. In addition, the results suggest that for quitters to maintain long-term abstinence, they should receive regular follow-up counseling for 1 year after completing a high-intensity smoking cessation intervention.
Summary
Korean summary
• 한국은 국가금연정책의 일환으로 중증고도흡연자를 위해 고강도의 입원형 금연 중재 프로그램을 운영하고 있다. • 고강도 금연 중재를 받은 후 첫 6개월은 재흡연이 가장 빈번히 일어나는 시기였다. • 장기 금연을 유지하기 위해서는 고강도 금연 중재 후에도 1년간 지속적인 추후 상담이 이루어져야 한다.
Key Message
• South Korea operates a high-intensity inpatient treatment program for heavy smokers. • Relapse typically occurred in the first 6 months after completing the intervention. • Continuous 1 year follow-up counseling is important for long-term abstinence.

Citations

Citations to this article as recorded by  
  • Residential Treatment Exclusively for Tobacco Use Disorder: A Narrative Review
    Symen Kornelis Spoelstra, Robert C. van de Graaf, Arie Dijkstra
    Journal of Addiction Medicine.2024; 18(1): 33.     CrossRef
  • Experiences with smoking habits and the need for cessation among habitual smokers in Japan: a qualitative study based on semi-structured interviews
    Kae Shiratani, Junko Shimasawa, Mayumi Mizutani
    BMC Primary Care.2024;[Epub]     CrossRef
  • Neurobiology of Stress-Induced Nicotine Relapse
    Xinyu Wang, Yun Chen, Jing Dong, Jing Ge, Xiaoliu Liu, Jianfeng Liu
    International Journal of Molecular Sciences.2024; 25(3): 1482.     CrossRef
  • Tobacco control in Qatar from 2002 to 2022: 20 years of progress and challenges
    Mohamed Ghaith Al-Kuwari, Abdulhmeed Ahmad Al-Khenji, Wadha Ahmad Al-Baker, Mohamed Osman Bala
    Journal of Public Health Research.2024;[Epub]     CrossRef
  • The Impact of Military Tobacco Control Policy: A Systematic Review
    Muhamad Arham Bin Hashim, Khairul Fikri Bin Sebri, Muhammad Faiz Bin Mohd Hanim, Diyana Shereen Binti Anwar, Nawwal Alwani Binti Mohd Radzi, Ahmad Farhan Bin Ahmad Fuad, Budi Aslinie Binti Md Sabri
    Military Medicine.2024;[Epub]     CrossRef
  • Applicability of machine learning algorithm to predict the therapeutic intervention success in Brazilian smokers
    Miyoko Massago, Mamoru Massago, Pedro Henrique Iora, Sanderland José Tavares Gurgel, Celso Ivam Conegero, Idalina Diair Regla Carolino, Maria Muzanila Mushi, Giane Aparecida Chaves Forato, João Vitor Perez de Souza, Thiago Augusto Hernandes Rocha, Samile
    PLOS ONE.2024; 19(3): e0295970.     CrossRef
  • How a 5-Day Stay in the Tobacco-Free Environment of the Stoptober House Supports Individuals to Quit Smoking: A Mixed Methods Pilot Study
    Floor A. Van den Brand, Thomas Martinelli, Charlotte I. de Haan-Bouma, Gert-Jan Meerkerk, Bjorn Winkens, Gera E. Nagelhout
    European Addiction Research.2024; 30(2): 103.     CrossRef
  • Development of a Risk Score to Predict Short-term Smoking Relapse Following an Inpatient Smoking Cessation Intervention
    Hwang Sik Shin, Yoon Hyung Park, Sung Soo Lee, Yong Jin Cho, Jun Tack Kwon, Youngs Chang, Mee-Ri Lee, Young Hwangbo
    Asia Pacific Journal of Public Health.2024;[Epub]     CrossRef
  • Attitudes and influencing factors associated with smoking cessation: An online cross-sectional survey in China
    Jian-Hua Wang, Yu-Feng Yang, Shi-Lei Zhao, Hai-Tao Liu, Lei Xiao, Li Sun, Xi Wu, Dong-Chao Yuan, Li-Yao Ma, Bao-Zhao Ju, Jian-Ping Liu
    Tobacco Induced Diseases.2023; 21(June): 1.     CrossRef
  • The smoking and vaping model, A user-friendly model for examining the country-specific impact of nicotine VAPING product use: application to Germany
    Luz María Sánchez-Romero, Alex C. Liber, Yameng Li, Zhe Yuan, Jamie Tam, Nargiz Travis, Jihyoun Jeon, Mona Issabakhsh, Rafael Meza, David T. Levy
    BMC Public Health.2023;[Epub]     CrossRef
  • Factors Related to Smoking Relapse Within Six-Months of Smoking Cessation Among Inpatients
    Ji Eun Bae, Chul-Woung Kim, Seung Eun Lee, Myungwha Jang
    Research in Community and Public Health Nursing.2023; 34: 307.     CrossRef
  • Factors associated with long-term smoking relapse in those who succeeded in smoking cessation using regional smoking cessation programs
    Seung Hun Lee, Yu Hyeon Yi, Young In Lee, Hyo Young Lee, Kyoung-Min Lim
    Medicine.2022; 101(31): e29595.     CrossRef
Application of a non-parametric non-mixture cure rate model for analyzing the survival of patients with colorectal cancer in Iran
Mehdi Azizmohammad Looha, Mohamad Amin Pourhoseingholi, Maryam Nasserinejad, Hadis Najafimehr, Mohammad Reza Zali
Epidemiol Health. 2018;40:e2018045.   Published online September 17, 2018
DOI: https://doi.org/10.4178/epih.e2018045
  • 10,396 View
  • 208 Download
  • 4 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Colorectal cancer (CRC) patients are considered to have been cured when the mortality rate of individuals with the disease returns to the same level as expected in the general population. This study aimed to assess the impact of various risk factors on the cure fraction of CRC patients using a real dataset of Iranian CRC patients with a non-mixture non-parametric cure model.
METHODS
This study was conducted on the medical records of 512 patients who were definitively diagnosed with CRC at Taleghani Hospital, Tehran, Iran from 2001 to 2007. A non-mixture non-parametric cure rate model was applied to the data after using stepwise selection to identify the risk factors of CRC.
RESULTS
For non-cured cases, the mean survival time was 1,243.83 days (95% confidence interval [CI], 1,174.65 to 1,313.00) and the median survival time was 1,493.00 days (95% CI, 1,398.67 to 1,587.33). The 1- and 3-year survival rates were 92.9% (95% CI, 91.0 to 95.0) and 73.4% (95% CI, 68.0 to 79.0), respectively. Pathologic stage T1 of the primary tumor (estimate=0.58; p=0.013), a poorly differentiated tumor (estimate=1.17; p<0.001), a body mass index (BMI) between 18.6 and 24.9 kg/m2 (estimate=−0.60; p=0.04), and a BMI between 25.0 and 29.9 kg/m2 (estimate=−1.43; p<0.001) had significant impacts on the cure fraction of CRC in the multivariate analysis. The proportion of cured patients was 64.1% (95% CI, 56.7 to 72.4).
CONCLUSIONS
This study found that the pathologic stage of the primary tumor, tumor grade, and BMI were potential risk factors that had an impact on the cure fraction. A non-mixture non-parametric cure rate model provides a flexible framework for accurately determining the impact of risk factors on the long-term survival of patients with CRC.
Summary

Citations

Citations to this article as recorded by  
  • Assessment of prognostic factors in long-term survival of male and female patients with colorectal cancer using non-mixture cure model based on the Weibull distribution
    Mehdi Azizmohammad Looha, Elaheh Zarean, Fatemeh Masaebi, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali
    Surgical Oncology.2021; 38: 101562.     CrossRef
  • Actual survival after resection of primary colorectal cancer: results from a prospective multicenter study
    Inge van den Berg, Robert R. J. Coebergh van den Braak, Jeroen L. A. van Vugt, Jan N. M. Ijzermans, Stefan Buettner
    World Journal of Surgical Oncology.2021;[Epub]     CrossRef
Spatial inequalities and predictors of HIV/AIDS mortality risk in Hamadan, Iran: a retrospective cohort study
Somayeh Momenyan, Amir Kavousi, Jalal Poorolajal, Narges Momenyan
Epidemiol Health. 2018;40:e2018038.   Published online August 5, 2018
DOI: https://doi.org/10.4178/epih.e2018038
  • 11,188 View
  • 212 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Understanding the geographic variation of HIV/AIDS mortality risk and human immunodeficiency virus (HIV) infection could help identify high-burden areas. The aim of our study was to evaluate the effects of predictors of the time interval between HIV diagnosis to death, while accounting for spatial correlations across counties, and to assess patterns of spatial inequalities in the risk of HIV/AIDS mortality in Hamadan Province, Iran.
METHODS
This retrospective study was conducted on 585 patients. The outcome in this study was the time period between the date of HIV/AIDS diagnosis and the date of death. A Weibull regression model with spatial random effects was used.
RESULTS
According to multivariate analysis, there were significant associations between age, tuberculosis co-infection, and marital status and the risk of death. In terms of spatial inequalities, a cluster of counties was identified with a somewhat higher death hazard in the north, northwest, northeast, and central regions. Additionally, a cluster with a somewhat lower hazard was identified in the south, southwest, southeast, and west regions.
CONCLUSIONS
The spatial pattern of HIV/AIDS death risk could reflect inequalities in access to antiretroviral therapy and public health services. Our results underscore the importance of attention to vulnerable groups in urban areas.
Summary

Citations

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  • Prevalence, Antibiotic Susceptibility Pattern, and Associated Factors of Enteric Bacterial Pathogens Among HIV Infected Patients with Diarrhea Attending the ART Clinic of Dilla University Referral Hospital, Southern Ethiopia
    Asaye Mitiku, Zerihin Solomon, Berhanu Gidisa, Kasie Gebeyhu, Haymanot Tewabe, Demissew Shenkute, Melkayehu Kassa, Addisu Gize
    Infection and Drug Resistance.2023; Volume 16: 4227.     CrossRef
  • Análise da tendência da mortalidade por doenças definidoras e não definidoras de HIV/aids segundo características sociodemográficas, por Unidade da Federação e Brasil, 2000-2018
    Ana Paula da Cunha, Marly Marques da Cruz
    Epidemiologia e Serviços de Saúde.2022;[Epub]     CrossRef
  • Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study
    Marcus Matheus Quadros Santos, Bianca Alessandra Gomes do Carmo, Taymara Barbosa Rodrigues, Bruna Rafaela Leite Dias, Cleyton Abreu Martins, Glenda Roberta Oliveira Naiff Ferreira, Andressa Tavares Parente, Cíntia Yollete Urbano Pauxis Aben-Atha, Sand
    Geospatial Health.2022;[Epub]     CrossRef
  • Clinical, health systems and neighbourhood determinants of tuberculosis case fatality in urban Blantyre, Malawi: a multilevel epidemiological analysis of enhanced surveillance data
    McEwen Khundi, Peter MacPherson, Helena R. A. Feasey, Rebeca Nzawa Soko, Marriott Nliwasa, Elizabeth L. Corbett, James R. Carpenter
    Epidemiology and Infection.2021;[Epub]     CrossRef
  • Spatial and temporal analysis of the human immunodeficiency virus in an area of social vulnerability in Northeast Brazil
    Géssyca Cavalcante de Melo, Emilia Carolle Azevedo de Oliveira, Iane Brito Leal, Carolina Piedade Morais de Freitas Soares Silva, Roberta Andrade Beltrão, Allan Dantas dos Santos, Renata Karina Reis, Marco Antônio Prado Nunes, Karina Conceição Gomes Macha
    Geospatial Health.2020;[Epub]     CrossRef
Brief Communication
Introduction of Relative Survival Analysis Program: Using Sample of Cancer Registry Data with Stata Software.
Kyu Won Jung, Hyun Joo Kong, Seon Hee Yim, Young Joo Won, Joohon Sung, Hai Rim Shin
Korean J Epidemiol. 2007;29(2):222-229.
  • 42,704 View
  • 119 Download
AbstractAbstract PDF
Abstract
Patient survival is one of the most important measures for the evaluation of progress in cancer patient care across the wide spectrum from diagnosis to treatment. The optimal monitoring method for cancer patient survival is to estimate survival based on representative data from cancer patients in the population, which is only achievable through using population-based cancer registration data. Relative survival is used to compare the survival experience in a study cohort that expected to result from background population mortality rates. This technique is useful when the cause of death is not accurate or not available, since it provides a measure of excess mortality in a group of patients with a certain disease. The purpose of this article is to demonstrate the procedures for estimating relative survival using the statistical software Stata. For this survival analysis to show the procedure, the example data set was randomly selected from the National Cancer Incidence Database, which was used in a recent article reporting the overall relative survival of cancer patients diagnosed during 1993-2002 in Korea.
Summary
Epidemiol Health : Epidemiology and Health
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