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Browsing by Author "Ryynänen, Heidi"

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  • Accuracy of Finnish Cancer Registry colorectal cancer data : a comparison between registry data and clinical records 
    Lunkka, Pipsa; Malila, Nea; Ryynänen, Heidi; Heikkinen, Sanna; Sallinen, Ville; Koskenvuo, Laura (2020)
    Background: The population-based Finnish Cancer Registry (FCR) is an important resource for research and healthcare politics in Finland. The aim of this study was to validate the accuracy of the colorectal cancer (CRC) data within the FCR. Material and Methods: FCR data is based on independent cancer report forms (CRFs) from both clinicians and pathologists. Data from patients diagnosed with CRC during a randomized, population-based CRC screening program between 2004 and 2012 were extracted from the FCR and compared to data extracted from the original clinical patient records of these individuals by two gastrointestinal surgeons. The study focused on tumour characteristics and primary treatment. Accuracy was measured by calculating Cohen´s kappa coefficient (k), which considers the possibility of agreement by chance. Results: Altogether, 1475 patients were studied. k was 0.74 for stage, 0.87 for tumour location (right/left), 0.78 for a more detailed location, 0.72 for tumour histology, 0.46 for surgical removal of the primary tumour, and 0.43 for chemotherapy. Among those who underwent surgery, the radicality of surgical treatment had a k of 0.24. In total, 173 (12%) patients were lacking a CRF from a clinician. Conclusion: The FCR data had good accuracy regarding tumour characteristics, but poor accuracy in treatment information. The main reason for this suboptimal accuracy was missing CRFs from treating clinicians. Awareness of these findings is crucial when research and decision making is based on FCR data. Measures have since been taken to improve the completeness of FCR recording.
  • Incidence trends and risk factors of lung cancer in never smokers : pooled analyses of seven cohorts 
    Rissanen, Emilia; Heikkinen, Sanna; Seppä, Karri; Ryynänen, Heidi; Eriksson, Johan G; Härkänen, Tommi; Jousilahti, Pekka; Knekt, Paul; Koskinen, Seppo; Männistö, Satu; Rahkonen, Ossi; Rissanen, Harri; Malila, Nea; Laaksonen, Maarit A; Pitkäniemi, Janne (2021)
    The trends in incidence of lung cancer in never smokers are unclear as well as the significance of risk factors. We studied time trends in the incidence and risk factors of lung cancer in never smokers in Finland in a large, pooled cohort. We pooled data from seven Finnish health cohorts from the period between 1972 and 2015 with 106 193 never smokers. The harmonized risk factors included education, alcohol consumption, physical activity, height, and BMI. We retrieved incident lung cancers from the nation-wide Finnish Cancer Registry. We estimated average annual percent change (AAPC) and the effects of risk factors on cause-specific hazard ratios (HRs) of lung cancer using Poisson regression. We detected 47 lung cancers in never smoking men (n=31 859) and 155 in never smoking women (n=74 334). The AAPC of lung cancer incidence was -3.30% (95% confidence interval (CI): -5.68% - -0.88%, p=0.009) in never smoking men and 0.00% (95% CI: -1.57%-1.60%, p=0.996) in never smoking women. Of the five studied risk factors only greater height in women had a statistically significant increased risk of lung cancer (multivariate HR=1.84, 95%CI: 1.08-3.12). It is plausible that tobacco control measures focused on working places have reduced passive smoking among men more than among women, which could explain the declining trend in lung cancer incidence in never smoker men but not in never smoker women. As tobacco control measures have not been targeted to domestic environments, it is likely that women’s exposure to passive smoking has continued longer.

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