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Department of Global Public Health and Primary Care
Research highlights

CANCER – individual studies to a global overview

Cancer was the second leading cause of death after cardiovascular disease globally in 2013. Over the past few months, researchers from different research groups at the Department of Global Public Health and Primary Care (IGS) have been involved in a number of individual studies and one important global review.

Cancer
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Stein Emil Vollset, an IGS Professor, was one of over 100 researchers from over 100 institutions around the world who contributed to an enormously important review article outlining the global cancer burden, assessing data from 1990-2013. The results can be used to guide intervention programmes, inform local cancer control strategies as well as to set priorities for research activities. The aim is to update it annually.

 

“25 by 25”

The article states that the global health community has responded to the cancer challenge by endorsing a “25 by 25” strategy: aiming to reduce avoidable mortality from non-communicable diseases by 25% by 2025. However, reaching this goal will be challenging, and the authors write that this will require commitment from all levels of society.

Vollset explains that the cancer study came out of the much larger Global Burden of Disease Study (GBD 2013) that is coordinated from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. Vollset spent one year as a visiting scientist at IHME. He adds that there are several researchers from Norway participating in this larger GBD collaboration that studies mortality and health loss from all diseases and injuries and their risk factors in 188 countries.

 

Long-term impacts of breast cancer

From 1 year pre-diagnosis to 3 years post-diagnosis, the experience of having breast cancer is associated with higher sickness-related absence levels 2 and 3 years post-diagnosis. Professor Karin Nordin from IGS was one of the authors of a recent population-based matched cohort study. The authors concluded that prevention and treatment of side effects are important for reducing the long-terms consequences of having breast cancer in a clinical setting.

 

Lifetime smoking increases breast cancer mortality

Anders Engeland, an Adjunct Professor at IGS, was an author on a cohort study with more than 4.1 million years of follow-up, examining the association between lifetime smoking exposure and breast cancer mortality.  The study focused especially on women who initiated smoking before the birth of their first child. The study covered a period between 1974-2007. It concluded that lifetime smoking exposure significantly increased the risk of breast cancer mortality compared to never smokers. Engeland was mainly involved in the data management of the project, which used information from many different Norwegian Health surveys.

 

Using bioluminescence to study tumours

Scaffold implants are used in tissue engineering. However, some of these may act as micro-environmental cues producing tumorigenic reactions in the surrounding tissues.  Several authors from the Centre for International Health (CIH) and IGS were part of a study to develop a non-invasive, sensitive model for monitoring the impact of various micro-environmental cues in head and neck cancer tumour formation.

The results showed that using bioluminescence in a bio-degradable scaffold was a successful, precise and non-invasive experimental model for evaluating the tumorigenic potential of micro-environmental cues in head and neck cancer. The establishment of this model allows further testing of the potential carcinogenic effect of various biomaterial scaffolds used for bone tissue engineering. In addition, it will be used for further in-depth studies on oral carcinogenesis.

Salwa Suliman reports that she and her colleagues have already applied this model to study functionalised biomaterial scaffolds for bone tissue engineering. She says that it has shown reliability and success in evaluating tumorigenic/ carcinogenic potential of these scaffolds. In addition, the model has also been used to study in-depth oral carcinogenesis. Reports of these latest studies are in preparation or submitted for publication.

 

Hormone therapy and cancer risk

IGS Post-doc, Lisa deRoo was one of the authors in a sister-matched study that showed that young women (under 50 years of age) who may take hormone therapy (HT) to help manage the symptoms of early or surgically induced menopause, do not have an increased risk of young-onset breast cancer. The study was the largest to date examining the association between HT use and young-onset breast cancer. The results provide valuable information about the trade-offs between risks and benefits of HT for young women. In particular, combined estrogen and progestin HT did not increase the risk; unopposed estrogen HT in some cases may actually be associated with a reduced risk; while progestin alone HT may actually increase the risk. deRoo Says that it is important now to replicate these results because no one single study can hold all of the answers.