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Hennings, Joakim
Publications (10 of 10) Show all publications
Zamora-Ros, R., Cayssials, V., Franceschi, S., Kyrø, C., Weiderpass, E., Hennings, J., . . . Rinaldi, S. (2019). Polyphenol intake and differentiated thyroid cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. International Journal of Cancer
Open this publication in new window or tab >>Polyphenol intake and differentiated thyroid cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort
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2019 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215Article in journal (Refereed) Epub ahead of print
Abstract [en]

Polyphenols are bioactive compounds with several anticarcinogenic activities; however, human data regarding associations with thyroid cancer (TC) is still negligible. Our aim was to evaluate the association between intakes of total, classes and subclasses of polyphenols and risk of differentiated TC and its main subtypes, papillary and follicular, in a European population. The European Prospective Investigation into Cancer and Nutrition cohort included 476,108 men and women from 10 European countries. During a mean follow-up of 14 years, there were 748 incident differentiated TC cases, including 601 papillary and 109 follicular tumors. Polyphenol intake was estimated at baseline using validated center/country-specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, no association between total polyphenol and the risks of overall differentiated TC (HRQ4 vs. Q1 = 0.99, 95% confidence interval [CI] 0.77-1.29), papillary (HRQ4 vs. Q1 = 1.06, 95% CI 0.80-1.41) or follicular TC (HRQ4 vs. Q1 = 1.10, 95% CI 0.55-2.22) were found. No associations were observed either for flavonoids, phenolic acids or the rest of classes and subclasses of polyphenols. After stratification by body mass index (BMI), an inverse association between the intake of polyphenols (p-trend = 0.019) and phenolic acids (p-trend = 0.007) and differentiated TC risk in subjects with BMI >= 25 was observed. In conclusion, our study showed no associations between dietary polyphenol intake and differentiated TC risk; although further studies are warranted to investigate the potential protective associations in overweight and obese individuals.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
polyphenols, flavonoids, intake, thyroid cancer, cohort, EPIC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-162862 (URN)10.1002/ijc.32589 (DOI)000480302800001 ()31342519 (PubMedID)
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-09-05
Odelberg, N., Cengiz, Y., Jänes, A. & Hennings, J. (2019). The Impact of a Surgical Unit's Structure and Operative Technique on Quality in Two Swedish Rural Hospitals. Journal of investigative surgery
Open this publication in new window or tab >>The Impact of a Surgical Unit's Structure and Operative Technique on Quality in Two Swedish Rural Hospitals
2019 (English)In: Journal of investigative surgery, ISSN 0894-1939, E-ISSN 1521-0553Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: Laparoscopic cholecystectomy (LC) is a commonly performed surgical procedure with a low complication rate. It is performed either as an acute or as an elective procedure. Most elective LCs are performed on nonlethal diseases and this is why good quality is important. Our study compared the quality of LC in two surgical units in northern Sweden (Sundsvall and ostersund) which use different clinical structures (subspecialised vs. general surgery) and surgical techniques (ultrasound fundus first vs. conventional diathermy). The study aimed to investigate whether these differences affected the quality of outcomes after LC.

Materials and methods: This is a registry-based study which included 607 elective LCs from January 2014 to May 2016. There were 286 from Sundsvall and 321 from ostersund. Primary outcomes were operative time and the percentage of day surgeries. The secondary outcome was the presence of postoperative complications within the first 30 days in terms of bile duct injury, bleeding that necessitated reoperation, bile leakage and abscesses treated with drainage and mortality.

Results: The time length of surgery was shorter in Sundsvall (mean 48.3 min) compared to ostersund (mean 108.6 min, p < 0.001. The percentage of day care surgeries was 94% in Sundsvall and 23% in ostersund, p < 0.001. Six patients (2.1%) had a complication in Sundsvall compared to seven patients (2.2%) in ostersund, p = 1.00.

Conclusion: There is a significant difference between the two hospitals regarding operative time and the percentage of day surgeries. Complication rates in both units were equal and low.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
laparoscopic cholecystectomy, operative technique, day surgery, complications, quality
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-157960 (URN)10.1080/08941939.2019.1579277 (DOI)000461920800001 ()30885014 (PubMedID)
Available from: 2019-04-16 Created: 2019-04-16 Last updated: 2019-04-16Bibliographically approved
Zamora-Ros, R., Beraud, V., Franceschi, S., Cayssials, V., Tsilidis, K. K., Boutron-Ruault, M.-C., . . . Rinaldi, S. (2018). Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. International Journal of Cancer, 142(3), 449-459
Open this publication in new window or tab >>Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study
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2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 142, no 3, p. 449-459Article in journal (Refereed) Published
Abstract [en]

Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68-1.15; p-trend=0.44), vegetables (HR: 0.89; 95% CI: 0.69-1.14; p-trend=0.56), or fruit (HR: 1.00; 95% CI: 0.79-1.26; p-trend=0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98-1.53; p-trend=0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
thyroid cancer, fruits, vegetables, fruit juices, intake, EPIC
National Category
Cancer and Oncology Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-143705 (URN)10.1002/ijc.30880 (DOI)000417763600004 ()28688112 (PubMedID)
Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2018-06-09Bibliographically approved
Enell, J., Bayadsi, H., Lundgren, E. & Hennings, J. (2018). Primary Hyperparathyroidism is Underdiagnosed and Suboptimally Treated in the Clinical Setting. World Journal of Surgery, 42(9), 2825-2834
Open this publication in new window or tab >>Primary Hyperparathyroidism is Underdiagnosed and Suboptimally Treated in the Clinical Setting
2018 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 42, no 9, p. 2825-2834Article in journal (Refereed) Published
Abstract [en]

To evaluate whether patients presenting with laboratory results consistent with primary hyperparathyroidism (pHPT) are managed in accordance with guidelines. The laboratory database at a hospital in Sweden, serving 127,000 inhabitants, was searched for patients with biochemically determined pHPT. During 2014, a total of 365 patients with biochemical laboratory tests consistent with pHPT were identified. Patients with possible differential diagnoses or other reasons for not being investigated according to international guidelines were excluded after scrutinizing records, after new blood tests, and clinical assessments by endocrine surgeons. Altogether, 92 patients had been referred to specialists and 82 had not. The latter group had lower serum calcium (median 2.54 mmol/L) and PTH (5.7 pmol/L). Out of these 82 cases, 9 patients were diagnosed with pHPT or had some sort of long-term follow-up planned as outpatients. Primary hyperparathyroidism is overlooked and underdiagnosed in a number of patients in the clinical setting. It is important to provide local guidelines for the management of patients presenting with mild pHPT to ensure that these patients receive proper evaluation and follow-up according to current research.

Place, publisher, year, edition, pages
SPRINGER, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-151043 (URN)10.1007/s00268-018-4574-1 (DOI)000441231600019 ()29532143 (PubMedID)
Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2018-09-04Bibliographically approved
Zamora-Ros, R., Rinaldi, S., Tsilidis, K. K., Weiderpass, E., Boutron-Ruault, M.-C., Rostgaard-Hansen, A. L., . . . Franceschi, S. (2016). Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study. International Journal of Cancer, 138(1), 65-73
Open this publication in new window or tab >>Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study
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2016 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 138, no 1, p. 65-73Article in journal (Refereed) Published
Abstract [en]

Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study was to investigate the associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from ten European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, and fiber were computed as g/1,000 kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we found significant associations only with total energy (HRQ4vs.Q1, 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4vs.Q1, 0.74; 95% CI, 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across body mass index (BMI) groups, i.e., positive associations with starch and GI were found in participants with a BMI25 and with sugar intake in those with BMI<25. Moreover, inverse associations with starch and GI were observed in subjects with BMI<25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people. What's New? The role of lifestyle factors in the growing numbers of thyroid cancer remains unclear. Here, the authors uncover associations with high total energy intake and low consumption of polyunsaturated fatty acids in a large European cohort (EPIC). They further find positive associations with starch intake and glycemic index only in people with a body mass index equal or larger than 25, possibly implicating an altered insulin response in the etiology of this cancer.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
macronutrients, total energy, glycemic index, differentiated thyroid carcinomas, EPIC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-111456 (URN)10.1002/ijc.29693 (DOI)000363203600011 ()26190646 (PubMedID)
Available from: 2015-12-08 Created: 2015-11-13 Last updated: 2018-06-07Bibliographically approved
Sen, A., Tsilidis, K. K., Allen, N. E., Rinaldi, S., Appleby, P. N., Almquist, M., . . . Franceschi, S. (2015). Baseline and lifetime alcohol consumption and risk of differentiated thyroid carcinoma in the EPIC study. British Journal of Cancer, 113(5), 840-847
Open this publication in new window or tab >>Baseline and lifetime alcohol consumption and risk of differentiated thyroid carcinoma in the EPIC study
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2015 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 113, no 5, p. 840-847Article in journal (Refereed) Published
Abstract [en]

Background: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered.

Methods: The association between alcohol consumption at recruitment and over the lifetime and risk of differentiated thyroid carcinoma was examined in the European Prospective Investigation into Cancer and Nutrition. Among 477 263 eligible participants (70% women), 556 (90% women) were diagnosed with differentiated thyroid carcinoma over a mean follow-up of 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models.

Results: Compared with participants consuming 0.1-4.9 g of alcohol per day at recruitment, participants consuming 15 or more grams (approximately 1-1.5 drinks) had a 23% lower risk of differentiated thyroid carcinoma (HR = 0.77; 95% CI = 0.60-0.98). These findings did not differ greatly when analyses were conducted for lifetime alcohol consumption, although the risk estimates were attenuated and not statistically significant anymore. Similar results were observed by type of alcoholic beverage, by differentiated thyroid carcinoma histology or according to age, sex, smoking status, body mass index and diabetes.

Conclusions: Our study provides some support to the hypothesis that moderate alcohol consumption may be associated with a lower risk of papillary and follicular thyroid carcinomas.

Place, publisher, year, edition, pages
Nature Publishing Group, 2015
Keywords
alcohol consumption, thyroid carcinoma, prospective study, lifetime exposure
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-109809 (URN)10.1038/bjc.2015.280 (DOI)000360727200019 ()26313664 (PubMedID)
Available from: 2015-10-08 Created: 2015-10-06 Last updated: 2018-06-07Bibliographically approved
Zamora-Ros, R., Rinaldi, S., Biessy, C., Tjonneland, A., Halkjaer, J., Fournier, A., . . . Franceschi, S. (2015). Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study. International Journal of Cancer, 136(5), 1218-1227
Open this publication in new window or tab >>Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study
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2015 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 136, no 5, p. 1218-1227Article in journal (Refereed) Published
Abstract [en]

Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for 5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for 9 vs. 1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR=1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR=1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.

Keywords
reproductive factors, menstrual factors, hormone use, differentiated thyroid carcinoma, EPIC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-99349 (URN)10.1002/ijc.29067 (DOI)000346350500047 ()
Available from: 2015-03-09 Created: 2015-02-07 Last updated: 2018-06-07Bibliographically approved
Schmidt, J. A., Allen, N. E., Almquist, M., Franceschi, S., Rinaldi, S., Tipper, S. J., . . . Travis, R. C. (2014). Insulin-like growth factor-I and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiology, Biomarkers and Prevention, 23(6), 976-985
Open this publication in new window or tab >>Insulin-like growth factor-I and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition
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2014 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 23, no 6, p. 976-985Article in journal (Refereed) Published
Abstract [en]

Background: Little is known about the causes of thyroid cancer, but insulin-like growth factor-I (IGF-I) might play an important role in its development due to its mitogenic and anti-apoptotic properties. Methods: This study prospectively investigated the association between serum IGF-I concentrations and risk of differentiated thyroid carcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. 345 incident cases of differentiated thyroid carcinoma were individually matched to 735 controls by study centre, sex, and age, date, time, and fasting status at blood collection, follow-up duration, and for women menopausal status, use of exogenous hormones, and phase of menstrual cycle at blood collection. Serum IGF-I concentrations were measured by immunoassay, and risk of differentiated thyroid cancer in relation to IGF-I concentration was estimated using conditional logistic regression. Results: There was a positive association between IGF-I concentrations and risk of differentiated thyroid carcinoma: the odds ratio for a doubling in IGF-I concentration was 1.48 (95% confidence interval: 1.06 - 2.08; ptrend = 0.02). The positive association with IGF-I was stable over time between blood collection and cancer diagnosis. Conclusion: These findings suggest that IGF-I concentrations may be positively associated with risk of differentiated thyroid carcinoma. Impact: This study provides the first prospective evidence of a potential association between circulating IGF-I concentrations and risk of differentiated thyroid carcinoma and may prompt the further investigations needed to confirm the association.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-88084 (URN)10.1158/1055-9965.EPI-13-1210-T (DOI)000345270800009 ()24646451 (PubMedID)
Available from: 2014-04-23 Created: 2014-04-23 Last updated: 2018-06-08Bibliographically approved
Rinaldi, S., Plummer, M., Biessy, C., Tsilidis, K. K., Nautrup Østergaard, J., Overvad, K., . . . Franceschi, S. (2014). Thyroid-stimulating hormone, thyroglobulin, and thyroid hormones and risk of differentiated thyroid carcinoma: the EPIC study. Journal of the National Cancer Institute, 106(6), dju097
Open this publication in new window or tab >>Thyroid-stimulating hormone, thyroglobulin, and thyroid hormones and risk of differentiated thyroid carcinoma: the EPIC study
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2014 (English)In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 106, no 6, p. dju097-Article in journal (Refereed) Published
Abstract [en]

Background Increased levels of thyroglobulin (Tg) and thyroid-stimulating hormone (TSH) are associated with differentiated thyroid carcinoma (TC) risk, but strong epidemiological evidence is lacking. Methods Three hundred fifty-seven incident TC case patients (n = 300 women and 57 men; mean age at blood collection = 51.5 years) were identified in the EPIC cohort study and matched with 2 (women) or 3 (men) control subjects using incidence density sampling. Matching included study center, sex, age, date, time, and fasting status at blood collection. Levels of total and free (f) thyroxine (T4) and triiodo-thyronine (T3), TSH, Tg, and anti-Tg antibodies (TgAb) were measured by commercially available immunoassays. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using conditional logistic regression. All statistical tests were two-sided. Results TC risk was positively associated with Tg (OR for the highest vs lowest quartile = 9.15; 95% CI = 5.28 to 15.90; P < .001) and negatively associated with TSH level (OR = 0.56; 95% CI = 0.38 to 0.81; P = .001). Odds ratios were not modified by adjustment for weight and height and were consistent across sexes, age groups, and countries. The association with Tg was stronger in follicular than papillary TC. The odds ratio for TgAb-positivity was 1.50 (95% CI = 1.05 to 2.15; P = .03). Among case patients, TSH level was stable over time, whereas Tg level was higher in proximity to TC diagnosis. Areas under the receiver operating characteristic curve were 57% and 74% for TSH and Tg level, respectively. Conclusions High Tg levels precede by up to 8 years the detection of TC, pointing to a long sojourn time of the disease. Low TSH levels may predispose to TC onset. Neither marker has sufficient accuracy to be a screening test.

Place, publisher, year, edition, pages
Oxford University Press, 2014
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-94170 (URN)10.1093/jnci/dju097 (DOI)000341636800008 ()
Available from: 2014-10-06 Created: 2014-10-06 Last updated: 2018-06-07Bibliographically approved
Hennings, J., Jansson, M., Lindmark, F. & Perris, F. (2012). Ileal GEP-NEN in Mother and Son: Option for Familial Disease. Paper presented at 9th Annual European-Neuroendocrine-Tumor-Society (ENETS) Conference for the Diagnosis and Treatment of Neuroendocine Tumor Disease, MAR 07-09, 2012, Copenhagen, DENMARK. Neuroendocrinology, 96, 35-35
Open this publication in new window or tab >>Ileal GEP-NEN in Mother and Son: Option for Familial Disease
2012 (English)In: Neuroendocrinology, ISSN 0028-3835, E-ISSN 1423-0194, Vol. 96, p. 35-35Article in journal, Meeting abstract (Other academic) Published
Keywords
familial, hereditary, gep-nen, midgut
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-59739 (URN)10.1159/000340053 (DOI)000308135300100 ()
Conference
9th Annual European-Neuroendocrine-Tumor-Society (ENETS) Conference for the Diagnosis and Treatment of Neuroendocine Tumor Disease, MAR 07-09, 2012, Copenhagen, DENMARK
Available from: 2012-10-01 Created: 2012-09-25 Last updated: 2018-06-08Bibliographically approved
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