A population-based study of testicular cancer risk among children and young adults from Norway and Utah, USA.

Similar family-based cancer and genealogy data from Norway and Utah allowed comparisons of the incidence of testicular cancer (TC), and exploration of the role of Scandinavian ancestry and family history of TC in TC risk. Our study utilizes data from the Utah Population Database and Norwegian Population Registers. All males born during 1951-2015 were followed for TC until the age of 29 years. A total of 1,974,287 and 832,836 males were born in Norway and Utah, respectively, of whom 2,686 individuals were diagnosed with TC in Norway and 531 in Utah. The incidence per year of TC in Norway (10.6) was twice that observed in Utah (5.1) for males born in the last period (1980-1984). The incidence rates of TC in Utah did not differ according to the presence or absence of Scandinavian ancestry (p = 0.669). Having a brother diagnosed with TC was a strong risk factor for TC among children born in Norway and Utah, with HR = 9.87 (95% CI 5.68-17.16) and 6.02 (95% CI 4.80-7.55), respectively; with even higher HR observed among the subset of children in Utah with Scandinavian ancestry (HR = 12.30, 95% CI 6.78-22.31). A clear difference in TC incidence among individuals born in Norway and descendants of Scandinavian people born in Utah was observed. These differences in TC rates point to the possibility of environmental influence. Family history of TC is a strong risk factor for developing TC in both populations.

Childhood central nervous system tumors and leukemia: Incidence and familial risk. A comparative population-based study in Utah and Norway.

BACKGROUND: In this study, we aimed to evaluate incidence rates and family risk of the most common childhood cancers, tumors in the central nervous system (CNS), and leukemia among individuals from Norway and individuals with Scandinavian ancestry living in Utah. METHODS: We used the Utah Population Database and the Norwegian National Population Register linked to Cancer registries to identify cancers in children born between 1966 and 2015 and their first-degree relatives. We calculated incidence rates and hazards ratios. RESULTS: The overall incidence of CNS tumors increased with consecutive birth cohorts similarly in Utah and Norway (both P < 0.001). Incidence rates of leukemia were more stable and similar in both Utah and in Norway with 4.6/100 000 person-years among children (<15 years) born in the last cohort. A family history of CNS tumors was significantly associated with risk of childhood CNS tumors in Utah HR = 3.05 (95% CI 1.80-5.16) and Norway HR = 2.87 (95% CI 2.20-3.74). In Norway, children with a first-degree relative diagnosed with leukemia had high risk of leukemia (HR = 2.39, 95% CI 1.61-3.55). CONCLUSION: Despite geographical distance and assumed large lifestyle differences, two genetically linked pediatric populations show similar incidences of CNS tumors and leukemia in the period 1966-2015. CNS tumors and leukemia aggregated in families in both countries.

Family history of cancer and risk of paediatric and young adult's testicular cancer: A Norwegian cohort study.

BACKGROUND: The aim of this study was to examine the association of a family history of cancer with the risk of testicular cancer in young adults. METHODS: This is a prospective cohort study including 1,974,287 males born 1951-2015, of whom 2686 were diagnosed with TC before the age of 30. RESULTS: A history of TC in male relatives was significantly associated with a diagnosis of TC among children and young adults, including brothers (6.3-fold), sons (4.7-fold), fathers (4.4-fold), paternal uncles (2.0-fold) and maternal uncles (1.9-fold). Individuals with a father diagnosed with a carcinoma or sarcoma showed an elevated risk (1.1-fold and 1.8-fold, respectively). A family history of mesothelioma was positively associated with a risk of TC [(father (2.8-fold), mother (4.6-fold) and maternal uncles and aunt (4.4-fold)]. Elevated risks were also observed when siblings were diagnosed with malignant melanoma (1.4-fold). The risk of TC was also increased when fathers (11.1-fold), paternal (4.9-fold) and maternal uncles and aunts (4.6-fold) were diagnosed with malignant neuroepithelial-tumours. CONCLUSION: We found an increased risk of TC among children and young adults with a family history of TC, carcinoma, mesothelioma, sarcoma, malignant melanoma and malignant neuroepithelial tumours. Hereditary cancer syndromes might underlie some of the associations reported in this study.

Family history of cancer and the risk of childhood solid tumours: a Norwegian nationwide register-based cohort study.

This corrects the article DOI: 10.1038/bjc.2017.85.

Association between urban green space and self-reported lifestyle-related disorders in Oslo, Norway.

AIMS: The need for studies from more countries on the relationship between urban green space and health has been emphasized. The aim of this study was to investigate the association between two types of measurement of urban green space and self-reported lifestyle-related disorders in Oslo, Norway. METHODS: Self-reported measures on mental disorders, asthma, type 2 diabetes and musculoskeletal pain of 8638 participants in the Oslo Health Study (HUBRO) were linked to two types of green space variables: the vegetation cover greenness derived from satellite data, which shows the city's vegetation cover regardless of property boundaries, and the land use greenness derived from municipal plans showing information about publicly accessible vegetation-covered areas. Associations between greenness and health measures were analysed by logistic regression models controlling for possible individual and contextual confounders. RESULTS: Increasing vegetation cover greenness was associated with fewer self-reported mental disorders for both men and women after controlling for possible confounders. The proportion of women who reported high levels of musculoskeletal pain increased with increasing degrees of both of the greenness measurements, but no significant association was observed for men. No association was found for asthma and diabetes type 2 for either men or women. CONCLUSIONS: Although there was a positive association between vegetation cover greenness and self-reported mental disorders, the main findings showed mixed results. The lack of clear associations between urban green space and lifestyle-related health disorders in Oslo might have been influenced by a large proportion of the inhabitants having easy access to green areas.

Poverty and the risk of leukemia and cancer in the central nervous system in children: A cohort study in a high-income country.

AIMS: The association between childhood cancer and socioeconomic status is inconclusive. Family income has seldom been included in large population-based studies, and the specific contributions of it remain unknown. METHODS: A total of 712,674 children born between 1967 and 2009 in the Oslo region were included. Of these, 864 were diagnosed with leukemia or cancer in the central nervous system before the age of 15 years. The association between poverty and childhood leukemia or brain cancer was analyzed using logistic regression and Cox proportional hazards models. Family income was stratified according to poverty lines. Parents' educational level and several perinatal variables were also examined. RESULTS: Family poverty during the first 2 years of life was associated with lymphoid leukemia before the age of 15 years: odds ratio 1.72, 95% confidence interval 1.11-2.64. In the same age group we found a significant dose response, with a 21% increased risk of lymphoid leukemia with increasing poverty. The risk for intracranial and intraspinal embryonal tumors in the whole study period was lower for children in the middle family income category. For astrocytomas there was a more than 70% increased risk in the medium income category when analyzing the two first years of life. The observed increase was reduced when all years each child contributed to the study were included. The risk of cancer in the central nervous system overall was 20% higher in the medium income category compared to the high-income category. CONCLUSIONS: Being born into a household of low family income the first 2 years of life was found to be a risk factor for development of lymphoid leukemia. For astrocytomas we observed an increased risk among children born into the medium income category throughout the first two years of life.

Does Parental Divorce Increase Risk Behaviors among 15/16 and 18/19 year-old Adolescents? A Study from Oslo, Norway.

BACKGROUND: Several studies have reported an increase in risk behaviors among adolescents after experience of parental divorce. The aim of the study was to investigate whether parental divorce is associated with risk behavior among adolescents independent of mental health problems, first when early divorce was experienced, and second after experience of late parental divorce. METHOD: One prospective (n=1861) and one cross-sectional study (n=2422) were conducted using data from two Young-HUBRO surveys in Oslo, Norway. All 15/16 year-old 10(th) grade students who participated in the first survey in the school year 2000/01 were followed-up in 2004 when they were 18/19 year-olds. The follow-up rate was 68%. The prospective study investigated the influence of late parental divorce that occurred between the age of 15/16 and 18/19. In the cross-sectional study we focused on early parental divorce that occurred before the participants were 15/16 year-old. RESULTS: In the prospective study we could not discern a significant association between experiencing late parental divorce and an increase in risk behaviors among 18/19 year-old adolescents. In the cross-sectional study parental divorce was significantly associated with cigarette smoking and using doping agents. CONCLUSION: Parental divorce that occurs when the children of divorced parents are 15/16 year-old or younger is associated with an increase in cigarette smoking and use of doping agents. However, no evidence of significant association is found between experience of late parental divorce and risk behaviors in late adolescence.

Municipal unemployment and municipal typologies as predictors of disability pensioning in Norway: a multilevel analysis.

BACKGROUND AND AIMS: The rise in the number of disability pensioners in Norway has been given much attention by the government and by researchers due to the resulting financial and societal challenges entailed. Eligibility for a disability pension is decided by The Norwegian Labour and Welfare Administration (NAV), and is closely correlated with several socioeconomic predictors. Geographical differences have also been observed in the allocations to recipients of disability pensions, and the purpose of this study was to investigate whether municipal unemployment rates and municipal typologies in Norway may explain some of the geographical variance in individual disability pensioning. METHODS: 436 municipalities in Norway and all 1,507,192 Norwegian males and females between the ages of 30-55 years in 1997 were included in the analysis. Multilevel random intercept analysis was performed to assess the influence on disability pensioning of the individual factors age, education and income together with the contextual factors municipal unemployment, centrality, industry affiliation and residential density. RESULTS: Individuals in high unemployment municipalities had a 7-17% higher risk of disability pension. Of the total variability in disability pensioning, 2.5% for males and 1.9% for females was between municipalities. The other municipal factors had only small influences. CONCLUSION: In addition to individual socioeconomic factors, contextual factors seem to be important determinants of disability pension rates. Municipal unemployment had the greatest influence.

Proof firm downsizing and diagnosis-specific disability pensioning in Norway.

BACKGROUND: We wanted to investigate if firm downsizing is related to an increased rate of disability pensions among the former employed, especially for those with musculoskeletal and psychiatric diagnoses, and for those having to leave the firm. METHODS: Statistics Norway provided a linked file with demographic information and all social security grants from the National Insurance Administration for 1992-2004 for all inhabitants in Norway. Our sample was aged 30-55 years in 1995, being alive, employed and not having a disability pension at the end of 2000. Downsizing was defined as percent change in number of employed per firm from 1995 to end 2000. Employment data were missing for 25.6% of the sample. RESULTS: Disability pension rates in the next four years were 25% higher for those experiencing a 30-59% downsizing than for those not experiencing a reduction of the workforce. 1-29% and 60-100% downsizing did not have this effect. Stayers following down-sizing had higher disability pension rates than leavers. What we have called complex musculoskeletal and psychiatric diagnoses were relatively most common. CONCLUSION: Moderate downsizing is followed by a significant increase in disability pension rates in the following four years, often with complex musculoskeletal and psychiatric diagnoses.

Parental divorce in late adolescence does not seem to increase mental health problems: a population study from Norway.

BACKGROUND: Former studies have shown increased mental health problems in adolescents after parental divorce all over the Western world. We wanted to see if that still is the case in Norway today when divorce turns to be more and more common. METHODS: In a prospective study design, two samples were constituted, adolescents at a baseline survey in 2001/02 (n = 2422) and those at follow-up in 2003/04 (n = 1861), when the adolescents were 15/16 and 18/19 years-old, respectively. They answered self-administered questionnaires in both surveys of Young-HUBRO in Oslo. Early parental divorce was defined as that which occured before age 15/16 years, and late divorce occured between age 15/16 and 18/19. Internalized and externalized mental health problems were measured by the Hopkin's Symptom Check List (HSCL-10) and the Strengths and Difficulties Questionnaire (SDQ). RESULTS: After linear regression models were adjusted for gender, ethnicity, family economy, social support, and mental health problem symptoms measured at baseline before parental divorce occured, late parental divorce did not lead to significant increase in mental health problems among adolescents in the city of Oslo. Early parental divorce was associated with internal mental health problems among young adolescents when adjusted only for the first four possible confounders. CONCLUSIONS: It seems that parental divorce in late adolescence does not lead to mental health problems in Norway any more, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce create less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common.

Excluded from social security: rejections of disability pension applications in Norway 1998-2004.

AIMS: Admission to disability pension (DP) in Norway, like most other countries, requires a medical condition as the main cause of income reduction. Still, a widespread assumption is that much of the recruitment to the programme is rather due to non-medical, mainly labour market factors. In this article, we study the grey zones between acceptance and rejection of DP applications, in light of the concept of marginalisation. METHODS: From the total Norwegian population, aged 18-66 in 1998, we included all first-time applications for DP between 1998 and 2004. Logistic regressions of both application and application outcome were then performed, controlling for a range of socioeconomic variables and medical diagnosis. RESULTS: Medical diagnosis had the strongest impact on application outcome, together with the applicant's age. High rejection risk was found among applicants with complex musculoskeletal diagnoses, and also for complex psychiatric diagnoses as compared to well-defined ones. Persons having previously received social assistance more often applied for a DP and more often were rejected. The same is true, though on a lesser scale, for people with a weak affiliation to the labour market. CONCLUSIONS: The DP programme in Norway is to a large degree medically oriented, not only judicially but also in practice. Nevertheless, non-medical factors have a bearing on both application rates and application outcome. The control system seems to work in a way that excludes the most marginalised applicants, thus possibly contributing to further marginalisation of already disadvantaged groups.

Unemployment and disability pension--an 18-year follow-up study of a 40-year-old population in a Norwegian county.

BACKGROUND: This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics. METHODS: A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new episodes of unemployment and cases of disability pension. The association between an unemployment period and disability pension in the subsequent year was estimated using discrete time multilevel logistic regressions and clustering individuals by municipality. The association between unemployment and disability pension was adjusted for age in the follow up-period, sex, baseline health status, health behaviour and education level. A conditional intra-class correlation coefficient (ICC) was estimated as a measure of inter-municipality variance. RESULTS: In the follow-up period, 2784 (35%) of the participants were granted disability pension. The crude odds ratio for receiving disability pension after unemployment (adjusted for age in follow-up period and sex only) was 1.42 (95% CI 1.1-1.8). Adjusting for baseline health indicators reduced the odds ratio of unemployment to 1.33 (CI 1.1-1.7). A fully adjusted model, including education level, further reduced the odds ratio of unemployment to 1.25 (CI 1.00-1.6). The ICC of the municipality level was approximately 2%. CONCLUSIONS: Becoming unemployed increased the risk of receiving subsequent disability pension. However, adjusting for baseline health status, health behaviour and education attenuated this impact considerably. The multilevel analysis indicated that a minor, yet statistically significant, proportion of the risk of disability pension can be attributed to the municipality of residence.

Rehabilitation time before disability pension.

BACKGROUND: The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. METHODS: A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. RESULTS: The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. CONCLUSIONS: There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

Chain of care for patients who have attempted suicide: a follow-up study from Bærum, Norway.

BACKGROUND: Individuals who have attempted suicide are at increased risk of subsequent suicidal behavior. Since 1983, a community-based suicide prevention team has been operating in the municipality of Bærum, Norway. This study aimed to test the effectiveness of the team's interventions in preventing repeated suicide attempts and suicide deaths, as part of a chain of care model for all general hospital treated suicide attempters. METHODS: Data has been collected consecutively since 1984 and a follow-up was conducted on all individuals admitted to the general hospital after a suicide attempt. The risk of repeated suicide attempt and suicide were comparatively examined in subjects who received assistance from the suicide prevention team in addition to treatment as usual versus those who received treatment as usual only. Logistic regression and Cox regression were used to analyze the data. RESULTS: Between January 1984 and December 2007, 1,616 subjects were registered as having attempted suicide; 197 of them (12%) made another attempt within 12 months. Compared to subjects who did not receive assistance from the suicide prevention team, individuals involved in the prevention program did not have a significantly different risk of repeated attempt within 6 months (adjusted OR = 1.08; 95% CI = 0.66-1.74), 12 months (adjusted OR = 0.86; 95% CI = 0.57-1.30), or 5 years (adjusted RR = 0.90; 95% CI = 0.67-1.22) after their first recorded attempt. There was also no difference in risk of suicide (adjusted RR = 0.85; 95% CI = 0.46-1.57). Previous suicide attempts, marital status, and employment status were significantly associated with a repeated suicide attempt within 6 and 12 months (p < 0.05). Alcohol misuse, employment status, and previous suicide attempts were significantly associated with a repeated attempt within 5 years (p < 0.05) while marital status became non-significant (p > 0.05). With each year of age, the risk of suicide increased by 3% (p < 0.05). CONCLUSIONS: The present study did not find any differences in the risk of fatal and non-fatal suicidal behavior between subjects who received treatment as usual combined with community assistance versus subjects who received only treatment as usual. However, assistance from the community team was mainly offered to attempters who were not receiving sufficient support from treatment as usual and was accepted by 50-60% of those deemed eligible. Thus, obtaining similar outcomes for individuals, all of whom were clinically judged to have different needs, could in itself be considered a desirable result.

Changes in mental health services and suicide mortality in Norway: an ecological study.

BACKGROUND: Mental disorders are strongly associated with excess suicide risk, and successful treatment might prevent suicide. Since 1990, and particularly after 1998, there has been a substantial increase in mental health service resources in Norway. This study aimed to investigate whether these changes have had an impact on suicide mortality. METHODS: We used Poisson regression analyses to assess the effect of changes in five mental health services variables on suicide mortality in five Norwegian health regions during the period 1990-2006. These variables included: number of man-labour years by all personnel, number of discharges, number of outpatient consultations, number of inpatient days, and number of hospital beds. Adjustments were made for sales of alcohol, sales of antidepressants, education, and unemployment. RESULTS: In the period 1990-2006, we observed a total of 9480 suicides and the total suicide rate declined by 26%. None of the mental health services variables were significantly associated with female or male suicide mortality in the adjusted analyses (p > 0.05). Sales of antidepressants (adjusted Incidence Rate Ratio = 0.98; 95% CI = 0.97-1.00) and sales of alcohol (adjusted IRR = 1.41; 95% CI = 1.18-1.72) were significantly associated with female suicide mortality; education (adjusted IRR = 0.86; 95% CI = 0.79-0.94) and unemployment (adjusted IRR = 0.91; 95% CI = 0.85-0.97) were significantly associated with male suicide mortality. CONCLUSIONS: The adjusted analyses in the present study indicate that increased resources in Norwegian mental health services in the period 1990-2006 were statistically unrelated to suicide mortality.

Education and disability pension: a stronger association than previously found.

INTRODUCTION: Although the Norwegian Welfare Law includes rigorous medical criteria for granting disability pensions, several non-medical factors have been shown to be associated with and possible causal factors of pensioning. OBJECTIVES: We analysed the relationship between disability pension and detailed information on educational attainment in different diagnostic groups. METHODS: All ethnic Norwegians aged 18-66 years and alive on 31 December 2003 (n = 2,522,430) were included. Age, sex, the receipt of a disability pension on 31 December 2003, and the diagnosis on the medical certificate were taken from a national social security file. The file also included six levels of education: primary school, low-level secondary school, secondary school, low-level university, university, and research level. RESULTS: We found a dramatic increase in the prevalence of persons granted disability pension with decreasing years of education across all levels of education. The disparities were much stronger than those seen for other health-related parameters and were especially strong for those with musculoskeletal diagnoses. The disability pension is more a consequence of health problems than a proxy for health status. The demonstrated relationship between education and disability pension may be partly explained by exclusion from the work force because of health-related work problems. CONCLUSIONS: To facilitate a more inclusive working life, attention should be focused on the work place's capacity to include people with different levels of competence and functioning rather than on the health problems of the employees.

A comparison of self reported air pollution problems and GIS-modeled levels of air pollution in people with and without chronic diseases.

OBJECTIVE: To explore various contributors to people's reporting of self reported air pollution problems in area of living, including GIS-modeled air pollution, and to investigate whether those with respiratory or other chronic diseases tend to over-report air pollution problems, compared to healthy people. METHODS: Cross-sectional data from the Oslo Health Study (2000-2001) were linked with GIS-modeled air pollution data from the Norwegian Institute of Air Research. Multivariate regression analyses were performed. 14 294 persons aged 30, 40, 45, 60 or 75 years old with complete information on modeled and self reported air pollution were included. RESULTS: People who reported air pollution problems were exposed to significantly higher GIS-modeled air pollution levels than those who did not report such problems. People with chronic disease, reported significantly more air pollution problems after adjustment for modeled levels of nitrogen dioxides, socio-demographic variables, smoking, depression, dwelling conditions and an area deprivation index, even if they had a non-respiratory disease. No diseases, however, were significantly associated with levels of nitrogen dioxides. CONCLUSION: Self reported air pollution problems in area of living are strongly associated with increased levels of GIS-modeled air pollution. Over and above this, those who report to have a chronic disease tend to report more air pollution problems in area of living, despite no significant difference in air pollution exposure compared to healthy people, and no associations between these diseases and NO2. Studies on the association between self reported air pollution problems and health should be aware of the possibility that disease itself may influence the reporting of air pollution.

Area deprivation and its association with health in a cross-sectional study: are the results biased by recent migration?

BACKGROUND: The association between area deprivation and health has mostly been examined in cross-sectional studies or prospective studies with short follow-up. These studies have rarely taken migration into account. This is a possible source of misclassification of exposure, i.e. an unknown number of study participants are attributed an exposure of area deprivation that they may have experienced too short for it to have any influence. The aim of this article was to examine to what extent associations between area deprivation and health outcomes were biased by recent migration. METHODS: Based on data from the Oslo Health Study, a cross-sectional study conducted in 2000 in Oslo, Norway, we used six health outcomes (self rated health, mental health, coronary heart disease, chronic obstructive pulmonary disease, smoking and exercise) and considered migration nine years prior to the study conduct. Migration into Oslo, between the areas of Oslo, and the changes in area deprivation during the period were taken into account. Associations were investigated by multilevel logistic regression analyses. RESULTS: After adjustment for individual socio-demographic variables we found significant associations between area deprivation and all health outcomes. Accounting for migration into Oslo and between areas of Oslo did not change these associations much. However, the people who migrated into Oslo were younger and had lower prevalences of unfavourable health outcomes than those who were already living in Oslo. But since they were evenly distributed across the area deprivation quintiles, they had little influence on the associations between area deprivation and health. Evidence of selective migration within Oslo was weak, as both moving up and down in the deprivation hierarchy was associated with significantly worse health than not moving. CONCLUSION: We have documented significant associations between area deprivation and health outcomes in Oslo after adjustment for socio-demographic variables in a cross-sectional study. These associations were weakly biased by recent migration. From our results it still appears that migration prior to study conduct may be relevant to investigate even within a relatively short period of time, whereas changes in area deprivation during such a period is of limited interest.

Psychological distress among immigrants from high- and low-income countries: findings from the Oslo Health Study.

This study compared psychological distress between immigrants from high- and low-income countries living in Oslo, and investigated whether pre- or post-migration factors could explain any such differences in distress levels. A cross-sectional survey with self-administered questionnaires was conducted between 2000 and 2001 among 812 immigrants from high-income countries and 1434 immigrants from low-income countries living in Oslo. The Hopkins Symptom Checklist (HSCL)-10 was used to measure psychological distress. The prevalence rates of psychological distress among immigrants from high- and low-income countries were 10.3% and 24.3%, respectively (P=0.001). Unadjusted odds ratio (OR) of distress among the latter group was 2.38 with 95% confidence interval (CI) 1.73-3.29. The first adjustment (socio-demographic variables) hardly attenuated the difference reported (adjusted OR =2.25, 95% CI 1.58-3.21), the second adjustment (socio-demographic and pre-migration variables) reduced the difference (adjusted OR =1.86, 95% CI 1.28-2.69) while the last adjustment (socio-demographic and pre- and post-migration variables) attenuated the difference below the level of significance (adjusted OR =1.33, 95% CI 0.88-2.01). This means that both pre-migration and post-migration factors were associated with the higher level of distress among immigrants from low-income countries, the post-migration factors in the host country probably being the most important.

The risk of cancer in the offspring and parental length of life.

BACKGROUND: We investigated if cancer onset in offspring is related to having short-lived parents for different cancer types and to see if there was a difference in smoking- and non-smoking related cancers. METHODS: Our study included 524,391 individuals born in Norway 1940-1950. All children were followed up for cancer from the age of 20 until they were between 59 and 69 years. Parental longevity was examined by grouping parental age of death into parents dying before 75 years of age and parents dying at 75 years of age or older. RESULTS: An increased risk of 1.14 (95%CI=1.10-1.19) among male offspring and 1.08 (95%CI=1.04-1.12) among female offspring was observed for total cancer when both parents died before the age of 75 compared to offspring with two long-lived parents. The highest increase was found for cancer in the lungs and trachea for both male (HR=1.67, 95%CI=1.50-1.86) and female offspring (HR=1.53, 95%CI=1.33-1.76). For other smoking-related cancers, the risk was lower. No increased risk was observed for non-smoking-related cancers. CONCLUSION: Offspring of long-lived parents have lower risk of developing cancer compared with offspring of short-lived parents. Intergenerational transmission of risk factors from parents to offspring may play an important role, especially for tobacco-related cancers. However, genetic factors cannot be ruled out, since consistent evidence has implicated genetic factors in smoking behaviour.