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TitlePolicy Framework for Population Screening for Cancer
Translated TitleBeleidskader Bevolkingsonderzoeken naar Kanker
PubliekssamenvattingHet Beleidskader Bevolkingsonderzoeken naar Kanker (BBK) geeft een overzicht van de wettelijke en beleidsmatige kaders voor de drie bevolkingsonderzoeken in Nederland naar kanker: borst-, baarmoederhals- en darmkanker. Daarnaast beschrijft het de samenwerking en onderlinge verhoudingen van partijen die betrokken zijn bij de voorbereiding, besluitvorming en uitvoering van deze bevolkingsonderzoeken. Op deze manier werken de betrokken partijen optimaal samen. Het Beleidskader is opgeteld door het RIVM en is vastgesteld door het ministerie van Volksgezondheid, Welzijn en Sport (VWS). Het document wordt regelmatig getoetst en zo nodig aangepast aan de actualiteit. <br> <br>Het RIVM ziet er als landelijke regiehouder op toe dat de bevolkingsonderzoeken voor de deelnemers een hoge kwaliteit hebben, en goed bereikbaar en betaalbaar zijn. Op die manier ontstaat een optimaal 'aanbod' voor de deelnemers aan de bevolkingsonderzoeken. Het Beleidskader is een instrument om de regie te voeren. Het vormt ook de basis voor de zogeheten uitvoeringskaders, waarin per bevolkingsonderzoek de precieze wijze waarop en door wie de bevolkingsonderzoeken worden uitgevoerd, is uitgewerkt. <br> <br>De bevolkingsonderzoeken bestaan uit een reeks van opeenvolgende handelingen die door verschillende partijen worden uitgevoerd en gecoördineerd (de uitnodiging voor het onderzoek, het onderzoek zelf, de beoordeling van de uitslag, de communicatie, en de eventuele doorverwijzing). Deze handelingen moeten goed op elkaar aansluiten en efficiënt gestructureerd zijn om de kwaliteit van het bevolkingsonderzoek te waarborgen. <br>
The Policy Framework for Population Screening for Cancer provides an overview of the legal and policy frameworks for the three population screening programmes for cancer in the Netherlands, namely for breast, cervical and bowel cancer. In addition, it describes the cooperation and the various relationships between the parties who are involved in the preparation, decision-making and implementation of the population screening programmes. This optimises the way in which the parties involved can work together. The Policy Framework has been drawn up by the National Institute for Public Health and the Environment (RIVM) and formalised by the Ministry of Health, Welfare and Sport (VWS). The document is regularly checked and updated when necessary to reflect the actual situation. <br> <br>The RIVM has the nationwide coordinating role, meaning that they monitor to ensure that high-quality population screening is provided for the participants and that it is easily accessible and affordable. This creates the optimum 'offering' for those participating in population screening. The Policy Framework is a tool for coordinating the programmes. It is also part of what are known as the 'implementation frameworks' in which the exact method is described for each population screening programme, along with who performs it. <br> <br>The population screening programme consists of a sequential series of actions that are carried out and coordinated by various parties (the invitation to take part in the programme, the investigation itself, the assessment of the results, the communication of the results and any referrals that may be needed). These activities must be aligned with each other well and must be efficiently structured in order to guarantee the quality of the population screening. <br>
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Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study.Naudin, Sabine; Li, Kuanrong; Jaouen, Tristan; Assi, Nada; Kyrø, Cecilie; Tjønneland, Anne; Overvad, Kim; Boutron-Ruault, Marie-Christine; Rebours, Vinciane; Védié, Anne-Laure; Boeing, Heiner; Kaaks, Rudolf; Katzke, Verena; Bamia, Christina; Naska, Androniki; Trichopoulou, Antonia; Berrino, Franco; Tagliabue, Giovanna; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Peeters, Petra H; Bueno-de-Mesquita, Bas; Weiderpass Vainio, Elisabete; Gram, Inger Torhild; Skeie, Guri; Chirlaque, Maria-Dolores; Rodríguez-Barranco, Miguel; Barricarte, Aurelio; Quirós, Jose Ramón; Dorronsoro, Miren; Johansson, Ingegerd; Sund, Malin; Sternby, Hanna; Bradbury, Kathryn E; Wareham, Nick; Riboli, Elio; Gunter, Marc; Brennan, Paul; Duell, Eric J; Ferrari, Pietro (2018-03-09)Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In this study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake. This article is protected by copyright. All rights reserved.
Interactions Between Genome-Wide Significant Genetic Variants and Circulating Concentrations of 25-Hydroxyvitamin D in Relation to Prostate Cancer Risk in the National Cancer Institute BPC3.Dimitrakopoulou, Vasiliki I; Travis, Ruth C; Shui, Irene M; Mondul, Alison; Albanes, Demetrius; Virtamo, Jarmo; Agudo, Antonio; Boeing, Heiner; Bueno-de-Mesquita, H Bas; Gunter, Marc J; Johansson, Mattias; Khaw, Kay-Tee; Overvad, Kim; Palli, Domenico; Trichopoulou, Antonia; Giovannucci, Edward; Hunter, David J; Lindström, Sara; Willett, Walter; Gaziano, J Michael; Stampfer, Meir; Berg, Christine; Berndt, Sonja I; Black, Amanda; Hoover, Robert N; Kraft, Peter; Key, Timothy J; Tsilidis, Konstantinos K (2017-03-15)Genome-wide association studies (GWAS) have identified over 100 single nucleotide polymorphisms (SNPs) associated with prostate cancer. However, information on the mechanistic basis for some associations is limited. Recent research has been directed towards the potential association of vitamin D concentrations and prostate cancer, but little is known about whether the aforementioned genetic associations are modified by vitamin D. We investigated the associations of 46 GWAS-identified SNPs, circulating concentrations of 25-hydroxyvitamin D (25(OH)D), and prostate cancer (3,811 cases, 511 of whom died from the disease, compared with 2,980 controls-from 5 cohort studies that recruited participants over several periods beginning in the 1980s). We used logistic regression models with data from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3) to evaluate interactions on the multiplicative and additive scales. After allowing for multiple testing, none of the SNPs examined was significantly associated with 25(OH)D concentration, and the SNP-prostate cancer associations did not differ by these concentrations. A statistically significant interaction was observed for each of 2 SNPs in the 8q24 region (rs620861 and rs16902094), 25(OH)D concentration, and fatal prostate cancer on both multiplicative and additive scales (P ≤ 0.001). We did not find strong evidence that associations between GWAS-identified SNPs and prostate cancer are modified by circulating concentrations of 25(OH)D. The intriguing interactions between rs620861 and rs16902094, 25(OH)D concentration, and fatal prostate cancer warrant replication.
Measured Adiposity in Relation to Head and Neck Cancer Risk in the European Prospective Investigation into Cancer and Nutrition.Ward, Heather A; Wark, Petra A; Muller, David C; Steffen, Annika; Johansson, Mattias; Norat, Teresa; Gunter, Marc J; Overvad, Kim; Dahm, Christina C; Halkjær, Jytte; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Mesrine, Sylvie; Brennan, Paul; Freisling, Heinz; Li, Kuanrong; Kaaks, Rudolf; Trichopoulou, Antonia; Lagiou, Pagona; Panico, Salavatore; Grioni, Sara; Tumino, Rosario; Vineis, Paolo; Palli, Domenico; Peeters, Petra H M; Bueno-de-Mesquita, H Bas; Weiderpass, Elisabete; Agudo, Antonio; Quirós, Jose Ramón; Larrañaga, Nerea; Ardanaz, Eva; Huerta, José María; Sánchez, María-José; Laurell, Göran; Johansson, Ingegerd; Westin, Ulla; Wallström, Peter; Bradbury, Kathryn E; Wareham, Nicholas J; Khaw, Kay-Tee; Pearson, Clare; Boeing, Heiner; Riboli, Elio (2017-06)Background: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error.Methods: Among 363,094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of head and neck cancer. Head and neck cancer risk was examined in relation to body mass index (BMI) [lean: <22.5 kg/m2, normal weight (reference): 22.5-24.9 kg/m2, overweight 25-29.9 kg/m2, obese: ≥30 kg/m2], waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) using Cox proportional hazards models.Results: Among men, a BMI < 22.5 kg/m2 was associated with higher head and neck cancer risk [HR 1.62; 95% confidence interval (CI), 1.23-2.12)]; BMI was not associated with head and neck cancer among women. WC and WHR were associated with greater risk of head and neck cancer among women (WC per 5 cm: HR, 1.08; 95% CI, 1.02-1.15; WHR per 0.1 unit: HR, 1.64; 95% CI, 1.38-1.93). After stratification by smoking status, the association for WHR was present only among smokers (Pinteraction = 0.004). Among men, WC and WHR were associated with head and neck cancer only upon additional adjustment for BMI (WC per 5 cm: HR 1.16; 95% CI, 1.07-1.26; WHR per 0.1 unit: HR, 1.42; 95% CI, 1.21-1.65).Conclusions: Central adiposity, particularly among women, may have a stronger association with head and neck cancer risk than previously estimated.Impact: Strategies to reduce obesity may beneficially impact head and neck cancer incidence. Cancer Epidemiol Biomarkers Prev; 26(6); 895-904. ©2017 AACR.