| Lost password
347 users onlineYou are not loggend in.  Login
life expectancy
 1 2
 1 2
06/24/2004 23:12
Kristen 
06/24/2004 23:12
Kristen 
Cancer deaths more prevalent in people with DC

An interesting (and depressing) study was conducted over a 15 year period showing cancer deaths to be statistically significant in people with stage 2 or greater DC. It was published in a medical journal in the UK. (see below)
I would assume that the presence of DC already indicates that your immune system is on the fritz (I'm not a doctor and "on the fritz" is not a medical term ;-) Kristen

Increased total mortality and cancer mortality in men with Dupuytren's disease: a 15-year follow-up study.
Gudmundsson Kristjan G; Arngrimsson Reynir; Sigfusson Nikulas; Jonsson
Thorbjorn
The Health Care Centre, Fludabakka 6, 540, Blonduos, Iceland.
kristgud@HNLfi.is
Journal of clinical epidemiology (England) Jan 2002, 55 (1) p5-10,
ISSN 0895-4356 Journal Code: 8801383
Document type: Journal Article
Languages: ENGLISH
Main Citation Owner: NLM
Record type: Completed
Subfile: INDEX MEDICUS
The aim of the present study was to evaluate the mortality rate and
causes of death of individuals with Dupuytren's disease. In 1981/82, as
part of The Reykjavik Study, a general health survey, 1297 males were
examined for clinical signs of Dupuytren's disease. Based on the clinical
evaluation the participants were classified into three groups: (1) those
with no signs of Dupuytren's disease were referred to as the reference
cohort; (2) those with palpable nodules in the palmar fascia were
classified as having stage 1; and (3) those who had contracted fingers or
had been operated on due to contractures were classified as having stage 2
of Dupuytren's disease. In 1997, after a 15- year follow-up period, the
mortality rate and causes of death were investigated in relation to the
clinical findings from 1981/82. Information about causes of death were
obtained from the National Icelandic Death Registry and the Icelandic
Cancer Registry. During the follow-up period, 21.5% (225/1048) of the
reference cohort were deceased compared to 29.9% (55/184) of those with
stage 1 and 47.7% (31/65) of those with stage 2 of Dupuytren's disease.
When adjusted for age, smoking habits and other possible confounders,
individuals with stage 2 of the disease showed increased total mortality
[hazard ratio (HR) = 1.6; 95% CI 1.1-2.4]. Cancer deaths were increased (HR
= 1.9; CI 1.0-3.6). In contrast, participants with stage 1 of Dupuytren's
disease did not show increased mortality. A moderate but non-significant
increase in cancer incidence was observed among individuals with stage 2 of
Dupuytren's disease (HR = 1.5; 95% CI 0.9-2.4, P = 0.15). The study showed
increased total mortality of individuals with Dupuytren's disease stage 2,
where 42% of the excess in mortality could be attributed to cancer deaths.
Tags: Human; Male; Support, Non-U.S. Gov't
Descriptors: *Cause of Death; *Dupuytren's Contracture--mortality--MO;
*Neoplasms--mortality--MO; Aged; Confounding Factors (Epidemiology);
Dupuytren's Contracture--complications--CO; Dupuytren's Contracture
--epidemiology--EP; Follow-Up Studies; Iceland--epidemiology--EP; Middle
Aged; Neoplasms--complications--CO; Prevalence; Registries; Risk Factors;
Smoking--adverse effects--AE

11/02/2004 23:01
Patsy 
11/02/2004 23:01
Patsy 
early death

I find this very upsetting. I plan to have at least an annual cancer exam due to this article.

11/03/2004 23:48
RHONDA

not registered

11/03/2004 23:48
RHONDA

not registered

CAUSE AND CONCERN~sq~S.

LET'S SEE, I DONT SMOKE, DONT HAVE DIABETES, DONT HAVE CANCER,I DON'T THINK I HAVE ALZIEMERS!!(?)AND ONLY DRINK EVERY NOW AND THEN, I'M AT A STAGE 4 AND A HALF SAYS MY THERAPIST FOR MY HAND,
(OF STAGES 1-4,,,, 4 BEING THE WORST), OH AND NO SWEEDISH IN THE FAMILY. SOO, WHAT MIGHT HAVE CAUSED MY D.C.?
AND IM 40 SOMETHING.

12/01/2004 23:53
Michael Lusk

not registered

12/01/2004 23:53
Michael Lusk

not registered

Dupuytren~sq~s and mortality


Kristen,

I read that Journal of Clinical Epidemiology article too. It does make depressing reading for people with stage 2 DD (with contracture). It concludes that men with stage 2 DD in late middle age are over 50% more likely to die in the next 15 years than those with stage 1 (palpable nodules, no contracture) or without any sign of DD. It also concludes that 42% of the increase in mortality is due to cancer. Stage 2-ers are almost twice as likely to die of cancer as non-DD or stage 1 men - although, curiously, the incidence of cancer is not statistically higher than the norm, meaning perhaps that cancer when it occurs is more aggressive in DD sufferers.

But a couple of things puzzle me:

1) It seems if DD had that marked an effect on mortality, it would have been discovered long ago. People who live in the Grampian Region of Scotland (population ~525,000, Viking or Celtic ancestry, take your pick) have an unusually high rate of DD, yet overall mortality and mortality from cancer is at about the British average.

2) If cancer accounts for 42% of the increased mortality, what accounts for the remaining 58%?

3) Why is the increase in cancer so uniformly spread throughout the types of cancer?

12/06/2004 23:28
mary h

not registered

12/06/2004 23:28
mary h

not registered

mortality studies

just curious about life expectancy research...any correlation between shortened life expectancy in females with DC ? studies quoted referred to amles i believe.

12/11/2004 23:54
Michael Lusk

not registered

12/11/2004 23:54
Michael Lusk

not registered

mortality studies

I've been ploughing through the Uppsala study mentioned by Sean. I'm probably missing some subtleties, but to this poor befuddled layman, it seems to contain some internal inconsistencies; and it comes to very different conclusions re cancer risk than the Journal of Clinical Epidemiology (Reykjavik) study. (In the following examples, remarks in parentheses are mine:

On page 32, it says: 'Cancer was the second most common cause of death (in those who had undergone surgery for Dups), with a significantly increased overall mortality of 20%'

On page 36, in a section entitled ‘Cancer and free oxygen radicals’ and refering to the results of the Reykjavik study, it says: ‘After adjustment for age, smoking habits, body mass index, fasting blood glucose, and manual or learned labour, individuals with clinical signs of DC showed an increased cancer mortality ratio of 1.9. (implying an increased cancer mortality of 90%, if I understand it correctly).

So are ‘increased overall mortality’ and ‘increased mortality ratio’ different concepts, or are the results of the two studies that drastically different?

The Reykjavik result is most worrisome, both because it implies a much larger cancer mortality risk, and because it adjusted for confounding factors like smoking. On the other hand, the Uppsala study had a much larger sample size (16,517) than the Reykjavik study (1,297). Uppsala also adjusted for diabetes.

Another apparent inconsistency:

On page 30, when discussing how increased overall mortality was related to the age of the patients when they had their surgeries, it says: ‘We observed a significant increase in overall mortality for both genders in all age groups except in patients under 20…, in women between 30 and 39…, and among patients over 70 at the time of surgery. In the next sentence it says: ‘…in women the (mortality) risk was more than doubled if they underwent surgery bfore the age of 50.’ How can both these things be true?

More befuddlement to come...


12/11/2004 23:59
Sean 
12/11/2004 23:59
Sean 
life expectancy

Michael,
I agree with you that there is still the impression that there could be correlating factors between DC and cancer. I thought (page 36) that their "explanation for the pattern of different cancers in patients with DC could be dietary factors, especially antioxidants. Oxidative stress has been associated with DC, as well as with the development of cardiovascular disease and diabetes. In our study of cancer incidence in patients operated for DC, we observed that gastric and colorectal cancers occurred more frequently than expected, as did cancers of the breast and prostate."

12/12/2004 23:59
Michael Lusk

not registered

12/12/2004 23:59
Michael Lusk

not registered

Dups & mortality


Sean,

Although the Uppsala study shows a significant increase in mortality for stage 2 DD-ers, it's certainly a lot more hopeful than the Iceland study. It concludes that the increased risk of mortality might be due to dietary factors and other lifestyle choices that also tend to trigger DD, meaning it's controllable. I for one am going to pay a lot more attention to antioxidants in my diet!

At this point, I don't see how the two studies can be entirely reconciled, but I guess the size of the sample populations (~16K vs 1267) gives the Uppsala study more credence.

Best Regards, Michael

 1 2
 1 2
individuals   increased   Mortality   studies   Neoplasms--mortality--MO   Neoplasms--complications--CO   statistically   level2=Dupuytrens%20Contracture%20-%20Partial%20Fasciectomy   increase   Contracture--complications--CO   patients   Smoking--adverse   Dupuytren   expectancy   non-significant   epidemiology   Contracture--mortality--MO   Surgery   Iceland--epidemiology--EP   disease