The Role of Comorbidities in the Social Gradient in Cancer Survival in Europe

Fowler, Helen; Minicozzi, Pamela; Luque-Fernández, Miguel Ángel; Rachet, Bernard

doi:10.1007/978-3-030-69329-9_18

Cited by 3 publications

(2 citation statements)

References 116 publications

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“…What are the major causes of the unequal consequences of disease? For Denmark, the exposures listed for Question 1 and unequal quality and implementation of effective care (see Question 8) are important, but differential comorbidity also seems to plays a major part [24,25]. Because many disorders share causes that have the same social patterning (Table II), they tend to cluster in disadvantaged groups.…”

Section: Planning For Health Equity: Eight Key Questionsmentioning

confidence: 99%

Planning for health equity in the crossfire between science and policy

Diderichsen

Whitehead

Dahlgren

2022

Scand J Public Health

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The persistence of health inequalities means that many public health professionals face an ongoing task to develop and update policies to tackle them. However, although the inequalities might be unchanged, the political priorities in the many policy areas involved are changing and the ambition to reduce the health divide is constantly facing strong forces pushing in the opposite direction. Recent proposals to re-think health inequalities need to be treated with caution because they are disconnected from what is needed for policy-making in this area. From our experience of 35 years in developing strategies to tackle health inequalities, we still see many entry points with space for local and national improvements, but it is crucial to ask the right questions. The aim of this Commentary is to present a new framework of eight questions that might provide a helpful structure for the necessary dialogue between researchers and policy-makers. Even if answers are not yet available for all of them, we believe that discussing them for a specific population in a specific political context will be fruitful to inform policy on the ground.

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Section: Planning For Health Equity: Eight Key Questionsmentioning

confidence: 99%

Planning for health equity in the crossfire between science and policy

Diderichsen

Whitehead

Dahlgren

2022

Scand J Public Health

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“…Unequal survival rates for specific disorders might be due to inequities in care and behaviour, but comorbidity may also play an important role 4. Several disorders show similar social patterning and multimorbidity therefore shows up as clustering of disorders with a particular steep social gradient 5–9.…”

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confidence: 99%

Mediating role of multimorbidity in inequality in mortality: a register study on the Danish population

Diderichsen

Bender

Lyth

et al. 2021

J Epidemiol Community Health

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BackgroundThe social inequality in mortality is due to differential incidence of several disorders and injury types, as well as differential survival. The resulting clustering and possible interaction in disadvantaged groups of several disorders make multimorbidity a potentially important component in the health divide. This study decomposes the effect of education on mortality into a direct effect, a pure indirect effect mediated by multimorbidity and a mediated interaction between education and multimorbidity.MethodsThe study uses the Danish population registers on the total Danish population aged 45–69 years. A multimorbidity index based on all somatic and psychiatric hospital contacts as well as prescribed medicines includes 22 diagnostic groups weighted together by their 5 years mortality risk as weight. The Aalen additive hazard model is used to estimate and decompose the 5 years risk difference in absolute numbers of deaths according to educational status.ResultsMost (69%–79%) of the effect is direct not involving multimorbidity, and the mediated effect is for low educated women 155 per 100 000 of which 87 is an effect of mediated interaction. For low educated men, the mediated effect is 250 per 100 000 of which 93 is mediated interaction.ConclusionMultimorbidity plays an important role in the social inequality in mortality among middle aged in Denmark and mediated interaction represents 5%–17%. As multimorbidity is a growing challenge in specialised health systems, the mediated interaction might be a relevant indicator of inequities in care of multimorbid patients.

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Identify miRNA-mRNA regulation pairs to explore potential pathogenesis of lung adenocarcinoma

Fan

Zou

Liu

et al. 2022

Aging

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Purpose: MicroRNA (miRNA) function via base-pairing with complementary sequences within mRNA molecules. This study aims to identify critical miRNA-mRNA regulation pairs contributing to lung adenocarcinoma (LUAD) pathogenesis. Patients and methods: MiRNA and mRNA microarray and RNA-sequencing datasets were downloaded from gene expression omnibus (GEO) and the cancer genome atlas (TCGA) databases. Differential miRNAs (DE-miRNAs) and mRNAs (DE-mRNAs) were screened by the GEO2R tool and R packages. DAVID, DIANA, and Hiplot tools were used to perform gene enrichment analysis. The pairs of miRNA-mRNA were screened from the experimentally validated miRNA-target interactions databases (miRTarBase and TarBase). External validation was carried out in 30 pairs of LUAD tissues by quantitative reverse transcription and polymerase chain reaction (qRT-PCR). The diagnostic value of the miRNA-mRNA regulation pairs was evaluated by receiver operating characteristic curve (ROC) and decision curve analysis (DCA). Biological function assay was were also performed to confirm the function of miRNA-mRNA axis in LUAD progression. The study also performed the clinical, survival and tumorassociated phenotypic analysis of miRNA-mRNA pairs. Results: A total of 7 miRNA and 13 mRNA expression datasets from GEO were analyzed, and 11 DE-miRNAs (5 down-regulated and 6 up-regulated in LUAD tissues) and 128 DE-mRNAs (30 up-regulated and 98 downregulated in LUAD tissues) were identified. The pairs of miR-1-3p(down) and CENPF(up) and miR-126-5p(down) and UGT8(up) were verified in the external validation cohort (30 LUAD vs. 30 NC) using qRT-PCR. Areas under the ROC curve of the two miRNA-mRNA regulation pairs panel were 0.973 in TCGA-LUAD and 0.771 in the external validation. The DCA also showed that the miRNA-mRNA regulation pairs had an excellent diagnostic performance distinguishing LUAD from normal controls. The expression of the regulation pairs is different in different ages, TNM stages, and gender. The overexpression of miR-1-3p and miR-126-5p significantly inhibited the proliferation and migration of LUAD cells. Correlation analysis showed that CENPF correlated with prognosis and tumor immunity. Conclusions: The research identified potential miRNA-mRNA regulation pairs, providing a new idea for exploring the genesis and development of LUAD.

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The Role of Comorbidities in the Social Gradient in Cancer Survival in Europe

Cited by 3 publications

References 116 publications

Planning for health equity in the crossfire between science and policy

Planning for health equity in the crossfire between science and policy

Mediating role of multimorbidity in inequality in mortality: a register study on the Danish population

Identify miRNA-mRNA regulation pairs to explore potential pathogenesis of lung adenocarcinoma

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