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Article ; Online: Ethnicity and socio-economic status affects the incidence and survival of hepatosplenic T-cell lymphoma.

Bishton, Mark J / Crooks, Colin J / Card, Timothy R / West, Joe

2024

Abstract: To address the lack of contemporary population-based epidemiological studies of hepatosplenic T-cell lymphoma (HSTCL), we undertook a population-based study of ICD-O-3-coded HSTCL in England. We used the National Cancer Registration Dataset and linked ... ...

Abstract	To address the lack of contemporary population-based epidemiological studies of hepatosplenic T-cell lymphoma (HSTCL), we undertook a population-based study of ICD-O-3-coded HSTCL in England. We used the National Cancer Registration Dataset and linked datasets on hospital admissions, Systemic Anti-Cancer Therapy, socio-demographics, comorbidities and death, identifying cases from 1 January 2013 to 31 December 2019 with survival data up to 5 January 2021. Crude and directly age-standardised incidence rates per million persons per year were calculated. Crude and adjusted incidence rate ratios compared incidence between groups using Poisson regression. A Cox proportional hazards model estimated mortality risks adjusted for age, sex, ethnicity, deprivation and allogenic stem cell transplant (allo-SCT; time varying). We identified 44 patients, mean age 42 years. Median survival was 11 months, and 1 and 5 year survivals were 48% (95% CI 29%-43%) and 22% (95% CI 12%-42%) respectively. The age-standardised incidence was 0.1 per million/year. Incidence was higher in areas with greater deprivation (0.15 per million/year), and more cases than expected were in non-White patients (39%). Non-Whites had a twofold increased risk of death (adjusted hazard ratio 2.21 [95% CI 1.03-4.78]) even after adjusting for deprivation, younger age and allo-SCT. In conclusion, ethnicity and socio-economic status affect both the incidence and survival of HSTCL.
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Journal Article
ZDB-ID	80077-6
ISSN	1365-2141 ; 0007-1048
ISSN (online)	1365-2141
ISSN	0007-1048
DOI	10.1111/bjh.19371
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Article ; Online: Public Health Policy, Political Ideology, and Public Emotion Related to COVID-19 in the U.S.

Gao, Jingjing / Gallegos, Gabriela A / West, Joe F

International journal of environmental research and public health

2023 Volume 20, Issue 21

Abstract: Social networks, particularly Twitter 9.0 (known as X as of 23 July 2023), have provided an avenue for prompt interactions and sharing public health-related concerns and emotions, especially during the COVID-19 pandemic when in-person communication ... ...

Abstract	Social networks, particularly Twitter 9.0 (known as X as of 23 July 2023), have provided an avenue for prompt interactions and sharing public health-related concerns and emotions, especially during the COVID-19 pandemic when in-person communication became less feasible due to stay-at-home policies in the United States (U.S.). The study of public emotions extracted from social network data has garnered increasing attention among scholars due to its significant predictive value for public behaviors and opinions. However, few studies have explored the associations between public health policies, local political ideology, and the spatial-temporal trends of emotions extracted from social networks. This study aims to investigate (1) the spatial-temporal clustering trends (or spillover effects) of negative emotions related to COVID-19; and (2) the association relationships between public health policies such as stay-at-home policies, political ideology, and the negative emotions related to COVID-19. This study employs multiple statistical methods (zero-inflated Poisson (ZIP) regression, random-effects model, and spatial autoregression (SAR) model) to examine relationships at the county level by using the data merged from multiple sources, mainly including Twitter 9.0, Johns Hopkins, and the U.S. Census Bureau. We find that negative emotions related to COVID-19 extracted from Twitter 9.0 exhibit spillover effects, with counties implementing stay-at-home policies or leaning predominantly Democratic showing higher levels of observed negative emotions related to COVID-19. These findings highlight the impact of public health policies and political polarization on spatial-temporal public emotions exhibited in social media. Scholars and policymakers can benefit from understanding how public policies and political ideology impact public emotions to inform and enhance their communication strategies and intervention design during public health crises such as the COVID-19 pandemic.
MeSH term(s)	Humans ; United States/epidemiology ; COVID-19/epidemiology ; Pandemics ; Emotions ; Public Policy ; Health Policy ; Social Media
Language	English
Publishing date	2023-10-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20216993
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Article ; Online: We need stronger evidence for (or against) hepatocellular carcinoma surveillance.

Jepsen, Peter / West, Joe

Journal of hepatology

2021 Volume 74, Issue 5, Page(s) 1234–1239

Abstract: Current guidelines from EASL recommend that most patients with cirrhosis are offered surveillance for hepatocellular carcinoma (HCC), but fewer patients than expected actually receive it. The recommendation is based on observational studies and ... ...

Abstract	Current guidelines from EASL recommend that most patients with cirrhosis are offered surveillance for hepatocellular carcinoma (HCC), but fewer patients than expected actually receive it. The recommendation is based on observational studies and simulations, not randomised trials. In this opinion piece we argue that a randomised trial of HCC surveillance vs. no surveillance is necessary and feasible, and we believe that clinician and patient participation in HCC surveillance would be better if it were based on trial results demonstrating its value.
MeSH term(s)	Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/etiology ; Early Detection of Cancer/methods ; Humans ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Neoplasms/diagnosis ; Liver Neoplasms/etiology ; Practice Guidelines as Topic ; Preventive Health Services/ethics ; Preventive Health Services/methods ; Preventive Health Services/standards
Language	English
Publishing date	2021-01-17
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	605953-3
ISSN	1600-0641 ; 0168-8278
ISSN (online)	1600-0641
ISSN	0168-8278
DOI	10.1016/j.jhep.2020.12.029
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Article ; Online: Editorial: seeing the light at the end of gastroscope - complications after elective procedures are ready for NICE, bright decision aid tools - authors' reply.

West, Joe / Card, Timothy R / Crooks, Colin J

Alimentary pharmacology & therapeutics

2022 Volume 56, Issue 1, Page(s) 157

MeSH term(s)	Crohn Disease/surgery ; Decision Support Techniques ; Elective Surgical Procedures/adverse effects ; Gastroscopes ; Humans
Language	English
Publishing date	2022-06-10
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.16987
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Article ; Online: The risk of unexpected hospital admissions and primary care visits after an elective day-case gastroscopy: a cohort study within England.

Crooks, Colin J / Card, Timothy R / West, Joe

Alimentary pharmacology & therapeutics

2022 Volume 56, Issue 1, Page(s) 56–66

Abstract: Aim: To determine the excess of acute medical contacts following a day-case diagnostic gastroscopy.: Methods: Cohort study using English linked primary, secondary care and death registry electronic health data. We included 277,535 diagnostic day-case ...

Abstract	Aim: To determine the excess of acute medical contacts following a day-case diagnostic gastroscopy. Methods: Cohort study using English linked primary, secondary care and death registry electronic health data. We included 277,535 diagnostic day-case gastroscopies in 225,304 people between 1998 and 2016 and followed up for 30 days. 1,383,535 30-day periods without a gastroscopy within 991,249 people frequency matched on year, gender and decade of birth. Non-cancer deaths, emergency non-cancer admissions and cardio, vascular or respiratory (CVR) primary care consultations were identified and adjusted for each other as competing risks. Outcomes related to possible indications for gastroscopy were censored. Results: 5.1% of day-case diagnostic gastroscopies were followed by emergency hospital admission, 0.4% for a CVR diagnosis. Adjusted for age, sex, morbidity, time trends, indications and competing risks, there was a 0.1% excess of CVR-related hospital admissions compared to controls. This reduced to 0.05% (95% confidence interval 0.04-0.06%) in people under 40 years without morbidity and increased to 1.1% (0.6%-1.6%) in people over 90 years with high comorbidity. Similarly, by 30 days, 3.8% had a primary care consultation for a CVR problem, with an excess after adjustment ranging from 0.13% (0.11%-0.16%) to 0.31% (0.14%-0.50%). Overall numbers needed to harm ranged from 1 in 294 gastroscopies to 1 in 67 gastroscopies. Conclusions: There was an excess of vascular and respiratory events associated with a diagnostic gastroscopy. In younger patients, this risk manifested as an increase in primary care consultations while in older patients there was an increase in emergency hospital admissions.
MeSH term(s)	Aged ; Cohort Studies ; Gastroscopy ; Hospitalization ; Hospitals ; Humans ; Primary Health Care
Language	English
Publishing date	2022-04-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.16946
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Article: Trends in indirect liver function marker testing in Wales from 2000 to 2017 and their association with age and sex: an observational study.

Hill, Trevor Alexander / Crooks, Colin John / West, Joe / Morling, Joanne R

BMJ open gastroenterology

2022 Volume 9, Issue 1

Abstract: Objective: If non-invasive markers of liver fibrosis were recorded frequently enough in clinical practice, it might be feasible to use them for opportunistic community screening for liver disease. We aimed to determine their current pattern of usage in ... ...

Abstract	Objective: If non-invasive markers of liver fibrosis were recorded frequently enough in clinical practice, it might be feasible to use them for opportunistic community screening for liver disease. We aimed to determine their current pattern of usage in the national primary care population in Wales. Design: Using the Secure Anonymised Information Linkage (SAIL) Databank at Swansea University (2000-2017), we quantified the frequency of common liver blood tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count and albumin) used in fibrosis marker algorithms. We examined measurement variation by age and sex. Results: During the 18-year study period, there were 2 145 178 adult patients with at least one blood test available for analysis. Over the study period, the percentage of SAIL patients receiving an ALT test in each year increased from 2% to 33%, with platelet count and albumin measurement increasing by a similar factor. AST testing, although initially rising, had decreased to 1% by the end of the study. AST and ALT values varied by age and sex, particularly in males with the upper normal range of ALT values decreasing rapidly from 90 U/L at age 30 to 45 U/L by age 80. Conclusion: The reduction in AST testing to only 1% of the adult population limits the use of many non-invasive liver marker algorithms. To enable widespread screening, alternative algorithms for liver fibrosis that do not depend on AST should be developed. Liver fibrosis markers should be modified to include age-specific and sex-specific normal ranges.
MeSH term(s)	Adult ; Aged, 80 and over ; Albumins ; Biomarkers ; Female ; Humans ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/epidemiology ; Liver Function Tests ; Male ; Middle Aged ; Wales/epidemiology
Chemical Substances	Albumins ; Biomarkers
Language	English
Publishing date	2022-04-29
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	2054-4774
ISSN	2054-4774
DOI	10.1136/bmjgast-2022-000885
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Article ; Online: Effects of statins and aspirin on HCC risk in alcohol-related cirrhosis: nationwide emulated trials.

Kraglund, Frederik / Christensen, Diana H / Eiset, Andreas H / Villadsen, Gerda E / West, Joe / Jepsen, Peter

Hepatology communications

2023 Volume 7, Issue 1, Page(s) e0013

Abstract: Background and aims: Observational studies have shown an association between statin or aspirin use and a decreased risk of HCC, but the effects of a well-defined treatment strategy remain unknown. We emulated trials of the effects of continuous statin ... ...

Abstract	Background and aims: Observational studies have shown an association between statin or aspirin use and a decreased risk of HCC, but the effects of a well-defined treatment strategy remain unknown. We emulated trials of the effects of continuous statin or aspirin use on HCC risk in patients with cirrhosis due to alcohol-related liver disease (ALD cirrhosis). Approach and results: We specified target trials for statins and, separately, aspirin and emulated them using Danish health care registries. All eligible patients with ALD cirrhosis diagnosed in 2000-2018 were included in either an exposed or an unexposed arm. Patients were followed until HCC or death without HCC. The 5-year risk of HCC was estimated using marginal structural models with inverse probability weighting. Using statins continuously for 5 years compared with not using statins resulted in a relative risk (RR) of HCC of 0.67 (95% CI: 0.45-0.91). The RR of death without HCC was 0.69 (95% CI: 0.65-0.77). For aspirin, the RR was 1.05 (95% CI: 0.60-1.42) for HCC and 1.02 (95% CI: 0.95-1.09) for death without HCC. Conclusions: In patients with ALD cirrhosis, 5 years of continuous statin use resulted in a 33% RR reduction of HCC (number needed to treat = 94) and a 31% RR reduction of death without HCC (number needed to treat = 7). Such strong causal effects are implausible and best explained by uncontrollable confounding, highlighting the need for randomized trials. Aspirin use likely does not affect the risk of HCC or death without HCC.
MeSH term(s)	Humans ; Aspirin/therapeutic use ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/prevention & control ; Carcinoma, Hepatocellular/chemically induced ; Liver Neoplasms/epidemiology ; Liver Neoplasms/prevention & control ; Liver Neoplasms/chemically induced ; Liver Cirrhosis, Alcoholic ; Liver Cirrhosis/complications ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/chemically induced ; Fibrosis
Chemical Substances	Aspirin (R16CO5Y76E) ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2023-01-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2471-254X
ISSN (online)	2471-254X
DOI	10.1097/HC9.0000000000000013
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Article ; Online: Cause-specific mortality in patients with alcohol-related liver disease in Denmark: a population-based study.

Kann, Anna Emilie / Jepsen, Peter / Madsen, Lone Galmstrup / West, Joe / Askgaard, Gro

The lancet. Gastroenterology & hepatology

2023 Volume 8, Issue 11, Page(s) 1028–1034

Abstract: Background: Increased knowledge of the causes of death will be essential to prevent premature death in alcohol-related liver disease. We examined cause-specific mortality, including death due to specific cancers, in the 15 years after diagnosis of ... ...

Abstract	Background: Increased knowledge of the causes of death will be essential to prevent premature death in alcohol-related liver disease. We examined cause-specific mortality, including death due to specific cancers, in the 15 years after diagnosis of alcohol-related liver disease. Methods: We used nationwide health registries to identify patients (aged ≥18 years) with a first diagnosis of alcohol-related liver disease between Jan 1, 2002, and Dec 31, 2017, in Denmark and followed up patients for their underlying cause of death up to Dec 31, 2019. We estimated the cause-specific mortality and investigated whether the cause-specific mortality differed by sex, age (<50, 50-59, and ≥60 years), alcohol-related liver disease severity at diagnosis (decompensated cirrhosis, compensated cirrhosis, alcoholic hepatitis, and steatosis or unspecified liver disease), and presence of diabetes. Findings: The study included 23 385 patients with incident alcohol-related liver disease. Patients had a median age of 58 years (IQR 51-65), 15 819 (68%) were men and 7566 (32%) were women, and 15 358 (66%) had cirrhosis. During 111 532 person-years of follow-up, 15 692 (67%) patients died. Liver disease was the leading cause of death. In the first 5 years after alcohol-related liver disease diagnosis, liver disease caused almost half of all deaths, and the 5-year risk of death due to liver disease was 25·8% (95% CI 25·3-26·4). Beyond 5 years, causes other than liver disease combined became more common; of these extrahepatic causes, cancer, cardiovascular disease, and alcohol use disorder were the most common. Hepatocellular carcinoma was the dominant cause of cancer death (10-year risk of 2·5%, 95% CI 2·3-2·7), followed by lung cancer (1·9%, 1·7-2·1). The 10-year risk of death due to liver disease (around 30%) was similar for patients in all age groups and independent of sex and diabetes but was three times higher for those with decompensated cirrhosis (46·7%, 44·8-48·4) than steatosis or unspecified liver disease (16·2%, 15·3-17·2). Interpretation: Patients diagnosed with alcohol-related liver disease were at high risk of dying from liver disease many years after diagnosis, irrespective of age and sex. Death due to specific cancers, including hepatocellular carcinoma, each contributed minimally to the total mortality in patients with alcohol-related liver disease. Funding: TrygFonden and the Novo Nordisk Foundation.
Language	English
Publishing date	2023-08-31
Publishing country	Netherlands
Document type	Journal Article
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(23)00192-9
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Article ; Online: Incidence and Survival in Patients With Enteropathy-associated T-Cell Lymphoma: Nationwide Registry Studies From England and Denmark.

West, Joe / Jepsen, Peter / Card, Timothy R / Crooks, Colin J / Bishton, Mark

Gastroenterology

2023 Volume 165, Issue 4, Page(s) 1064–1066.e3

MeSH term(s)	Humans ; Enteropathy-Associated T-Cell Lymphoma/epidemiology ; Enteropathy-Associated T-Cell Lymphoma/complications ; Incidence ; Registries ; England/epidemiology ; Denmark/epidemiology
Language	English
Publishing date	2023-06-09
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2023.06.003
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Article: Smoking is a Risk Factor for Autoimmune Hepatitis: An English Registry-Based Case-Control Study.

Grønbæk, Lisbet / Omeife, Harmony / Ban, Lu / Crooks, Colin J / Card, Timothy R / Jepsen, Peter / West, Joe

Clinical epidemiology

2024 Volume 16, Page(s) 23–30

Abstract: Purpose: Smoking is a risk factor for some autoimmune diseases, but its association with autoimmune hepatitis remains unknown. We conducted a population-based matched case-control study to examine the association between tobacco smoking and the risk of ... ...

Abstract	Purpose: Smoking is a risk factor for some autoimmune diseases, but its association with autoimmune hepatitis remains unknown. We conducted a population-based matched case-control study to examine the association between tobacco smoking and the risk of autoimmune hepatitis in England. Patients and methods: From the Clinical Practice Research Datalink and linked Hospital Episode Statistics, 2005-2017, we included 987 cases diagnosed with autoimmune hepatitis after age 18 years and up to 10 frequency-matched population controls per case. We used multiple logistic regression to estimate the odds ratio of autoimmune hepatitis in ever-smokers vs never-smokers, adjusting for sex, age, general practice, calendar time of registration with the general practice, and socioeconomic status. Results: The autoimmune hepatitis cases were more likely to be ever-smokers than the controls (44% vs 37%). The ever-smokers had an increased risk of autoimmune hepatitis compared with the never-smokers (adjusted odds ratio = 1.20, 95% confidence interval 1.03-1.39). Conclusion: Smoking was associated with an increased risk of autoimmune hepatitis.
Language	English
Publishing date	2024-01-31
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494772-6
ISSN	1179-1349
ISSN	1179-1349
DOI	10.2147/CLEP.S439219
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