Five-year cumulative incidence of smoking in adult Croatian population: the CroHort study

The aim of this paper is to investigate the incidence of smoking and changes in smoking habits in Croatia during a 5-year period. Data from the Croatian Adult Health Study of 2003 and 2008 was used for the study (N = 3229). The results of this study suggest that the incidence of smoking is the highest in youngest men and decreases with age. In ages 35 to 64 and older than 65 the incidence was higher in women than men. The cumulative smoking incidence is low in Croatia, but particularly alarming is a higher incidence in women than in men.     

Factors affecting the incidence of hypertension.

The incidence of hypertension was determined among 10,173 patients of general practices in southwestern Ontario studied from 1978 to 1982. For both sexes the incidence of hypertension rose with increasing age. The incidence was higher among men than among women until age 50, after which it was similar for the two sexes. Obesity was positively associated with incidence for both sexes. In men this association diminished significantly with increasing age. The similar trend in women fell just short of statistical significance. In men but not women heavy alcohol consumption was positively related to the incidence of hypertension. However, the broad definition of this variable may have obscured a relation in women. Among men the effect of obesity on the incidence of hypertension was less for heavy drinkers than for light drinkers. Smoking was not related to the incidence of hypertension in either sex.     

Insulin-like growth factor-2 genotype, fat-free mass, and muscle performance across the adult life span.

The influence of insulin-like growth factor-2 (IGF2) genotype on total body fat-free mass (FFM), muscle strength, and sustained power (SP) was evaluated repeatedly at approximately 2-yr intervals in two cohorts from the Baltimore Longitudinal Study of Aging. Cohort 1 was comprised of 94 men tested for isometric grip strength and SP. Cohort 2 was comprised of 246 men and 239 women tested for total body FFM and isokinetic peak torque. Subjects were retrospectively genotyped for the IGF2 gene's ApaI polymorphism. Differences between genotype groups for total FFM, strength, and SP at first visit, at peak age (35 yr), at age 65, and across the adult age span were analyzed using either two-sample t-tests or mixed-effects models, depending on the specific comparisons made. Isokinetic arm strength at the time of first visit was lower in A/A men than in G/G men (P < 0.05). Compared with G/G women, A/A women had lower total body FFM, lower isokinetic arm and leg strength at the time of first visit, and lower values at age 35 (all P < 0.05) for these muscle phenotypes. Furthermore, this difference between the genotype groups was maintained at age 65 and across the adult age span (P < 0.05). No genotype-associated differences in rates of loss of grip strength or SP were found in cohort 1. These results from cohort 2 support the hypothesis that variation within a gene known to influence developing muscle affects muscle mass and muscle function in later life.     

Declines in physiological functional capacity with age: a longitudinal study in peak swimming performance.

We followed up swimming performance times of 321 women and 319 men who participated in the US Masters Swimming Championships over a 12-yr period. All swimmers placed in the top 10 in their age group over 3 yr (mean = 5 yr). A random coefficients model for repeated measures was used to derive a line of best fit from a group of regression lines for each subject. Both 50- and 1,500-m swimming performance declined modestly until approximately 70 yr of age, where a more rapid decline was observed in both men and women. Compared with 1,500-m swimming, the 50-m freestyle declined more modestly and slowly with age. The rate and magnitude of declines in swimming performance with age were greater in women than in men in 50-m freestyle; such sex-related differences were not observed in 1,500-m freestyle. Overall, the variability along a population regression line increased markedly with advancing age. The present longitudinal findings indicate that 1) swimming performance declines progressively until age 70, where the decrease becomes quadratic; 2) the rates of the decline in swimming performance with age are greater in a long-duration than in a short-duration event, suggesting a relatively smaller loss of anaerobic muscular power with age compared with cardiovascular endurance; 3) the age-related rates of decline are greater in women than in men only in a short-duration event; and 4) the variability of the age-related decline in performance increases markedly with advancing age.     

UVA tanning is involved in the increased incidence of skin cancers in fair-skinned young women

Melanomas are the most prevalent cancers in 25–29 yr old females and compose roughly 12% of cancers in 20–40 yr old women; under the age of 40, women have a higher incidence of melanomas than do men. Within the past few decades, the alarming trend to use commercial sunlamps for cosmetic pigmentation is of particular concern, especially since 71% of those patrons are women with 50% of patrons under the age of 29. A major problem may be the use of UVA-rich sunlamps which produce a visible tan but afford little to no protection from subsequent UV exposure. We hypothesize that the additional exposure of adolescents to unnaturally large amounts of UVA from artificial UV sources is implicated in the increasing incidence of malignant melanomas disproportionately in young women.     

Is Difference in Body Weight,Antler Length,Age or Dominance Rank related to the Number of Fights between Fallow Deer (Dama dama)?

Competitive interactions between mature male fallow deer were investigated to determine whether antler length, body weight, age or dominance rank were related to the number of fights between individuals. Four different hypotheses were tested; the first predicted that body weight and antler length indicate individual quality and, therefore, as the difference between competitors in body weight and antler length increases, there should be a corresponding decrease in fight rate. The second and third hypotheses predicted that, as difference in dominance rank increased there would be a decrease in fight rate between males either, as a risk reduction measure or because of inhibitory control by dominant males. A fourth hypothesis predicted that, where dominance rank does not mediate fight rate, that similarity between contestants based on age might be important. If this is the case, then as the difference in age between competitors increased there should be a decrease in fight rate. Our results show that when dominance rank is controlled for, there was no relation between body weight, antler length or age with fight rate. There was a negative relation between dominance rank difference and fight rate, a result that supports both the risk reduction and inhibitory hypotheses. There was an increasing tendency to fight with closely ranked males as cohorts reached peak reproductive age; males aged 5 yr fought with other 5‐yr‐old males based on rank difference and males aged 6 yr fought with other males aged six and across all age groups based on rank difference. This trend was not observed in 4 or 7‐yr‐old males. Our results suggest that males in prime breeding condition limit potential costs of fighting (such as time and energy) by only interacting with other males of similar rank.     

Compensatory muscle fiber hypertrophy in elderly men.

Muscle strength and muscle morphology have been studied three times during a period of 11 yr in nine elderly men. On the last occasion the average age was 80.4 (range 79-82) yr. Body cell mass decreased by 6% and muscle strength for knee extension, measured by means of isometric and concentric isokinetic (30-60 degrees/s) recordings, declined by 25-35% over the 11-yr period. Between 76 and 80 yr of age only the isokinetic strength for 30 degrees/s decreased significantly. Muscle fiber composition in the vastus lateralis did not change between 69 and 76 yr of age, but there was a significant reduction in the proportion of type IIb fibers from 76 to 80 yr. The decrease in type II fiber areas was not significant between 69 and 76 yr of age (as in a larger sample from the same population), but a significant increase in both type I and type II fiber areas was recorded from 76 to 80 yr of age and biceps brachii showed similar tendencies. In the same period, the enzymatic activities of myokinase and lactate dehydrogenase subsided in the vastus lateralis, but there was no change for triose phosphate dehydrogenase, 3-hydroxy-CoA-dehydrogenase, and citrate synthase. The muscle fiber hypertrophy in this group of elderly men with maintained physical activity between 76 and 80 yr of age is interpreted as a compensatory adaptation for the loss of motor units. In addition, the adaptation with respect to oxidative capacities seems to be maintained at this age.     

Age and gender interactions in physiological functional capacity: insight from swimming performance

Tanaka, Hirofumi, and Douglas R. Seals. Age and genderinteractions in physiological functional capacity: insight from swimming performance. J. Appl.Physiol. 82(3): 846-851, 1997.One experimentalapproach to studying the effects of aging on physiological functionalcapacity in humans is to analyze the peak exercise performance ofhighly trained athletes with increasing age. To gain insight into therelationships among age, gender, and exercise task duration with use ofthis model, we performed a 5-yr (1991-1995) retrospective analysisof top freestyle performance times from the US Masters SwimmingChampionships. Regression analysis showed that in both men and womenendurance swimming performance (i.e., 1,500 m) declined linearly frompeak levels at age 35-40 yr until ~70 yr of age, whereuponperformance declined exponentially thereafter. In both genders, thevariability among the top 10 winning times in each 5-yr age intervalincreased markedly with advancing age. Compared with the 1,500-mfreestyle, performance in the 50-m freestyle (short-duration task)showed only a modest decline until ages 75 and 80 yr in women and men,respectively. The rate and magnitude of the declines in both short- andlong-duration swimming performance with age were significantly(P < 0.05) greater in women than in men. In the women, the percent decline in swimming performance over a50-yr age period from the 19- to 24-yr to the 69- to 74-yr age groupsbecame progressively greater from the shortest distance (50 m) to thetwo longest distances (800 and 1,500 m), whereas in men, no differenceswere observed in the magnitude of performance decline with age amongthe five longest distance events (i.e., 100-1,500 m). The percentgender difference in performance throughout the age range studiedbecame progressively smaller (P < 0.05) with increasing distance from 50 m (19 ± 1%) to 1,500 m (11 ± 1%). The findings in this cross-sectional study indicate that from peak levels at age 35-40 yr, physiological functionalcapacity, as assessed by swimming performance, decreases linearly until ~70-80 yr of age, whereupon the decline becomes exponential.Moreover, the rate of decline with advancing age appears to beassociated with event duration and gender.

     

Effects of moderate-velocity strength training on peak muscle power and movement velocity: do women respond differently than men?

The effects of a 10-wk unilateral knee extension strength training (ST) program on peak power (PP) and peak movement velocity (PV), at given absolute (force load) and relative (same % of 1 repetition maximum) resistances (loads), were examined in 30 older men [64 yr (7 SD)] and 32 older women [62 yr (6 SD)]. PP increased significantly in both men and women at the same absolute (P < 0.001) and relative loads (P < 0.01) with ST. Men had a significantly greater increase in relative PP than women with ST at 60% (P < 0.01) and 70% (P < 0.001) of 1 repetition maximum when covarying for baseline differences and age. However, when each subject was tested at the same absolute load and when PP was normalized for the muscle volume of the trained knee extensors (i.e., absolute muscle power quality), women increased by 9% (P < 0.05), whereas men did not change. Both men and women increased their absolute PV (P < 0.001) but decreased their relative PV significantly with ST (P < 0.05). However, when baseline values and age were covaried, women had significantly less of a decrease in relative PV quality with ST than men (P < 0.01), although the difference was small. These normalized data suggest that ST-induced increases in PP depend on muscular hypertrophy in men, but not in women, providing further support for the hypothesis developed from our previous report (Ivey FM, Tracy BL, Lemmer JT, NessAiver M, Metter EJ, Fozard JL and Hurley BF. J Gerontol A Biol Sci Med Sci 55: B152-B157, 2000) that improvements in muscle function with ST result from nonmuscle mass adaptations to a greater extent in women than men.     

Secular trends in incidence and mortality of bladder cancer in China, 1990–2017: A joinpoint and age-period-cohort analysis

BackgroundBladder cancer is closely related to occupational carcinogens, and China is undergoing a rapid industrialization. However, trend of bladder cancer incidence and mortality remains unknown in China.MethodsIncidence and mortality rates of bladder cancer (1990–2017) were collected for each 5-year age group stratified by gender (males/females) from the Global Burden of Disease (GBD) 2017 study. The average annual percentage change (AAPC) of rates were analyzed by joinpoint regression analysis; age, period and cohort effects on incidence and mortality were simultaneously estimated by age-period-cohort model.ResultsThrough 1990–2017, age-standardized incidence rates significantly rose in men (AAPC = 0.72%, 95% CI: 0.5%, 0.9%) while decreased in women (-1.25%: -1.6%, -0.9%); age-standardized mortality rates decreased in both men (-1.09%: -1.2%, -0.9%) and women (-2.48%: -2.8%, -2.2%). The joinpoint regression analysis showed the mortality almost decreased in all age groups; while the incidence increased in men for older age groups (from 45 to 49 to 80–84). Moreover, age effect showed the incidence and mortality increased with age; the incidence and mortality increased with time period, while in women period effect stop decreasing and began to increase since 2007; cohort effect showed them decreased with birth cohorts.ConclusionsThe incidence of bladder cancer is increasing in men but mortality decreases in both sexes. Both the incidence and mortality in men substantially increase with age and period, while the rates in women increased with period since 2007. The period effect may indicate the increased risks to bladder cancer in Chinese men. Etiological studies are needed to identify the factors driving these trends of bladder cancer.     

Young Bighorn (Ovis canadensis) Males: can they Successfully Woo Females?

Mating by young males or low male‐to‐female ratios can decrease pregnancy rates and postpone birthdates in ungulates, thereby hindering population growth. Young (2.5–3.5 yr old) male bighorn (Ovis canadensis) behave differently than older males, and age, horn size, mating behavior, and social rank help determine reproductive success. We estimated birthdates in two populations of bighorn sheep in Utah, USA, to determine if mating by young males or low male‐to‐female ratios resulted in fewer young born per female, a shift in mean timing of births, or asynchronous births. When reintroduced, the Rock Canyon population consisted of four males (two each of 2.5 yr old and 1.5 yr old) and a 1 to 7.5 ratio of males (>2 yr old) to adult females (≥3.5 yr old); the Mount Nebo population consisted of four males ≤1.5 yr old and a 0 to 12 ratio of males to adult females. For both populations, the number of young born per female did not differ between the first parturition period after reintroduction (where females were impregnated by males from their source populations) and the second period of parturition (where females were impregnated by young, reintroduced males). Mean birthdates and synchrony (SD) of births did not differ for Rock Canyon (May 12, 2001 ± 4.5 d, May 14, 2002 ± 3.2 d) or Mount Nebo (May 23, 2005 ± 8.1 d, May 22, 2006 ± 10.2 d) between the first and second years following reintroduction. Mating by young males or low male‐to‐female ratios had no demonstrable effect on the number of young born per female or timing and synchrony of births in these populations.     

Lipid oxidation in fit young adults during postexercise recovery.

To evaluate the hypothesis that lipid oxidation predominates in postexercise recovery, we examined healthy men (n = 6; age = 21.2 +/- 0.6 yr) and women (n = 6; age = 22.8 +/- 2.1 yr) during and after two exercise tasks [89 min at 45% and 60 min at 65% of peak rate of oxygen consumption (V(O2 peak))] as well as a time-matched resting control trial (Con). Exercise bouts were matched for energy expenditure. Respiratory exchange ratios (RER) during exercise at 65% V(O2 peak) for both men and women (0.95 +/- 0.01 and 0.93 +/- 0.02) were significantly higher than 45% V(O2 peak) (0.89 +/- 0.01 and 0.86 +/- 0.02) and Con trials (0.86 +/- 0.01 and 0.86 +/- 0.02, respectively). During recovery, for men RER values were 0.78 +/- 0.01 and 0.76 +/- 0.01 after 45% and 65% exercise, respectively. For women, values were 0.79 +/- 0.01 and 0.78 +/- 0.01. These were significantly lower than during both the preexercise resting period and the corresponding no-exercise Con period (0.82 +/- 0.01 and 0.83 +/- 0.01, mean RER for men and women, respectively). Hence, the contribution of lipid oxidation to energy supply increased significantly during recovery compared with preexercise levels, and it was greater after exercise than during the time-matched, no-exercise Con period. It is concluded that, although carbohydrate is the major fuel source during moderate- to high-intensity exercise, 1) there is substantial postexercise lipid oxidation; and 2) lipid oxidation is the same during postexercise recovery whether the relative power output is 45% or 65% of V(O2 peak) when energy expenditure of exercise is matched.     

Age-related changes of vertebral bone mineral density in Russian population]

Vertebral trabecular bone mineral density (BMD) was measured by quantitative computed tomography (QCT) in 1061 subjects (610 females and 451 males aged from 7 to 91 and from 12 to 89, respectively) with known history of diseases or taking medicines affecting bone metabolism. Peak BMD values in our patients were observed at the age of 20-29 years with further gradual decrement in men and more steep in women. Negative relationship between BMD and age was r = -0.991 for men and r = -0.968 for women. Analyzing BMD changes by decades we observed the largest decrement in men after 60 (13.1% for 60-69 and 14.1% for 70-79 years of age) and in women after 50 (22.5% for 50-59, 22.1% for 60-69 and 20.8% for 70-79 years) which was most probably due to decline in sex hormones production that is known to significantly influence bone metabolism. This was confirmed by BMD values three-phase approximation in women showing the lowest rate of calcium loss by trabecular bone in reproductive period (1.9 mg/cm3/yr) and the highest in perimenopause (3.98 mg/cm3/yr). Annual calcium loss in postmenopause was 2.22 mg/cm3.     

Cancer incidence in Nigeria: A report from population-based cancer registries

Introduction: Cancer has become a major source of morbidity and mortality globally. Despite the threat that cancer poses to public health in sub-Saharan Africa (SSA), few countries in this region have data on cancer incidence. In this paper, we present estimates of cancer incidence in Nigeria based on data from 2 population-based cancer registries (PBCR) that are part of the Nigerian national cancer registry program. Materials and methods: We analyzed data from 2 population based cancer registries in Nigeria, the Ibadan Population Based Cancer Registry (IBCR) and the Abuja Population Based Cancer Registry (ABCR) covering a 2 year period 2009-2010. Data are reported by registry, gender and in age groups. We present data on the age specific incidence rates of all invasive cancers and report age standardized rates of the most common cancers stratified by gender in both registries. Results: The age standardized incidence rate for all invasive cancers from the IBCR was 66.4 per 100000 men and 130.6 per 100000 women. In ABCR it was 58.3 per 100000 for men and 138.6 per 100000 for women. A total of 3393 cancer cases were reported by the IBCR. Of these cases, 34% (1155) were seen among males and 66% (2238) in females. In Abuja over the same period, 1128 invasive cancers were reported. 33.6% (389) of these cases were in males and 66.4% (768) in females. Mean age of diagnosis of all cancers in men for Ibadan and Abuja were 51.1 and 49.9 years respectively. For women, mean age of diagnosis of all cancers in Ibadan and Abuja were 49.1 and 45.4 respectively. Breast and cervical cancer were the commonest cancers among women and prostate cancer the most common among men. Breast cancer age standardized incidence rate (ASR) at the IBCR was 52.0 per 100000 in IBCR and 64.6 per 100000 in ABCR. Cervical cancer ASR at the IBCR was 36.0 per 100000 and 30.3 per 100000 at the ABCR. The observed differences in incidence rates of breast, cervical and prostate cancer between Ibadan and Abuja, were not statistically significant. Conclusion: Cancer incidence data from two population based cancer registries in Nigeria suggests substantial increase in incidence of breast cancer in recent times. This paper highlights the need for high quality regional cancer registries in Nigeria and other SSA countries.     

Effects of age and gender on finger coordination in MVC and submaximal force-matching tasks.

The objective of the study is to examine the effects of age and gender on finger coordination. Twelve young (24 +/- 8 yr; 6 men and 6 women) and 12 elderly (75 +/- 5 yr; 6 men and 6 women) subjects performed single-finger maximal contraction [maximal voluntary contraction (MVC)], four-finger MVC, and four-finger ramp force production tasks by pressing on individual force transducers. A drop in the force of individual fingers during four-finger MVC tasks compared with single-finger MVC tasks (force deficit) was larger, whereas unintended force production by other fingers during single-finger MVC tasks (enslaving) was smaller, in elderly than in young subjects and in women than in men. Force deficit was smaller and enslaving was larger in subjects with higher peak force. During the ramp task, the difference between the variance of total force and the sum of variances of individual forces showed a logarithmic relation to the level of total force, across all subject groups. These findings suggest that indexes of finger coordination scale with force-generating capabilities across gender and age groups.     

Blood Pressure Measurement under Within-Visit Conditions in Normotensive Volunteers

The dynamics of mean values and blood pressure (BP) variability were studied under within-visit conditions in normotensive subjects. The study involved 104 volunteers aged 20 to 65 years (46 men and 58 women) without the history of hypertension. Nine repeated BP measurements were performed within 35 min in a summer period to determine the final time for the BP decrease, i.e., for the “stabilization” of BP within one visit, and the within-visit BP variability (WVV) expressed as the standard deviation (SD) and the coefficient of variation (CV). The tenth measurement of BP was conducted to assess the effect of physical activity after a 5-min walk followed by a 5-min seated position. In order to study the effect of seasons on the BP variation, 32 volunteers were examined in winter (January–February) and in summer (June–July) of the same year. The within-visit BP in normotensive subjects was characterized by two aspects. The first one associated with a decrease in systolic BP (SBP) and diastolic BP (DBP), on average, by 7 mmHg and up to 2 mmHg, respectively, ended by the 25th minute and was followed by the period of conventional stabilization in mean values. The following two periods were observed in the SBP decrease: a 5-min rapid decrease (1 mmHg/min) and a 20-min slow decrease (0.1 mmHg/min). The dynamics of mean SBP values depended on gender and age. The second aspect is the individual SBP variability, which continued against the stabilization of mean values. The CV of 35-min SBP reached, on average, 4% and was higher in women compared with men. SD was higher in the older age group. The maximum variability was observed within the first 5 min under the investigation. Then, in the periods of slow decrease and stabilization, the variability did not change significantly (not exceeding 3%, on average), despite a significant decrease in the mean SBP values. During a rapid SBP decrease neither of variability indices depended on gender or age. The SD of SBP during the slow decrease and stabilization was higher in the older female group than in the young women, not differing in men of both age categories. After 5 min of rest in a seated position, the consequences of walking for BP were insignificant in normotensive subjects. The dynamics of SBP did not differ in summer and winter of the same year.     

Sex difference in sleep-time preference and sleep need: a cross-sectional survey among Italian pre-adolescents, adolescents, and adults

The aim of this study was to examine sex differences in sleep-time preference by age among Italian pre-adolescents, adolescents, and adults. The final sample consisted of 8,972 participants (5,367 females and 3,605 males) from 10 to 87 yrs of age. To assess preferred sleep habits, we considered the answers to the open-ended questions of the Morningness-Eveningness Questionnaire (MEQ). In agreement with previous studies, we found that sleep-time preference started to shift toward eveningness from the age of 13 yrs. Females reached their peak in eveningness earlier (about 17 yrs of age) than males (about 21 yrs of age). Thereafter, the ideal sleep-time preference advanced in men and women with increasing age. Females presented a more significant advanced sleep phase than males only during the years when sexual hormones are typically active. Moreover, females reported a longer ideal sleep duration than males across all age groups examined, except in over 55 yrs one.     

Gender difference in antidiuretic response to desmopressin

Increased age and female gender are well-known risk factors for the development of desmopressin-induced hyponatremia. However, little focus has been on exploring gender differences in the antidiuretic response to desmopressin. Based on an exploratory analysis from three clinical trials, we report a significant gender difference in the effects of desmopressin on nocturnal urine volume that could not be explained by pharmacokinetic differences. Mean desmopressin concentration profiles were tested for covariates, and age and gender were not statistically significant and only weight was significant for log(C(max)) (P = 0.0183) and borderline significant for log(AUC) (P = 0.0571). The decrease in nocturnal urine volume in nocturia patients treated with desmopressin over 28 days was significantly larger for women at the lower desmopressin melt doses of 10 and 25 μg than for men. The ED(50) for men was modeled to be 43.2 μg and 16.1 μg for women, with the ED(50) men/women estimated to be 2.7 (1.3-8.1 95% CI), corresponding to significantly higher sensitivity to desmopressin in women. An increasing incidence of hyponatremia with increasing dose was found, and at the highest dose level of 100 μg decreases in serum sodium were approximately twofold greater in women over 50 yr of age than in men. A new dose recommendation stratified by gender is suggested in the treatment of nocturia: for men, 50- to 100-μg melt is an efficacious and safe dose, while for women a dose of 25 μg melt is recommended as efficacious with no observed incidences of hyponatremia. Areas for further research are proposed to uncover pathophysiological mechanism(s) behind these gender differences.     

Influence of aging on the in vivo properties of human patellar tendon

Tendons are important for optimal muscle force transfer to bone and play a key role in functional ability. Changes in tendon properties with aging could contribute to declines in physical function commonly associated with aging. We investigated the in vivo mechanical properties of the patellar tendon in 37 men and women [11 young (27 +/- 1 yr) and 26 old (65 +/- 1 yr)] using ultrasonography and magnetic resonance imaging (MRI). Patella displacement relative to the tibia was monitored with ultrasonography during ramped isometric contractions of the knee extensors, and MRI was used to determine tendon cross-sectional area (CSA) and signal intensity. At peak force, patellar tendon deformation, stress, and strain were 13 (P = 0.05), 19, and 12% less in old compared with young (P < 0.05). Additionally, deformation, stiffness, stress, CSA, and length were 18, 35, 41, 28, and 11% greater (P < 0.05), respectively, in men compared with women. After normalization of mechanical properties to a common force, no age differences were apparent; however, stress and strain were 26 and 22% higher, respectively, in women compared with men (P < 0.05). CSA and signal intensity decreased 12 and 24%, respectively, with aging (P < 0.05) in the midregion of the tendon. These data suggest that differences in patellar tendon in vivo mechanical properties with aging are more related to force output rather than an age effect. In contrast, the decrease in signal intensity indirectly suggests that the internal milieu of the tendon is altered with aging; however, the physiological and functional consequence of this finding requires further study.     

Trends in incidence and survival from anal cancer and incidence of high-grade anal intraepithelial neoplasia in Denmark

ObjectiveThe aim of the current study was to assess temporal trends in incidence of anal squamous cell carcinomas (SCC) and high-grade anal intraepithelial lesions (AIN2/3), and estimate survival from anal cancer and factors related to 5-year mortality in Denmark.MethodsWe analyzed anal SCC and AIN2/3 cases in the period of 1998–2018 from the Danish Cancer Register and the Danish Registry of Pathology, respectively. Overall, period, gender, and histology specific age-standardized incidence rates, average annual percentage change (AAPC), and 5-year relative survival were estimated. Cox proportional hazards models were applied to evaluate the effect on 5-year mortality of period, age, gender, and stage of disease.ResultsAltogether 2580 anal cancers and 871 AIN2/3 were identified. The AIN2/3 incidence increased for women 1998–2007 (AAPC: 3.5% (95% CI −0.7, 8.0)) and then tended to decrease during 2008–2018(AAPC: −5.2% (95% CI −9.6, −0.6)). A similar pattern was observed for men, although at a lower incidence with the decrease starting later (2008–2012) and the trend not reaching statistical significance. The anal SCC incidence increased over the whole study period for both women and men (women AAPC: 4.0% (95% CI 3.2%, 4.9%) and men AAPC: 3.6% (95% CI 2.3%, 4.9%)). The relative survival improved over time (from 61% to 72%). Being older and male was associated with a higher risk of dying within 5 years.ConclusionsThere is a need to focus attention on anal cancer and its precursor lesions, as the cancer incidence continues to increase. Actions could include screening and gender-neutral HPV vaccination.