Christian Vutuc

Time trends of the prevalence of asthma and allergic disease in Austrian children

After a substantial increase in the prevalence of atopic disease in Europe, recent studies indicate that a plateau has been reached. However, variation across countries and age groups exists. We studied the prevalence and time trends of asthma and allergic disease among schoolchildren in Austria, a country with traditionally low rates of asthma, hay fever, and eczema. As part of the International Study of Asthma and Allergies in Childhood (ISAAC), symptoms and physician diagnoses of asthma and allergic disease of 13,399 Austrian children aged 6–7 yr and 1516 children aged 12–14 yr were surveyed between 1995 and 1997. A similar survey was conducted between 2001 and 2003. Among children aged 6–7 yr, significant increases were seen in the prevalence of physician‐diagnosed asthma (+16%; p = 0.013), hay fever (+22%; p < 0.001), and eczema (+37%; p < 0.001) between 1995 and 2003. These changes were paralleled by an increase in the prevalence of symptoms typical for hay fever (itchy eyes and runny nose), but not by an increase in wheeze. Among children aged 12–14 yr, the lifetime prevalence of diagnosed asthma increased by 32%, of hay fever by 19%, and of eczema by 28% (all, p < 0.001). These changes were paralleled by increases in the prevalence of wheezing as documented by both questions before and after a video showing wheezing children but not by symptoms typical for hay fever such as itchy eyes and runny nose. In conclusion, in Austria, contrary to other European countries, the prevalence of asthma and allergic disease increased among schoolchildren. Additional studies are needed to continue monitoring the dynamics of the prevalence of asthma and allergic disease in Austria and to explore trends in their risk factors.

Breaking bad news to cancer patients: survey and analysis.

Purpose: To find out how patients perceived the disclosure of news about their cancer as regards the physician counselling and how they perceived the flow of information between hospital‐based and family physicians.

Breast cancer trends: opportunistic screening in Austria versus controlled screening in Finland and Sweden.

The objective of the study was to compare the trends of incidence and of mortality of breast cancer in Austria, Finland and Sweden, where different mammography screening strategies (opportunistic versus controlled) are applied. Furthermore, to find out whether a change in screening strategies would be feasible for Austria. Age-standardized incidence rates (1983–2000) and mortality rates (1980–2001/2) were analysed. Furthermore, the annual per cent change and the annual rate change (annual rate change=±n/100 000 per year) and the 95% confidence interval were calculated. In all three countries, incidence rates increased significantly (Austria +26.4%, Finland +86.7%, Sweden +38.8%) during the period analysed (P<0.01). The annual per cent change and the annual rate change in Austria (1.57 and 1.56, respectively) are below the annual per cent change and the annual rate change in Finland (3.38 and 3.49, respectively) and in Sweden (1.80 and 2.19, respectively) for the period analysed. Total breast cancer mortality decreased significantly in Sweden since 1980 (−20.5%, P<0.01), in Finland since 1988 (−18.3%, P<0.05) and in Austria since 1990 (−19.8%, P<0.01). The annual per cent change and the annual rate change in Austria (−1.81 and −0.59, respectively) are below the annual per cent change and the annual rate change in Finland (−0.57 and −0.16, respectively) and in Sweden (−1.02 and −0.28, respectively) for the period analysed. In conclusion, despite its unsophisticated opportunistic screening, Austria does well in comparison with countries operating organized breast cancer screenings.

Self-reported prostate cancer screening in Austria

Objectives: The prevalence of self-reported participation and frequency of prostate cancer screening (digital rectal examination (DRE), prostate-specific antigen (PSA)) in Austrian men aged 40–79 years in the year 2005 is reported. Methods: In a population-based cross-sectional study, a representative sample of 500 men was asked whether they ever had heard of early detection of prostate cancer by DRE or PSA test and, if so, whether they had ever had a prostate cancer screening test during their life, and if so the number of tests and the type of physician. Results: Overall, the prevalence of self-reported prostate cancer screening was 55.8% (23.7% DRE only). The highest prevalence was observed in the age group of 60–69 years with 68.8% (28.1% DRE only). The highest prevalence of PSA tests was observed in the age group 70–79 years (40.9%). About 75% of the screening tests were performed by urologists. Conclusions: More than half of the target population (men aged 40–79 years) have had at least one prostate cancer screening test. Nearly one-third of men have already had one or more PSA tests. One-fifth of the PSA tests were requested by general practitioners or internists.

Complementary therapies in cancer patients: prevalence and patients' motives

ZusammenfassungHintergrundAus einer Reihe europäischer Länder sind Daten hinsichtlich der Inanspruchnahme komplementärmedizinischer Methoden durch onkologische Patienten bekannt. Für Österreich liegen keine aktuellen Daten zu dieser Fragestellung vor.ZielIn Erfahrung zu bringen, wie verbreitet der Einsatz komplementärer Behandlungsmethoden ist. aufgrund welcher Motive Krebspatienten diese anwenden, welche Methoden eingesetzt werden und wer die Behandler sind.StudiendesignQuerschnittsstudie.Patienten und Methode231 Patienten, welche die Wiener Krebshilfe aufsuchten, wurden mittels Fragebogen exploriert. Die statistische Auswertung erfolgte mittels Chi-Quadrat- und Mantel-Haenszel-Test.Ergebnisse27,3% hatten eine komplementäre Therapie erhalten. Das waren 33,1% aller weiblichen und 20,5% aller männlichen Krebspatienten (p=0,045). Jene Patienten, die unter dem Median der Altersverteilung (53,8 Jahre) lagen, hatten statistisch signifikant häufiger komplementäre Methoden in Anspruch genommen (35,5% vs. 21,1%; p=0,023). Die wichtigsten Motive waren „Unterstützung der natürlichen Heilung” und Empfehlung durch den Hausarzt. Komplementäre Methoden wurden in 44,4% vom Hausarzt, in 39,7% von den Patienten selber, in 6,3% vom einem Spitalsarzt, in 6,3% „vom medizinischen Laien oder Heilpraktiker gegen Entgelt” und in 4,8% vom niedergelassenen Facharzt angewandt.SchlussfolgerungenAufgrund des hohe Prozentsatzes von Krebspatienten, die komplementäre Methoden ohne Konsultation eines Arztes anwenden oder dies aufgrund der Empfehlung anderer tun, erscheint es wahrscheinlich, dass deren Einsatz häufig nicht mit der konventionellen onkologischen Therapie abgestimmt ist. Um dem abzuhelfen, sollten Onkologen und Allgemeinärzte grundlegende Kenntnisse der Komplementärmedizin und ihrer Methoden haben. Bei der Patientenberatung sollte die Frage der Anwendung komplementärer Methoden angesprochen werden.SummaryBackgroundData relating to the use of complementary/alternative medicine (CAM) in cancer patients have been published for a number of European countries. No recent data are available for Austria.AimTo ascertain the extent of CAM use by cancer patients, what patients’ motives are, what methods are used and who the CAM providers are.DesignSelf-administered questionnaire; cross-sectional study.Patients and methodsA sample of 231 cancer patients who had consulted the Viennese Cancer League. Chi-square and Mantel-Haenszel tests were used for the statistical evaluation.Results27.3% of the cancer patients had received CAM therapy: 33.1% of the female and 20.5% of the male participants (p=0.045). Those who were below the median of the age categories (53.8 years) had used CAM to a statistically higher degree (35.5% vs. 21.1%; p=0.023). The most important motives were the enhancement of “nature” and the GPs’ recommendation. CAM was administered in 44.4% of cases by the family doctor, in 39.7% by patients themselves, in 6.3% by a hospital doctor, in 6.3% by a lay-practitioner or “non-medical practitioner against payment” and in 4.8% of cases by a practising oncologist.ConclusionFrom the high percentage of patients who use CAM without consulting a physician or who follow the advice of others, it would seem highly probable that conventional and complementary methods are rarely effectively coordinated. To rectify this we conclude that oncologists and GPs should have a basic knowledge of CAM and address the issue when counselling their cancer patients.

Lung cancer risk in women in relation to tar yields of cigarettes

Abstract Of 297 female lung cancer patients studied, 188 or 63% were cigarette smokers, significantly ( P R = 1.5, for group II-type cigarettes (15–24 mg tar/cig.) R = 2.7 ( P 24 mg tar/cig.) R = 6.3. The risks for smokers who had smoked primarily cigarettes belonging to groups I, II, and III were R = 2.6, R = 4.4 ( P R = 8.9 ( P

Survival in a cohort of patients with haemophilia at the haemophilia care center in Vienna, Austria, from 1983 to 2006.

Summary.  Survival of patients with haemophilia is still a relevant issue of great interest. A survival analysis was conducted among 226 patients with haemophilia A and B (128 severe haemophiliacs), who were treated at the haemophilia care centre in Vienna. Information on mortality in our patient cohort was obtained from the Austrian Central Death Register. Overall, 96 of a total of 226 patients (42.5%) died between 1983 and 2006; 37 patients (38.5%) died due to HIV‐infection, 15 due to HCV infection, 15 due to bleeding (15.6%, respectively) and 29 (30.2%) due to various other causes. The mortality of HIV‐positive patients was 74.3% (n = 55) and that of HCV‐positive patients was 40.4% (n = 55) in the analysed period. The patient mortality rates were compared with those of the general Austrian male population following adjustment for age and calendar period. We found that the cumulative relative survival of all patients was 0.694 (95% CI 0.614–0.767). The cumulative relative survival of patients with severe haemophilia (FVIII or IX level ≤1%) was 0.489 (0.394–0.579), but was normal (0.986; 95% CI 0.858–1.082) for patients with mild or moderate haemophilia (FVIII or IX level 2–50%). The survival rate was lowest in HIV‐positive patients (0.287; 95% CI 0.186–0.398), but was also decreased to 0.874 (0.776–0.951) in HIV‐negative patients. It can, therefore, be concluded that the survival of patients with severe haemophilia is still decreased compared to those with non‐severe haemophilia and the general male population, regardless of HIV‐infection.

Attitudes About the Use of Complementary and Alternative Medicine in Cancer Treatment

OBJECTIVES The aim of this study was to achieve an understanding what determines the attitude of people toward complementary and alternative medicine (CAM) is essential in decisions about costly therapies in cancer treatment. DESIGN This study involved population-based surveys conducted in 1995 and 2005. SETTING In 1995 and 2005, a quota sample of 2400 Austrians ages > or =15 was selected and invited in writing to participate in a survey to study beliefs and attitudes about cancer, its risk factors, and treatment. The sample comprised 0.04% of the population > or =15 years of age and was representative in terms of age, sex, occupational status, and area of residence. SUBJECTS The subjects included 4073 Austrian adults (2073 participants enrolled in the 1995 survey and 2000 participants of the 2005 survey). INTERVENTION Respondents were visited in their homes by trained interviewers. The interview was face-to-face, using a standardized questionnaire. OUTCOME MEASURES We used a dichotomized variable as the outcome, placing high value on CAM (rated as 1 or 2 on a 5-level Likert scale) versus everything else (rated 3-5). RESULTS Positive personal experiences with people cured of cancer improved the likelihood of a positive perception of CAM (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.17-1.59 for those who reported knowing someone who was cured of cancer, compared to those who did not). In multivariate models adjusting for personal attitude toward mainstream medicine, subjects with more formal education were also more likely to believe that CAM is valuable (OR, 1.28; 95% CI, 1.02-1.61), as were women (OR, 1.40; 95% CI, 1.20-1.64) and people ages 70 and above (OR, 1.46; 95% CI, 1.02-2.08). A higher appreciation of mainstream medicine was inversely associated with the value placed on CAM in cancer therapy (OR, 0.43; 95% CI, 0.22-0.85). CONCLUSIONS In this, to our knowledge, the first study to evaluate predictors of CAM preference in cancer treatment in a national probability sample, we found more formal education, female gender, and older age to be the strongest predictors of a person favoring CAM therapy in cancer treatment. Our data also suggest that people who are satisfied with conventional care were less inclined to value CAM, whereas a positive personal experience with cancer cures improved positive perception of CAM.

Austrian women's attitudes toward and knowledge of breast self-examination

BACKGROUND Education of women to perform breast self-examination is a main objective of cancer societies worldwide. METHODS By means of a questionnaire, 975 healthy women in an Austria-wide population-based cross-sectional study were asked about their knowledge of breast self-examination (BSE) and mammography, and their cancer histories. RESULTS 92% of the women knew BSE but only 31% practiced it thoroughly. Women living in rural communities with a life companion and younger women were more likely to practice BSE. Women who had family histories of cancer, especially older women, performed BSE significantly more often. There was a trend towards increasing BSE with increasing personal perception of the risk of cancer, especially among older women. The study showed a positive association between BSE and screening mammography. CONCLUSIONS Although knowledge of BSE is widespread, it is actually practiced by only one third of women. Older women but not young women carry out BSE significantly more often when they have family histories of cancer. Information campaigns should target specific groups and emphasize the effectiveness of properly done BSE.

Self-reported colonoscopy screening in Austria.

In Austria, since the early 1980s, the faecal-occult blood test is freely available within the annual health check-up system (≥40 years of age/once a year). Since 2005 colonoscopy is recommended by the health authorities as a primary screening tool for asymptomatic persons older than 50 years (every 7–10 years). We report on the prevalence of self-reported participation and frequency of colonoscopy screening in Austrian men and women aged 40–79 years. The data analysed were extracted from a nationwide population-based cross-sectional study conducted in 2005. The study population consisted of 502 men and 553 women, which then was analysed by 10-year age groups. The questionnaire explicitly asked about a screening colonoscopy in asymptomatic persons and not for diagnostic examination in patients with symptoms. The survey revealed that of men 79.1% (n=397) knew about early detection of colorectal cancer in asymptomatic persons by screening colonoscopy and of women 82.1% (n=454). Of the 502 male respondents, 24.5% (n=123) were screened at least once and 9.8% were screened twice or more. Of the 553 female respondents, 23.7% (n=131) were screened at least once and 8.0% were screened twice or more often. The main location of colonoscopy screening was the hospital (men: 65.1%, women: 74.8%). Approximately a quarter of the respondents reported having had at least one screening colonoscopy. Compared with mammography screening (82%) and prostate cancer screening by digital rectal examination alone or combined with a prostate-specific antigen test (56%) the participation is low.