Marit Bragelien Veierød

• Robsahm, Trude Eid; Skog, Anna; Veierød, Marit Bragelien; Roscher, Ingrid; Brevig, Trine & Ghiasvand, Reza [Show all 7 contributors for this article] (2026). Nationwide study of cutaneous basal cell carcinoma incidence trends in Norway, 2012–2022. Cancer Epidemiology. ISSN 1877-7821. 105. doi: 10.1016/j.canep.2026.103210.
• Giorcelli, Anastasia; Valberg, Morten; Green, Adele C.; Veierød, Marit Bragelien; Costa, Denise Reis & Gran, Jon Michael [Show all 11 contributors for this article] (2026). Risk of recurrence of stage I to III melanoma in Norway, 2008–2022. European Journal of Cancer. ISSN 0959-8049. 245. doi: 10.1016/j.ejca.2026.116940. Full text in Research Archive
• Moro, Ornella; Schopf, Thomas Roger Griesbeck; Veierød, Marit Bragelien & Sebastiani, Giovanni (2026). Temporal trends in the probability of melanoma diagnosis in four Nordic countries, 1973-1999. Cancer Causes and Control. ISSN 0957-5243. 37(6). doi: 10.1007/s10552-026-02181-w. Full text in Research Archive
• Perrier, Flavie; Ahimbisibwe, Ashley; Valberg, Morten; Green, Adele C.; Ghiasvand, Reza & Rueegg, Corina Silvia [Show all 10 contributors for this article] (2026). Exploring the paradoxical association of sun exposure and melanoma-specific mortality: The Norwegian Women and Health (NOWAC) Study. European Journal of Cancer. ISSN 0959-8049. 241. doi: 10.1016/j.ejca.2026.116787. Full text in Research Archive Show summary

  Background Paradoxically, some studies have found that high sun exposure, a well-known cause of melanoma, is associated with lower mortality among melanoma patients. In the Norwegian Women and Health cohort, we aimed to investigate associations between pre-diagnosis sun exposure and melanoma-specific and overall death, and the potential impact of unmeasured confounding and selection bias (conditioning on melanoma diagnosis) on any observed association between markers of high sun exposure and death. Methods We estimated hazard ratios (HRs) by Cox regression, observed covariate E-values, bias-adjusted HRs, and performed frailty analysis. Results Among 2234 patients with a first melanoma (311 deaths, 168 from melanoma; mean follow-up 8.0 years), we found significantly reduced risk of melanoma-specific (HR=0.41, 95% confidence interval (CI)=0.24–0.68) and overall (HR=0.49, 95%CI=0.33–0.72) death for ever- versus never-sunburn and a negative trend for cumulative number of sunburns (ptrend≤0.001), but not for sunbathing vacations (HR=0.69, 95%CI=0.37–1.27, melanoma-specific death). Neither the E-value approach nor bias-adjusted HRs suggested a large degree of unmeasured confounding for the sunburn-death association. However, frailty analysis suggested that selection may partly explain the association. Conclusion While sunburns appear protective, this association might reflect unobserved heterogeneity in melanoma risk and selection bias, and the associations may not represent a true causal effect.

• Acosta, Carmelo Betancort; Zamorano, Garlene Zamora; Malé, María Luisa Álvarez; Perestelo-Perez, Lilisbeth; Castaño, Alezandra Torres & Veierød, Marit B [Show all 20 contributors for this article] (2026). Effect of a Personalized Mobile Health Intervention Using Artificial Intelligence (the WARIFA App) Versus a Nonpersonalized Intervention on User-Defined Objectives, Healthy Lifestyles, and Management of Type 1 Diabetes (T1D): Protocol for a Randomized Controlled Trial. JMIR Research Protocols. 15, p. 84510–84510. doi: 10.2196/84510. Full text in Research Archive Show summary

  Background Noncommunicable diseases are the leading cause of death worldwide. Cardiovascular and respiratory diseases, cancer, and type 2 diabetes share common risk factors that can be addressed: physical activity, a healthy diet, and avoiding smoking and alcohol. The Watching the Risk Factors (WARIFA) mobile health app was created for general health awareness and to support users in adopting healthier behaviors, as well as to support type 1 diabetes (T1D) self-management. Objective This study aims to evaluate the effectiveness of the WARIFA app with personalized artificial intelligence (AI)–driven messages, compared to a nonpersonalized version, in promoting health-related behavior change among the general population and individuals with T1D. Methods A total of 108 European participants, including individuals with T1D, were to be randomized (computer-generated sequence, double-blind, 1:1 ratio) to an intervention or control group. In the intervention group, participants used the WARIFA app with personalized messages and the use of AI. This applied to certain functionalities, such as providing recommendations on healthy dietary habits based on food logging and offering advice and encouragement through daily step tracking. It also provided risk predictions for cardiovascular and respiratory diseases, cancer, and type 2 diabetes. Participants with T1D were offered glucose predictions based on previous measurements. In the control group, participants used a WARIFA app without personalized messages or AI. Both WARIFA app versions offered access to air quality and UV index information for the geographical area, as well as displaying physical activity in the form of daily steps and sleep hours, as well as glucose results for participants with T1D. Both groups were provided with an activity monitor and used the WARIFA app for 8-12 weeks. The primary outcome is a self-defined goal, chosen from a set of proposed objectives at baseline and assessed at the end of the study using a Likert scale (1 to 10 points, 0 being no achievement at all and 10 being full achievement of the objective). Secondary outcomes include: engagement with the app, changes in lifestyle behavior, body composition, lipid profile, glycated hemoglobin (T1D only), hypoglycemic events (T1D only), and health-related quality of life, as well as acquired knowledge, self-efficacy, and usability. Results The clinical trial took place between January and June 2025. A total of 88 participants were finally recruited. The data are being analyzed, and the results are expected to be published in 2026. Conclusions There is evidence that improving lifestyle behavior can prevent noncommunicable diseases. In this study, we aim to evaluate the effectiveness of the WARIFA app to improve lifestyle behaviors and T1D management. Trial Registration ClinicalTrials.gov NCT06918444; https://clinicaltrials.gov/study/NCT06918444 International Registered Report Identifier (IRRID) DERR1-10.2196/84510

• Leitzinger, Nils; Falk, Ragnhild Sørum; Jespersen, Henrik; Eide, Nils; Green, Adele C. & Robsahm, Trude Eid [Show all 7 contributors for this article] (2026). Trends in incidence and survival for uveal melanoma in Norway, 1993–2021. British Journal of Ophthalmology. ISSN 0007-1161. doi: 10.1136/bjo-2025-327605. Full text in Research Archive
• Tyrdal, Mari Kristine; Perrier, Flavie; Røe, Cecilie; Natvig, Bård; Wahl, Astrid Klopstad & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2026). Treatment trajectories among patients with musculoskeletal disorders in Norway–a register-based cohort study over 2 years. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 44(1), p. 1–15. doi: 10.1080/02813432.2026.2633751. Full text in Research Archive Show summary

  Objective Explore treatment trajectories over a two-year follow-up among patients with musculoskeletal disorders (MSDs) in Norway and investigate the associations with education and country of origin. Design Register-based cohort study. Settings Data were obtained from three national registers, the Norwegian Control and Payment of Health Reimbursements Database (KUHR), the Norwegian Patient Registry (NPR) and Statistics Norway (SSB). Subjects Patients diagnosed with MSDs in 2015 in primary healthcare according to the International Classification of Primary Care, second edition (ICPC-2). Main outcome measures Treatment trajectory classes of healthcare use over a 2-years follow-up were generated using group-based multi-trajectory modelling, for all patients registered with MSDs and three common diagnoses: spine pain, osteoarthritis and fibromyalgia. Results From the analysis, four treatment trajectory classes of healthcare use were identified for MSD patients overall; low (75%), stable (10%), descending (9%) and high use (5%). The pattern was almost similar for the three diagnostic groups. High use was primarily caused by consistent high use of physiotherapy. For MSD patients overall, low education increased the probability of being in the low and stable use classes, while high education increased the probability of being in the descending use class. Patients with Norway as country of origin, were less likely to be in the class with low use and more likely to be in the class with descending use. Conclusion Using nationwide register data and group-based multi-trajectory modelling show that about 75% of all patients with MSD, consulting primary healthcare in Norway, were classified as low users of healthcare services and 5% were classified as high users. Overall, both education and country of origin were associated with the treatment trajectory classes. However, high use was not associated with neither education nor country of origin.

• Arnesen, Erik Kristoffer; Christensen, Jacob J.; Laake, Ida; Carlsen, Monica Hauger; Veierød, Marit Bragelien & Retterstøl, Kjetil (2025). Low-fat and whole milk consumption in relation to cardiovascular disease–related and all-cause mortality: a prospective cohort study in 3 Norwegian counties. American Journal of Clinical Nutrition. ISSN 0002-9165. 122(4), p. 1075–1085. doi: 10.1016/j.ajcnut.2025.07.035. Full text in Research Archive Show summary

  Background The impact of milk consumption on cardiovascular disease (CVD) risk or mortality is unclear, and specific comparisons between types of milk are scarce. Objectives We aimed to investigate the associations between milk consumption, measured in a large Norwegian cohort in 3 counties during 1974–1988, and CVD–related mortality and all-cause mortality and to compare the associations between whole (full-fat) and low-fat milk. Methods This population-based, prospective cohort study included adults invited to repeated health screenings in the Norwegian Counties Study (>80% attendance). Dietary intake was assessed from food frequency questionnaires at each screening in 1974–1988. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% CIs for the associations between milk intake (assessed as cumulative mean intake from repeated questionnaires) and risk of death from all CVD, ischemic heart disease (IHD), acute myocardial infarction (AMI), and all causes. Results Among 73,860 participants included in this study (mean age: 41.2 years at baseline; 49% females), 26,393 deaths occurred (8590 from CVD, 4372 from IHD, and 3047 from AMI) during a median follow-up of 33 y. Comparing the highest with the lowest quintile of overall milk intake, the HR was 1.12 (95% CI: 1.03, 1.21) for CVD-related mortality and 1.22 (95% CI: 1.16, 1.28) for all-cause mortality. For whole milk, high compared with no intake was positively associated with CVD (HR: 1.07; 95% CI: 0.99, 1.16), IHD (HR: 1.13; 95% CI: 1.01, 1.27), and all-cause mortality (HR: 1.15; 95% CI: 1.10, 1.21). Compared with whole milk, low-fat milk intake was associated with lower CVD-related, IHD-related, AMI-related, and all-cause mortality. The associations were attenuated in analyses considering only baseline intakes. Conclusions In this cohort with high milk consumption, whole milk is associated with higher CVD and all-cause mortality, whereas low-fat milk is not. Low-fat milk may be associated with lower risks than whole milk.

• Christensen, Jacob J; Holven, Kirsten Bjørklund; Bogsrud, Martin Prøven; Retterstøl, Kjetil; Lennep, Jeanine E Roeters van & Michelsen, Trond Melbye [Show all 8 contributors for this article] (2025). Statin use in pregnancy and risk of congenital malformations: a Norwegian nationwide study. European Heart Journal. ISSN 0195-668X. 47(3), p. 318–327. doi: 10.1093/eurheartj/ehaf592. Full text in Research Archive Show summary

  Background and Aims Statins and other lipid-modifying agents (LMAs) have traditionally been contraindicated during pregnancy due to concerns about harmful fetal effects; however, the risks associated with exposure to statins and other LMAs in human pregnancies remain unclear. Therefore, this study aimed to examine the associations between statin and LMA exposure in pregnancy and congenital malformations in offspring, while updating a 2022 meta-analysis with the results from the present study. Methods National registry data were linked for all pregnant women in Norway in 2005–18. Associations between first-trimester statin prescription fills and congenital malformations were estimated with mixed-effects logistic regression, adjusting for age, parity, pre-pregnancy folate use, smoking in early pregnancy, comorbidity, and co-medication. Meta-analyses were performed with the generic inverse–variance method and random-effects model. Results Congenital malformations occurred among 34 755 out of 803 830 (4.3%) statin non-exposed pregnancies, 74 out of 1255 (5.9%) statin-discontinuer pregnancies, and 19 out of 283 (6.7%) statin-exposed pregnancies. Adjusted odds ratios (ORs) for exposed vs non-exposed pregnancies were 1.30 [95% confidence interval (CI) .81–2.09] for any, 1.15 (.61–2.19) for major, and 1.47 (.75–2.89) for minor malformations. In analyses of exposed vs discontinuer pregnancies, there were no associations between statin exposure and any (adjusted OR 1.01, 95% CI .59–1.72), major (1.08, .52–2.25), or minor malformations (.94, .44–2.00). Results were similar across sensitivity analyses. There was also no association between any LMA exposure and heart malformations (adjusted OR 1.22, 95% CI .50–3.01). The updated meta-analysis suggested no increased risk of major (adjusted OR 1.06, 95% CI .86–1.31) or heart malformations (1.24, 95% CI .94–1.64). Conclusions In this large, nationwide study and updated meta-analysis, no significant association was observed between first-trimester exposure to statins or other LMAs and congenital malformations. Although limited power may have prevented detection of weak but clinically relevant associations, the findings do not support a strong or independent association between statin exposure in pregnancy and congenital malformations.

• Moro, Ornella; Gram, Inger Torhild; Løchen, Maja-Lisa; Veierød, Marit Bragelien; Wägner, Ana Maria & Sebastiani, Giovanni (2025). Quantification of the influence of risk factors with application to cardiovascular diseases in subjects with type 1 diabetes. Statistical Methods in Medical Research. ISSN 0962-2802. 34(10), p. 1901–1919. doi: 10.1177/09622802251327680. Full text in Research Archive Show summary

  Future occurrence of a disease can be highly influenced by some specific risk factors. This work presents a comprehensive approach to quantify the event probability as a function of each separate risk factor by means of a parametric model. The proposed methodology is mainly described and applied here in the case of a linear model, but the non-linear case is also addressed. To improve estimation accuracy, three distinct methods are developed and their results are integrated. One of them is Bayesian, based on a non-informative prior. Each of the other two, uses aggregation of sample elements based on their factor values, which is optimized by means of a different specific criterion. For one of these two, optimization is performed by Simulated Annealing. The methodology presented is applicable across various diseases but here we quantify the risk for cardiovascular diseases in subjects with type 1 diabetes. The results obtained combining the three different methods show accurate estimates of cardiovascular risk variation rates for the factors considered. Furthermore, the detection of a biological activation phenomenon for one of the factors is also illustrated. To quantify the performances of the proposed methodology and to compare them with those from a known method used for this type of models, a large simulation study is done, whose results are illustrated here.

• Lergenmuller, Simon; Rueegg, Corina Silvia; Ghiasvand, Reza & Veierød, Marit Bragelien (2025). Sunscreen Use and Cutaneous Squamous Cell Carcinoma Risk: A Review of the Evidence. Acta Dermato-Venereologica. ISSN 0001-5555. 105. doi: 10.2340/actadv.v105.42550. Full text in Research Archive
• Shala, Nita Kaupang; Veierød, Marit Bragelien; Babigumira, Ronnie; Berge, Leon Alexander Mclaren; Samuelsen, Sven Ove & Kirkeleit, Jorunn [Show all 14 contributors for this article] (2025). Occupational exposures and kidney cancer among 25 000 male offshore petroleum industry workers: relative risks and healthy worker survivor bias. American Journal of Epidemiology. ISSN 0002-9262. 195(1), p. 81–91. doi: 10.1093/aje/kwaf039. Full text in Research Archive Show summary

  Kidney cancer has been a suspected occupational disease in petroleum workers. Health conditions that are linked to kidney cancer may prompt termination or change of work, and thereby restrict occupational exposures in high-risk individuals, creating a healthy worker survivor bias (HWSB). We examined associations between occupational exposures and kidney cancer among males in the Norwegian Offshore Petroleum Workers (NOPW) cohort using a case-cohort design, with 169 incident cancers identified by linkage to national registry data (1999-2021) and a subcohort of 2090 non-cases, all employed 1965-1998. Relative risks (hazard ratios, HRs) by cumulative exposure to benzene, crude oil, chlorinated degreasing agents (CDA), asbestos, welding fumes, or surface treatment (priming, painting), were estimated by weighted Cox regression. Inverse exposure-response trends suggested HWSB, reinforced by analyses of necessary components of HWSB. Bias was partly alleviated by adjustment for total employment duration, and by 20-year lagging of cumulative exposure to benzene, crude oil, or CDA. Workers in surface treatment (ever vs. never) showed increased HR=2.22, 95% confidence interval 1.04-4.72 (9 cases, only). For asbestos and welding fumes, the initial inverse trends largely remained after adjustment. In sum, we could neither confirm nor exclude an occupational impact on kidney cancer.

• Perrier, Flavie; Ahimbisibwe, Ashley; Ghiasvand, Reza; Rueegg, Corina Silvia; Green, Adele C. & Borch, Kristin Benjaminsen [Show all 11 contributors for this article] (2025). Physical activity and mortality in melanoma patients within the Norwegian Women and Cancer study (NOWAC). International Journal of Cancer. ISSN 0020-7136. 157(5), p. 846–857. doi: 10.1002/ijc.35430. Full text in Research Archive Show summary

  Pre- and post-diagnosis physical activity (PA) have been associated with decreased mortality and recurrence in cancer patients, but its effect is under-studied in patients with cutaneous melanoma. We investigated the association between pre-diagnosis PA (most recent level and long-term trajectories) and melanoma-specific, other-cause, and overall mortality. Additionally, PA levels before and after a melanoma diagnosis were compared. We used information at recruitment and follow-ups in the prospective population-based Norwegian Women and Cancer cohort linked to the Cancer Registry of Norway. In total 1829 women were diagnosed with a first primary melanoma in 1991─2020, aged 34–93 years. We used Cox regression adjusted for age at diagnosis, education, smoking status, region of residence, melanoma thickness, and summary stage. Most recent pre-diagnosis PA was non-significantly associated with lower risk of melanoma-specific mortality (hazard ratio (HR) = 0.69, 95% confidence interval (CI) = 0.44─1.07, high vs. low) and significantly associated with other-cause (HR = 0.50, 95% CI = 0.28─0.89) and overall mortality (HR = 0.59, 95% CI = 0.42─0.82). Four pre-diagnosis PA trajectory classes were identified using a latent class mixed model (low, decreasing, moderate, and high). The PA trajectory classes were not significantly associated with melanoma-specific mortality. However, significantly decreased risks of other-cause (HR = 0.51, 95% CI = 0.30─0.87) and overall mortality (HR = 0.59, 95% CI = 0.42─0.84) were found in the moderate versus low class. Only 275 patients reported both pre- and post-diagnosis PA, and among those, 69% had a similar PA level before and after melanoma diagnosis. Our results suggest that pre-diagnosis PA reduces mortality in middle-aged Norwegian women with melanoma.

• Moro, Ornella; Gram, Inger Torhild; Løchen, Maja-Lisa; Veierød, Marit Bragelien; Wägner, Ana Maria & Sebastiani, Giovanni (2025). A Bayesian Belief Network model for the estimation of risk of cardiovascular events in subjects with type 1 diabetes. Computers in Biology and Medicine. ISSN 0010-4825. 190. doi: 10.1016/j.compbiomed.2025.109967. Full text in Research Archive
• Babigumira, Ronnie; Veierød, Marit Bragelien; Larsen, Inger Kristin; Berge, Leon Alexander Mclaren; Shala, Nita Kaupang & Marjerrison, Niki [Show all 22 contributors for this article] (2025). Benzene exposure and risk of colorectal cancer by anatomical subsite in the Norwegian offshore petroleum workers cohort. Environmental Research. ISSN 0013-9351. 276, p. 1–9. doi: 10.1016/j.envres.2025.121407. Full text in Research Archive Show summary

  Objective: To investigate the association between low levels of benzene exposure (≤0.879 parts per million [ppm]-years) and risk of colorectal cancer (CRC) including its anatomical subsites. Methods: Among 25,347 male workers in the Norwegian Offshore Petroleum Workers (NOPW) cohort with offshore work history (1965–1998), 455 CRC cases were diagnosed 1999–2021. We compared these with a subcohort (n = 2031) drawn from the full cohort. Work histories were linked to a previously developed industry-specific benzene job-exposure matrix (JEM). Cox regression for case-cohort analyses was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC, adjusted for age, body mass index, smoking, alcohol intake, red/processed meat intake, and physical activity. Results: Risks of CRC increased with increasing benzene exposure. For all CRC, the HRs (95% CI) for the most exposed [quartile 4] vs. the unexposed were 1.32 (0.96 to 1.81, [0.177–0.879 ppm-years]; p-trend = 0.085) for cumulative, 1.52 (1.11 to 2.07, [17–34 years]; p-trend = 0.032) for duration, and 1.56 (1.15 to 2.12, [0.015–0.046 ppm]; p-trend = 0.005) for average intensity of benzene exposure. For right-sided colon cancer, the association was most evident for exposure duration (HR = 2.25 (1.33 to 3.80), quartile 4 [17–34 years] vs. unexposed; p-trend = 0.007). Sensitivity analyses showed consistent associations. Conclusion: This study found positive exposure-response associations between low-level benzene exposure and CRC risk in offshore petroleum workers. These findings add to emerging evidence that benzene can be associated with solid tumours including lung and bladder, which potentially has important occupational and public health implications.

• Nafisi, Sara; Støer, Nathalie Charlotte; Veierød, Marit Bragelien; Randel, Kristin R.; Hoff, Geir & Löfling, Leif Lukas [Show all 8 contributors for this article] (2024). Low-Dose Aspirin and Prevention of Colorectal Cancer: Evidence From a Nationwide Registry-Based Cohort in Norway. American Journal of Gastroenterology. ISSN 0002-9270. 119(7), p. 1402–1411. doi: 10.14309/ajg.0000000000002695. Full text in Research Archive Show summary

  Objectives: To examine the association between low-dose aspirin use and risk of colorectal cancer (CRC). Methods: In this nationwide cohort study, we identified individuals aged ≥50 years residing for 6 months or more in Norway in 2004-2018, and obtained data from national registers on drug prescriptions, cancer occurrence, and sociodemographic factors. Multivariable Cox regression models were used to estimate the association between low-dose aspirin use and CRC risk. Additionally, we calculated the number of CRCs potentially averted by low-dose aspirin use. Results: We included 2,186,390 individuals. During the median follow-up of 10.9 years, 579,196 (26.5%) used low-dose aspirin, and 38,577 (1.8%) were diagnosed with CRC. Current use of aspirin vs. never use was associated with lower CRC risk (hazard ratios [HR]=0.87, 95% confidence intervals [CI] 0.84-0.90). The association was more pronounced for metastatic CRC (HR=0.79; 95%CI 0.74-0.84) than regionally advanced (HR=0.89; 95%CI 0.85-0.92) and localized CRC (HR=0.93; 95%CI 0.87-1.00; Pheterogeneity=0.001). A significant trend was found between duration of current use and CRC risk: HR=0.91 (95%CI 0.86-0.95) for <3 years, HR=0.85 (0.80-0.91) for ≥3 and <5 years, and HR=0.84 (0.80-0.88) for ≥5 years of use vs. never use (Ptrend<0.001). For past use, HRs were 0.89 (95%CI 0.84-0.94) for <3 years, 0.90 (0.83-0.99) for ≥3 and <5 years, and 0.98 (0.91-1.06) for ≥5 years since last use vs. never use (Ptrend<0.001). We estimated that aspirin use averted 1073 (95%CI 818-1338) CRCs in the study period. Conclusion: In this nationwide cohort, use of low-dose aspirin was associated with a lower risk of CRC.

• Tyrdal, Mari Kristine; Perrier, Flavie; Røe, Cecilie; Natvig, Bård; Wahl, Astrid Klopstad & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2024). Musculoskeletal disorders in Norway: trends in health care utilization and patient pathways: a nationwide register study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 42(4), p. 582–592. doi: 10.1080/02813432.2024.2368848. Full text in Research Archive Show summary

  Objective Describe trends in health care utilization, demographic characteristics and patient pathways among patients with musculoskeletal disorders (MSD) in Norway. Design Register-based cohort study. Settings Data were obtained from two Norwegian National registries; the Norwegian Control and Payment of Health Reimbursements Database (KUHR) and the Norwegian Patient Registry (NPR). Subjects Patients with MSD according to ICPC-2 and ICD-10 during 2014–2017. Main outcome measures Patient pathways from the first contact and the following two years, described in a Sankey Diagram for all MSD patients and three common diagnoses: spine pain, osteoarthritis (OA) and fibromyalgia (FM). Result About 26% of the Norwegian population consulted PHC annually while 7% were treated in SHC. Mean age was 47 and 53 years in PHC and SHC, respectively. The proportion of women increased by age. Spine pain was the most common diagnosis; 33% and 22% in PHC and SHC, respectively. Over 90% visited a GP first, 50% of them were treated by PT and/or in SHC during follow-up. Patients visiting the PT first were less likely to be treated in SHC. OA patients were most likely to be treated by more than one health care professional (>70%). Conclusion One third of the Norwegian population consulted health care services due to MSD annually between 2014–2017. GP was the most consulted health care professional. Among MSD patients with long-term use of health care services, 50% were treated by a PT and/or in SHC in addition to a GP.

• Gómez-Martínez, Vanesa; Chushig-Muzo, David; Veierød, Marit Bragelien; Granja, Conceição & Soguero-Ruiz, Cristina (2024). Ensemble feature selection and tabular data augmentation with generative adversarial networks to enhance cutaneous melanoma identification and interpretability. BioData Mining. 17. doi: 10.1186/s13040-024-00397-7. Full text in Research Archive Show summary

  Background Cutaneous melanoma is the most aggressive form of skin cancer, responsible for most skin cancer-related deaths. Recent advances in artificial intelligence, jointly with the availability of public dermoscopy image datasets, have allowed to assist dermatologists in melanoma identification. While image feature extraction holds potential for melanoma detection, it often leads to high-dimensional data. Furthermore, most image datasets present the class imbalance problem, where a few classes have numerous samples, whereas others are under-represented. Methods In this paper, we propose to combine ensemble feature selection (FS) methods and data augmentation with the conditional tabular generative adversarial networks (CTGAN) to enhance melanoma identification in imbalanced datasets. We employed dermoscopy images from two public datasets, PH2 and Derm7pt, which contain melanoma and not-melanoma lesions. To capture intrinsic information from skin lesions, we conduct two feature extraction (FE) approaches, including handcrafted and embedding features. For the former, color, geometric and first-, second-, and higher-order texture features were extracted, whereas for the latter, embeddings were obtained using ResNet-based models. To alleviate the high-dimensionality in the FE, ensemble FS with filter methods were used and evaluated. For data augmentation, we conducted a progressive analysis of the imbalance ratio (IR), related to the amount of synthetic samples created, and evaluated the impact on the predictive results. To gain interpretability on predictive models, we used SHAP, bootstrap resampling statistical tests and UMAP visualizations. Results The combination of ensemble FS, CTGAN, and linear models achieved the best predictive results, achieving AUCROC values of 87% (with support vector machine and IR=0.9) and 76% (with LASSO and IR=1.0) for the PH2 and Derm7pt, respectively. We also identified that melanoma lesions were mainly characterized by features related to color, while not-melanoma lesions were characterized by texture features. Conclusions Our results demonstrate the effectiveness of ensemble FS and synthetic data in the development of models that accurately identify melanoma. This research advances skin lesion analysis, contributing to both melanoma detection and the interpretation of main features for its identification.

• Wigers, Sigrid Hørven; Veierød, Marit Bragelien; Mengshoel, Anne Marit; Forseth, Karin Maria Øien; Dahli, Mina Piiksi & Juel, Niels Gunnar [Show all 7 contributors for this article] (2024). Healthcare experiences of fibromyalgia patients and their associations with satisfaction and pain relief. A patient survey. Scandinavian Journal of Pain. ISSN 1877-8860. 24(1). doi: 10.1515/sjpain-2023-0141. Full text in Research Archive Show summary

  Objectives The etiology of fibromyalgia (FM) is disputed, and there is no established cure. Quantitative data on how this may affect patients’ healthcare experiences are scarce. The present study aims to investigate FM patients’ pain-related healthcare experiences and explore factors associated with high satisfaction and pain relief. Methods An anonymous, online, and patient-administered survey was developed and distributed to members of the Norwegian Fibromyalgia Association. It addressed their pain-related healthcare experiences from both primary and specialist care. Odds ratios for healthcare satisfaction and pain relief were estimated by binary logistic regression. Directed acyclic graphs guided the multivariable analyses. Results The patients (n = 1,626, mean age: 51 years) were primarily women (95%) with a 21.8-year mean pain duration and 12.7 years in pain before diagnosis. One-third did not understand why they had pain, and 56.6% did not know how to get better. More than half had not received satisfactory information on their pain cause from a physician, and guidance on how to improve was reported below medium. Patients regretted a lack of medical specialized competence on muscle pain and reported many unmet needs, including regular follow-up and pain assessment. Physician-mediated pain relief was low, and guideline adherence was deficient. Only 14.8% were satisfied with non-physician health providers evaluating and treating their pain, and 21.5% were satisfied (46.9% dissatisfied) with their global pain-related healthcare. Patients’ knowledge of their condition, physicians’ pain competence and provision of information and guidance, agreement in explanations and advice, and the absence of unmet needs significantly increased the odds of both healthcare satisfaction and pain relief. Conclusions Our survey describes deficiencies in FM patients’ pain-related healthcare and suggests areas for improvement to increase healthcare satisfaction and pain relief. (REC# 2019/845, 09.05.19).

• Arnesen, Erik Kristoffer; Laake, Ida; Carlsen, Monica Hauger; Veierød, Marit Bragelien & Retterstøl, Kjetil (2024). Potato Consumption and All-Cause and Cardiovascular Disease Mortality – A Long-Term Follow-Up of a Norwegian Cohort. Journal of Nutrition. ISSN 0022-3166. 154(7), p. 2226–2235. doi: 10.1016/j.tjnut.2024.05.011. Full text in Research Archive Show summary

  Background Potatoes are a staple food in many traditional cuisines, yet their impact on long-term risk of cardiovascular disease (CVD) and mortality is unclear, hampering evidence-based dietary guidelines. Objectives This study aimed to examine the association between potato consumption and all-cause and CVD-specific death over a substantial follow-up period within a cohort predominantly consuming boiled potatoes. Methods Adults from 3 Norwegian counties were invited to 3 health screenings in 1974–1988 (>80% attendance). Dietary data were collected using semiquantitative food frequency questionnaires at each screening to categorize weekly potato consumption (≤6, 7–13, or ≥14 potatoes/wk) and calculate daily cumulative mean intakes (grams/day). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression to estimate HRs and 95% CIs for the association between potato consumption and risk of death from all causes, CVD, ischemic heart disease (IHD), and acute myocardial infarction (AMI). Results Among 77,297 participants with a mean baseline age of 41.1 y (range: 18.0–63.9 y), we observed 27,848 deaths, including 9072 deaths due to CVD, over a median follow-up of 33.5 y. Participants who consumed ≥14 potatoes/wk had a lower risk of all-cause death compared with those consuming ≤6 potatoes/wk (HR: 0.88; 95% CI: 0.84, 0.93). Potato consumption was associated with a minor, inverse risk of death due to CVD, IHD, and AMI. In continuous analyses of cumulative intakes, each 100 g/d increment was associated with 4% lower risk of death from all causes (HR: 0.96; 95% CI: 0.94, 0.98), CVD (HR: 0.96; 95% CI: 0.93, 0.99), IHD (HR: 0.96; 95% CI: 0.91, 1.00), and AMI (HR: 0.96, 95% CI: 0.91, 1.01). Conclusions In this cohort with a generally high consumption of predominantly boiled potatoes, we find modest, inverse associations between potato consumption and death from all causes, CVD, and IHD.

• Berge, Leon Alexander Mclaren; Shala, Nita Kaupang; Barone-Adesi, Francesco; Hosgood, H Dean; Samuelsen, Sven Ove & Bråtveit, Magne [Show all 13 contributors for this article] (2024). Exposure to fibres and risk of pleural mesothelioma in the Norwegian Offshore Petroleum Workers cohort. Occupational and Environmental Medicine. ISSN 1351-0711. 81(7), p. 331–338. doi: 10.1136/oemed-2024-109424. Full text in Research Archive Show summary

  Objectives Pleural mesothelioma is a rare respiratory cancer, mainly caused by inhalation of asbestos fibres. Other inorganic fibres are also suggested risk factors. We aimed to investigate the association between exposure to asbestos or refractory ceramic fibres (RCFs) and pleural mesothelioma among male Norwegian offshore petroleum workers. Methods Among 25 347 men in the Norwegian Offshore Petroleum Workers (NOPW) cohort (1965–1998), 43 pleural mesothelioma cases were identified through the Cancer Registry of Norway (1999–2022). A case–cohort study was conducted with 2095 randomly drawn non-cases from the cohort. Asbestos and RCF exposures were assessed with expert-made job-exposure matrices (JEMs). Weighted Cox regression was used to estimate HRs and 95% CIs, adjusted for age at baseline and pre-offshore employment with likely asbestos exposure. Results An increased risk of pleural mesothelioma was indicated for the highest versus lowest tertile of average intensity of asbestos (HR=1.21, 95% CI: 0.57 to

• Arnesen, Erik Kristoffer; Laake, Ida; Veierød, Marit Bragelien & Retterstøl, Kjetil (2024). Saturated fatty acids and total and CVD mortality in Norway: a prospective cohort study with up to 45 years of follow-up. British Journal of Nutrition. ISSN 0007-1145. 132, p. 466–478. doi: 10.1017/S0007114524001351. Full text in Research Archive Show summary

  The contribution of dietary saturated fatty acids (SFA) to cardiovascular disease (CVD) and mortality remains debated after decades of research. Few previous studies had repeated dietary assessments and power to assess mortality. Evidence for individual SFA is limited. In this large population-based cohort study, we investigated associations between intake of total and individual SFA and risk of total and CVD mortality. Adult residents (mean 41·1 years at baseline) in three Norwegian counties were invited to repeated health screenings between 1974 and 1988 (> 80 % attendance). We calculated cumulative average intakes of macronutrients from semi-quantitative FFQ. Median (interquartile range) intake of SFA was 14·6 % (12·8–16·6 %) of total energy (E%). Hazard ratios (HR) and 95 % CI were estimated using multivariable Cox regression models to assess total, CVD, ischaemic heart disease (IHD) and acute myocardial infarction (AMI) mortality. Among 78 725 participants, 28 555 deaths occurred during a median follow-up of 33·5 years, with 9318 deaths due to CVD. Higher intake of SFA (replacing carbohydrates) was positively associated with all mortality endpoints, including total (HR per 5 E% increment, 1·18; 95 % CI 1·13, 1·23) and CVD mortality (1·16; 95 % CI 1·07, 1·25). Theoretical isoenergetic substitution of SFA with carbohydrates or MUFA was associated with lower risk. Of individual SFA, myristic (14:0) and palmitic acid (16:0) were positively associated with mortality. In summary, dietary SFA intake was strongly associated with higher total and CVD mortality in this long-term cohort study. This supports policies implemented to reduce SFA consumption in favour of carbohydrates and unsaturated fats.

• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar; Nordby, Karl-Christian & Olsen, Raymond [Show all 9 contributors for this article] (2024). Occupational exposures of firefighting and prostate cancer risk in the Norwegian Fire Departments Cohort. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 51(2), p. 100–110. doi: 10.5271/sjweh.4202. Full text in Research Archive Show summary

  Objectives Excess incidence of prostate cancer (PC) is frequently observed among firefighters; however, the association with specific occupational exposures of firefighting, as well as the influence of a medical surveillance bias, remains unclear. Our aim was to study PC risk within a firefighter cohort, applying indicators of exposures. Methods We used indicators of various firefighting exposures to examine PC risk among men in the Norwegian Fire Departments Cohort (N=4251). Incident PC cases, including clinical characteristics, were obtained from the Cancer Registry of Norway (1960–2021). Cox regression was used to estimate hazard ratios (HR) by cumulative exposure in tertiles (reference: lowest) for all, aggressive, and indolent PC, with adjustment for age and birth cohort. The cumulative incidence of PC across birth cohorts and diagnostic periods was examined. Results No clear associations emerged for any of the exposure indicators, although we observed an HR of 1.31 [95% confidence interval (CI) 0.63–2.72] for aggressive PC in the highest tertile of fire exposure score and 1.31 (95% CI 0.60–2.89) for indolent PC in the highest tertile of inhalation score. Assessment of cumulative incidence demonstrated a greater number of diagnoses at younger ages after 1990, particularly for indolent and unclassifiable PC. Conclusions We found little support for an association between firefighting exposures and PC risk. However, our study had few cases in analyses by clinical stage. Challenges in studies of firefighters’ PC risk remain, including difficulties in exposure characterization and the unclear magnitude of a medical surveillance bias.

• Årsand, Eirik; Muzny, Miroslav; Rishaug, Tina; Wägner, Anna M.; Betancort, Carmelo & Granja, Conceição [Show all 22 contributors for this article] (2024). Using One App Only – Collecting a Comprehensive Set of Health-Related Data for Prevention of Chronic Conditions. Studies in Health Technology and Informatics. ISSN 0926-9630. 316, p. 247–251. doi: 10.3233/SHTI240391. Full text in Research Archive Show summary

  This paper presents the design, implementation and early tests of an app that collects a comprehensive set of health-related data, as part of the EU-project WARIFA. To achieve the main aim of the project – using AI to prevent chronic conditions – a wide range of data needs to be collected and stored at a backend server for processing. The methods and elements for creating this system are presented, as well as results from the co-creation process and early user-tests. Challenges regarding complexity, security, and privacy are discussed, as well as the needs and prospectives for easier ways of collecting health-related data.

• Rimal, Raju; Robsahm, Trude Eid; Green, Adele C.; Ghiasvand, Reza; Rueegg, Corina Silvia & Bassarova, Assia Vassileva [Show all 12 contributors for this article] (2024). Trends in Invasive Melanoma Thickness in Norway, 1983-2019. Acta Dermato-Venereologica. ISSN 0001-5555. 104. doi: 10.2340/actadv.v104.26110. Full text in Research Archive Show summary

  Monitoring melanoma incidence time trends by tumour thickness is essential to understanding the evolution of melanoma occurrence and guiding prevention strategies. To assess long-term incidence trends, tumour thickness was extracted from pathology reports in the Cancer Registry of Norway (1983–2007) and the Norwegian Melanoma Registry (2008–2019), n = 45,635 patients. Across all anatomic sites, T1 (≤ 1 mm) incidence increased most (men annual percentage change [AAPC] = 4.6, 95% confidence interval [95% CI] 4.2–5.0; women AAPC = 3.2, 95% CI 2.8–3.6); the increase was steep until 1989/90, followed by a plateau, and a further steep increase from 2004/05. Increased incidence was also observed for T2 (>1.0–2.0) melanoma (men AAPC = 2.8, 95% CI 2.4–3.2; women AAPC = 1.5, 95% CI 1.1–1.9), and T3 (>2.0–4.0) in men (AAPC = 1.4, 95% CI 0.9–1.9). T4 (>4.0) melanoma followed a similar overall pattern (men AAPC = 1.3, 95% CI 0.9–1.7, head/neck, upper limbs, and trunk; women AAPC = 0.9, 95% CI 0.4–1.4, upper limbs and trunk). Men had the highest T3 and T4 incidence and the sex difference increased with age. Regarding birth cohorts, age-specific incidence increased in all T categories in the oldest age groups, while stabilizing in younger patients born after 1950. Overall, the steep increase in T1 melanoma was not accompanied by a decrease in thick melanoma.

• Ghiasvand, Reza; Green, Adele C.; Veierød, Marit Bragelien & Robsahm, Trude Eid (2024). Incidence and Factors Associated with Second Primary Invasive Melanoma in Norway. JAMA dermatology. ISSN 2168-6068. 160(4), p. 402–408. doi: 10.1001/jamadermatol.2023.6251. Full text in Research Archive Show summary

  Importance Patients diagnosed with a primary melanoma are at high risk of subsequent melanomas. Understanding the risk of second primary invasive melanoma and associated factors is crucial to optimize patient follow-up. Objective To assess the incidence rate of second primary invasive melanoma and time between the first and second primary invasive melanoma in the Norwegian population. Design, Setting, and Participants This population-based cohort study included data from deidentified records of all invasive melanomas diagnosed in Norway in 2008 to 2020, obtained from the Cancer Registry of Norway. Data were from adults aged 18 years or older diagnosed with a first primary melanoma. Data analysis was performed from March to August 2023. Main Outcomes and Measures The main outcome was the incidence rate of second primary invasive melanoma at least 30 days after the first. Accelerated failure time models were fitted to examine potential associations with patient and tumor characteristics. Median time between first and second primary melanomas and 95% CIs were calculated. The likelihood of, and median interval for, second primary melanomas on the same or different site as the first primary were calculated. Results A total of 19 196 individuals aged 18 years or older were diagnosed with a first primary melanoma. The mean (SD) age at diagnosis of the first primary melanoma was 62 (16) years (range, 18-104 years), and 9763 (51%) were female. The incidence rate in the year following diagnosis was 16.8 (95% CI, 14.9-18.7) per 1000 person-years, which decreased to 7.3 (95% CI, 6.0-8.6) during the second year and stabilized thereafter. Median time between first and second primaries decreased with advancing age and was 37 months (95% CI, 8-49) in patients younger than 40 years, 18 (95% CI, 13-24) in patients aged 50 to 59 years, and 11 (95% CI, 7-18) in patients aged 80 years or older. The second primary was on the same site as their first primary for 47% (359 patients), and on a different site for 53% (407 patients). The median interval until second melanoma on the same site as the initial melanoma was 12 (95% CI, 7-19) months in men and 22 (95% CI, 11-35) months in women. Conclusions and Relevance Older age and male sex were associated with an increased risk, suggesting that increased surveillance intensity may be considered for men, especially those older than 50 years, for at least 3 years after their initial diagnosis, regardless of the characteristics of their first invasive melanoma.

• Ghiasvand, Reza; Berge, Leon Alexander Mclaren; Kulle, Bettina; Green, Adele C.; Rahmoun, Marie Al & Fournier, Agnès [Show all 9 contributors for this article] (2023). Statin use and risk of cutaneous melanoma: a nationwide nested case-control study. British Journal of Dermatology. ISSN 0007-0963. 188(6), p. 805–807. doi: 10.1093/bjd/ljad057. Full text in Research Archive Show summary

  This nationwide nested case–control study examined the association between statin use and risk of cutaneous melanoma. We included 12 048 adult patients with melanoma and 117 895 randomly selected cancer-free controls, matched on age and sex. Cancer data were obtained from the Cancer Registry of Norway and data on drug use was retrieved from the Norwegian Prescription Database. We estimated rate ratios with 95% confidence intervals and conducted sensitivity analyses. We observed an inverse dose–response association between statin use and melanoma risk, stronger in women. The highest statin intake was associated with a reduced risk of melanoma, particularly on the head/neck and lower limbs. Our finding may have implications for melanoma prevention in high-risk groups.

• Deniz-Garcia, Alejandro; Fabelo, Himar; Rodriguez-Almeida, Antonio J.; Zamora-Zamorano, Garlene; Castro-Fernandez, Maria & Ruano, Maria del Pino Alberiche [Show all 27 contributors for this article] (2023). Quality, Usability, and Effectiveness of mHealth Apps and the Role of Artificial Intelligence: Current Scenario and Challenges. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 25. doi: 10.2196/44030. Full text in Research Archive Show summary

  The use of artificial intelligence (AI) and big data in medicine has increased in recent years. Indeed, the use of AI in mobile health (mHealth) apps could considerably assist both individuals and health care professionals in the prevention and management of chronic diseases, in a person-centered manner. Nonetheless, there are several challenges that must be overcome to provide high-quality, usable, and effective mHealth apps. Here, we review the rationale and guidelines for the implementation of mHealth apps and the challenges regarding quality, usability, and user engagement and behavior change, with a special focus on the prevention and management of noncommunicable diseases. We suggest that a cocreation-based framework is the best method to address these challenges. Finally, we describe the current and future roles of AI in improving personalized medicine and provide recommendations for developing AI-based mHealth apps. We conclude that the implementation of AI and mHealth apps for routine clinical practice and remote health care will not be feasible until we overcome the main challenges regarding data privacy and security, quality assessment, and the reproducibility and uncertainty of AI results. Moreover, there is a lack of both standardized methods to measure the clinical outcomes of mHealth apps and techniques to encourage user engagement and behavior changes in the long term. We expect that in the near future, these obstacles will be overcome and that the ongoing European project, Watching the risk factors (WARIFA), will provide considerable advances in the implementation of AI-based mHealth apps for disease prevention and health promotion.

• Shala, Nita Kaupang; Stenehjem, Jo; Babigumira, Ronnie; Liu, Fei-Chih; Berge, Leon Alexander Mclaren & Silverman, Debra T. [Show all 16 contributors for this article] (2023). Exposure to benzene and other hydrocarbons and risk of bladder cancer among male offshore petroleum workers. British Journal of Cancer. ISSN 0007-0920. 129(5), p. 838–851. doi: 10.1038/s41416-023-02357-0. Full text in Research Archive Show summary

  Background Occupational exposures constitute the second leading cause of urinary bladder cancer after tobacco smoking. Increased risks have been found in the petroleum industry, but high-quality exposure data are needed to explain these observations. Methods Using a prospective case-cohort design, we analysed 189 bladder cancer cases (1999–2017) and 2065 randomly drawn non-cases from the Norwegian Offshore Petroleum Workers cohort. Cases were identified in the Cancer Registry of Norway, while work histories (1965–1998) and lifestyle factors were recorded by questionnaire at baseline (1998). Occupational petroleum-related hydrocarbon exposures were assessed by expert-developed job-exposure matrices. Hazard ratios were estimated by weighted Cox-regressions, adjusted for age, tobacco smoking, education, and year of first employment, and with lagged exposures. Results Increased risks were found in benzene-exposed workers, either long-term exposure (≥18.8 years, HR = 1.89, 95% CI: 1.14–3.13; p-trend = 0.044) or high-level cumulative benzene exposure (HR = 1.60, 95% CI: 0.97–2.63; p-trend = 0.065), compared with the unexposed. Associations persisted with 20-year exposure lag. No associations were found with skin or inhalation exposure to crude oil, mineral oil (lubrication, hydraulics, turbines, drilling), or diesel exhaust. Conclusions The results suggest that exposures in the benzene fraction of the petroleum stream may be associated with increased bladder cancer risk.

• Nafisi, Sara; Randel, Kristin Ranheim; Støer, Nathalie Charlotte; Veierød, Marit Bragelien; Hoff, Geir Svein & Holme, Øyvind [Show all 8 contributors for this article] (2023). Association between use of low-dose aspirin and detection of colorectal polyps and cancer in a screening setting. Digestive and Liver Disease. ISSN 1590-8658. 55, p. 1126–1132. doi: 10.1016/j.dld.2023.01.156. Full text in Research Archive Show summary

  Background: The possible protective effect of aspirin on risk of colorectal cancer (CRC) is still highly debated. Methods: We used data from Bowel Cancer Screening in Norway, a trial randomizing individuals from general population, aged 50-74 years, to flexible sigmoidoscopy or faecal immunochemical test (FIT), to study the association between aspirin use and detection of CRC and two CRC precursors: adenomas and advanced serrated lesions (ASL). Prescriptions of low-dose aspirin were obtained from Norwegian prescription database. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among 64,889 screening participants (24,159 sigmoidoscopy, 40,730 FIT), 314 (0.5%) had CRC, 6,208 (9.6%) adenoma and 659 (1.0%) ASL. Overall and short-term use (<3 years) of low-dose aspirin, versus no use, were not associated with any colorectal lesion. Long-term use (≥3 years) was associated with lower detection of CRC (overall OR 0.66, 95%CI 0.46-0.93; sigmoidoscopy: 0.56, 0.33-0.97; FIT: 0.72, 0.45-1.15), adenomas in sigmoidoscopy arm (overall OR 0.95, 95%CI 0.87-1.03; sigmoidoscopy: 0.89, 0.80-0.99; FIT: 1.03, 0.89-1.18), but not ASLs. We did not observe significant differences in the effect of aspirin according to the location of colorectal lesions. Conclusion: Our results suggest that long-term use of aspirin might have a protective effect against adenomas and colorectal cancer, but not ASLs.

• Babigumira, Ronnie; Veierød, Marit Bragelien; Hosgood, H. Dean; Samuelsen, Sven Ove; Bråtveit, Magne & Kirkeleit, Jorunn [Show all 13 contributors for this article] (2023). Benzene exposure and risk of lung cancer in the Norwegian Offshore Petroleum Worker cohort: a prospective case-cohort study. Occupational and Environmental Medicine. ISSN 1351-0711. 81(1). doi: 10.1136/oemed-2023-109139. Full text in Research Archive Show summary

  Objective The objective of our study was to examine whether occupational exposure to benzene is associated with lung cancer among males in the Norwegian Offshore Petroleum Workers cohort. Methods Among 25 347 male offshore workers employed during 1965–1998, we conducted a case-cohort study with 399 lung cancer cases diagnosed between 1999 and 2021, and 2035 non-cases sampled randomly by 5-year birth cohorts. Individual work histories were coupled to study-specific job-exposure matrices for benzene and other known lung carcinogens. Weighted Cox regression was used to estimate HRs and 95% CIs for the associations between benzene exposure and lung cancer, by major histological subtypes, adjusted for age, smoking and occupational exposure to welding fumes, asbestos and crystalline silica. Missing data were imputed. Results For lung cancer (all subtypes combined), HRs (95% CIs) for the highest quartiles of benzene exposure versus unexposed were 1.15 (0.61 to 2.35) for cumulative exposure, 1.43 (0.76 to 2.69) for duration, and 1.22 (0.68 to 2.18) for average intensity (0.280≤P-trend≤0.741). For 152 adenocarcinoma cases, a positive trend was observed for exposure duration (P-trend=0.044). Conclusions In this cohort of offshore petroleum workers generally exposed to low average levels of benzene, we did not find an overall clear support for an association with lung cancer (all subtypes combined), although an association was suggested for duration of benzene exposure and adenocarcinoma. The limited evidence might be due to restricted statistical power.

• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar; Nordby, Karl-Christian & Olsen, Raymond [Show all 8 contributors for this article] (2023). Occupational exposures of firefighting and urinary tract cancer risk among men in the Norwegian Fire Departments Cohort. Occupational and Environmental Medicine. ISSN 1351-0711. 80(12). doi: 10.1136/oemed-2023-109003. Full text in Research Archive Show summary

  Objectives: Increased risks of bladder cancer and mesothelioma were the strongest evidence for the recent reclassification of firefighting as carcinogenic (Group 1) by the International Agency for Research on Cancer. Our study aim was to develop indicators for specific firefighting exposures and examine associations with urinary tract cancer (UTC), including bladder cancer. Methods: We developed indicators for exposure from employment at a fire department or in firefighting jobs, to fire and smoke, and to diesel exhaust for men in the Norwegian Fire Departments Cohort (n=4250). Incident UTC cases were obtained from the Cancer Registry of Norway (1960–2021). Poisson regression was used to estimate incidence rate ratios (IRR) with cumulative exposures grouped into tertiles (reference: lowest exposed tertile) with 0-year, 10-year and 15-year lagging of exposures. Results: During 125 090 person-years of follow-up, there were 76 cases of UTC. IRRs were mostly non-significantly increased in the middle tertile and at or below 1 in the highest tertile for total duration of employment, number of fires attended and fire exposure score with and without lags. In the middle tertile for diesel exhaust exposure, UTC risk was elevated over twofold with 10-year (IRR 2.27, 95% CI 1.22 to 4.20) and 15- year (2.21, 1.18 to 4.16) lags, and near 1 in the highest tertile. Findings for bladder cancer were similar to those for UTC. Conclusions: Dose-response associations between the exposure indicators and UTC were not observed. Future studies using the indicators with more cases are needed.

• Brathovde, Mari; Moger, Tron Anders; Aalen, Odd O.; Grotmol, Tom; Veierød, Marit Bragelien & Valberg, Morten (2023). A lean additive frailty model: With an application to clustering of melanoma in Norwegian families. Statistics in Medicine. ISSN 0277-6715. p. 1–29. doi: 10.1002/sim.9856. Full text in Research Archive Show summary

  Additive frailty models are used to model correlated survival data. However, the complexity of the models increases with cluster size to the extent that practical usage becomes increasingly challenging. We present a modification of the additive genetic gamma frailty (AGGF) model, the lean AGGF (L‐AGGF) model, which alleviates some of these challenges by using a leaner additive decomposition of the frailty. The performances of the models were compared and evaluated in a simulation study. The L‐AGGF model was used to analyze population‐wide data on clustering of melanoma in 2 391 125 two‐generational Norwegian families, 1960‐2015. Using this model, we could analyze the complete data set, while the original model limited the analysis to a restricted data set (with cluster sizes ). We found a substantial clustering of melanoma in Norwegian families and large heterogeneity in melanoma risk across the population, where 52% of the frailty was attributed to the 10% of the population at highest unobserved risk. Due to the improved scalability, the L‐AGGF model enables a wider range of analyses of population‐wide data compared to the AGGF model. Moreover, the methods outlined here make it possible to perform these analyses in a computationally efficient manner.

• Megen, Frida van; Fossli, Maria; Skodje, Gry Irene; Carlsen, Monica Hauger; Andersen, Lene Frost & Veierød, Marit Bragelien [Show all 8 contributors for this article] (2023). Nutritional assessment of women with celiac disease compared to the general population. Clinical Nutrition ESPEN. ISSN 2405-4577. 54, p. 251–257. doi: 10.1016/j.clnesp.2023.01.031. Full text in Research Archive Show summary

  Background & aims The nutritional quality of a gluten-free diet is debated because of the elimination of grains that are important sources of nutrients. The aim of this cross-sectional study was to perform a nutritional assessment in treated women with celiac disease and ongoing symptoms, and compare dietary intake with a healthy reference group (Norkost 3). Methods Celiac disease patients with biopsy confirmed mucosal healing, but persistent gastrointestinal symptoms, were included from an ongoing clinical trial. Nutritional assessment included anthropometrics, blood samples and dietary intake obtained by two 24 h recalls. Dietary intake in celiac women was compared with dietary intake in healthy women (Norkost 3). Two sample t-test was used for comparison of CeD and Norkost 3 women. Adjustment for age, BMI, education and smoking, by use of multiple linear regression analysis, did not change the results. Results In total, 59 women with celiac disease and 925 women that participated in Norkost 3 were included, with a mean age of 45 years in both groups. Women with celiac disease had a higher proportion of energy (E%) from fat (39 vs 34%, P < 0.001) and saturated fat (15 vs 13%, P = 0.01), a lower E% from protein (16 vs 18%, P = 0.01) and a lower intake of dietary fiber (19 vs 22 g, P = 0.002) compared to Norkost 3 women. Women with celiac disease had a lower intake of bread, fruit and milk, and a higher intake of cereals and cheese compared to Norkost 3 women. The average requirement was not met for several micronutrients, but blood analysis revealed few nutritional deficiencies: two women with insufficient vitamin D status and one with insufficient folic acid status. Conclusion The women with celiac disease had an unbalanced diet with a higher intake of total- and saturated fatty acids and a lower intake of fiber compared to the general population. These findings emphasizes the need for nutritional follow-up of celiac patients and development of nutrient dense gluten-free products.

• Gjersvik, Petter; Falk, Ragnhild Sørum; Roscher, Ingrid; Rizvi, Syed Mohammad Husain; Mjøen, Geir & Gude, Einar [Show all 10 contributors for this article] (2023). Rates of Second Tumor, Metastasis, and Death from Cutaneous Squamous Cell Carcinoma in Patients with and Without Transplant-Associated Immunosuppression. JAMA dermatology. ISSN 2168-6068. 159(9), p. 923–929. doi: 10.1001/jamadermatol.2023.2029. Full text in Research Archive
• Ali, Maryan Mohamed; Gedde-Dahl, Tobias; Osnes, Liv T. N.; Perrier, Flavie; Veierød, Marit Bragelien & Tjønnfjord, Geir Erland [Show all 7 contributors for this article] (2023). Extracorporeal Photopheresis as Graft-versus-Host Disease Prophylaxis: A Randomized Controlled Trial. Transplantation and Cellular Therapy (TCT). ISSN 2666-6375. 29(6), p. 364.e1–364.e11. doi: 10.1016/j.jtct.2023.02.023. Full text in Research Archive Show summary

  Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the sole curative option for many patients diagnosed with hematologic malignancies. A major obstacle is graft-versus-host disease (GVHD), causing significant morbidity and mortality. Extracorporeal photopheresis (ECP) is an increasingly applied treatment for GVHD, owing in part to its favorable safety profile. In contrast, reports on the use of ECP to prevent GVHD are rare, and randomized controlled trials (RCTs) are lacking. We conducted an RCT to assess whether ECP applied post-transplantation could prevent the development of GVHD within the first year of transplantation. We enrolled 157 patients (age 18 to 74 years) with a hematologic malignancy undergoing their first allo-HSCT, randomized as 76 to the intervention group and 81 to the control group. ECP was initiated directly on engraftment and was planned twice weekly for 2 weeks, then once weekly for 4 weeks. GVHD, relapse, and death were analyzed by Cox regression analysis. During the first year, 45 patients in the intervention group and 52 control patients developed GVHD (hazard ratio [HR], .82; 95% confidence interval [CI], .55 to 1.22; P = .32). There were no differences in acute or chronic GVHD or its organ distribution in this intention-to-treat RCT. A per-protocol analysis revealed a significant difference in GVHD between the intervention group (per-protocol; n = 39 of 76) and the control group (n = 77), 46% versus 68%, respectively (HR, .47; 95% CI, .27 to .80; P = .006). Relapse occurred in 15 patients in the intervention group and in 11 control patients (HR, 1.38; 95% CI, .64 to 3.01; P = .42). GVHD-free relapse-free survival, event-free survival, overall survival, and nonrelapse mortality did not differ significantly between the 2 study groups. There also was no significant difference in immune reconstitution between the 2 groups. This first intention-to-treat RCT investigating ECP as GVHD prophylaxis in allo-HSCT for hematologic malignancy does not support the use of ECP as an adjunct to standard drug-based GVHD prophylaxis.

• Ahimbisibwe, Ashley; Valberg, Morten; Green, Adele C.; Ghiasvand, Reza; Rüegg, Corina Silvia & Rimal, Raju [Show all 10 contributors for this article] (2023). Nevus Count, Pigmentary Characteristics, and Melanoma-specific Mortality among Norwegian Women with Melanoma >1.0 mm Thick. Acta Dermato-Venereologica. ISSN 0001-5555. 103. doi: 10.2340/actadv.v103.4403. Full text in Research Archive Show summary

  Little is known about if and how nevi and pigmentation are associated with melanoma-specific mortality. However, increased melanoma awareness in people with lighter pigmentation and many nevi may result in earlier diagnosis of thinner less-lethal tumors. The aim of this study was to investigate associations between nevus count (asymmetrical > 5 mm and small symmetrical), pigmentary characteristics (hair colour, eye colour, skin colour, freckling, pigmentary score), and melanoma-specific mortality in subjects with melanomas > 1 mm. Data from the Norwegian Women and Cancer cohort, established in 1991, with complete follow-up of melanoma patients until 2018 through the Cancer Registry of Norway, were used to estimate hazard ratios with 95% confidence intervals for the associations between nevus count, pigmentary characteristics, and melanoma-specific mortality, stratified by tumor thickness using Cox regression. Estimated hazard ratios consistently indicated a higher risk of melanoma death for those with darker vs lighter pigmentary characteristics in patients with tumors > 1.0–2.0 mm and > 2.0 mm thick (e.g. pigmentary score hazard ratio 1.25, 95% confidence interval (0.74–2.13)). Among women with melanomas >1.0 mm thick, lighter pigmentation and asymmetrical nevi may be associated with lower melanoma-specific mortality, suggesting that factors that increase the risk of melanoma may also be associated with decreased risk of death from melanoma.

• Gjersvik, Petter; Veierød, Marit Bragelien; Thompson, Alec K; Grzyb, Krzysztof; Liland, Katrine Høeg & Vazov, Nikolay Aleksandrov [Show all 8 contributors for this article] (2022). Histopatologisk revurdering av melanom og andre melanocytære hudlesjoner eksidert i 2009 og 2018–19. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(15), p. 1306–1311. doi: 10.4045/tidsskr.22.0204. Full text in Research Archive Show summary

  BAKGRUNN Histopatologisk vurdering av melanom og andre melanocytære hudlesjoner kan være vanskelig, og kan variere mellom patologer. MATERIALE OG METODE Histopatologiske snitt av 196 melanocytære hudlesjoner fra 2009 og 2018–19 ble hentet fra arkivet til Avdeling for patologi ved Oslo universitetssykehus og delt inn i seks diagnosekategorier: 1) benign nevus, 2) irregulær/dysplastisk nevus, 3) nevus med atypi, 4) melanoma in situ, 5) superfisielt spredende eller lentiginøst melanom og 6) nodulært melanom. Snittene ble deretter undersøkt individuelt og blindt av tre erfarne patologer og kategorisert på samme måte. Interobservatørsamsvar ble vurdert med Cohens kappa og samsvar med opprinnelig diagnose med andel vurderinger i samme diagnosekategori. RESULTATER Vurderingene fra de tre patologene viste kappaverdier på mellom 0,45 og 0,50. Andelen revurderinger som samsvarte med opprinnelig diagnosekategori, var henholdsvis 85,7 % (95 %-KI 75,7 til 92,1), 29,2 % (19,9 til 40,5), 27,8 % (20,9 til 36,0), 78,3 % (70,4 til 84,5), 81,2 % (73,7 til 86,9) og 93,3 % (82,1 til 97,7), dvs. høyest for nodulært melanom. Andelen revurderinger der diagnosen var mer alvorlig eller mindre alvorlig enn den opprinnelige, var henholdsvis høyere og lavere for snitt fra 2009 enn for snitt fra 2018–19. FORTOLKNING Forskjellene mellom patologenes vurderinger og avvikene fra opprinnelig diagnose kan forklares med vanskelig reproduserbare diagnostiske kriterier, diagnoseentiteter med overlappende morfologi og økende oppmerksomhet om tidlige malignitetstegn. En viss endring i diagnostisk praksis kan ikke utelukkes. Hovedfunn Ved histopatologisk revurdering av 196 melanocytære hudlesjoner fra 2009 og 2018–19 anga tre patologer ofte ulike diagnosekategorier (kappaverdier på mellom 0,45 og 0,50). Andelen revurderinger som samsvarte med opprinnelig diagnosekategori, var 78,3 % for melanoma in situ og 81,2 % for superfisielt spredende eller lentiginøst melanom. Andelen revurderinger der diagnosen var mer alvorlig enn den opprinnelige, var høyere for histopatologiske snitt fra 2009 (29,8 %) enn for snitt fra 2018–19 (19,3 %).

• Liu, Fei-Chih; Veierød, Marit Bragelien; Kjærheim, Kristina; Robsahm, Trude Eid; Ghiasvand, Reza & Hosgood, H Dean [Show all 17 contributors for this article] (2022). Night shift work, chemical coexposures and risk of female breast cancer in the Norwegian Offshore Petroleum Workers (NOPW) cohort: A prospectively recruited case-cohort study. BMJ Open. 12(1). doi: 10.1136/bmjopen-2021-056396. Full text in Research Archive Show summary

  Objectives This study examined the association between night shift work and risk of breast cancer, overall and by hormone receptor subtype, among females in the Norwegian Offshore Petroleum Workers (NOPW) cohort. We also examined the association of coexposure (chlorinated degreasers and benzene) and breast cancer risk, and possible interaction with work schedule. Design Prospectively recruited case- cohort study within the NOPW cohort. Setting Female offshore petroleum workers active on the Norwegian continental shelf. Participants 600 female workers (86 cases and 514 non- cases) were included in the study. We excluded workers that died or emigrated before start of follow-up, had missing work history, were diagnosed with breast cancer or other prior malignancy (except non-melanoma skin cancer) before start of follow-up. Results No overall association was found between breast cancer risk and work schedule (HR 0.87, 95% CI 0.52 to 1.46 for work schedule involving night shift vs day shift only). There was no significant association between work schedule and risk of any breast cancer subtype. No significant interactions were found between work schedule and chemical coexposures (breast cancer overall Pinteraction chlorinated degreasers =0.725 and Pinteraction benzene =0.175). Conclusions Our results did not provide supporting evidence that work schedule involving night shift affects breast cancer risk in female offshore petroleum workers, but should be considered cautiously due to few cases. Further studies with larger sample sizes are warranted

• Christensen, Jacob Juel; Bogsrud, Martin Prøven; Holven, Kirsten Bjørklund; Retterstøl, Kjetil; Veierød, Marit Bragelien & Nordeng, Hedvig Marie Egeland (2022). Use of statins and other lipid-modifying agents across pregnancy: A nationwide drug utilization study in Norway in 2005–2018. Atherosclerosis. ISSN 0021-9150. p. 1–10. doi: 10.1016/j.atherosclerosis.2022.11.022. Full text in Research Archive Show summary

  Background and aims Statins are becoming more widely used among women of reproductive age; however, nationwide data on statin use across pregnancy is scarce. We therefore aimed to describe the drug utilization patterns for statins and other lipid-modifying agents (LMAs) before, during, and after pregnancy, for all pregnancies in Norway from 2005 to 2018. Methods We linked individual-level data from four nationwide electronic health care registries in Norway and characterized the prescription fills of statins and other LMAs across pregnancy. We also examined trends in pregnancy-related LMA use, and characterized women using statins and other LMAs on parameters of health status and co-morbidity. Results In total, 822,071 pregnancies for 503,723 women were included. The number of statin prescription fills decreased rapidly during the first trimester and returned to pre-pregnancy levels about one year postpartum. Pregnancy-related statin use increased from 2005 (approx. 0.11% of all pregnancies) to 2018 (approx. 0.29% of all pregnancies); however, in total, few statin prescriptions were filled within any trimester of pregnancy (n = 331, 0.04% of all pregnancies). Statin use was more common in women with higher age, higher weight, smoking, and comorbidities such as hypertension and diabetes mellitus; also, statin users often had co-medication pertinent to these conditions. Conclusions Although statins and other LMAs were increasingly being used around the time of pregnancy among women in Norway, drug use was mostly discontinued during the first trimester. Our results suggest that pregnancy-related statin use should be monitored, and that drug safety analyses for maternal and offspring health outcomes are needed.

• Skodje, Gry Irene; Megen, Frida van; Stendahl, Marianne; Henriksen, Christine; Lundin, Knut Erik Aslaksen & Veierød, Marit Bragelien (2022). Detection of gluten immunogenic peptides and the Celiac Disease Adherence Test to monitor gluten-free diet: a pilot study. European Journal of Clinical Nutrition. ISSN 0954-3007. 76. doi: 10.1038/s41430-021-01054-6. Full text in Research Archive
• Christensen, Jacob Juel; Bogsrud, Martin Prøven; Holven, Kirsten Bjørklund; Retterstøl, Kjetil; Veierød, Marit Bragelien & Nordeng, Hedvig Marie Egeland (2022). Use of statins and other lipid-modifying agents across pregnancy – a nationwide drug utilization study of 822 071 pregnancies in Norway in 2005-2018. medRxiv. doi: 10.1101/2022.06.28.22276237. Full text in Research Archive
• Lergenmuller, Simon; Rueegg, Corina Silvia; Perrier, Flavie; Robsahm, Trude Eid; Green, Adele C. & Lund, Eiliv [Show all 8 contributors for this article] (2022). Lifetime sunburn trajectories and associated risks of cutaneous melanoma and squamous cell carcinoma among a cohort of Norwegian women. JAMA dermatology. ISSN 2168-6068. 158(12), p. 1367–1377. doi: 10.1001/jamadermatol.2022.4053. Full text in Research Archive Show summary

  Key Points Question What are the lifetime trajectories of sunburns among Norwegian women, and how are these associated with subsequent risk of cutaneous melanoma and squamous cell carcinoma? Findings In this cohort study of 168 553 participants from the Norwegian Women and Cancer Study, 5 classes of lifetime sunburn trajectories were identified, in line with health behaviors generally observed in people. Trajectories with high sunburn frequencies in childhood and throughout life were associated with both increased melanoma and cSCC risks. Meaning Lifetime trajectories of sunburns were identified, and the findings provide supporting evidence that avoiding sunburns throughout life, in particular in childhood, is crucial. Abstract Importance To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk. Objective To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC). Design, Setting, and Participants This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021. Exposures Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood. Main Outcomes and Measures Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens. Results Of the 172 472 women (age range, 31-70 years) who returned questionnaires, 169 768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n = 159 773), up to 49 years (n = 153 297), and up to 59 years (n = 119 170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (≤39 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates. Conclusion and Relevance This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.

• Megen, Frida van; Skodje, Gry Irene; Lergenmuller, Simon; Zühlke, Stephanie; Aabakken, Lars & Veierød, Marit Bragelien [Show all 8 contributors for this article] (2022). A low FODMAP diet reduces symptoms in treated celiac patients with ongoing symptoms–A randomized controlled trial. Clinical Gastroenterology and Hepatology. ISSN 1542-3565. 20(10), p. 2258–2266.E3. doi: 10.1016/j.cgh.2022.01.011. Full text in Research Archive Show summary

  Background & Aims A gluten-free diet usually leads to mucosal remission in celiac disease, but persistent symptoms are common. A low fermentable oligo-, di-, monosaccharides and polyols (FODMAP) diet is an established treatment for irritable bowel syndrome (IBS). We have assessed the efficacy of a moderately low FODMAP diet on persistent symptoms in treated celiac patients. Methods A randomized controlled trial was performed from 2018 to 2019 in 70 adults with biopsy-proven celiac disease. Inclusion criteria were as follows: persistent gastrointestinal symptoms defined by a Gastrointestinal Symptom Rating Scale (GSRS)–IBS version score of 30 or higher, gluten-free diet adherence for 12 months or longer, and serologic and mucosal remission. Participants were randomized to a low FODMAP–gluten-free diet (intervention) or usual gluten-free diet (control). The GSRS-IBS score was recorded at baseline and at weeks 1 to 4, and the Celiac Symptom Index at baseline and at week 4. Statistics included marginal models for repeated data and analyses of covariance. Results We included 34 participants in the intervention group and 36 in the control group. Time development of GSRS–IBS total scores differed significantly between the groups (Pinteraction < .001), evident after 1 week (mean difference in intervention vs control, -8.2; 95% CI, -11.5 to -5.0) and persisting through week 4 (mean difference in intervention vs control, -10.8; 95% CI, -14.8 to -6.8). Moreover, significantly lower scores were found for the dimensions of pain, bloating, diarrhea, and satiety (Pinteraction ≤ .04), but not constipation (Pinteraction = .43). FODMAP intake during the intervention was moderately low (mean, 8.1 g/d; 95% CI, 6.7–9.3 g/d). The Celiac Symptom Index was significantly lower in the intervention group at week 4 (mean difference, -5.8; 95% CI, -9.6 to -2.0). Conclusions A short-term moderately low FODMAP diet significantly reduced gastrointestinal symptoms and increased celiac disease–specific health, and should be considered for the management of persistent symptoms in celiac disease. ClinicalTrials.gov: NCT03678935.

• Hovland, Anders; Mundal, Liv; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund; Bogsrud, Martin Prøven & Tell, Grethe Seppola [Show all 8 contributors for this article] (2022). The risk of various types of cardiovascular diseases in mutation positive familial hypercholesterolemia; a review. Frontiers in Genetics. 13. doi: 10.3389/fgene.2022.1072108. Full text in Research Archive Show summary

  Familial hypercholesterolemia (FH) is a common, inherited disease characterized by high levels of low-density lipoprotein Cholesterol (LDL-C) from birth. Any diseases associated with increased LDL-C levels including atherosclerotic cardiovascular diseases (ASCVDs) would be expected to be overrepresented among FH patients. There are several clinical scoring systems aiming to diagnose FH, however; most individuals who meet the clinical criteria for a FH diagnosis do not have a mutation causing FH. In this review, we aim to summarize the literature on the risk for the various forms of ASCVD in subjects with a proven FH-mutation (FH+). We searched for studies on FH+ and cardiovascular diseases and also included our and other groups published papers on FH + on a wide range of cardiovascular and other diseases of the heart and vessels. FH + patients are at a markedly increased risk of a broad range of ASCVD. Acute myocardial infarction (AMI) is the most common in absolute numbers, but also aortic valve stenosis is by far associated with the highest excess risk. Per thousand patients, we observed 3.6 incident AMI per year compared to 1.9 incident aortic valve stenosis, however, standardized incidence ratio (SIR) for incident AMI was 2.3 compared to 7.9 for incident aortic valve stenosis. Further, occurrence of ischemic stroke seems not to be associated with increased risk in FH+. Clinicians should be aware of the excess risk of almost all kind of ASCVD in FH+, and the neutral risk of stroke need to be studied further in FH + patients.

• Stenehjem, Jo S.; Støer, Nathalie Charlotte; Ghiasvand, Reza; Grimsrud, Tom Kristian; Babigumira, Ronnie & Rees, Judy R. [Show all 11 contributors for this article] (2022). Prediagnostic serum 25-hydroxyvitamin D and leptin in relation to melanoma-specific death and overall death. Pigment Cell & Melanoma Research. ISSN 1755-1471. 35(2), p. 280–284. doi: 10.1111/pcmr.13026. Full text in Research Archive
• Berge, Leon Alexander Mclaren; Liu, Fei-Chih; Grimsrud, Tom Kristian; Babigumira, Ronnie; Støer, Nathalie Charlotte & Kjærheim, Kristina [Show all 15 contributors for this article] (2022). Night shift work and risk of aggressive prostate cancer in the Norwegian Offshore Petroleum Workers (NOPW) cohort. International Journal of Epidemiology. ISSN 0300-5771. 52(4), p. 1003–1014. doi: 10.1093/ije/dyac235. Full text in Research Archive Show summary

  Background: Night shift work may acutely disrupt the circadian rhythm, with possible carcinogenic effects. Prostate cancer has few established risk factors though night shift work, a probable human carcinogen, may increase the risk. We aimed to study the association between night shift work and chlorinated degreasing agents (CDAs) as possible endocrine disrupters in relation to aggressive prostate cancer as verified malignancies. Methods: We conducted a case-cohort study on 299 aggressive prostate cancer cases and 2056 randomly drawn non-cases in the Norwegian Offshore Petroleum Workers cohort (1965-98) with linkage to the Cancer Registry of Norway (1953-2019). Work history was recorded as years with day, night, and rollover (rotating) shift work, and CDA exposure was assessed with expert-made job-exposure matrices. Weighted Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for aggressive prostate cancer, adjusted for education and year of first employment, stratified by 10-year birth cohorts, and with 10, 15, and 20 years of exposure lag periods. Results: Compared with day work only, an increased hazard of aggressive prostate cancer (HR = 1.86, 95% CI 1.18-2.91; P-trend = 0.046) was found in workers exposed to ≥19.5 years of rollover shift work. This persisted with longer lag periods (HR = 1.90, 95% CI 0.92-3.95; P-trend = 0.007). The exposure-hazard curve for a non-linear model increased linearly (HRs ≥1.00) for 18-26 years of rollover shift work. No association was found with CDA exposure. Conclusions: Long-term exposure to rollover shift work may increase the hazard of aggressive prostate cancer in offshore petroleum workers.

• Ghiasvand, Reza; Berge, Leon Alexander Mclaren; Kulle, Bettina; Stenehjem, Jo Steinson; Heir, Trond & Karlstad, Øystein [Show all 11 contributors for this article] (2022). Use of antihypertensive drugs and risk of cutaneous melanoma: A nationwide nested case-control study. International Journal of Epidemiology. ISSN 0300-5771. 52(3), p. 887–898. doi: 10.1093/ije/dyac223. Full text in Research Archive Show summary

  Abstract Background Most antihypertensives can induce dermal photosensitivity, which may increase melanoma risk. However, corroborating evidence is limited. We examined the associations between use of antihypertensives and melanoma risk. Methods A nationwide nested case-control study was conducted using data from the Cancer Registry of Norway, the National Registry and the Norwegian Prescription Database in 2004–15. Ten controls were randomly selected for each melanoma case, matched on sex and birth year. The study included 12 048 cases and 117 895 controls. We estimated rate ratios (RRs) with 95% confidence intervals (CIs). All analyses were adjusted for ambient ultraviolet radiation (UVR). We additionally performed active comparator analyses, and sensitivity analyses by only including new users, distinguishing between exclusive and mixed users, allowing for different latency periods, and subgroup analyses by melanoma subtype and clinical stage. Results Compared with non-use, we observed a slightly increased melanoma risk in users of diuretics (RR 1.08, CI 1.01–1.15), calcium-channel blockers (RR 1.10, CI 1.04–1.18) and drugs affecting the renin-angiotensin system (RR 1.10, CI 1.04–1.16), but not for beta blockers (RR 0.97, CI 0.92–1.03). We found no heterogeneity of associations by melanoma subtype or clinical stage and no dose-response relationship between the cumulative defined daily doses (DDDs) and melanoma. No interaction was found between cumulative DDDs and ambient UVR. Conclusions Weak associations, with lack of a dose-response relationship and lack of interactions with ambient UVR, in the DDD analysis in this nationwide study do not support a causal relationship between antihypertensives and melanoma risk.

• Berge, Leon Alexander Mclaren; Grimsrud, Tom Kristian; Babigumira, Ronnie; Støer, Nathalie Charlotte; Shala, Nita Kaupang & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2022). Cancer epidemiology in practice: Working notes on cancer history-based selection and censoring. Norsk Epidemiologi. ISSN 0803-2491. 30(1-2), p. 107–112. doi: 10.5324/nje.v30i1-2.4986. Full text in Research Archive Show summary

  Researchers conducting observational studies of exposure-cancer associations must make decisions regarding the selection and censoring of study subjects with respect to their cancer history. Given available information, this may include cancers prior to start of follow-up (prevalent cases), and multiple primary cancers (MPCs) at the same or different time-points during follow-up. The choice of analytical strategy may have implications for statistical power and for potential biases. We discuss herein two approaches, the “all cancer approach” and the “first primary cancer approach”. Each contains a set of criteria, primarily for, but not limited to, cohort studies of exposure-cancer associations. Both approaches exclude subjects with prevalent cancers at start of follow-up to avoid information and selection bias but differ in terms of case definition and censoring criteria. In the “all cancer approach”, subjects are censored on non-eligible cancer subtypes of the cancer under study, though subjects with MPCs are not censored on other incident cancers preceding or occurring simultaneously (at time of diagnosis) with the cancer under study. To limit the influence of prior treatment regimens, the “first primary cancer approach” censors subjects upon any first primary incident cancer not under study, including any “simultaneous” MPCs, as well as non-eligible subtypes of the cancer under study. Depending on the cancer under study, these approaches may yield different estimates of the exposure-cancer association and may in this regard be utilized for sensitivity analyses. These alternative approaches are presented and discussed here as a potential resource and source of further discussion for peers in the field of cancer epidemiology.

• Tyrdal, Mari Kristine; Veierød, Marit Bragelien; Røe, Cecilie; Natvig, Bård; Wahl, Astrid Klopstad & Robinson, Hilde Stendal (2022). Neck and back pain: Differences between patients treated in primary and specialist health care. Journal of Rehabilitation Medicine. ISSN 1650-1977. 54, p. jrm00300–jrm00300. doi: 10.2340/jrm.v54.363. Full text in Research Archive Show summary

  Objective: To describe and compare patients with neck and back pain treated by physiotherapists in primary healthcare (PHC) and in departments for physical medicine and rehabilitation in specialist healthcare (SHC) in Norway. Design: Cross-sectional study using data from the FYSIOPRIM database in PHC and the Norwegian Neck and Back Registry in SHC. Neck and back pain patients in the period 2014–18 aged ≥ 18 years were included. Demographics, lifestyle and clinical factors were investigated. Results: A total of 8,125 patients were included: 584 in PHC and 7,541 in SHC. Mean age was 47.1 and 45.5 years, respectively, with more females in PHC (72% vs 56%). Low levels of education and physical activity, high workload and receiving social benefits were associated with treatment in SHC. Treatment in SHC was most common from 3 to 12 months’ pain duration. Higher pain intensity and lower health-related quality of life were found in patients treated in SHC, no differences were found for psychological distress. Conclusion: This is the first study comparing register data in patients with neck and back pain treated in PHC and SHC. Differences were found in pain and health-related quality of life, but levels of psychological distress were similar between patients treated in PHC and those treated in SHC. LAY ABSTRACT Patients with neck or back pain have high levels of healthcare utilization, both in primary and specialist healthcare. The aim of this study was to investigate patients referred and treated by physiotherapists in primary healthcare and by specialists in specialist healthcare in Norway, to evaluate differences in the demographics, lifestyle and clinical factors of patients treated in each healthcare setting. Included patients had been diagnosed with neck or back pain from 2014 to 2018, and were aged ≥18 years. Patients in specialist care had more pain and lower health-related quality of life, but similar levels of psychological distress to those treated in primary healthcare. Furthermore, patients treated in specialist healthcare had lower socioeconomic status (education, workload, social benefits) compared with those treated in primary healthcare.

• Page, Christian Magnus; Nøst, Therese Haugdahl; Djordjilović, Vera; Thoresen, Magne; Frigessi, Arnoldo & Sandanger, Torkjel M [Show all 7 contributors for this article] (2022). Pre-diagnostic DNA methylation in blood leucocytes in cutaneous melanoma; a nested case–control study within the Norwegian Women and Cancer cohort. Scientific Reports. 12(1). doi: 10.1038/s41598-022-18585-y. Full text in Research Archive Show summary

  The prognosis of cutaneous melanoma depends on early detection, and good biomarkers for melanoma risk may provide a valuable tool to detect melanoma development at a pre-clinical stage. By studying the epigenetic profile in pre-diagnostic blood samples of melanoma cases and cancer free controls, we aimed to identify DNA methylation sites conferring melanoma risk. DNA methylation was measured at 775,528 CpG sites using the Illumina EPIC array in whole blood in incident melanoma cases (n = 183) and matched cancer-free controls (n = 183) in the Norwegian Women and Cancer cohort. Phenotypic information and ultraviolet radiation exposure were obtained from questionnaires. Epigenome wide association (EWAS) was analyzed in future melanoma cases and controls with conditional logistic regression, with correction for multiple testing using the false discovery rate (FDR). We extended the analysis by including a public data set on melanoma (GSE120878), and combining these different data sets using a version of covariate modulated FDR (AdaPT). The analysis on future melanoma cases and controls did not identify any genome wide significant CpG sites (0.85 ≤ padj ≤ 0.99). In the restricted AdaPT analysis, 7 CpG sites were suggestive at the FDR level of 0.15. These CpG sites may potentially be used as pre-diagnostic biomarkers of melanoma risk.

• Perrier, Flavie; Ghiasvand, Reza; Lergenmuller, Simon; Robsahm, Trude Eid; Green, Adele C. & Borch, Kristin Benjaminsen [Show all 10 contributors for this article] (2022). Life-Course Trajectories of Physical Activity and Melanoma Risk in a Large Cohort of Norwegian Women. Clinical Epidemiology. 14, p. 1571–1584. doi: 10.2147/CLEP.S382454. Full text in Research Archive Show summary

  Purpose: Physical activity (PA) is a cornerstone in disease prevention and varies throughout life. A pooled analysis of cohort studies and a meta-analysis of cohort studies found positive associations between PA and melanoma risk. However, previous studies focused on PA at specific ages and often lacked information on ultraviolet radiation (UVR) exposure. Using the population-based Norwegian Women and Cancer (NOWAC) cohort, including information on PA and UVR exposure, we estimated life-course PA trajectories from adolescence to adulthood and their associations with melanoma.<p> <p>Methods: Total PA across different domains (recreation, occupation, transport, household) was reported for ages 14 and 30 years, and when responding to the questionnaire (31– 76 years) using a 10-point scale, validated to rank PA levels in Norwegian females. We estimated life-course PA trajectories using a latent class mixed model in 152,248 women divided into three subcohorts depending on age at questionnaire completion: 31– 39 (n = 27,098), 40– 49 (n = 52,515) and ≥ 50 years (n = 72,635). The unique 11-digit identity number of Norwegian citizens was used to link NOWAC to the Cancer Registry of Norway for information on cancer diagnoses, emigration and death. Associations between PA trajectories and melanoma risk were estimated in each subcohort using multivariable Cox regression.<p> <p>Results: Five classes of individual life-course PA trajectories were identified in subcohort 31– 39 years (low, moderate, high, decreasing, increasing PA) and four in subcohorts 40– 49 and ≥ 50 years (low, moderate, high, decreasing PA). No significant association was found between life-course PA trajectories and melanoma risk in any subcohort. Hazard ratios (95% confidence intervals) for the high versus moderate trajectory were 0.92 (0.66– 1.29), 1.15 (0.97– 1.37) and 0.90 (0.78– 1.05) for subcohorts 31– 39, 40– 49 and ≥ 50 years, respectively.<p> <p>Conclusion: Our results do not support a positive association between PA and melanoma risk found in previous studies, which is important for public health guidelines promoting regular PA.

• Lofterød, Trygve; Frydenberg, Hanne; Veierød, Marit Bragelien; Jenum, Anne Karen; Reitan, Jon Brinchmann & Wist, Erik [Show all 7 contributors for this article] (2022). The influence of metabolic factors and ethnicity on breast cancer risk, treatment and survival: The Oslo ethnic breast cancer study. Acta Oncologica. ISSN 0284-186X. 61(5), p. 649–657. doi: 10.1080/0284186X.2022.2053573. Full text in Research Archive Show summary

  Background Breast cancer risk remains higher in high-income compared with low-income countries. However, it is unclear to what degree metabolic factors influence breast cancer development in women 30 years after immigration from low- to a high-incidence country. Methods Using Cox regression models, we studied the association between pre-diagnostic metabolic factors and breast cancer development, and whether this association varied by ethnicity among 13,802 women participating in the population-based Oslo Ethnic Breast Cancer Study. Ethnic background was assessed and pre-diagnostic metabolic factors (body mass index, waist:hip ratio, serum lipids and blood pressure) were measured. A total of 557 women developed invasive breast cancer, and these women were followed for an additional 7.7 years. Results Among women with an unfavorable metabolic profile, women from south Asia, compared with western European women, had a 2.3 times higher breast cancer risk (HR 2.30, 95% CI 1.18–4.49). Compared with the western European women, the ethnic minority women were more likely to present with triple-negative breast cancer (TNBC) (OR 2.11, 95% CI 0.97–4.61), and less likely to complete all courses of planned taxane treatment (OR 0.26, 95% CI 0.08–0.82). Among TNBC women, above-median triglycerides:HDL-cholesterol (>0.73) levels, compared with below-median triglycerides:HDL-cholesterol (≤0.73) levels, was associated with 2.9 times higher overall mortality (HR 2.88, 95% CI 1.02–8.11). Conclusions Our results support the importance of metabolic factors when balancing breast cancer prevention and disease management among all women, and in particular among non-western women migrating from a breast cancer low-incidence to a high-incidence country.

• Marjerrison, Niki; Jakobsen, Jarle; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar & Nordby, Karl-Christian [Show all 8 contributors for this article] (2022). Cancer incidence in sites potentially related to occupational exposures: 58 years of follow-up of firefighters in the Norwegian Fire Departments Cohort. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 48(3), p. 210–219. doi: 10.5271/sjweh.4009. Full text in Research Archive Show summary

  Objectives Firefighters are exposed to a variety of known and suspected carcinogens through their work. However, the association with cancer risk has limited evidence. We examined cancer incidence among firefighters in the newly established Norwegian Fire Departments Cohort restricted to sites with established associations with carcinogens encountered during firefighting. This included sites within the respiratory, urinary, and lympho-hematopoietic systems, and the skin and all sites combined. Methods Male firefighters (N=3881) in the cohort were linked to the Cancer Registry of Norway for incident cancer cases occurring during the period 1960–2018. We calculated standardized incidence ratios (SIR) with rates for the national male population as reference, and stratified SIR analyses by period of first employment, duration of employment, and time since first employment. Results Elevated risk was seen for all sites combined (SIR 1.15, 95% confidence interval 1.07–1.23). Elevated risk of urinary tract cancer was observed among firefighters who began working before 1950, and with observation ≥40 years since first employment. Risk of mesothelioma and laryngeal cancer were elevated with ≥40 years since first employment and with ≥30 years employment duration. Conclusions The observed associations between firefighting and urinary tract cancer, laryngeal cancer, and mesothelioma have been observed in some studies previously, and our results suggest the observed elevated risks are related to carcinogenic occupational exposures. Differences in risk by period of employment potentially reflect changes in exposures from improved quality and use of personal protective equipment.

• Marjerrison, Niki; Jacobsen, Jarle; Demers, Paul A.; Grimsrud, Tom Kristian; Hansen, Johnni & Martinsen, Jan Ivar [Show all 9 contributors for this article] (2022). Comparison of cancer incidence and mortality in the Norwegian Fire Departments Cohort, 1960-2018. Occupational and Environmental Medicine. ISSN 1351-0711. 79, p. 736–743. doi: 10.1136/oemed-2022-108331. Full text in Research Archive Show summary

  Objectives Elevated risk of cancer at several sites has been reported among firefighters, although with mixed findings. The purpose of this study was to calculate standardised incidence ratios (SIRs) and standardised mortality ratios (SMRs) for cancer and compare them to assess whether use of the different measures could be a source of inconsistencies in findings. Methods The Norwegian Fire Departments Cohort, comprising 4295 male employees who worked at 15 fire departments across Norway, was linked to health outcome registries for the period 1960–2018. SIRs and SMRs were derived using national reference rates. Results Overall, we observed elevated incidence of colon cancer (SIR, 95% CI 1.27, 1.01 to 1.58), mesothelioma (2.59, 1.12 to 5.11), prostate cancer (1.18, 1.03 to 1.34) and all sites combined (1.15, 1.08 to 1.23). Smaller, non-significant elevations were found for mortality of colon cancer (SMR, 95% CI 1.20, 0.84 to 1.67) and mesothelioma (1.66, 0.34 to 4.86), while SMR for prostate cancer was at unity. Potential errors were observed in some of the mortality data, notably for mesothelioma cases. Among those who died of cancer, 3.7% (n=14) did not have a prior diagnosis of malignancy at the same site group. Conclusions Assessment of incidence or mortality did not greatly influence the interpretation of results. The most prominent differences in SIR and SMR appeared to be due to inconsistencies between sites of cancer diagnosis and cause of death. The difference in SIR and SMR for prostate cancer suggested a detection bias from differential screening practices.

• Mahamat-Saleh, Yahya; Al-Rahmoun, Marie; Severi, Gianluca; Ghiasvand, Reza; Veierød, Marit Bragelien & Caini, Saverio [Show all 37 contributors for this article] (2022). Baseline and lifetime alcohol consumption and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). International Journal of Cancer. ISSN 0020-7136. 152(3), p. 348–362. doi: 10.1002/ijc.34253. Full text in Research Archive Show summary

  Experimental evidence suggests that alcohol induces cutaneous carcinogenesis, yet epidemiological studies on the link between alcohol intake and skin cancer have been inconsistent. The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective cohort initiated in 1992 in 10 European countries. Alcohol intake at baseline and average lifetime alcohol intake were assessed using validated country-specific dietary and lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in Cox models. A total of 14 037 skin cancer cases (melanoma: n = 2457; basal-cell carcinoma (BCC): n = 8711; squamous-cell carcinoma (SCC): n = 1928; unknown: n = 941) were identified among 450 112 participants (average follow-up: 15 years). Baseline alcohol intake was positively associated with SCC (>15 vs 0.1-4.9 g/day: HR = 1.44, 95% CI = 1.17-1.77; Ptrend = .001), BCC (HR = 1.12, 95% CI = 1.01-1.23; Ptrend = .04), and melanoma risks in men (HR = 1.17, 95% CI = 0.95-1.44; Ptrend = .17), while associations were more modest in women (SCC: HR = 1.09, 95% CI = 0.90-1.30; Ptrend = .13; BCC: HR = 1.08, 95% CI = 1.00-1.17, Ptrend = .03; melanoma: HR = 0.93, 95% CI = 0.80-1.08, Ptrend = .13). Associations were similar for lifetime alcohol intake, with an attenuated linear trend. Lifetime liquor/spirit intake was positively associated with melanoma (fourth vs first quartile: HR = 1.47, 95% CI = 1.08-1.99; Ptrend = .0009) and BCC risks in men (HR = 1.17, 95% CI = 1.04-1.31; Ptrend = .14). Baseline and lifetime intakes of wine were associated with BCC risk (HR = 1.25 in men; HR = 1.11-1.12; in women). No statistically significant associations were found between beverage types and SCC risk. Intake of beer was not associated with skin cancer risk. Our study suggests positive relationships between alcohol intake and skin cancer risk, which may have important implications for the primary prevention of skin cancer.

• Tsuruda, Kaitlyn; Veierød, Marit Bragelien; Houssami, Nehmat; Wåde, Gunvor Gipling; Mangerud, Gunhild & Hofvind, Solveig (2021). Women’s conceptual knowledge about breast cancer screening and overdiagnosis in Norway: a cross-sectional study. BMJ Open. 11(12), p. 1–10. doi: 10.1136/bmjopen-2021-052121. Full text in Research Archive Show summary

  Objective To investigate conceptual knowledge about mammographic screening among Norwegian women. Design We administered a cross-sectional, web-based survey. We used multiple-choice questions and a grading rubric published by a research group from Australia. Setting Our Norwegian-language survey was open from April to June 2020 and targeted women aged 45–74 years. Participants 2033 women completed our questionnaire. We excluded 13 women outside the target age range and 128 women with incomplete data. Responses from 1892 women were included in the final study sample. Primary and secondary outcome measures The questionnaire focused on women’s knowledge about the breast cancer mortality reduction, false positive results and overdiagnosis associated with mammographic screening. The primary outcome was the mean number of marks assigned in each of the three themes and overall. There were three potential marks for questions about breast cancer mortality, one for false positives and six for overdiagnosis. Results Most women (91.7%) correctly reported that screened women are less likely to die of breast cancer than non-screened women. 39.7% of women reported having heard of a ‘false positive screening result’ and 86.2% identified the term’s definition; 51.3% of women had heard of ‘overdiagnosis’ and 14.8% identified the term’s definition. The mean score was 2.59 of 3 for questions about breast cancer mortality benefit and 0.93 of 1 for the question about false positive screening results. It was 2.23 of 6 for questions about overdiagnosis. Conclusions Most participants correctly answered questions about the breast cancer mortality benefit and false positive results associated with screening. The proportion of correct responses to questions about overdiagnosis was modest, indicating that conceptual knowledge about overdiagnosis was lower. Qualitative studies that can obtain in-depth information about women’s understanding of overdiagnosis may help improve Norwegian-language information about this challenging topic.

• Liu, Fei-Chih; Grimsrud, Tom Kristian; Veierød, Marit Bragelien; Robsahm, Trude Eid; Ghiasvand, Reza & Babigumira, Ronnie [Show all 8 contributors for this article] (2021). Ultraviolet radiation and risk of cutaneous melanoma and squamous cell carcinoma in males and females in the Norwegian Offshore Petroleum Workers cohort. American Journal of Industrial Medicine. ISSN 0271-3586. 64, p. 496–510. doi: 10.1002/ajim.23240. Full text in Research Archive Show summary

  Background Increased risk of cutaneous melanoma and squamous cell carcinoma (SCC) has been reported among petroleum workers, but few studies include females, exposure data on ultraviolet radiation (UVR), and potential confounding factors. We aimed to examine UVR exposure in relation to risk of melanoma and SCC among male and female offshore petroleum workers. We also examined the association between UVR exposure and melanoma (Breslow) thickness. Methods The Norwegian Offshore Petroleum Workers (NOPW) cohort (n = 27,917) holds information on sunbathing, indoor tanning, sunburns, sunscreen use, and other lifestyle factors recorded in 1998. Linkage to the Cancer Registry of Norway gave information on cancer diagnosis through 2017. We used Cox and logistic regression to estimate hazard ratios (HRs) of skin cancer and odds ratios (OR) of thick (≥1 mm) melanomas, respectively, with 95% confidence intervals (CIs). Results Melanoma risk increased with increasing frequency of sunbathing after age 20 (ptrend = 0.031), sunburn average intensity (ptrend = 0.028), and sunscreen use (HR = 2.16; 95% CI: 1.42 -3.27 for almost always vs. never/rarely). The risk of thick melanoma was inversely associated with sunbathing frequency after age 20 (OR = 0.38; 95% CI: 0.16 - 0.90 for ≥4 weeks/year vs. 1 week/year). SCC risk increased with increasing frequency of indoor tanning after age 20 (HR = 2.72; 95% CI: 1.22 - 6.05 for ≥3 times/months vs. never), sunburn average intensity (ptrend < 0.001), and sunscreen use (ptrend < 0.001). Conclusions Our results support associations between UVR exposure and skin cancer risk in male and female offshore petroleum workers. This occupational group may be especially relevant for targeted sun protection advice.

• Lergenmuller, Simon; Ghiasvand, Reza; Robsahm, Trude Eid; Green, Adèle C.; Lund, Eiliv & Rueegg, Corina Silvia [Show all 7 contributors for this article] (2021). Sunscreens With High Versus Low Sun Protection Factor and Cutaneous Squamous Cell Carcinoma Risk: A Population-Based Cohort Study. American Journal of Epidemiology. ISSN 0002-9262. 191(1), p. 75–84. doi: 10.1093/aje/kwab216. Full text in Research Archive Show summary

  Evidence on sunscreen use and cutaneous squamous cell carcinoma (cSCC) risk is limited. Most studies have not taken sun protection factor (SPF) into consideration and used nonusers of sunscreen as the reference group. Nonusers are likely a priori at lower cSCC risk than users. No study has investigated the effect of high- versus low-SPF sunscreens on cSCC, appropriately adjusting for time-varying confounding. Using data from the Norwegian Women and Cancer Study (1991–2016), we investigated whether use of SPF ≥15 versus SPF <15 sunscreens reduces cSCC risk. We used a marginal structural Cox proportional hazards model with inverse probability of treatment and censoring weights to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During follow-up of 148,781 women (mean follow-up, 14.3 years), 653 women were diagnosed with cSCC. The effect on cSCC risk of sunscreens with SPF ≥15 versus SPF <15 was close to the null when used at any latitudes (HR = 1.02, 95% CI: 0.82, 1.27) and when used in lower-latitude settings (HR = 1.05, 95% CI: 0.84, 1.32). In conclusion, we found no indication that sunscreens with SPF ≥15 reduced Norwegian women’s cSCC risk more than sunscreens with SPF <15, suggesting that either there is no difference in their effects long-term or the difference is diluted by incorrect application.

• Jakobsen, Jarle; Veierød, Marit Bragelien; Grimsrud, Tom Kristian; Fosså, Sophie Dorothea; Hammarström, Bato & Kjærheim, Kristina (2021). Early detection of prostate cancer in firefighters: a register-based study of prognostic factors and survival. Occupational and Environmental Medicine. ISSN 1351-0711. doi: 10.1136/oemed-2021-107622. Full text in Research Archive Show summary

  Objectives To examine age at diagnosis, prognostic factors and survival of prostate cancer (PCa) in Norwegian firefighters and three other occupations undergoing occupational health check-ups, and comparing with PCa cases in the general population. Methods All PCa cases diagnosed in 1960–2017 were extracted from the Cancer Registry of Norway. Firefighters, military employees, pilots and police officers were identified through occupational data from Statistics Norway. Age at diagnosis, clinical stage, prostate-specific antigen (PSA), Gleason score, performance status and overall survival and PCa-specific survival in cases in these occupations were compared with cases in the general population. Results Firefighters were significantly younger at PCa diagnosis than cases in the general population in 1960–1993 (mean difference: 2.1 years) and 2007–2017 (mean difference: 4.3 years). At diagnosis, firefighters had significantly lower PSA values, Gleason scores and performance status scores than the general population. Firefighters diagnosed in 2007–2017 had lower risk of all-cause death than the general population (crude HR 0.71 (0.53–0.95)). No difference remained after adjusting for age at diagnosis (HR 1.03 (0.77–1.37)). Firefighters were older at diagnosis in 1994–2006 (mean difference: 3.0 years), but showed no other significant differences in age at diagnosis, PSA values, Gleason scores or performance status compared with military employees, pilots and police officers. Conclusions Younger age and better prognostic factors at PCa diagnosis among firefighters and other occupations with requirements for health check-ups than cases in the general population may indicate an increased diagnostic intensity, likely contributing to elevated PCa incidence in such occupations.

• Megen, Frida van; Skodje, Gry Irene; Stendahl, Marianne; Veierød, Marit Bragelien; Lundin, Knut E. A. & Henriksen, Christine (2021). High disease burden in treated celiac patients–a web-based survey. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 56(8), p. 882–888. doi: 10.1080/00365521.2021.1930146. Full text in Research Archive Show summary

  Background Strict adherence to a gluten-free diet usually leads to clinical and histological remission in celiac disease. Few studies have investigated the prevalence of persistent symptoms in a celiac population. We aimed to study the impact of gastrointestinal symptoms on general health in a large number of treated celiac patients, and describe the prevalence of persistent gastrointestinal symptoms and investigate associated factors. Methods Adults with celiac disease filled out background questions, the Celiac Symptom Index (CSI) and the celiac disease adherence test (CDAT) in a web-based national survey. Participants who reported gastrointestinal symptoms during the previous week also recorded the gastrointestinal symptom rating scale-irritable bowel syndrome version (GSRS-IBS). Statistical analysis included chi-squared test, t-test, correlation, and linear regression. Results Of 3834 participants (82% women; mean age 47 years), 54% reported gastrointestinal symptoms the previous week, and 30% of these had CSI score ≥45, indicative of the relatively poor quality of life (vs. 5% among those without gastrointestinal symptoms). The prevalence of persistent gastrointestinal symptoms (GSRS-IBS ≥30) was 40% and the most prominent symptoms were bloating (44%) and pain (37%). Age, sex, symptoms at the time of diagnosis, comorbidity, dietary adherence and CeD-specific health were significantly associated with gastrointestinal symptoms (p < .001). Conclusion In this national cross-sectional study among participants with celiac disease, persistent gastrointestinal symptoms were frequent, and were associated with a high symptom burden and reduced CeD-specific health. Several factors were associated with gastrointestinal symptoms, but more research is needed to find the cause of persistent symptoms in patients with celiac disease.

• Perrier, Flavie; Ghiasvand, Reza; Lergenmuller, Simon; Robsahm, Trude Eid; Green, Adele C. & Borch, Kristin Benjaminsen [Show all 10 contributors for this article] (2021). Physical activity and cutaneous melanoma risk: A Norwegian population-based cohort study. Preventive Medicine. ISSN 0091-7435. 153, p. 1–9. doi: 10.1016/j.ypmed.2021.106556. Full text in Research Archive Show summary

  Physical activity (PA) is an important factor in cancer prevention, but positive association between PA and risk of cutaneous melanoma found in recent studies may complicate this strategy. Ultraviolet radiation (UVR) exposure during outdoor PA is a plausible explanation for a positive association. We investigated the associations between PA, UVR and melanoma risk in the Norwegian Women and Cancer cohort. Overall PA was reported by 151,710 women, aged 30–75 at inclusion, using a validated 10-point-scale at enrolment and during follow-up, together with recent numbers of sunburns, indoor tanning sessions and weeks on sunbathing vacations. Seasonal outdoor walking and seasonal PAs were recorded in subsamples (n = 102,671 and n = 29,077, respectively). Logistic and Cox regression were used. Mean follow-up was 18.5 years, and 1565 invasive incident melanoma cases were diagnosed. Overall PA was inversely associated with sunburns, while positively associated with sunbathing vacations and indoor tanning. Overall PA was not associated with melanoma risk in all body sites combined (ptrend = 0.61), but reduced risk was found in upper limb melanomas (hazard ratio (HR) = 0.70, 95% confidence interval (CI) 0.51–0.96; high versus low PA). Non-significant reduced risks were found for seasonal outdoor walking >2 h/day versus 30–60 min/day (summer HR = 0.81, 95% CI 0.66–1.00; autumn HR = 0.74, 95%CI 0.55–1.01). Seasonal PAs were not associated with melanoma risk. In conclusion, we found positive associations between overall PA and sunbathing vacations and indoor tanning, and, unlike literature, inverse association between overall PA and sunburns. Our results do not support a positive association between PA and melanoma risk in Norwegian women.

• Øyri, Linn Kristin Lie; Bogsrud, Martin Prøven; Christensen, Jacob J.; Ulven, Stine Marie; Brantsæter, Anne Lise & Retterstøl, Kjetil [Show all 13 contributors for this article] (2021). Novel associations between parental and newborn cord blood metabolic profiles in the Norwegian Mother, Father and Child Cohort Study. BMC Medicine. 19(19). doi: 10.1186/s12916-021-01959-w. Full text in Research Archive Show summary

  Background:More than one third of Norwegian women and men between 20 and 40 years of age have elevated cholesterol concentration. Parental metabolic health around conception or during pregnancy may affect the offspring’s cardiovascular disease risk. Lipids are important for fetal development, but the determinants of cord blood lipids have scarcely been studied. We therefore aimed to describe the associations between maternal andpaternal peri-pregnancy lipid and metabolic profile and newborn cord blood lipid and metabolic profile. Methods:This study is based on 710 mother–father–newborn trios from the Norwegian Mother, Father and ChildCohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). The sample included in thisstudy consisted of parents with and without self-reported hypercholesterolemia the last 6 months before pregnancy and their partners and newborns. Sixty-four cord blood metabolites detected by nuclear magnetic resonance spectroscopy were analyzed by linear mixed model analyses. The false discovery rate procedure wasused to correct for multiple testing. Results:Among mothers with hypercholesterolemia, maternal and newborn plasma high-density lipoproteincholesterol, apolipoprotein A1, linoleic acid, docosahexaenoic acid, alanine, glutamine, isoleucine, leucine, valine,creatinine, and particle concentration of medium high-density lipoprotein were significantly positively associated(0.001≤q≤0.09). Among mothers without hypercholesterolemia, maternal and newborn linoleic acid, valine,tyrosine, citrate, creatinine, high-density lipoprotein size, and particle concentration of small high-density lipoproteinwere significantly positively associated (0.02≤q≤0.08). Among fathers with hypercholesterolemia, paternal andnewborn ratio of apolipoprotein B to apolipoprotein A1 were significantly positively associated (q= 0.04). Amongfathers without hypercholesterolemia, no significant associations were found between paternal and newbornmetabolites. Sex differences were found for many cord blood lipids. Conclusions:Maternal and paternal metabolites and newborn sex were associated with several cord bloodmetabolites. This may potentially affect the offspring’s long-term cardiovascular disease risk.Keywords:MoBa, the Norwegian Mother, Father and Child Cohort Study, MBRN, Medical Birth Registry of Norway,Cholesterol, Metabolic profiling, Cord blood, Sex differences

• Robsahm, Trude Eid; Helsing, Per; Svendsen, Henrik Løvendahl & Veierød, Marit Bragelien (2021). Clinical Suspicion Sensitivity of Nodular and Superficial Spreading Melanoma. Acta Dermato-Venereologica. ISSN 0001-5555. 101, p. 1–4. doi: 10.2340/00015555-3782. Full text in Research Archive Show summary

  In Norway, nodular melanoma is the most fatal melanoma subtype and superficial spreading melanoma the most common, indicating diagnostic challenges. The aim of this study was to assess the clinical suspicion sensitivity of nodular melanoma and superficial spreading melanoma, by diagnosing physician, using randomly selected 100 nodular melanomas and 100 superficial spreading melanomas from the Norwegian Melanoma Registry, diagnosed in 2014 to 2015. Information about suggested diagnoses and diagnosing physician was collected from pathology request forms. Suspicion sensitivity was defined as the proportion (%) of cases with “melanoma” as a suggested diagnosis, estimated with 95% confidence interval (95% CI). Most melanomas (74.5%) were diagnosed by non-dermatologists, with a suspicion sensitivity of 23% (95% CI 15–34) for nodular melanoma and 24% (95% CI 16–35) for superficial spreading melanoma. Corresponding estimates for dermatologists were 50% (95% CI 32–68) and 96% (95% CI 80–99), respectively (pinteraction=0.007). The low suspicion sensitivity for both subtypes among non-dermatologists calls for educational efforts.

• Ghiasvand, Reza; Green, Adele C.; Sandanger, Torkjel M; Weiderpass, Elisabete; Robsahm, Trude Eid & Veierød, Marit Bragelien (2021). Phenotypic Characteristics and Melanoma Thickness in Women. Acta Dermato-Venereologica. ISSN 0001-5555. 101. doi: 10.2340/00015555-3806. Full text in Research Archive Show summary

  Patients’ phenotypic characteristics might be associated with melanoma aggressiveness, but the evidence is scarce. This study examined the associations be­tween pigmentary characteristics, naevi and melanoma thickness. Data from the Norwegian Women and Cancer (NOWAC) study were analysed. By 2014, 1,243 women were diagnosed with a primary melanoma, and 1,140 had information on thickness. Using ordinal logistic regression models, the probability of being diagnosed with a specific thickness category was calculated by pigmentary score and naevi. Fair pigmentary score was associated with thinner trunk melanomas (probabilities of being diagnosed with a tumour ≤1.0 mm thickness were 74%, 66%, and 51% for fair, medium and dark pigmentary scores, respectively), but not the other sites. High number of naevi was associated with thicker nodular melanoma (NM) but not with super­ficial spreading melanoma. These findings suggest the need for greater overall vigilance and skin checks among women with fair pigmentary score. The association between naevi and NM suggest possible biological mechanisms.

• Jakobsen, Jarle; Babigumira, Ronnie; Danielsen, Marie; Grimsrud, Tom Kristian; Olsen, Raymond & Rosting, Cecilie [Show all 8 contributors for this article] (2020). Work conditions and practices in Norwegian Fire Departments From 1950 until today. A Survey on factors potentially influencing carcinogen exposure. SH@W Safety and Health at Work. ISSN 2093-7911. 11(4), p. 509–516. doi: 10.1016/j.shaw.2020.07.004. Full text in Research Archive Show summary

  Background Meta-analyses have shown firefighters to be at an increased risk of several cancer types. Occupational carcinogen exposure may explain these increased risks. This study aims to describe Norwegian fire departments' work conditions from 1950 until today, focusing on factors relevant for potential occupational carcinogen exposure. Methods With the help of a reference group, we developed a questionnaire on topics related to occupational exposure to carcinogens for the period 1950–2018. Selected Norwegian fire departments provided department-specific responses. Results Sixteen departments, providing fire services for 48% of the Norwegian population as of 2019 and mainly consisting of professional firefighters, responded to our questionnaire. The introduction of synthetic firefighting foams, more regular live fire training, the introduction of chemical diving, and a higher number of diesel-driven fire service vehicles were identified as changes thought to increase exposure to occupational carcinogens. Changes thought to decrease exposure included the switch from negative to positive pressure self-contained breathing apparatuses, the use of self-contained breathing apparatuses during all phases of firefighting, the use of ventilating fans during firefighting, increased attention to flammable materials used during live fire training, increased attention to handling and cleaning of turnout gear and other equipment, and installment of exhaust removal systems in apparatus bays. Conclusion Norwegian fire departments' work conditions have seen several changes since 1950, and this could influence firefighters' occupational carcinogen exposure. A peak of carcinogen exposure may have occurred in the 1970s and 1980s before recent changes have reduced exposure.

• Berge, Leon Alexander; Kulle, Bettina; Stenehjem, Jo S.; Heir, Trond; Furu, Kari & Juzeniene, Asta [Show all 11 contributors for this article] (2020). Use of Antidepressants and Risk of Cutaneous Melanoma: A Prospective Registry-Based Case-Control Study. Clinical Epidemiology. 12, p. 193–202. doi: 10.2147/CLEP.S241249. Full text in Research Archive Show summary

  Purpose: Melanoma is the cancer with the most rapidly rising incidence rate in Norway. Although exposure to ultraviolet radiation (UVR) is the major environmental risk factor, other factors may also contribute. Antidepressants have cancer inhibiting and promoting side effects, and their prescription rates have increased in parallel with melanoma incidence. Thus, we aimed to prospectively examine the association between use of antidepressants and melanoma by using nation-wide data from the Cancer Registry of Norway, the National Registry, the Norwegian Prescription Database and the Medical Birth Registry of Norway. Patient and Methods: All cases aged 18– 85 with a primary cutaneous invasive melanoma diagnosed during 2007– 2015 (n=12,099) were matched to population controls 1:10 (n=118,467) by sex and year of birth using risk-set sampling. We obtained information on prescribed antidepressants and other potentially confounding drug use (2004– 2015). Conditional logistic regression was used to estimate adjusted rate ratios (RRs) and 95% confidence intervals (CIs) for the association between overall and class-specific use of antidepressants and incident melanoma. Results: Compared with ≤ 1 prescription, ≥ 8 prescriptions of antidepressants overall were negatively associated with melanoma (RR 0.81 CI 0.75– 0.87). Class-specific analyses showed decreased RRs for selective serotonin reuptake inhibitors (RR 0.82 CI 0.73– 0.93) and mixed antidepressants (RR 0.77 CI 0.69– 0.86). The negative association was found for both sexes, age ≥ 50 years, residential regions with medium and highest ambient UVR exposure, all histological subtypes, trunk, upper and lower limb sites and local disease. Conclusion: Use of antidepressants was associated with decreased risk of melanoma. There are at least two possible explanations for our results; cancer-inhibiting actions induced by the drug and less UVR exposure among the most frequent users of antidepressants.

• Stenehjem, Jo S.; Støer, Nathalie Charlotte; Ghiasvand, Reza; Grimsrud, Tom Kristian; Babigumira, Ronnie & Rees, Judy R. [Show all 11 contributors for this article] (2020). Prediagnostic serum 25-hydroxyvitamin D and melanoma risk. Scientific Reports. 10, p. 1–11. doi: 10.1038/s41598-020-77155-2. Full text in Research Archive Show summary

  Abstract Previous studies of serum 25-hydroxyvitamin D (25(OH)D) in relation to melanoma have shown conflicting results. We conducted a nested case–control study of 708 cases and 708 controls, using prediagnostically collected serum, to study 25(OH)D and melanoma risk in the population-based Janus Serum Bank Cohort. Stratified Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for ultraviolet radiation (UVR) indicators and stratified by ambient UVB of residence and body mass index (BMI). Non-linear associations were studied by restricted cubic splines. Missing data were handled with multiple imputation by chained equations. We found an HR of melanoma risk of 1.01 (95% CI: 0.99, 1.04) and an HR imputed of 1.02 (95% CI: 1.00, 1.04) per 5-nmol/L increase. The spline model showed exposure-risk curves with significantly reduced melanoma risk between 60 and 85 nmol/L 25(OH)D (reference 50 nmol/L). Non-significant J-shaped curves were found in sub-analyses of subjects with high ambient UVB of residence and of subjects with BMI &lt; 25 kg/m 2 . Our data did not yield persuasive evidence for an association between 25(OH)D and melanoma risk overall. Serum levels within the medium range might be associated with reduced risk, an association possibly mediated by BMI.

• Christensen, Lene; Vøllestad, Nina Køpke; Veierød, Marit Bragelien; Jakobsen, Vidar Eivind; Stuge, Britt & Bakke, Eva [Show all 8 contributors for this article] (2020). Trunk, pelvic and hip kinematics during the Stork test in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women. Clinical Biomechanics. ISSN 0268-0033. 80:105168, p. 1–8. doi: 10.1016/j.clinbiomech.2020.105168. Full text in Research Archive Show summary

  Background: Pelvic girdle pain is prevalent during pregnancy, and women affected report weight-bearing activities to be their main disability. The Stork test is a commonly used single-leg-stance test. As clinicians report specific movement patterns in those with pelvic girdle pain, we aimed to investigate the influence of both pregnancy and pelvic girdle pain on performance of the Stork test. Methods: In this cross-sectional study, 25 pregnant women with pelvic girdle pain, 23 asymptomatic pregnant and 24 asymptomatic non-pregnant women underwent three-dimensional kinematic analysis of the Stork test. Linear mixed models were used to investigate between-group differences in trunk, pelvic and hip kinematics during neutral stance, weight shift, leg lift and single leg stance. Findings: Few and small significant between-group differences were found. Pregnant women with pelvic girdle pain had significantly less hip adduction during single leg stance compared to asymptomatic pregnant women (estimated marginal means (95% confidence intervals) -1.1° (−2.4°, 0.3°) and 1.0° (−0.4°, 2.4°), respectively; P = 0.03). Asymptomatic pregnant women had significantly less hip internal rotation compared to non-pregnant women 4.1° (1.6°, 6.7°) and 7.9° (5.4°, 10.4°), respectively (P = 0.04) and greater peak hip flexion angle of the lifted leg in single leg stance 80.4° (77.0°, 83.9°) and 74.1° (70.8°, 77.5°), respectively (P = 0.01). Variation in key kinematic variables was large across participants in all three groups. Interpretation: Our findings indicate that trunk, pelvic and hip movements during the Stork test are not specific to pregnancy and/or pelvic girdle pain in the 2nd trimester. Instead, movement strategies appear unique to each individual.

• Robsahm, Trude Eid; Stenehjem, Jo S.; Berge, Leon Alexander & Veierød, Marit Bragelien (2020). Prevalence of Indoor Tanning Among Teenagers in Norway Before and After Enforcement of Ban for Ages Under 18 Years. Acta Dermato-Venereologica. ISSN 0001-5555. 100(8). doi: 10.2340/00015555-3482. Full text in Research Archive
• Stenehjem, Jo S.; Babigumira, Ronnie; Hosgood, H Dean; Veierød, Marit Bragelien; Samuelsen, Sven Ove & Bråtveit, Magne [Show all 18 contributors for this article] (2020). Cohort Profile: The Norwegian Offshore Petroleum Workers (NOPW) Cohort. International Journal of Epidemiology. ISSN 0300-5771. 50(2). doi: 10.1093/ije/dyaa107. Full text in Research Archive
• Mundal, Liv; Hovland, Anders; Igland, Jannicke; Vetrhus, Morten; Veierød, Marit Bragelien & Holven, Kirsten Bjørklund [Show all 10 contributors for this article] (2020). Increased risk of peripheral artery disease in persons with familial hypercholesterolaemia: a prospective registry study. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 28(18). doi: 10.1093/eurjpc/zwaa024. Full text in Research Archive
• Page, Christian; Djordjilovic, Vera; Nøst, Therese Haugdahl; Ghiasvand, Reza; Sandanger, Torkjel M & Rattalma, Arnoldo Frigessi Di [Show all 8 contributors for this article] (2020). Lifetime ultraviolet radiation exposure and DNA methylation in blood leukocytes: The Norwegian Women and Cancer Study. Scientific Reports. 10, p. 1–8. doi: 10.1038/s41598-020-61430-3. Full text in Research Archive Show summary

  Ultraviolet radiation (UVR) exposure is a leading cause of skin cancers and an ubiquitous environmental exposure. However, the molecular mechanisms relating UVR exposure to melanoma is not fully understood. We aimed to investigate if lifetime UVR exposure could be robustly associated to DNA methylation (DNAm). We assessed DNAm in whole blood in three data sets (n = 183, 191, and 125) from the Norwegian Woman and Cancer cohort, using Illumina platforms. We studied genome-wide DNAm, targeted analyses of CpG sites indicated in the literature, global methylation, and accelerated aging. Lifetime history of UVR exposure (residential ambient UVR, sunburns, sunbathing vacations and indoor tanning) was collected by questionnaires. We used one data set for discovery and the other two for replication. One CpG site showed a genome-wide significant association to cumulative UVR exposure (cg01884057) (pnominal = 3.96e-08), but was not replicated in any of the two replication sets (pnominal ≥ 0.42). Two CpG sites (cg05860019, cg00033666) showed suggestive associations with the other UVR exposures. We performed extensive analyses of the association between long-term UVR exposure and DNAm. There was no indication of a robust effect of past UVR exposure on DNAm.

• Mahamat-Saleh, Yahya; Cervenka, Iris; Al-Rahmoun, Marie; Mancini, Francesca R.; Severi, Gianluca & Ghiasvand, Reza [Show all 38 contributors for this article] (2020). Citrus intake and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). European Journal of Epidemiology (EJE). ISSN 0393-2990. 35, p. 1057–1067. doi: 10.1007/s10654-020-00666-9. Full text in Research Archive Show summary

  Citrus intake has been suggested to increase the risk of skin cancer. Although this relation is highly plausible biologically, epidemiologic evidence is lacking. We aimed to examine the potential association between citrus intake and skin cancer risk. EPIC is an ongoing multi-center prospective cohort initiated in 1992 and involving ~ 520,000 participants who have been followed-up in 23 centers from 10 European countries. Dietary data were collected at baseline using validated country-specific dietary questionnaires. We used Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI). During a mean follow-up of 13.7 years, 8448 skin cancer cases were identified among 270,112 participants. We observed a positive linear dose–response relationship between total citrus intake and skin cancer risk (HR = 1.10, 95% CI 1.03–1.18 in the highest vs. lowest quartile; P_trend = 0.001), particularly with basal cell carcinoma (BCC) (HR = 1.11, 95% CI 1.02–1.20, P_trend = 0.007) and squamous cell carcinoma (SCC) (HR = 1.23, 95% CI 1.04–1.47, P_trend = 0.01). Citrus fruit intake was positively associated with skin cancer risk (HR = 1.08, 95% CI 1.01–1.16, P_trend = 0.01), particularly with melanoma (HR = 1.23, 95% CI 1.02–1.48; P_trend = 0.01), although with no heterogeneity across skin cancer types (P_homogeneity = 0.21). Citrus juice was positively associated with skin cancer risk (P_trend = 0.004), particularly with BCC (P_trend = 0.008) and SCC (P_trend = 0.004), but not with melanoma (P_homogeneity = 0.02). Our study suggests moderate positive linear dose–response relationships between citrus intake and skin cancer risk. Studies with available biomarker data and the ability to examine sun exposure behaviors are warranted to clarify these associations and examine the phototoxicity mechanisms of furocoumarin-rich foods.

• Kaiser, Isabelle; Pfahlberg, Anette B.; Uter, Wolfgang; Heppt, Markus V.; Veierød, Marit Bragelien & Gefeller, Olaf (2020). Risk prediction models for melanoma: A Systematic review on the heterogeneity in model development and validation. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 17(21), p. 1–24. doi: 10.3390/ijerph17217919. Full text in Research Archive Show summary

  The rising incidence of cutaneous melanoma over the past few decades has prompted substantial efforts to develop risk prediction models identifying people at high risk of developing melanoma to facilitate targeted screening programs. We review these models, regarding study characteristics, differences in risk factor selection and assessment, evaluation, and validation methods. Our systematic literature search revealed 40 studies comprising 46 different risk prediction models eligible for the review. Altogether, 35 different risk factors were part of the models with nevi being the most common one (n = 35, 78%); little consistency in other risk factors was observed. Results of an internal validation were reported for less than half of the studies (n = 18, 45%), and only 6 performed external validation. In terms of model performance, 29 studies assessed the discriminative ability of their models; other performance measures, e.g., regarding calibration or clinical usefulness, were rarely reported. Due to the substantial heterogeneity in risk factor selection and assessment as well as methodologic aspects of model development, direct comparisons between models are hardly possible. Uniform methodologic standards for the development and validation of risk prediction models for melanoma and reporting standards for the accompanying publications are necessary and need to be obligatory for that reason.

• Berge, Leon Alexander; Kulle, Bettina; Stenehjem, Jo S.; Heir, Trond; Karlstad, Øystein & Juzeniene, Asta [Show all 11 contributors for this article] (2020). Use of immunomodulating drugs and risk of cutaneous melanoma: A nationwide nested case-control study. Clinical Epidemiology. 12, p. 1389–1401. doi: 10.2147/CLEP.S269446. Full text in Research Archive Show summary

  Purpose: Cutaneous melanoma is among the fastest growing malignancies in Norway and ultraviolet radiation (UVR) exposure is the primary environmental risk factor. Immunomodulating drugs can increase skin photosensitivity and suppress immune responses, and by such mechanisms influence melanoma risk. We, therefore, aimed to examine the associations between use of immunomodulating drugs and melanoma risk, at a nationwide population level. Patients and Methods: In the Cancer Registry of Norway, we identified all cases aged 18– 85 with a first primary cutaneous melanoma diagnosed in 2007– 2015 (n=12,106). These were matched to population controls from the Norwegian National Registry 1:10 (n=118,564), on sex and year of birth using risk set sampling. Information on prescribed drugs (2004– 2015) was obtained by linkage to the Norwegian Prescription Database (NorPD). Conditional logistic regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for associations between use of immunomodulating drugs (immunosuppressants and corticosteroids) and melanoma risk, adjusted for ambient UVR and other drug use. Results: Compared with ≤ 1 prescription, use of ≥ 8 prescriptions of immunosuppressants was associated with increased risk of melanoma (RR 1.50, 95% CI 1.27, 1.77). Similar associations were found for subgroups of immunosuppressants: drugs typically prescribed to organ transplant recipients (OTRs) (RR 2.02, 95% CI 1.35, 3.03) and methotrexate (RR 1.27, 95% CI 1.04, 1.55). Similar results were found for high levels of cumulative doses and across all histological subtypes. Use of corticosteroids was not associated with melanoma risk. Conclusion: We found a positive association between use of immunosuppressants and melanoma risk, with the highest risk seen for drugs prescribed to OTRs. Knowledge about this risk increase is important for physicians and users of these drugs, for intensified surveillance, awareness and cautious sun exposure.

• Tsuruda, Kaitlyn; Hovda, Tone; Bhargava, Sameer; Veierød, Marit Bragelien & Hofvind, Solveig (2020). Survival among women diagnosed with screen-detected or interval breast cancer classified as true, minimal signs, or missed through an informed radiological review. European Radiology. ISSN 0938-7994. 31(5), p. 2677–2686. doi: 10.1007/s00330-020-07340-4. Full text in Research Archive Show summary

  Objectives: “True” breast cancers, defined as not being visible on prior screening mammograms, are expected to be more aggressive than “missed” cancers, which are visible in retrospect. However, the evidence to support this hypothesis is limited. We compared the risk of death from any cause for women with true, minimal signs, and missed invasive screen-detected (SDC) and interval breast cancers (IC). Methods: This nation-wide study included 1022 SDC and 788 IC diagnosed through BreastScreen Norway during 2005–2016. Cancers were classified as true, minimal signs, or missed by five breast radiologists in a consensus-based informed review of prior screening and diagnostic images. We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of death from any cause associated with true, minimal signs, and missed breast cancers, adjusting for age at diagnosis, histopathologic tumour diameter and grade, and subtype. Separate models were created for SDC and IC. Results: Among SDC, 463 (44%) were classified as true and 242 (23%) as missed; among IC, 325 (39%) were classified as true and 235 (32%) missed. Missed SDC were associated with a similar risk of death as true SDC (HR = 1.20, 95% CI (0.49, 2.46)). Similar results were observed for missed versus true IC (HR = 1.31, 95% CI (0.77, 2.23)). Conclusions: We did not observe a statistical difference in the risk of death for women diagnosed with true or missed SDC or IC; however, the number of cases reviewed and follow-up time limited the precision of our estimates.

• Lergenmuller, Simon; Ghiasvand, Reza; Robsahm, Trude Eid; Green, Adele C.; Lund, Eiliv & Rueegg, Corina Silvia [Show all 7 contributors for this article] (2019). Association of lifetime indoor tanning and subsequent risk of cutaneous squamous cell carcinoma. JAMA dermatology. ISSN 2168-6068. p. 1–8. doi: 10.1001/jamadermatol.2019.2681. Full text in Research Archive Show summary

  <i>Importance</i> - No study, to our knowledge, has prospectively investigated a dose-response association between lifetime indoor tanning and risk of cutaneous squamous cell carcinoma (SCC).<p> <p><i>Objective</i> - To investigate the dose-response association between lifetime indoor tanning and SCC risk, the association between duration of use and age at initiation with SCC risk, and the association between age at initiation and age at diagnosis.<p> <p><i>Design, Setting, and Participants</i> - This cohort study included data from women born from 1927 to 1963 from the Norwegian Women and Cancer study, established in 1991 with follow-up through December 31, 2015. Baseline questionnaires were issued to participants from 1991 to 2007, with follow-up questionnaires given every 5 to 7 years. Data analysis was performed from January 2, 2018, to March 2, 2019.<p> <p><i>Exposures</i> - Participants reported pigmentation factors. Sunburns, sunbathing vacations, and indoor tanning were reported for childhood, adolescence, and adulthood.<p> <p><i>Main Outcomes and Measures</i> - Information on all cancer diagnoses and dates of emigration or death were obtained through linkage to the Cancer Registry of Norway, using the unique personal identification number of Norwegian citizens.<p> <p><i>Results</i> - A total of 159 419 women (mean [SD] age at inclusion, 49.9 [8.3] years) were included in the study. During follow-up (mean [SD], 16.5 [6.4] years), 597 women were diagnosed with SCC. Risk of SCC increased with increasing cumulative number of indoor tanning sessions. The adjusted hazard ratio (HR) for highest use vs never use was 1.83 (95% CI, 1.38-2.42; <i>P</i> < .001 for trend). A significantly higher risk of SCC was found among women with 10 years or less of use (HR, 1.41; 95% CI, 1.08-1.85) and more than 10 years of use (HR, 1.43; 95% CI, 1.16-1.76) and among women with age at initiation of 30 years or older (HR, 1.36; 95% CI, 1.11-1.67) and younger than 30 years (HR, 1.51; 95% CI, 1.18-1.92) vs never users. No significant association was found between age at initiation and age at diagnosis (estimated regression coefficient, −0.09 [95% CI, −1.11 to 0.94] for age at initiation of ≥30 years and −0.02 [95% CI, −1.27 to 1.22] for <30 years vs never use).<p> <p><i>Conclusion and Relevance</i> - The findings provide supporting evidence that there is a dose-response association between indoor tanning and SCC risk among women. The association between cumulative exposure to indoor tanning and SCC risk was the same regardless of duration of use and age at initiation. These results support development of policies that regulate indoor tanning.

• Rueegg, Corina Silvia; Stenehjem, Jo S.; Egger, Matthias; Ghiasvand, Reza; Cho, Eunyoung & Lund, Eiliv [Show all 9 contributors for this article] (2019). Challenges in assessing the sunscreen-melanoma association. International Journal of Cancer. ISSN 0020-7136. 144, p. 2651–2668. doi: 10.1002/ijc.31997. Full text in Research Archive Show summary

  Whether sunscreen use affects melanoma risk has been widely studied with contradictory results. To answer this question we performed a systematic review of all published studies, accounting for sources of heterogeneity and bias. We searched for original articles investigating the sunscreen‐melanoma association in humans to February 28, 2018. We then used random‐effects meta‐analysis to combine estimates of the association, stratified by study design. Stratified meta‐analysis and meta‐regression were used to identify sources of heterogeneity. We included 21,069 melanoma cases from 28 studies published 1979–2018: 23 case–control (11 hospital‐based, 12 population‐based), 1 ecological, 3 cohort and 1 randomised controlled trial (RCT). There was marked heterogeneity across study designs and among case–control studies but adjustment for confounding by sun exposure, sunburns and phenotype systematically moved estimates toward decreased melanoma risk among sunscreen users. Ever‐ vs. never‐use of sunscreen was inversely associated with melanoma in hospital‐based case–control studies (adjusted odds ratio (OR) = 0.57, 95%confidence interval (CI) 0.37–0.87, <i>P</i>_{heterogeneity} < 0.001), the ecological study (rate ratio = 0.48, 95%CI 0.35–0.66), and the RCT (hazard ratio (HR) = 0.49, 95%CI 0.24–1.01). It was not associated in population‐based case–control studies (OR = 1.17, 95%CI 0.90–1.51, <i>P</i>_{heterogeneity} < 0.001) and was positively associated in the cohort studies (HR = 1.27, 95%CI 1.07–1.51, <i>P</i>_{heterogeneity} = 0.236). The association differed by latitude (<i>P</i>_interaction = 0.042), region (<i>P</i>_interaction = 0.008), adjustment for naevi/freckling (<i>P</i>_interaction = 0.035), and proportion of never‐sunscreen‐users (<i>P</i>_interaction = 0·012). Evidence from observational studies on sunscreen use and melanoma risk was weak and heterogeneous, consistent with the challenges of controlling for innate confounding by indication. The only RCT showed a protective effect of sunscreen.

• Ghiasvand, Reza; Robsahm, Trude Eid; Green, Adele; Rueegg, Corina Silvia; Weiderpass, Elisabete & Lund, Eiliv [Show all 7 contributors for this article] (2019). Association of phenotypic characteristics and UV radiation exposure with risk of melanoma on different body sites. JAMA dermatology. ISSN 2168-6068. 155(1), p. 39–49. doi: 10.1001/jamadermatol.2018.3964. Full text in Research Archive Show summary

  <p><i>Importance</i>: Two pathways have been hypothesized for the development of cutaneous melanoma: one typically affects the head and neck, a site with chronic sun damage, and the other affects the trunk, which is less exposed to the sun. However, the possible cause of limb melanomas is less studied under this hypothesis.</p> <p><i>Objective</i>: To investigate the association between phenotypic characteristics, pattern of UV radiation exposure, and risk of melanoma on different body sites.</p> <p><i>Design, Setting, and Participants</i>: This study used data on 161 540 women with information on phenotypic characteristics and UV radiation exposure who were part of the Norwegian Women and Cancer study, a population-based prospective study established in 1991 with exposure information collected by questionnaires at baseline and every 4 to 6 years during follow-up through 2015. Data analysis was performed from October 2017 through May 2018.</p> <p><i>Exposures</i>: Participants reported hair color, eye color, untanned skin color, number of small symmetric and large asymmetric nevi, and freckling, as well as histories of sunburns, sunbathing vacations, and indoor tanning in childhood, adolescence, and adulthood.</p> <p><i>Main Outcomes and Measures</i>: The Norwegian Women and Cancer study was linked to the Cancer Registry of Norway for data on cancer diagnosis and date of death or emigration. Primary melanoma site was categorized as head and neck, trunk, upper limbs, and lower limbs.</p> <p><i>Results</i>: During follow-up of the 161 540 women in the study (mean age at study entry, 50 years [range, 34-70 years]; mean age at diagnosis, 60 years [range, 34-87 years]), 1374 incident cases of melanoma were diagnosed. Having large asymmetric nevi was a significant risk factor for all sites and was strongest for the lower limbs (relative risk [RR], 3.38; 95% CI, 2.62-4.38) and weakest for the upper limbs (RR, 1.96; 95% CI, 1.22-3.17; P = .02 for heterogeneity). Mean lifetime number of sunbathing vacations was significantly associated with risk of trunk melanomas (RR, 1.14; 95% CI, 1.07-1.22) and lower limb melanomas (RR, 1.12; 95% CI, 1.05-1.19) but not upper limb melanomas (RR, 0.98; 95% CI, 0.88-1.09) and head and neck melanomas (RR, 0.87; 95% CI, 0.73-1.04; P = .006 for heterogeneity). Indoor tanning was associated only with trunk melanomas (RR for the highest tertile, 1.49; 95% CI, 1.16-1.92) and lower limb melanomas (RR for the highest tertile, 1.33; 95% CI, 1.00-1.76; P = .002 for heterogeneity). Skin color, hair color, small symmetric nevi, and history of sunburns were associated with risk of melanoma on all sites.</p> <p><i>Conclusions and Relevance</i>: These results appear to support the hypothesis of divergent pathways to melanoma and that recreational sun exposure and indoor tanning are associated with melanoma on the lower limbs, the most common site of melanoma in women. These findings appear to have important preventive implications.

• Rizvi, Syed Mohammad Husain; Veierød, Marit Bragelien; Mørk, Gro; Helsing, Per & Gjersvik, Petter (2019). Ablative Fractional Laser-assisted Daylight Photodynamic Therapy for Actinic Keratoses of the Scalp and Forehead in Organ Transplant Recipients: A Pilot Study. Acta Dermato-Venereologica. ISSN 0001-5555. 99(11), p. 1047–1048. doi: 10.2340/00015555-3274. Full text in Research Archive Show summary

  Actinic keratoses are common in organ transplant recipients (OTRs) and may be difficult to treat successfully. Several treatment modalities are available (1), including photodynamic therapy (PDT), i.e. applying a topical photosenzitiser to the lesions and exposing them to either artificial or natural daylight (2). Ablative fractional laser treatment (AFL) has been introduced to increase the absorption of the photosenzitiser and thereby increasing the treatment response in PDT (3). With very few clinical trials on the treatment of AKs in OTRs (1, 4), we set out to perform a clinical trial on AFL-assisted daylight PDT versus daylight PDT for AKs and field cancerization on scalp and forehead in OTRs, using a within-subject randomized controlled study design.

• Christensen, Lene; Vøllestad, Nina Køpke; Veierød, Marit Bragelien; Stuge, Britt; Cabri, Jan Maria Hendrick & Robinson, Hilde Stendal (2019). The Timed Up & Go test in pregnant women with pelvic girdle pain compared to asymptomatic pregnant and non-pregnant women. Musculoskeletal Science and Practice. ISSN 2468-8630. 43, p. 110–116. doi: 10.1016/j.msksp.2019.03.006. Full text in Research Archive Show summary

  Background: The Timed Up and Go (TUG) test, a standardized functional mobility test, has been proposed as aphysical performance-based measure in pregnant women with pelvic girdle pain (PGP).Objectives:This cross-sectional study aimed to investigate physical function by the use of TUG in pregnantwomen with PGP compared to asymptomatic pregnant and non-pregnant women, and to identify factors asso-ciated with increased TUG.Methods:In total, 25 pregnant women with PGP, 24 asymptomatic pregnant and 25 asymptomatic non-pregnantwomen participated. One-way analysis of variance was used to explore difference in TUG between the groupsand multiple linear regression analyses to explore associations between TUG and potential explanatory variables.Results:The time on TUG varied among pregnant women with PGP, and was significantly higher (mean (95% CI)6.9 (6.5, 7.3) seconds) than for asymptomatic pregnant (5.8 (5.5, 6.0), p < 0.001) and non-pregnant (5.5 (5.4,5.6), p < 0.001) women. In the total study sample, group, increased BMI and sick leave were significantlyassociated with increased TUG (p-values≤0.02). In pregnant women with PGP, pain intensity was the onlysignificant clinical factor associated with increased TUG (p= 0.002).Conclusion:Pregnant women with PGP used longer time and showed larger variation in TUG than asymptomaticpregnant and non-pregnant women, this underpins that TUG targets activities relevant to PGP. Our resultsprovide new knowledge about factors influencing TUG time. Importantly, multivariable analyses suggest thatpain intensity should be considered when interpreting TUG time in pregnant women with PGP.

• Djordjilovic, Vera; Page, Christian Magnus; Gran, Jon Michael; Nøst, Therese Haugdahl; Sandanger, Torkjel M & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2019). Global test for high-dimensional mediation: Testing groups of potential mediators. Statistics in Medicine. ISSN 0277-6715. 38(18), p. 3346–3360. doi: 10.1002/sim.8199. Full text in Research Archive Show summary

  We address the problem of testing whether a possibly high‐dimensional vector may act as a mediator between some exposure variable and the outcome of interest. We propose a global test for mediation, which combines a global test with the intersection‐union principle. We discuss theoretical properties of our approach and conduct simulation studies that demonstrate that it performs equally well or better than its competitor. We also propose a multiple testing procedure, ScreenMin, that provides asymptotic control of either familywise error rate or false discovery rate when multiple groups of potential mediators are tested simultaneously. We apply our approach to data from a large Norwegian cohort study, where we look at the hypothesis that smoking increases the risk of lung cancer by modifying the level of DNA methylation.

• Rylander, Charlotta; Veierød, Marit Bragelien; Weiderpass, Elisabete; Lund, Eiliv & Sandanger, Torkjel M (2019). Use of skincare products and risk of cancer of the breast and endometrium: a prospective cohort study. Environmental health. 18(1). doi: 10.1186/s12940-019-0547-6. Full text in Research Archive Show summary

  <i>Background</i> - Concerns have been raised that extensive use of personal care products that contain endocrine disrupting compounds increase the risk of hormone sensitive cancers.<p> <p><i>Objective</i> - To assess the effect of skincare product use on the risk of pre- and postmenopausal breast cancer, estrogen receptor positive (ER+) and negative (ER-) breast cancer and cancer of the endometrium.<p> <p><i>Methods</i> - We used data from 106,978 participants in the population-based Norwegian Women and Cancer cohort. Participants were categorized into non-, light, moderate, frequent and heavy users of skincare products based on self-reported use of hand and facial cream and body lotion. Cancer incidence information from the Cancer Registry of Norway was linked to individual data through the unique identity number of Norwegian citizens. Multivariable Cox proportional hazard regression was used to assess the effect of skincare product use on the risk of cancer of the breast and endometrium. We used multiple imputation by chained equations to evaluate the effect of missing data on observed associations.<p> <p><i>Results</i> - We found no associations between use of skincare products and incidence of premenopausal breast cancer (frequent/heavy versus non−/light use: hazard ratio [HR] =1.10, 95% confidence interval [CI]: 0.92–1.32), postmenopausal breast cancer (heavy versus light use: HR = 0.87, 95% CI: 0.65–1.18, frequent versus light use: HR = 0.97, 95% CI: 0.88, 1.07) or endometrial cancer (frequent/heavy versus non−/light use: HR = 0.97, 95% CI: 0.79–1.20). Use of skincare products did not increase the risk of ER+ or ER- breast cancer and there was no difference in effect across ER status (0.58 ≤ _{pheterogeneity} ≤ 0.99). The magnitude and direction of the effect estimates based on complete case analyses and multiple imputation were similar.<p> <p><i>Conclusion</i> Heavy use of skincare products, i.e. creaming the body up to two times per day during mid-life, did not increase the risk of cancer of the breast or endometrium.

• Skodje, Gry Irene; Minelle, Ingunn Hillestad; Rolfsen, Kjersti; Iacovou, Marina; Lundin, Knut Erik Aslaksen & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2019). Dietary and symptom assessment in adults with self-reported non-coeliac gluten sensitivity. Clinical Nutrition ESPEN. ISSN 2405-4577. 31, p. 88–94. doi: 10.1016/j.clnesp.2019.02.012. Full text in Research Archive
• Støer, Nathalie Charlotte; Botteri, Edoardo; Ghiasvand, Reza; Busund, Marit Katinka; Vangen, Siri & Lund, Eiliv [Show all 8 contributors for this article] (2019). Reproductive factors and risk of melanoma: a population-based cohort study. British Journal of Dermatology. ISSN 0007-0963. 181, p. 282–289. doi: 10.1111/bjd.17771. Full text in Research Archive Show summary

  Background: The association between reproductive factors and risk of cutaneous melanoma (CM) is unclear. We investigated this issue in the Norwegian Women and Cancer (NOWAC) cohort study. Objectives: To examine the association between the reproductive factors age at menarche, menstrual cycle length, parity, age at first and last birth, menopausal status, breastfeeding duration and length of ovulatory life and CM risk, overall and by histological subtypes and anatomical site Methods We followed 165,712 women aged 30-75 at inclusion from 1991-2007 to the end of 2015. Multivariable Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Results: The mean age at cohort enrolment was 49 years. During a median follow-up of 18 years, 1,347 CM cases were identified. No reproductive factors were clearly associated with CM risk. When stratifying by histological subtype we observed significant heterogeneity (p = 0.01) in the effect of length of ovulatory life on the risk of superficial spreading melanoma (HR 1.02, 95% CI 1.01-1.04 per year increase) and nodular melanoma (HR 0.97, 95% CI 0.94-1.01 per year increase). When stratifying by anatomical site, menopausal status (HR 0.54, 95% CI 0.31-0.92, postmenopausal compared to premenopausal) and menstrual cycle length (HR 1.07, 95% CI 1.01-1.13, per day increase) were associated with CM of the trunk, and significant heterogeneity between anatomical sites was observed for menopausal status (p = 0.04). Conclusions: In this large population-based Norwegian cohort study, we did not find convincing evidence of an association between reproductive factors and risk of CM.

• Skaarud, Kristin Aneta Joan; Veierød, Marit Bragelien; Lergenmuller, Simon; Bye, Asta; Iversen, Per Ole & Tjønnfjord, Geir Erland (2019). Body weight, body composition and survival after 1 year: follow-up of a nutritional intervention trial in allo-HSCT recipients. Bone Marrow Transplantation. ISSN 0268-3369. doi: 10.1038/s41409-019-0638-6. Full text in Research Archive Show summary

  The role of body weight change in survival among recipients of hematopoietic stem-cell transplantation is controversial. We assessed the effect of optimizing energy and protein intake on 1-year survival, body weight and body composition, and the effect of body weight and body composition on 1-year survival in 117 patients (57 intervention, 60 control) in a randomized controlled trial. Cox regression was used to study effects of the intervention, weight and body composition on death, relapse, and nonrelapse mortality (NRM). We found no significant effect of intervention versus control on death hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.54−2.04, p = 0.88), relapse (HR 1.15, 95% CI 0.48−2.27, p = 0.75), and NRM (HR 0.95, 95% CI 0.39−2.28, p = 0.90). Body weight, fat-free mass index, body fat mass index and total body water changed over time (p < 0.001), similarly in both groups (0.17 ≤ p ≤ 0.98). In multivariable analyses adjusted for group, gender and age, HRs and 95% CIs per one kilo increase in weight were 1.03 (1.01−1.06) and 1.04 (1.01−1.08) for death and NRM after 1 year (p ≤ 0.02), respectively, and 1.08 (1.01−1.15) for relapse after 3 months (p = 0.02). In conclusion, weight gain is possibly due to fluid retention and is an indicator of a complication in HSCT, rather than a marker of improved nutritional status.

• Lien, Katarina; Johansen, Bjørn; Veierød, Marit Bragelien; Haslestad, Annicke Stranda; Bøhn, Siv Kjølsrud & Melsom, Morten Nissen [Show all 8 contributors for this article] (2019). Abnormal blood lactate accumulation during repeated exercise testing in myalgic encephalomyelitis/chronic fatigue syndrome. Physiological Reports. 7(11). doi: 10.14814/phy2.14138. Full text in Research Archive Show summary

  Post‐exertional malaise and delayed recovery are hallmark symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME /CFS ). Studies on repeated cardiopulmonary exercise testing (CPET ) show that previous exercise negatively affects oxygen uptake (VO 2) and power output (PO ) in ME /CFS . Whether this affects arterial lactate concentrations ([Laa]) is unknown. We studied 18 female patients (18–50 years) fulfilling the Canadian Consensus Criteria for ME /CFS and 15 healthy females (18–50 years) who underwent repeated CPET s 24 h apart (CPET 1 and CPET 2) with [Laa] measured every 30th second. VO 2 at peak exercise (VO 2peak) was lower in patients than in controls on CPET 1 (P < 0.001) and decreased in patients on CPET 2 (P < 0.001). However, the difference in VO 2peak between CPET s did not differ significantly between groups. [Laa] per PO was higher in patients during both CPET s (P interaction < 0.001), but increased in patients and decreased in controls from CPET 1 to CPET 2 (P interaction < 0.001). Patients had lower VO 2 (P = 0.02) and PO (P = 0.002) at the gas exchange threshold (GET , the point where CO 2 production increases relative to VO 2), but relative intensity (%VO 2peak) and [Laa] at GET did not differ significantly from controls on CPET 1. Patients had a reduction in VO 2 (P = 0.02) and PO (P = 0.01) at GET on CPET 2, but no significant differences in %VO 2peak and [Laa] at GET between CPET s. Controls had no significant differences in VO 2, PO or %VO 2peak at GET between CPET s, but [Laa] at GET was reduced on CPET 2 (P = 0.008). In conclusion, previous exercise deteriorates physical performance and increases [Laa] during exercise in patients with ME /CFS while it lowers [Laa] in healthy subjects.

• Øyri, Linn Kristin Lie; Narverud, Ingunn; Bogsrud, Martin Prøven; Hansson, Patrik; Leder, Lena & Byfuglien, Marte Gjeitung [Show all 10 contributors for this article] (2019). Postprandial changes in gene expression of cholesterol influx and efflux mediators after intake of SFA compared to n-6 PUFA in subjects with and without familial hypercholesterolemia – secondary outcomes of a randomized controlled trial. Journal of Nutritional Science (JNS). 8:e27, p. 1–27. doi: 10.1017/jns.2019.25. Full text in Research Archive Show summary

  The long-term cholesterol lowering effect of replacing intake of saturated fatty acids (SFAs) with polyunsaturated fatty acids (PUFAs) is well established, however not fully explained mechanistically. We examined the postprandial response of meals with different fat quality on expression of lipid genes in peripheral blood mononuclear cells (PBMC) in subjects with and without familial hypercholesterolemia (FH). Thirteen subjects with FH (who had discontinued lipid-lowering treatment ≥4 weeks prior to both test days) and 14 normolipidemic controls were included in a randomized controlled double-blind crossover study with two meals, each with 60 grams of fat either mainly SFAs (~40 E%) or n-6 PUFAs (~40 E%). PBMCs were isolated in fasting, and 4 and 6 hours postprandial blood samples. Expression of 33 lipid genes was analysed by reverse transcription quantitative polymerase chain reaction. A linear mixed model was used to assess postprandial effects between meals and groups. There was a significant interaction between meal and group for MSR1 (p=0.03), where intake of SFAs compared to n-6 PUFAs induced a larger reduction in gene expression in controls only (p=0.01). Intake of SFAs compared to n-6 PUFAs induced larger reduction in gene expression levels of LDLR and FADS1/2, smaller increase of INSIG1 and FASN, and larger increase of ABCA1 and ABCG1 (p=0.01 for all, no group interaction). Intake of SFAs compared to n-6 PUFAs induced changes in gene expression of cholesterol influx and efflux mediators in PBMCs including lower LDLR and higher ABCA1/G1, potentially explaining the long-term cholesterol-raising effect of a high SFA intake.

• Kverneland, Magnhild; Taubøll, Erik; Molteberg, Ellen; Veierød, Marit Bragelien; Selmer, Kaja Kristine & Nakken, Karl Otto [Show all 7 contributors for this article] (2019). Pharmacokinetic interaction between modified Atkins diet and antiepileptic drugs in adults with drug-resistant epilepsy. Epilepsia. ISSN 0013-9580. 60, p. 2235–2244. doi: 10.1111/epi.16364. Full text in Research Archive Show summary

  Objective The aim was to examine the influence of modified Atkins diet on serum concentration of antiepileptic drugs (AEDs). Methods Prospective data from 63 adult patients with either focal or generalized drug‐resistant epilepsy recruited to 12‐week dietary treatment as add‐on to AEDs are analyzed. AED serum concentrations, ketones, glucose, and hemoglobin A1c were measured before and after the dietary intervention. Paired t test was used and Spearman correlation coefficient, r, was estimated. Results Mean age was 37 years (range 16‐65 years). Mean serum concentrations of carbamazepine, clobazam, and valproate were significantly reduced after 4 and 12 weeks of the diet period (<.001 ≤ P ≤ .02). Levels of lacosamide, lamotrigine, and topiramate were less reduced (.02 ≤ P ≤ .08), whereas the serum concentrations of oxcarbazepine, zonisamide, and levetiracetam were unchanged (.06 ≤ P ≤ .90). The largest reduction in serum concentration was found for clobazam: mean reduction after 12 weeks was 1.5 μmol/L (34%). Percent change in serum concentration after 4 and 12 weeks of all drugs analyzed was −10.5% (95% confidence interval [CI] −14.1 to −6.8; n = 60; P < .001) and −13.5% (95% CI −18.8 to −8.3; n = 56; P < .001), respectively. Percent change in serum concentration of AEDs was not significantly correlated to percent change in seizure frequency after 12 weeks of dietary treatment (r = .14, P = .33, n = 53) but negatively correlated to urine ketosis (r = −.43; P = .003; n = 46). Significance A reduction in AED serum concentrations may counteract a seizure‐reducing effect of the diet, and in patients without such an effect, it may cause seizure aggravation. Thus, we recommend that clinicians who are treating patients with ketogenic diets monitor serum concentrations of the concomitant AEDs.

• Mundal, Liv; Hovland, Anders; Igland, Jannicke; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund & Bogsrud, Martin Prøven [Show all 9 contributors for this article] (2019). Association of low-density lipoprotein cholesterol with risk of aortic valve stenosis in familial hypercholesterolemia. JAMA cardiology. ISSN 2380-6583. 4(11), p. 1–5. doi: 10.1001/jamacardio.2019.3903. Full text in Research Archive Show summary

  Importance: Aortic valve stenosis (AS) is the most common valve disease. Elevated levels of low-density lipoprotein (LDL) cholesterol are a risk factor; however, lipid-lowering treatment seems not to prevent progression of AS. The importance of LDL cholesterol in the development of AS thus remains unclear. People with familial hypercholesterolemia (FH) have elevated LDL cholesterol levels from birth and until lipid-lowering treatment starts. Thus, FH may serve as a model disease to study the importance of LDL cholesterol for the development of AS. Objective: To compare the incidence of AS per year in all genetically proven patients with FH in Norway with the incidence of these diseases in the total Norwegian population of about 5 million people. Design, Setting, and Participants: This is a registry-based prospective cohort study of all Norwegian patients with FH with regard to first-time AS between 2001 and 2009. All genotyped patients with FH in Norway were compared with the total Norwegian populations through linkage with the Cardiovascular Disease in Norway project and the Norwegian Cause of Death Registry regarding occurrence of first-time AS. Data were analyzed between January 1, 2018, and December 31, 2018. Main Outcomes and Measures: Standardized incidence ratios. Results: In total, 53 cases of AS occurred among 3161 persons (1473 men [46.6%]) with FH during 18 300 person-years of follow-up. Mean age at inclusion and at time of AS were 39.9 years (range, 8-91 years) and 65 years (range, 44-88 years), respectively. Total standardized incidence ratios were 7.9 (95% CI, 6.1-10.4) for men and women combined, 8.5 (95% CI, 5.8-12.4) in women, and 7.4 (95% CI, 5.0-10.9) in men, respectively, indicating marked increased risk of AS compared with the general Norwegian population. Conclusions and Relevance: In this prospective registry study, we demonstrate a marked increase in risk of AS in persons with FH.

• Tsuruda, Kaitlyn; Hofvind, Solveig; Akslen, Lars A.; Hoff, Solveig Roth & Veierød, Marit Bragelien (2019). Terminal digit preference: a source of measurement error in breast cancer diameter reporting. Acta Oncologica. ISSN 0284-186X. 59(3), p. 260–267. doi: 10.1080/0284186X.2019.1669817. Full text in Research Archive Show summary

  Objectives: Women diagnosed with breast cancer are offered treatment and therapy based on tumor characteristics, including tumor diameter. There is scarce knowledge whether tumor diameter is accurately reported, or whether it is unconsciously rounded to the nearest half-centimeter (terminal digit preference). This study aimed to assess the precision (number of digits) of breast cancer tumor diameters and whether they are affected by terminal digit preference. Furthermore, we aimed to assess the agreement between mammographic and histopathologic tumor diameter measurements. Material and Methods: This national registry study included reported mammographic and registered histopathologic tumor diameter information from the Cancer Registry of Norway for invasive breast cancers diagnosed during 2012–2016. Terminal digit preference was assessed using histograms. Agreement between mammographic and histopathologic measurements was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Results: Mammographic, histopathologic, or both tumor measurements were available for 7792, 13,541 and 6865 cases, respectively. All mammographic and 97.2% of histopathologic tumor diameters were recorded using whole mm. Terminal digits of zero or five were observed among 38.7% and 34.8% of mammographic and histopathologic measurements, respectively. There was moderate agreement between the two measurement methods (ICC = 0.52, 95% CI: 0.50–0.53). On average, mammographic measurements were 1.26 mm larger (95% limits of agreement: −22.29–24.73) than histopathologic measurements. This difference increased with increasing tumor size. Conclusion: Terminal digit preference was evident among breast cancer tumor diameters in this nationwide study. Further studies are needed to investigate the potential extent of under-staging and under-treatment resulting from this measurement error.

• Berge, Leon Alexander; Kulle, Bettina; Stenehjem, Jo S.; Larsen, Inger Kristin; Furu, Kari & Juzeniene, Asta [Show all 11 contributors for this article] (2019). Cardiovascular, antidepressant and immunosuppressive drug use in relation to risk of cutaneous melanoma: A protocol for a prospective case-control study. BMJ Open. 9:e025246(2), p. 1–8. doi: 10.1136/bmjopen-2018-025246. Full text in Research Archive Show summary

  The incidence of cutaneous melanoma (hereafter melanoma) has increased dramatically among fair-skinned populations worldwide. In Norway, melanoma is the most rapidly growing type of cancer, with a 47% increase among women and 57% among men in 2000–2016. Intermittent ultraviolet exposure early in life and phenotypic characteristics like a fair complexion, freckles and nevi are established risk factors, yet the aetiology of melanoma is multifactorial. Certain prescription drugs may have carcinogenic side effects on the risk of melanoma. Some cardiovascular, antidepressant and immunosuppressive drugs can influence certain biological processes that modulate photosensitivity and immunoregulation. We aim to study whether these drugs are related to melanoma risk.Methods and analysisA population-based matched case–control study will be conducted using nation-wide registry data. Cases will consist of all first primary, histologically verified melanoma cases diagnosed between 2007 and 2015 identified in the Cancer Registry of Norway (14 000 cases). Ten melanoma-free controls per case (on date of case melanoma diagnosis) will be matched based on sex and year of birth from the National Registry of Norway. For the period 2004—2015, and by using the unique personal identification numbers assigned to all Norwegian citizens, the case–control data set will be linked to the Norwegian Prescription Database for information on drugs dispensed prior to the melanoma diagnosis, and to the Medical Birth Registry of Norway for data regarding the number of child births. Conditional logistic regression will be used to estimate associations between drug use and melanoma risk, taking potential confounding factors into account.Ethics and disseminationThe project is approved by the Regional Committee for Medical Research Ethics in Norway and by the Norwegian Data Protection Authority. The study is funded by the Southeastern Norway Regional Health Authority. Results will be published in peer-reviewed journals and disseminated further through scientific conferences, news media and relevant patient interest groups.

• Cervenka, Iris; Rahmoun, Marie Al; Mahamat-Saleh, Yahya; Fournier, Agnès; Boutron-Ruault, Marie-Christine & Severi, Gianluca [Show all 41 contributors for this article] (2019). Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition. International Journal of Cancer. ISSN 0020-7136. p. 1–14. doi: 10.1002/ijc.32674. Full text in Research Archive Show summary

  Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country‐specific self‐administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992–2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline‐significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00–1.26), with no detected heterogeneity across countries (<i>p</i>_homogeneity = 0.42). This risk increased linearly with duration of use (<i>p</i>_trend = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97–1.43), which was heterogeneous across countries (<i>p</i>_homogeneity = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.

• Christensen, Lene; Veierød, Marit Bragelien; Vøllestad, Nina Køpke; Jakobsen, Vidar Eivind; Stuge, Britt & Cabri, Jan Maria Hendrick [Show all 7 contributors for this article] (2019). Kinematic and spatiotemporal gait characteristics in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women. Clinical Biomechanics. ISSN 0268-0033. 68, p. 45–52. doi: 10.1016/j.clinbiomech.2019.05.030. Full text in Research Archive Show summary

  Background Walking difficulties are common among pregnant women with pelvic girdle pain. This cross-sectional study investigated the influence of pelvic girdle pain, pregnancy and speed on spatiotemporal and trunk, pelvic and hip kinematics during gait in the 2nd trimester of pregnancy. Methods Three-dimensional gait analysis at self-selected speed was performed in 25 pregnant women with pelvic girdle pain, 24 asymptomatic pregnant and 24 non-pregnant women. Linear mixed models were used to investigate between-group differences in gait variables. Adjustment for gait speed was included in the analysis. Correlations between speed and fear of movement, disability and pain were examined using Spearman correlation coefficient (rs). Findings Pregnant women with pelvic girdle pain walked 18% slower (estimated marginal means (95% confidence intervals) 1.18 (1.22, 1.24) meter/s) compared to asymptomatic pregnant women (1.44 (1.38, 1.50) meter/s) (P < 0.001). Moreover, with longer double limb support (5%, P = 0.04), shorter contralateral step length (3%, P = 0.03) and more restricted pelvic and hip kinematics (0.001 ≤ P ≤ 0.01) adjusted for speed. Only stance, double limb support and thoracic rotation (0.001 ≤ P ≤ 0.04) differed between asymptomatic pregnant and non-pregnant women. Speed was negatively correlated with fear of movement (rs = −0.63, P = 0.01) and disability (rs = −0.46, P = 0.03) in the pelvic girdle pain group. Interpretation Gait is primarily influenced by pelvic girdle pain and less by pregnancy. Pregnant women with pelvic girdle pain walked slower and with a more rigid gait pattern compared to asymptomatic pregnant women, presumably related to altered load transfer. Our results may assist clinical evaluation of pelvic girdle pain, as well as direct future research.

• Narverud, Ingunn; Bogsrud, Martin Prøven; Øyri, Linn Kristin Lie; Ulven, Stine Marie; Retterstøl, Kjetil & Ueland, Thor [Show all 12 contributors for this article] (2019). Lipoprotein (a) concentration is associated with plasma arachidonic acid in subjects with familial hypercholesterolemia. British Journal of Nutrition. ISSN 0007-1145. doi: 10.1017/S0007114519001600. Full text in Research Archive Show summary

  Elevated lipoprotein(a) (Lp(a)) is associated with CVD and is mainly genetically determined. Studies suggest a role of dietary fatty acids (FA) in the regulation of Lp(a); however, no studies have investigated the association between plasma Lp(a) concentration and n-6 FA. We aimed to investigate whether plasma Lp(a) concentration was associated with dietary n-6 FA intake and plasma levels of arachidonic acid (AA) in subjects with familial hypercholesterolaemia (FH). We included FH subjects with (n 68) and without (n 77) elevated Lp(a) defined as ≥75 nmol/l and healthy subjects (n 14). Total FA profile was analysed by GC–flame ionisation detector analysis, and the daily intake of macronutrients (including the sum of n-6 FA: 18 : 2n-6, 20 : 2n-6, 20 : 3n-6 and 20 : 4n-6) were computed from completed FFQ. FH subjects with elevated Lp(a) had higher plasma levels of AA compared with FH subjects without elevated Lp(a) (P = 0·03). Furthermore, both FH subjects with and without elevated Lp(a) had higher plasma levels of AA compared with controls (P &amp;lt; 0·001). The multivariable analyses showed associations between dietary n-6 FA intake and plasma levels of AA (P = 0·02) and between plasma levels of Lp(a) and AA (P = 0·006). Our data suggest a novel link between plasma Lp(a) concentration, dietary n-6 FA and plasma AA concentration, which may explain the small diet-induced increase in Lp(a) levels associated with lifestyle changes. Although the increase may not be clinically relevant, this association may be mechanistically interesting in understanding more of the role and regulation of Lp(a).

• Øyri, Linn Kristin Lie; Hansson, Patrik; Bogsrud, Martin Prøven; Narverud, Ingunn; Florholmen, Geir & Leder, Lena [Show all 10 contributors for this article] (2018). Delayed postprandial TAG peak after intake of SFA compared with PUFA in subjects with and without familial hypercholesterolaemia: A randomised controlled trial. British Journal of Nutrition. ISSN 0007-1145. 119(10), p. 1142–1150. doi: 10.1017/S0007114518000673. Full text in Research Archive Show summary

  Postprandial hypertriacylglycerolaemia is associated with an increased risk of developing CVD. How fat quality influences postprandial lipid response is scarcely explored in subjects with familial hypercholesterolaemia (FH). The aim of this study was to investigate the postprandial response of TAG and lipid sub-classes after consumption of high-fat meals with different fat quality in subjects with FH compared with normolipidaemic controls. A randomised controlled double-blind cross-over study with two meals and two groups was performed. A total of thirteen hypercholesterolaemic subjects with FH who discontinued lipid-lowering treatment 4 weeks before and during the study, and fourteen normolipidaemic controls, were included. Subjects were aged 18–30 years and had a BMI of 18·5–30·0 kg/m2. Each meal consisted of a muffin containing 60 g (70 E%) of fat, either mainly SFA (40 E%) or PUFA (40 E%), eaten in a random order with a wash-out period of 3–5 weeks between the meals. Blood samples were collected at baseline (fasting) and 2, 4 and 6 h after intake of the meals. In both FH and control subjects, the level of TAG and the largest VLDL sub-classes peaked at 2 h after intake of PUFA and at 4 h after intake of SFA. No significant differences were found in TAG levels between meals or between groups (0·25≤P≤0·72). The distinct TAG peaks may reflect differences in the postprandial lipid metabolism after intake of fatty acids with different chain lengths and degrees of saturation. The clinical impact of these findings remains to be determined.

• Kverneland, Magnhild; Molteberg, Ellen; Iversen, Per Ole; Veierød, Marit Bragelien; Taubøll, Erik & Selmer, Kaja Kristine [Show all 7 contributors for this article] (2018). Effect of modified Atkins diet in adults with drug-resistant focal epilepsy: A randomized clinical trial. Epilepsia. ISSN 0013-9580. 59(8), p. 1567–1576. doi: 10.1111/epi.14457. Full text in Research Archive
• Stenehjem, Jo Steinson; Veierød, Marit Bragelien; Nilsen, Lill Tove Norvang; Ghiasvand, Reza; Johnsen, Bjørn J & Grimsrud, Tom Kristian [Show all 10 contributors for this article] (2018). Anthropometric factors and Breslow thickness: prospective data on 2570 cases of cutaneous melanoma in the population-based Janus Cohort. British Journal of Dermatology. ISSN 0007-0963. 179(3), p. 632–641. doi: 10.1111/bjd.16825. Full text in Research Archive Show summary

  Background Breslow thickness is the most important prognostic factor of localized cutaneous melanoma (CM), but associations with anthropometric factors have been sparsely and incompletely investigated. Objectives To examine prediagnostic body mass index (BMI), body surface area (BSA), and height, weight and weight change in relation to Breslow thickness, overall and by anatomical site and histological subtype; and to assess possible nonlinear associations between these anthropometric factors and Breslow thickness. Methods CMs in the Janus Cohort were identified between 1972 and 2014. Linear regression was used to estimate geometric mean ratios (GMRs) of Breslow thickness with 95% confidence intervals (CIs) according to anthropometric factors. Restricted cubic splines in generalized linear models predicted adjusted mean Breslow thickness, and were used to assess possible nonlinear relationships. Results Of 2570 cases of CM, obese patients had a GMR of 1·16 (95% CI 1·04–1·30) of Breslow thickness vs. normal‐weight patients. For BSA and weight, quintile 5 showed GMRs of 1·13 (95% CI 1·00–1·27) and 1·17 (95% CI 1·03–1·33) of Breslow thickness vs. quintile 1, respectively. Associations seemed restricted to superficial spreading melanomas and CMs on the trunk and lower limbs. The associations plateaued at an adjusted mean Breslow thickness of about 2·5 mm (BMI 29 kg m−2, BSA 2·05 m2 and weight 90 kg), before declining for the highest values. No associations were found for height and weight change. Conclusions This large case‐series of incident CM demonstrated positive associations between BMI, BSA, weight and Breslow thickness, and suggested that behavioural or other mechanisms apply at high values. This is the peer reviewed version of the article, which has been published in final form at Wiley. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."

• Hovland, Anders; Mundal, Liv; Igland, Jannicke; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund & Bogsrud, Martin Prøven [Show all 9 contributors for this article] (2018). Risk of Ischemic Stroke and Total Cerebrovascular Disease in Familial Hypercholesterolemia. Stroke. ISSN 0039-2499. 50(1), p. 172–174. doi: 10.1161/STROKEAHA.118.023456. Full text in Research Archive Show summary

  Familial hypercholesterolemia (FH) is a common autosomal dominant disease leading to increased level of serum LDL (low-density lipoprotein) cholesterol and risk of coronary heart disease. Whether FH increases the risk of cerebrovascular disease, including ischemic stroke, is debated. Accordingly, we studied the incidence of cerebrovascular disease in a cohort of people with genetically verified FH compared with the entire Norwegian population and examined whether people in this cohort with previous cohort had increased risk of cerebrovascular disease.

• Kristoffersen, Doris Tove; Helgeland, Jon; Clench-Aas, Jocelyne; Laake, Petter & Veierød, Marit Bragelien (2018). Observed to expected or logistic regression to identify hospitals with high or low 30-day mortality? PLOS ONE. 13(4). doi: 10.1371/journal.pone.0195248. Full text in Research Archive Show summary

  Introduction A common quality indicator for monitoring and comparing hospitals is based on death within 30 days of admission. An important use is to determine whether a hospital has higher or lower mortality than other hospitals. Thus, the ability to identify such outliers correctly is essential. Two approaches for detection are: 1) calculating the ratio of observed to expected number of deaths (OE) per hospital and 2) including all hospitals in a logistic regression (LR) comparing each hospital to a form of average over all hospitals. The aim of this study was to compare OE and LR with respect to correctly identifying 30-day mortality outliers. Modifications of the methods, i.e., variance corrected approach of OE (OE-Faris), bias corrected LR (LR-Firth), and trimmed mean variants of LR and LR-Firth were also studied. Materials and methods To study the properties of OE and LR and their variants, we performed a simulation study by generating patient data from hospitals with known outlier status (low mortality, high mortality, non-outlier). Data from simulated scenarios with varying number of hospitals, hospital volume, and mortality outlier status, were analysed by the different methods and compared by level of significance (ability to falsely claim an outlier) and power (ability to reveal an outlier). Moreover, administrative data for patients with acute myocardial infarction (AMI), stroke, and hip fracture from Norwegian hospitals for 2012–2014 were analysed. Results None of the methods achieved the nominal (test) level of significance for both low and high mortality outliers. For low mortality outliers, the levels of significance were increased four- to fivefold for OE and OE-Faris. For high mortality outliers, OE and OE-Faris, LR 25% trimmed and LR-Firth 10% and 25% trimmed maintained approximately the nominal level. The methods agreed with respect to outlier status for 94.1% of the AMI hospitals, 98.0% of the stroke, and 97.8% of the hip fracture hospitals. Conclusion We recommend, on the balance, LR-Firth 10% or 25% trimmed for detection of both low and high mortality outliers

• Bradbury, Kathryn E; Appleby, Paul N; Tipper, Sarah; Travis, Ruth C; Allen, Naomi E & Kvaskoff, Marina [Show all 46 contributors for this article] (2018). Circulating insulin-like growth factor I in relation to melanoma risk in the European prospective investigation into cancer and nutrition. International Journal of Cancer. ISSN 0020-7136. 144(5), p. 957–966. doi: 10.1002/ijc.31854. Full text in Research Archive Show summary

  Insulin‐like growth factor‐I (IGF‐I) regulates cell proliferation and apoptosis, and is thought to play a role in tumour development. Previous prospective studies have shown that higher circulating concentrations of IGF‐I are associated with a higher risk of cancers at specific sites, including breast and prostate. No prospective study has examined the association between circulating IGF‐I concentrations and melanoma risk. A nested case–control study of 1,221 melanoma cases and 1,221 controls was performed in the European Prospective Investigation into Cancer and Nutrition cohort, a prospective cohort of 520,000 participants recruited from 10 European countries. Conditional logistic regression was used to estimate odds ratios (ORs) for incident melanoma in relation to circulating IGF‐I concentrations, measured by immunoassay. Analyses were conditioned on the matching factors and further adjusted for age at blood collection, education, height, BMI, smoking status, alcohol intake, marital status, physical activity and in women only, use of menopausal hormone therapy. There was no significant association between circulating IGF‐I concentration and melanoma risk (OR for highest <i>vs</i> lowest fifth = 0.93 [95% confidence interval [CI]: 0.71 to 1.22]). There was no significant heterogeneity in the association between IGF‐I concentrations and melanoma risk when subdivided by gender, age at blood collection, BMI, height, age at diagnosis, time between blood collection and diagnosis, or by anatomical site or histological subtype of the tumour (Pheterogeneity≥0.078). We found no evidence for an association between circulating concentrations of IGF‐I measured in adulthood and the risk of melanoma.

• Stenehjem, Jo Steinson; Veierød, Marit Bragelien; Nilsen, Lill Tove N; Ghiasvand, Reza; Johnsen, Bjørn & Grimsrud, Tom Kristian [Show all 9 contributors for this article] (2018). Anthropometric factors and cutaneous melanoma: Prospective data from the population-based Janus Cohort. International Journal of Cancer. ISSN 0020-7136. 142(4), p. 681–690. doi: 10.1002/ijc.31086. Full text in Research Archive Show summary

  The aim of the present study was to prospectively examine risk of cutaneous melanoma (CM) according to measured anthropometric factors, adjusted for exposure to ultraviolet radiation (UVR), in a large population‐based cohort in Norway. The Janus Cohort, including 292,851 Norwegians recruited 1972–2003, was linked to the Cancer Registry of Norway and followed for CM through 2014. Cox regression was used to estimate hazard ratios (HRs) of CM with 95% confidence intervals (CIs). Restricted cubic splines were incorporated into the Cox models to assess possible non‐linear relationships. All analyses were adjusted for attained age, indicators of UVR exposure, education, and smoking status. During a mean follow‐up of 27 years, 3,000 incident CM cases were identified. In men, CM risk was positively associated with body mass index, body surface area (BSA), height and weight (all ptrends < 0.001), and the exposure‐response curves indicated an exponential increase in risk for all anthropometric factors. Weight loss of more than 2 kg in men was associated with a 53% lower risk (HR 0.47, 95% CI: 0.39, 0.57). In women, CM risk increased with increasing BSA (ptrend = 0.002) and height (ptrend < 0.001). The shape of the height‐CM risk curve indicated an exponential increase. Our study suggests that large body size, in general, is a CM risk factor in men, and is the first to report that weight loss may reduce the risk of CM among men. This is the peer reviewed version of the article, which has been published in final form at Wiley. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

• Skaarud, Kristin Aneta Joan; Hjermstad, Marianne Jensen; Bye, Asta; Veierød, Marit Bragelien; Gudmundstuen, Anne Marte & Lundin, Knut Erik Aslaksen [Show all 10 contributors for this article] (2018). Effects of individualized nutrition after allogeneic hematopoietic stem cell transplantation following myeloablative conditioning; a randomized controlled trial. Clinical Nutrition ESPEN. ISSN 2405-4577. 28, p. 59–66. doi: 10.1016/j.clnesp.2018.08.002. Full text in Research Archive Show summary

  Background & aims: Reduced quality of life (QoL) is prevalent after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this randomized trial we examined the effect of individualized nutritional support during hospitalization for allo-HSCT. Primary outcome was change in global QoL three months post-HSCT with oral mucositis (OM) and acute graft-versus-host disease (aGVHD) as main secondary outcomes. Methods: Whereas the intervention group received recommended minimum daily intakes of 126 kJ/kg and 0.75 g protein/kg as food, supplements, enteral or parenteral nutrition, the controls received routine feeding. QoL was self-reported using the EORTC QLQ-C30 questionnaire. Results: Between August, 2010 and February, 2016, we randomized 59 and 60 patients to intervention and control, respectively; 40 and 48 being eligible for analysis of QoL. There was no difference between the two groups in mean global QoL after three months (-3.10, 95% 45 CI -11.90-5.69; P=0.49). Nor were there any differences in OM grades 3-4 (RR (vs grades 0-2), 1.11, 95% CI 0.59-2.11 and 0.95, 95% CI 0.72-1.25, respectively; P=0.78), or a GVHD grades 3 or 4 (RR (vs grades 0-2) 0.44, 95% CI 0·12-1.60; and 0.65, 95% CI 0.20-2.20, respectively; P=0.37). Conclusion: Individualized nutritional support with recommended energy and protein intakes during hospitalization had no effect on QoL, OM or aGVHD three months after allo-HSCT compared to routine nutrition.

• Chortatos, Arthur; Iversen, Per Ole; Haugen, Margaretha; Eberhard-Gran, Malin; Bjelland, Elisabeth Krefting & Veierød, Marit Bragelien (2018). Nausea and vomiting in pregnancy - association with pelvic girdle pain during pregnancy and 4-6 months post-partum. BMC Pregnancy and Childbirth. 18. doi: 10.1186/s12884-018-1764-7. Full text in Research Archive Show summary

  Background To better understand previous associations reported regarding nausea and vomiting in pregnancy (NVP) and pelvic girdle pain (PGP), an investigation into timing of symptom onset for NVP and PGP in pregnancy, as well as the association of NVP with PGP 4-6 months post-partum was performed. We hypothesised that women with NVP symptoms would be most susceptible to experiencing persistence of PGP post-partum. Methods Fifty two thousand six hundred seventy-eight pregnancies from the Norwegian Mother and Child Cohort Study were analysed regarding nausea, vomiting, pelvic girdle pain, and health outcome data collected from questionnaires answered between gestation weeks 15, 20, 30, and 6 months post-partum. Logistic regression was used. Results Women experiencing NVP and PGP together (6.9%) were heaviest in the sample, youngest at menarche and had highest proportion with education ≤12 years. The primiparous women in this group had the lowest timespan from menarche to pregnancy. Women with nausea alone (NP) and NVP had higher odds of PGP 4-6 months post-partum (adjusted odds ratio, aOR = 2.14, 95% CI 1.70–2.71, and aOR = 2.83, 95% CI 2.25–3.57, respectively), compared to symptom-free women. NP/NVP symptoms appeared early in the first trimester, while PGP symptoms appeared later in pregnancy. Women with longer durations of nausea and/or vomiting had a higher proportion of PGP compared to shorter duration women. Conclusions Women with NP and NVP had increased odds of PGP 4-6 months post-partum, and women with a long duration of nausea and/or vomiting had a higher proportion of PGP than women with shorter duration, both during pregnancy and 4-6 months post-partum. This finding suggests a synergistic relationship between NP/NVP and PGP.

• Mundal, Liv; Igland, Jannicke; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund; Ose, Leiv & Selmer, Randi [Show all 11 contributors for this article] (2018). Impact of age on excess risk of coronary heart disease in patients with familial hypercholesterolaemia. Heart. ISSN 1355-6037. 104(19), p. 1600–1607. doi: 10.1136/heartjnl-2017-312706. Full text in Research Archive Show summary

  Objective: The primary objective was to study the risk of acute myocardial infarction (AMI) and coronary heart disease (CHD) in patients with familial hypercholesterolaemia (FH) and compare with the risk in the general population. Methods: Patients with an FH mutation but without prior AMI (n=3071) and without prior CHD (n=2795) were included in the study sample during 2001–2009. We obtained data on all AMI and CHD hospitalisations in Norway. We defined incident cases as first time hospitalisation or out-of-hospital death due to AMI or CHD. We estimated standardised incidence ratios (SIRs) with 95% CIs with indirect standardisation using incidence rates for the total Norwegian population stratified by sex, calendar year and 1 year age groups as reference rates. Results: SIRs for AMI (95% CIs) were highest in the age group 25–39 years; 7.5 (3.7 to 14.9) in men and 13.6 (5.1 to 36.2) in women and decreased with age to 0.9 (0.4 to 2.1) in men and 1.8 (0.9 to 3.7) in women aged 70–79 years. Similarly, SIRs for CHD were highest among patients 25–39 years old; 11.1 (7.1–17.5) in men and 17.3 (9.6–31.2) in women and decreased 2.4 (1.4–4.2) in men and 3.2 (1.5–7.2) in women at age 70–79. For all age groups, combined SIRs for CHD were 4.2 (3.6–5.0) in men and 4.7 (3.9–5.7) in women. Conclusion: Patients with FH are at severely increased risk of AMI and CHD compared with the general population. The highest excess risk was in the youngest group aged 25–39 years, in both sexes.

• Holven, Kirsten Bjørklund; Narverud, Ingunn; Lennep, Jeanine Roeters van; Versmissen, Jorie; Øyri, Linn Kristin Lie & Galema-Boers, Annette [Show all 11 contributors for this article] (2018). Sex differences in cholesterol levels from birth to 19 years of age may lead to increased cholesterol burden in females with FH. Journal of Clinical Lipidology. ISSN 1933-2874. 12(3), p. 748–755.e2. doi: 10.1016/j.jacl.2018.02.021. Full text in Research Archive Show summary

  Background: The increased risk of cardiovascular disease in familial hypercholesterolemia (FH) is caused by increased cholesterol burden from birth. Even small elevation in cholesterol level accumulates over time and aggravates atherosclerosis. Objectives: The aim of the present study was to describe the lipid profile across sex and age in a large cohort of untreated children and adolescents with FH, as this have not clearly been described. Methods: FH children (438 girls, 452 boys) not receiving lipid-lowering therapy, aged 0 to 19 years were included and divided into 4 age groups (<5, 5–9, 10–14, and 15–19 years). Information was retrieved from the medical records. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-HDL cholesterol (non–HDL-C) were studied in relation to sex and age by multiple linear regression analysis. Results: Girls with FH as compared to boys had significantly higher TC, LDL-C, and non–HDL-C (P < .001 for all) levels with mean (95% confidence interval) differences of 0.48 mmol/L (0.28, 0.68) (18.6 g/dL), 0.39 mmol/L (0.19, 0.59) (15.08 mg/dL), and 0.42 mmol/L (0.22, 0.63) (16.24 mg/dL), respectively. These estimates did not change after adjustment for age. We also observed sex differences for HDL-C; girls had higher HDL-C in the youngest (<5 years, P = .05) and oldest age groups (15–19 years, P < .001). Conclusions: FH girls have higher levels of TC, LDL-C, and non–HDL-C levels than boys from birth up to 19 years of age. This may contribute significantly to the total lifelong cholesterol burden in FH women.

• Veierød, Marit Bragelien; Page, Christian; Aaserud, Stein; Bassarova, Assia Vassileva; Jacobsen, Kari Dolven & Helsing, Per [Show all 7 contributors for this article] (2018). Melanoma staging: Varying precision and terminal digit clustering in Breslow thickness data is evident in a population-based study. Journal of American Academy of Dermatology. ISSN 0190-9622. 79(1), p. 118–125.e1. doi: 10.1016/j.jaad.2018.03.023. Full text in Research Archive Show summary

  Background Errors in Breslow thickness reporting can give misclassification of T category, an important classifier in melanoma staging. Objective We sought to investigate precision (number of digits) and terminal digit clustering in Breslow thickness and potential consequences for T category. Methods All first primary and morphologically verified invasive melanomas in Norway between 2008 and 2015 were included. A smoothing model was fitted to estimate the underlying Breslow thickness distribution without digit clustering. Results Thickness was reported for 13,057 (97.5%) patients; the median was 1.0 mm (range, 0.09-85). It was reported as whole numbers (15.6%), to 1 decimal (78.2%) and 2 decimal places (6.2%)—thin tumors with more precision than thick tumors. Terminal digit clustering was found with marked peaks in the observed frequency distribution for terminal digits 0 and 5, and with drops around these peaks. Terminal digit clustering increased proportions of patients classified with T1 and T4 tumors and decreased proportions classified with T2 and T3. Limitations Breslow thickness was not reported in 2.5% of cases. Conclusions The Norwegian recommendation of measurement to the nearest 0.1 mm was not followed. Terminal digit clustering was marked, with consequences for T category. Pathologists, clinicians, and epidemiologists should know that clustering of thickness data around T category cut points can impact melanoma staging with consequent effect on patient management and prognosis.

• Robsahm, Trude Eid; Helsing, Per; Nilssen, Yngvar; Vos, Linda; Rizvi, Syed Mohammad Husain & Akslen, Lars A. [Show all 7 contributors for this article] (2018). High mortality due to cutaneous melanoma in norway: A study of prognostic factors in a nationwide cancer registry. Clinical Epidemiology. 10, p. 537–548. doi: 10.2147/CLEP.S151246. Full text in Research Archive Show summary

  Purpose: The purpose of this study was to examine why Norway has the highest rate of mortality due to cutaneous melanoma (CM) in Europe. The Norwegian Malignant Melanoma Registry (NMMR) enables the study of clinical and histopathological characteristics of patients who die due to CM. Patients and methods: The NMMR and the Norwegian Cause of Death Registry provided data on the clinical and histopathological factors as well as the date and cause of death, through June 2015 for all first invasive CMs diagnosed in 2008–2012 (n=8087). Cox regression was used to estimate associations between clinical and pathological factors and CM-specific death. Multiple imputation was used to handle missing data. Results: The CMs were equally distributed between men (49.9%) and women (50.1%), and the median follow-up was 4.0 years (range: 0.08–7.5 years). Trunk was the most common anatomic site (48%), superficial spreading melanoma was the dominant melanoma subtype (68.2%), median Breslow thickness was 1.0 mm, ulceration was present in 23% of CMs, and 91.8% of cases were in a local clinical stage at diagnosis. Compared to women, men were diagnosed at a higher age, with thicker and more-often-ulcerated tumor, and more often were in advanced clinical stages. During follow-up, 1015 patients died due to CM, representing 52.8% of all deaths. The nodular subtype made up the dominant proportion of fatal CM cases (55.3% in women, 64.6% in men). Sex, age, anatomic site (trunk), T-stage, ulceration, clinical stage, and having a second primary CM were associated with increased risk of CM-specific death. Conclusion: Our data suggest that the high rate of mortality due to CM observed in Norway is attributable to the more advanced stage of the disease at diagnosis. Most high-risk cases occurred in male patients ≥70 years of age. Efforts to improve awareness and secondary prevention of CM, including warning signs of all melanoma subtypes, are required urgently and should be targeted toward men in particular.

• Caini, Saverio; Masala, Giovanna; Saieva, Calogero; Kvaskoff, Marina; Savoye, Isabelle & Sacerdote, Carlotta [Show all 48 contributors for this article] (2017). Coffee, tea and melanoma risk: findings from the European Prospective Investigation into Cancer and Nutrition. International Journal of Cancer. ISSN 0020-7136. 140(10), p. 2246–2255. doi: 10.1002/ijc.30659. Full text in Research Archive Show summary

  In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date. We examined the relationships between coffee (total, caffeinated or decaffeinated) and tea consumption and risk of melanoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a multicentre prospective study that enrolled over 500,000 participants aged 25–70 years from ten European countries in 1992–2000. Information on coffee and tea drinking was collected at baseline using validated country‐specific dietary questionnaires. We used adjusted Cox proportional hazards regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations between coffee and tea consumption and melanoma risk. Overall, 2,712 melanoma cases were identified during a median follow‐up of 14.9 years among 476,160 study participants. Consumption of caffeinated coffee was inversely associated with melanoma risk among men (HR for highest quartile of consumption vs. non‐consumers 0.31, 95% CI 0.14–0.69) but not among women (HR 0.96, 95% CI 0.62–1.47). There were no statistically significant associations between consumption of decaffeinated coffee or tea and the risk of melanoma among both men and women. The consumption of caffeinated coffee was inversely associated with melanoma risk among men in this large cohort study. Further investigations are warranted to confirm our findings and clarify the possible role of caffeine and other coffee compounds in reducing the risk of melanoma.

• Stenehjem, Jo Steinson; Grimsrud, Tom Kristian; Rees, Judith R.; Vos, Linda; Babigumira, Ronnie & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2017). A protocol for prospective studies of 25-hydroxyvitamin D, leptin and body mass index in relation to cutaneous melanoma incidence and survival. BMJ Open. 7(6). doi: 10.1136/bmjopen-2016-014829. Full text in Research Archive
• Skodje, Gry Irene; Henriksen, Christine; Salte, Tore; Drivenes, Therese; Toleikyte, Ieva & Løvik, Astrid [Show all 8 contributors for this article] (2017). Wheat challenge in self-reported gluten sensitivity: a comparison of scoring methods. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 52(2), p. 185–192. doi: 10.1080/00365521.2016.1244705. Full text in Research Archive Show summary

  Background: The condition non-coeliac gluten sensitivity (NCGS) is clinically similar to coeliac disease, but lack objective diagnostic criteria. Symptom relief on gluten-free diet followed by gluten containing food challenge may confirm the condition in clinical settings. Aim: To describe the results of an open bread challenge in patients with suspected NCGS, and to compare the results with recently suggested cut-offs for symptom change. Material and methods: Fifty-six patients (12 males) self-instituted on gluten-free diet with negative coeliac disease diagnostics were examined for NCGS by an open bread challenge. Symptoms were reported by Gastrointestinal Symptom Rating Scale, IBS-version (GSRS-IBS) and visual analogue scale (VAS). Results were retrospectively compared to the Salerno and Monash cut-offs for symptom change. Results: Forty-seven patients were diagnosed with NCGS. Total GSRS-IBS score and overall symptoms by VAS increased significantly in NCGS (p < .001), but not in non-NCGS patients (p < .12 and p = .08, respectively). Total GSRS-IBS challenge score and overall symptoms by VAS were significantly higher in NCGS than in non-NCGS patients (53 vs. 37, p = .004 and 76 vs. 39 mm, p = .02, respectively). Applying the Salerno and Monash cut-offs, 63 and 75% would be classified with NCGS, respectively. According to total GSRS–IBS absolute agreement was lowest between clinician’s diagnosis and Salerno cut-off (63%) and highest between Salerno and Monash cut-offs (88%). Conclusion: Clinician diagnosed 85% with NCGS. The proportion of NCGS was lower according to the Salerno and Monash cut-offs. The Salerno cut-off should be the starting point for a common definition of symptom change. This research has been published in the Scandinavian Journal of Gastroenterology. © 2016 Taylor & Francis

• Strømmen, Kenneth; Haag, Alexander; Moltu, Sissel; Veierød, Marit Bragelien; Blakstad, Elin Wahl & Nakstad, Britt [Show all 12 contributors for this article] (2017). Enhanced nutrient supply to very low birth weight infants is associated with higher blood amino acid concentrations and improved growth. Clinical Nutrition ESPEN. ISSN 2405-4577. 18, p. 16–22. doi: 10.1016/j.clnesp.2017.01.003. Full text in Research Archive
• Skodje, Gry Irene; Sarna, Vikas Kumar; Minelle, Ingunn Hillestad; Rolfsen, Kjersti Langballe; Muir, Jane & Gibson, Peter R. [Show all 9 contributors for this article] (2017). Fructan, rather than gluten, as symptom trigger in self-reported non-celiac gluten sensitivity. Gastroenterology. ISSN 0016-5085. 154(3), p. 529–539.e2. doi: 10.1053/j.gastro.2017.10.040. Full text in Research Archive Show summary

  Background & Aims: Non-celiac gluten sensitivity is characterized by symptom improvement after gluten withdrawal in absence of celiac disease. The mechanisms of non-celiac gluten sensitivity are unclear, and there are no biomarkers for this disorder. Foods with gluten often contain fructans, a type of fermentable oligo-, di-, monosaccharides and polyols. We aimed to investigate the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity. Methods: We performed a double-blind crossover challenge of 59 individuals on a self-instituted gluten-free diet, for whom celiac disease had been excluded. The study was performed at Oslo University Hospital in Norway from October 2014 through May 2016. Participants were randomly assigned to groups placed on diets containing gluten (5.7 g), fructans (2.1 g), or placebo, concealed in muesli bars, for 7 days. Following a minimum 7-day washout period (until the symptoms induced by the previous challenge were resolved), participants crossed over into a different group, until they completed all 3 challenges (gluten, fructan, and placebo). Symptoms were measured by Gastrointestinal Symptom Rating Scale Irritable Bowel Syndrome (GSRS-IBS) version. A linear mixed model for analysis was used. Results: Overall GSRS-IBS scores differed significantly during gluten, fructan, and placebo challenges; mean values were 33.1 ± 13.3, 38.6 ± 12.3, and 34.3 ± 13.9, respectively (P = .04). Mean scores for GSRS-IBS bloating were 9.3 ± 3.5, 11.6 ± 3.5, and 10.1 ± 3.7, respectively, during the gluten, fructan, and placebo challenges (P = .004). The overall GSRS-IBS score for participants consuming fructans was significantly higher than for participants consuming gluten (P = .049), as was the GSRS bloating score (P = .003). Thirteen participants had the highest overall GSRS-IBS score after consuming gluten, 24 had the highest score after consuming fructan, and 22 had the highest score after consuming placebo. There was no difference in GSRS-IBS scores between gluten and placebo groups. Conclusions: In a randomized, double-blind, placebo-controlled crossover study of individuals with self-reported non-celiac gluten sensitivity, we found fructans to induce symptoms, measured by the GSRS-IBS. Clinicaltrials.gov no: NCT02464150.

• Hovland, Anders; Mundal, Liv; Igland, Jannicke; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund & Bogsrud, Martin Prøven [Show all 9 contributors for this article] (2017). Increased risk of heart failure and atrial fibrillation in heterozygous familial hypercholesterolemia. Atherosclerosis. ISSN 0021-9150. 266, p. 69–73. doi: 10.1016/j.atherosclerosis.2017.09.027. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Tell, Grethe S.; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund & Leren, Trond Paul [Show all 7 contributors for this article] (2017). Standardized incidence ratio of peripheral arterial disease and aortic stenosis in genotyped familial hypercholesterolemia in Norway during 2001-2009. Atherosclerosis Supplements. ISSN 1567-5688. doi: 10.1016/j.atherosclerosis.2017.06.258. Full text in Research Archive
• Ghiasvand, Reza; Rueegg, Corina Silvia; Weiderpass, Elisabete; Green, Adele C; Lund, Eiliv & Veierød, Marit Bragelien (2017). Indoor Tanning and Melanoma Risk: Long-Term Evidence from a Prospective Population-Based Cohort Study. American Journal of Epidemiology. ISSN 0002-9262. 185(3), p. 147–156. doi: 10.1093/aje/kww148. Full text in Research Archive
• Henriksen, Hege; Ræder, Hanna; Bøhn, Siv Kjølsrud; Paur, Ingvild; Kværner, Ane Sørlie & Billington, Siv Åshild [Show all 14 contributors for this article] (2017). The Norwegian dietary guidelines and colorectal cancer survival (CRC-NORDIET) study: A food-based multicentre randomized controlled trial. BMC Cancer. 17(1). doi: 10.1186/s12885-017-3072-4. Full text in Research Archive Show summary

  Background Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. Methods/design This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study. Men and women aged 50–80 years diagnosed with primary invasive colorectal cancer (Stage I-III) are invited to this randomized controlled, parallel two-arm trial 2–9 months after curative surgery. The intervention group (n = 250) receives an intensive dietary intervention lasting for 12 months and a subsequent maintenance intervention for 14 years. The control group (n = 250) receives no dietary intervention other than standard clinical care. Both groups are offered equal general advice of physical activity. Patients are followed-up at 6 months and 1, 3, 5, 7, 10 and 15 years after baseline. The study center is located at the Department of Nutrition, University of Oslo, and patients are recruited from two hospitals within the South-Eastern Norway Regional Health Authority. Primary outcomes are disease-free survival and overall survival. Secondary outcomes are time to recurrence, cardiovascular disease-free survival, compliance to the dietary recommendations and the effects of the intervention on new comorbidities, intermediate biomarkers, nutrition status, physical activity, physical function and quality of life. Discussion The current study is designed to gain a better understanding of the role of a healthy diet aimed at dampening inflammation and oxidative stress on long-term disease outcomes and survival in colorectal cancer patients. Since previous research on the role of diet for colorectal cancer survivors is limited, the study may be of great importance for this cancer population. Trial registration ClinicalTrials.gov Identifier: NCT01570010 .

• Laake, Ida; Larsen, Inger Kristin; Selmer, Randi; Thune, Inger & Veierød, Marit Bragelien (2016). Pre-diagnostic body mass index and weight change in relation to colorectal cancer survival among incident cases from a population-based cohort study. BMC Cancer. 16. doi: 10.1186/s12885-016-2445-4. Full text in Research Archive Show summary

  Background:<br> Whether excess body weight influences colorectal cancer (CRC) survival is unclear. We studied pre-diagnostic body mass index (BMI) and weight change in relation to CRC-specific mortality among incident CRC cases within a large, Norwegian cohort.<br> Methods:<br> Participants’ weight was measured at health examinations up to three times between 1974 and 1988. CRC cases were identified through linkage with the Norwegian Cancer Registry. In total, 1336 men and 1180 women with a weight measurement >3 years prior to diagnosis were included in analyses. Hazard ratios (HRs) and confidence intervals (CIs) were estimated with Cox regression.<br> Results:<br> During a mean follow-up of 5.8 years, 507 men and 432 women died from CRC. Obesity (BMI ≥30 kg/m2) was associated with higher CRC-specific mortality than normal weight (BMI 18.5–25 kg/m2) in men with proximal colon cancer, HR = 1.85 (95 % CI 1.08–3.16) and in women with rectal cancer, HR = 1.93 (95 % CI 1.13–3.30). Weight gain was associated with higher CRC-specific mortality in women with CRC, colon cancer, and distal colon cancer, HRs per 5 kg weight gain were 1.18 (95 % CI 1.01–1.37), 1.22 (95 % CI 1.02–1.45), and 1.40 (95 % CI 1.01–1.95), respectively. Weight gain was not significantly associated with survival in men.<br> Conclusions:<br> Maintaining a healthy weight may benefit CRC survival, at least in women.<br> Keywords:<br> Colorectal cancer Survival Body mass index Weight change Cohort study

• Markussen, Marianne Skov; Veierød, Marit Bragelien; Ursin, Giske & Andersen, Lene Frost (2016). The effect of under-reporting of energy intake on dietary patterns and on the associations between dietary patterns and self-reported chronic disease in women aged 50-69 years. British Journal of Nutrition. ISSN 0007-1145. 116(3), p. 547–558. doi: 10.1017/S000711451600218X. Full text in Research Archive Show summary

  The aim of this cross-sectional study was to investigate whether under-reporting of energy intake affects derived dietary patterns and the association between dietary patterns and self-reported chronic disease. Diets of 6204 women aged 50–69 years participating in the Norwegian Breast Cancer Screening Program were assessed using a 253-item FFQ. We identified dietary patterns using principal component analysis. According to the revised Goldberg cut-off method, women with a ratio of reported energy intake:estimated BMR<1·10 were classified as low energy reporters (n 1133, 18 %). We examined the associations between dietary patterns and self-reported chronic diseases by log-binomial regression, and the results are presented as prevalence ratios (PR) and CI. ‘Prudent’, ‘Western’ and ‘Continental’ dietary patterns were identified among all reporters and plausible reporters. The PR expressing the associations between the ‘Western’ and ‘Prudent’ dietary pattern scores and self-reported chronic diseases were consistently highest among plausible reporters except for joint/muscle/skeletal disorders. The largest difference in PR among plausible v. all reporters was found for the association between the ‘Prudent’ pattern and diabetes (PR for highest v. lowest tertile: PRall reporters 2·16; 95 % CI 1·50, 3·13; Ptrend<0·001; PRplausible reporters 2·86; 95 % CI 1·81, 4·51; Ptrend<0·001). In conclusion, our results suggest that under-reporting can result in systematic error that can affect the association between dietary pattern and disease. In studies of dietary patterns, investigators ought to consider reporting effect estimates both for all individuals and for plausible reporters.

• Blakstad, Elin Wahl; Moltu, Sissel; Nakstad, Britt; Veierød, Marit Bragelien; Strømmen, Kenneth & Juliusson, Petur Benedikt [Show all 11 contributors for this article] (2016). Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants :. Food & Nutrition Research (FNR). ISSN 1654-6628. 60:33171, p. 1–11. doi: 10.3402/fnr.v60.33171. Full text in Research Archive
• Valberg, Morten; Grotmol, Tom; Tretli, Steinar; Veierød, Marit Bragelien; Moger, Tron Anders & Devesa, Susan S. [Show all 7 contributors for this article] (2016). Prostate-specific antigen testing for prostate cancer: Depleting a limited pool of susceptible individuals? European Journal of Epidemiology (EJE). ISSN 0393-2990. 20(6), p. 511–520. doi: 10.1007/s10654-016-0185-z. Full text in Research Archive
• Aniansson, Boel Maria; Veierød, Marit Bragelien; Rylander, Charlotta; Lund, Eiliv & Sandanger, Torkjel M (2016). Characterization of heavy users of skin care products among Norwegian women from 2003 to 2011. Archives of Public Health. ISSN 0778-7367. 74(1). doi: 10.1186/s13690-016-0165-5. Full text in Research Archive Show summary

  Background: Several ingredients in personal care products (PCPs) have been classified as endocrine disruptors (EDs) and concern has been raised whether use of PCPs can affect human health. We aimed to characterize Norwegian female users of skin care products and compare life style characteristics between heavy users and non-users. <p>Methods: This cross-sectional study consisted of 114 202 women (age 41–76 years) participating in the Norwegian Women and Cancer study, a large population-based prospective cohort study. Based on self-reported questionnaire data, we classified the study subjects into five groups according to a calculated percentage of skin area creamed per day. Life-style characteristics were then compared between heavy users (using body lotion twice a day) and non-users. Change in use from 2003 to 2011 was assessed through repeated measurements (n = 8484). <p>Results: Heavy users of skin care products had a significantly lower BMI, higher level of physical activity, higher income, higher alcohol consumption, fewer children and a shorter total time of breastfeeding than non-users (p < 0.001). There were significantly fewer current smokers and more former smokers among heavy users than among non-users (p < 0.01). Current and earlier use of oral contraceptives, hormone replacement therapy or hormonal intra-uterine device were significantly more common among heavy users than among non-users (p < 0.01). The use of skin care products was, to a moderate extent (weighted kappa 0.52), consistent over time from 2003 to 2011, and as many as 91. 5% of the women were classified into the same user group ±1 category in 2003 and 2011. <p>Conclusions: Heavy users of skin care products differ significantly from non-users on BMI, degree of daily physical activity, income, number of children, use of hormonal pharmaceuticals, smoking and alcohol consumption. Use of skin care products is common among women aged 41–76 years in Norway, and the use is consistent over time.

• Torvik, Kristin; Narverud, Ingunn; Ottestad, Inger; Svilaas, Arne B; Gran, Jon Michael & Retterstøl, Kjetil [Show all 11 contributors for this article] (2016). Dietary counseling is associated with an improved lipid profile in children with familial hypercholesterolemia. Atherosclerosis. ISSN 0021-9150. 252, p. 21–27. doi: 10.1016/j.atherosclerosis.2016.07.913. Full text in Research Archive
• Ghiasvand, Reza; Weiderpass, Elisabete; Green, Adele C; Lund, Eiliv & Veierød, Marit Bragelien (2016). Sunscreen use and subsequent melanoma risk: A population-based cohort study. Journal of Clinical Oncology. ISSN 0732-183X. 34(33), p. 3976–3983. doi: 10.1200/JCO.2016.67.5934. Full text in Research Archive Show summary

  Purpose To assess melanoma risk in relation to sunscreen use and to compare high– with low–sun protection factor (SPF) sunscreens in relation to sunbathing habits in a large cohort study. Materials and Methods We used data from the Norwegian Women and Cancer Study, a prospective population-based study of 143,844 women age 40 to 75 years at inclusion with 1,532,247 person-years of follow-up and 722 cases of melanoma. Multivariable Cox proportional hazards regression was used to estimate the association between sunscreen use (never, SPF < 15, SPF ≥ 15) and melanoma risk by calculating hazard ratios and 95% CIs. The population attributable fraction associated with sunscreen use was estimated. Results Sunscreen users reported significantly more sunburns and sunbathing vacations and were more likely to use indoor tanning devices. SPF ≥ 15 sunscreen use was associated with significantly decreased melanoma risk compared with SPF < 15 use (hazard ratio, 0.67; 95% CI, 0.53 to 0.83). The estimated decrease in melanoma (population attributable fraction) with general use of SPF ≥ 15 sunscreens by women age 40 to 75 years was 18% (95% CI, 4% to 30%). Conclusion Use of SPF ≥ 15 rather than SPF < 15 sunscreens reduces melanoma risk. Moreover, use of SPF ≥ 15 sunscreen by all women age 40 to 75 years could potentially reduce their melanoma incidence by 18%.

• Mundal, Liv; Igland, Jannicke; Ose, Leiv; Holven, Kirsten Bjørklund; Veierød, Marit Bragelien & Leren, Trond Paul [Show all 7 contributors for this article] (2016). Cardiovascular disease mortality in patients with genetically verified familial hypercholesterolemia in Norway during 1992-2013. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 24(2), p. 137–144. doi: 10.1177/2047487316676135. Full text in Research Archive
• Strømmen, Kenneth; Lyche, Jan Ludvig; Blakstad, Elin Wahl; Moltu, Sissel; Veierød, Marit Bragelien & Almaas, Astrid [Show all 13 contributors for this article] (2016). Increased levels of phthalates in very low birth weight infants with septicemia and bronchopulmonary dysplasia. Environment International. ISSN 0160-4120. 89-90, p. 228–234. doi: 10.1016/j.envint.2016.01.024. Full text in Research Archive
• Vuong, Kylie; Armstrong, Bruce K; Weiderpass, Elisabete; Lund, Eiliv; Adami, Hans-Olov & Veierød, Marit Bragelien [Show all 21 contributors for this article] (2016). Development and external validation of a melanoma risk prediction model based on self-assessed risk factors. JAMA dermatology. ISSN 2168-6068. 152(8), p. 889–896. doi: 10.1001/jamadermatol.2016.0939. Full text in Research Archive
• Mundal, Liv; Veierød, Marit Bragelien; Halvorsen, Thomas; Holven, Kirsten Bjørklund; Ose, Leiv & Iversen, Per Ole [Show all 9 contributors for this article] (2016). Cardiovascular disease in patients with genotyped familial hypercholesterolemia in Norway during 1994-2009, a registry study. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 23(18), p. 1962–1969. doi: 10.1177/2047487316666371. Full text in Research Archive Show summary

  BACKGROUND: Familial hypercholesterolaemia increases the risk for cardiovascular disease. The primary aim of the present study was to describe sex differences in incidence and prevalence of cardiovascular disease leading to hospitalisation in a complete cohort of genotyped familial hypercholesterolaemia patients. DESIGN AND METHODS: In this registry study data on 5538 patients with verified genotyped familial hypercholesterolaemia were linked to data on all Norwegian cardiovascular disease hospitalisations, and hospitalisations due to pre-eclampsia/eclampsia, congenital heart defects and diabetes. RESULTS: During 1994-2009 a total of 1411 of familial hypercholesterolaemia patients were hospitalised, and ischaemic heart disease was reported in 90% of them. Mean (SD) age at first hospitalisation and first re-hospitalisation was 45.1 (16.5) and 47.6 (16.3) years, respectively, with no sex differences (P = 0.66 and P = 0.93, respectively). More men (26.9%) than women (24.1%) with familial hypercholesterolaemia were hospitalised (P = 0.02). The median (25th-75th percentile) number of hospital admissions was four (two to seven) per familial hypercholesterolaemia patient, with no sex differences (P = 0.87). Despite having familial hypercholesterolaemia at the time of hospitalisation, the diagnosis of familial hypercholesterolaemia was registered in only 45.7% of the patients at discharge. CONCLUSION: Most cardiovascular disease hospitalisations were due to ischaemic heart disease. Familial hypercholesterolaemia patients were first time hospitalised at age 45.1 years, with no significant sex differences in age, which are important novel findings. The awareness and registration of the familial hypercholesterolaemia diagnosis during the hospital stays were disturbingly low.

• Nilsen, Lill Tove Norvang; Hannevik, Merete & Veierød, Marit Bragelien (2016). Ultraviolet exposure from indoor tanning devices: A systematic review. British Journal of Dermatology. ISSN 0007-0963. 174(4), p. 730–740. doi: 10.1111/bjd.14388. Full text in Research Archive
• Markussen, Marianne Skov; Veierød, Marit Bragelien; Kristiansen, Anne Lene; Ursin, Giske & Andersen, Lene Frost (2016). Dietary patterns of women aged 50-69 years and associations with nutrient intake, sociodemographic factors and key risk factors for non-communicable diseases. Public Health Nutrition (PHN). ISSN 1368-9800. 19(11), p. 2024–2032. doi: 10.1017/S1368980015003547. Full text in Research Archive Show summary

  Objective In women, the risk for non-communicable diseases increases after menopause. We aimed to identify major dietary patterns and study their associations with nutrient intake, sociodemographic factors and risk factors for non-communicable diseases among women aged 50–69 years. Design A cross-sectional study. Food intake was recorded by a 253-item FFQ. Dietary patterns were identified using principal component analysis. The associations between the dietary patterns and nutrients were described by Pearson’s correlation coefficients and multiple regression analysis was used to examine the associations between the dietary patterns and age, education, BMI, physical activity and smoking. Setting The Norwegian Breast Cancer Screening Programme. Subjects Women (n 6298) aged 50–69 years. Results Three dietary patterns were identified: ‘Prudent’, ‘Western’ and ‘Continental’. Adherence to the ‘Prudent’ pattern was related to older age, higher education, higher BMI, more physical activity (Ptrend<0·001) and being a non-smoker (P<0·001). Adherence to the ‘Western’ pattern was related to older age, lower education, higher BMI, less physical activity (0·001≤Ptrend≤0·006) and lower alcohol intake (r =−0·28). Adherence to the ‘Continental’ pattern was related to younger age, higher education, higher BMI, less physical activity, (Ptrend<0·001), being a smoker (P<0·001) and higher alcohol intake (r=0·36). Conclusions Three distinct dietary patterns were identified. High adherence to a ‘Prudent’ pattern was associated with a healthy lifestyle, while high adherence to a ‘Western’ or ‘Continental’ pattern was associated with an unhealthy lifestyle. These findings are valuable knowledge for health authorities when forming strategies to promote a healthier lifestyle among women.

• Helsing, Per; Robsahm, Trude Eid; Vos, Linda; Rizvi, Syed Mohammad H.; Akslen, Lars A. & Veierød, Marit Bragelien (2016). Cutaneous head and neck melanoma (CHNM): A population-based study of the prognostic impact of tumor location. Journal of American Academy of Dermatology. ISSN 0190-9622. 75, p. 975–982. doi: 10.1016/j.jaad.2016.06.048. Full text in Research Archive
• Narverud, Ingunn; Retterstøl, Kjetil; Iversen, Per Ole; Halvorsen, Bente; Ueland, Thor & Ulven, Stine Marie [Show all 10 contributors for this article] (2015). Markers of atherosclerotic development in children with familial hypercholesterolemia: a literature review. Atherosclerosis. ISSN 0021-9150. 235(2), p. 299–309. doi: 10.1016/j.atherosclerosis.2014.05.917. Full text in Research Archive
• Berwick, Marianne; Buller, David A; Cust, Anne; Gallagher, Richard; Lee, Tim K & Meyskens, Frank [Show all 10 contributors for this article] (2015). Melanoma epidemiology and prevention. In Kaufman, Howard L & Mehnert, Janice M (Ed.), Melanoma. Springer Publishing Company. ISSN 9783319225388. p. 17–41. Full text in Research Archive
• Blakstad, Elin Wahl; Strømmen, Kenneth; Moltu, Sissel; Wattam-Bell, John; Nordheim, Trond & Almaas, Astrid [Show all 15 contributors for this article] (2015). Improved visual perception in very low birth weight infants on enhanced nutrient supply. Neonatology. ISSN 1661-7800. 108(1), p. 30–37. doi: 10.1159/000381660. Full text in Research Archive
• Langslet, Gisle; Bogsrud, Martin Prøven; Halvorsen, Ida; Fjeldstad, Heidi; Retterstøl, Kjetil & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2015). Long-term follow-up of young adults with familial hypercholesterolemia after participation in clinical trials during childhood. Journal of Clinical Lipidology. ISSN 1933-2874. 9(6), p. 778–785. doi: 10.1016/j.jacl.2015.08.008. Full text in Research Archive
• Chortatos, Arthur; Haugen, Margaretha; Iversen, Per Ole; Vikanes, Åse Vigdis; Eberhard-Gran, Malin & Bjelland, Elisabeth Krefting [Show all 8 contributors for this article] (2015). Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the Norwegian Mother and Child Cohort Study. BMC Pregnancy and Childbirth. 15. doi: 10.1186/s12884-015-0580-6. Full text in Research Archive Show summary

  Background: To compare pregnancy complications and birth outcomes for women experiencing nausea and vomiting in pregnancy, or nausea only, with symptom-free women. Methods: Pregnancies from the Norwegian Mother and Child Cohort Study (n = 51 675), a population-based prospective cohort study, were examined. Data on nausea and/or vomiting during gestation and birth outcomes were collected from three questionnaires answered between gestation weeks 15 and 30, and linked with data from the Medical Birth Registry of Norway. Chi-squared tests, one way analysis of variance, multiple linear and logistic regression analyses were used. Results: Women with nausea and vomiting (NVP) totalled 17 070 (33 %), while 20 371 (39 %) experienced nausea only (NP), and 14 234 (28 %) were symptom-free (SF). When compared to SF women, NVP and NP women had significantly increased odds for pelvic girdle pain (adjusted odds ratio, aOR, 2.26, 95 % confidence interval, 95 % CI, 2.09–2.43, and aOR 1.90, 95 % CI, 1.76–2.05, respectively) and proteinuria (aOR 1.50, 95 % CI 1.38–1.63, and 1.20, 95 % CI 1.10–1.31, respectively). Women with NVP also had significantly increased odds for high blood pressure (aOR 1.40, 95 % CI 1.17–1.67) and preeclampsia (aOR 1.13, 95 % CI 1.01–1.27). Conversely, the NVP and NP groups had significantly reduced odds for unfavourable birth outcomes such as low birth weight infants (aOR 0.72, 95 % CI 0.60–0.88, and aOR 0.73, 95 % CI 0.60–0.88, respectively) and small for gestational age infants (aOR 0.78, 95 % CI 0.73–0.84, and aOR 0.87, 95 % CI 0.81–0.93, respectively). Conclusions: We found that women with NVP and NP are more likely to develop pregnancy complications, yet they display mostly favourable delivery and birth outcomes.

• Iversen, Per Ole; Ha, Lisa Ah Fung; Blomhoff, Rune; Hauge, Truls & Veierød, Marit Bragelien (2015). Baseline oxidative defense and survival after 5-7 years among elderly stroke patients at nutritional risk: Follow-up of a randomized, nutritional intervention trial. Clinical Nutrition. ISSN 0261-5614. 34(4), p. 775–778. doi: 10.1016/j.clnu.2014.07.002. Full text in Research Archive
• Rizvi, Syed Mohammad H.; Veierød, Marit Bragelien; Thorsby, Per Medbøe & Helsing, Per (2015). Vitamin d in Norwegian renal transplant recipients: A longitudinal study with repeated measurements in winter and summer. EJD. European journal of dermatology. ISSN 1167-1122. 25(3), p. 234–239. doi: 10.1684/ejd.2015.2524. Full text in Research Archive
• Narverud, Ingunn; Lennep, Jeanine Roeters van; Christensen, Jacob Juel; Versmissen, Jorie; Gran, Jon Michael & Iversen, Per Ole [Show all 15 contributors for this article] (2015). Maternal inheritance does not predict cholesterol levels in children with familial hypercholesterolemia. Atherosclerosis. ISSN 0021-9150. 243(1), p. 155–160. doi: 10.1016/j.atherosclerosis.2015.09.014. Full text in Research Archive
• Mansoor, Nadia; Vinknes, Kathrine; Veierød, Marit Bragelien & Retterstøl, Kjetil (2015). Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors a meta-analysis of randomised controlled trials. British Journal of Nutrition. ISSN 0007-1145. 115(3), p. 466–479. doi: 10.1017/S0007114515004699. Full text in Research Archive
• Robsahm, Trude Eid; Helsing, Per & Veierød, Marit Bragelien (2015). Cutaneous squamous cell carcinoma in norway 1963-2011: Increasing incidence and stable mortality. Cancer Medicine. 4(3), p. 472–480. doi: 10.1002/cam4.404. Full text in Research Archive
• Ghiasvand, Reza; Lund, Eiliv; Edvardsen, Kåre; Weiderpass, Elisabete & Veierød, Marit Bragelien (2015). Prevalence and trends of sunscreen use and sunburn among Norwegian women. British Journal of Dermatology. ISSN 0007-0963. 172(2), p. 475–483. doi: 10.1111/bjd.13434. Full text in Research Archive
• Markussen, Marianne Skov; Veierød, Marit Bragelien; Sakhi, Amrit Kaur; Ellingjord-Dale, Merete; Blomhoff, Rune & Ursin, Giske [Show all 7 contributors for this article] (2015). Evaluation of dietary patterns among Norwegian postmenopausal women using plasma carotenoids as biomarkers. British Journal of Nutrition. ISSN 0007-1145. 113(4), p. 672–682. doi: 10.1017/S0007114514004103. Full text in Research Archive Show summary

  A number of studies have examined dietary patterns in various populations. However, to study to what extent such patterns capture meaningful differences in consumption of foods is of interest. In the present study, we identified important dietary patterns in Norwegian postmenopausal women (age 50–69 years, n 361), and evaluated these patterns by examining their associations with plasma carotenoids. Diet was assessed by a 253-item FFQ. These 253 food items were categorised into forty-six food groups, and dietary patterns were identified using principal component analysis. We used the partial correlation coefficient (radj) and multiple linear regression analysis to examine the associations between the dietary patterns and the plasma carotenoids α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene and zeaxanthin. Overall, four dietary patterns were identified: the ‘Western’; ‘Vegetarian’; ‘Continental’; ‘High-protein’. The ‘Western’ dietary pattern scores were significantly inversely correlated with plasma lutein, zeaxanthin, lycopene and total carotenoids ( − 0·25 ≤ radj≤ − 0·13). The ‘Vegetarian’ dietary pattern scores were significantly positively correlated with all the plasma carotenoids (0·15 ≤ radj≤ 0·24). The ‘Continental’ dietary pattern scores were significantly inversely correlated with plasma lutein and α-carotene (radj= − 0·13). No significant association between the ‘High-protein’ dietary pattern scores and the plasma carotenoids was found. In conclusion, the healthy dietary pattern, the ‘Vegetarian’ pattern, is associated with a more favourable profile of the plasma carotenoids than our unhealthy dietary patterns, the ‘Western’ and ‘Continental’ patterns.

• Qureshi, Samera Azeem; Lund, Annette Christin; Veierød, Marit Bragelien; Carlsen, Monica Hauger; Blomhoff, Rune & Andersen, Lene Frost [Show all 7 contributors for this article] (2014). Food items contributing most to variation in antioxidant intake; A cross-sectional study among Norwegian women. BMC Public Health. 14(1). doi: 10.1186/1471-2458-14-45. Full text in Research Archive Show summary

  Background Fruit and vegetable intake has been found to reduce the risk of cardiovascular disease, certain types of cancer and diabetes mellitus. It is possible that antioxidants play a large part in this protective effect. However, which foods account for the variation in antioxidant intake in a population is not very clear. We used food frequency data from a population-based sample of women to identify the food items that contributed most to the variation in antioxidant intake in Norwegian diet. Methods We used data from a study conducted among participants in the Norwegian Breast Cancer Screening Program (NBCSP), the national program which invites women aged 50–69 years to mammographic screening every 2 years. A subset of 6514 women who attended the screening in 2006/2007 completed a food frequency questionnaire (FFQ). Daily intake of energy, nutrients and antioxidant intake were estimated. We used multiple linear regression analysis to capture the variation in antioxidant intake. Results The mean (SD) antioxidant intake was 23.0 (8.5) mmol/day. Coffee consumption explained 54% of the variation in antioxidant intake, while fruits and vegetables explained 22%. The twenty food items that contributed most to the total variation in antioxidant intake explained 98% of the variation in intake. These included different types of coffee, tea, red wine, blueberries, walnuts, oranges, cinnamon and broccoli. Conclusions In this study we identified a list of food items which capture the variation in antioxidant intake among these women. The major contributors to dietary total antioxidant intake were coffee, tea, red wine, blueberries, walnuts, oranges, cinnamon and broccoli. These items should be assessed in as much detail as possible in studies that wish to capture the variation in antioxidant intake.

• Frøslie, Kathrine Frey; Røislien, Jo; Qvigstad, Elisabeth; Godang, Kristin; Bollerslev, Jens & Henriksen, Tore [Show all 7 contributors for this article] (2014). Shape information in repeated glucose curves during pregnancy provided significant physiological information for neonatal outcomes. PLOS ONE. 9(3). doi: 10.1371/journal.pone.0090798. Full text in Research Archive
• Buonaccorsi, John P.; Laake, Petter & Veierød, Marit Bragelien (2014). On the power of the Cochran-Armitage test for trend in the presence of misclassification. Statistical Methods in Medical Research. ISSN 0962-2802. 3, p. 218–243. doi: 10.1177/0962280211406424. Full text in Research Archive
• Veierød, Marit Bragelien; Couto, Elisabeth; Lund, Eiliv; Adami, Hans Olov & Weiderpass, Elisabete (2014). Host characteristics, sun exposure, indoor tanning, and risk of squamous cell carcinoma of the skin. International Journal of Cancer. ISSN 0020-7136. 135(2), p. 413–422. doi: 10.1002/ijc.28657. Full text in Research Archive
• Moltu, Sissel; Blakstad, Elin Wahl; Strømmen, Kenneth; Almaas, Astrid; Nakstad, Britt & Rønnestad, Arild Erlend [Show all 11 contributors for this article] (2014). Enhanced feeding and diminished postnatal growth failure in very-low-birth-weight infants - a randomized, controlled trial. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 58(3), p. 344–351. doi: 10.1097/MPG.0000000000000220. Full text in Research Archive
• Valberg, Morten; Grotmol, Tom; Tretli, Steinar; Veierød, Marit Bragelien; Moger, Tron Anders & Aalen, Odd O. (2014). A hierarchical frailty model for familial testicular germ-cell tumors. American Journal of Epidemiology. ISSN 0002-9262. 179(4), p. 499–506. doi: 10.1093/aje/kwt267. Full text in Research Archive
• Moltu, Sissel; Sachse, Daniel; Blakstad, Elin Wahl; Strømmen, Kenneth; Nakstad, Britt & Almaas, Astrid [Show all 14 contributors for this article] (2014). Urinary metabolite profiles in premature infants show early postnatal metabolic adaption and maturation. Nutrients. 6(5), p. 1913–1930. doi: 10.3390/nu6051913. Full text in Research Archive
• Robinson, Hilde Stendal; Vøllestad, Nina Køpke & Veierød, Marit Bragelien (2014). Clinical course of pelvic girdle pain postpartum - Impact of clinical findings in late pregnancy. Manual Therapy. ISSN 1356-689X. 19(3), p. 190–196. doi: 10.1016/j.math.2014.01.004. Full text in Research Archive
• Chortatos, Arthur; Haugen, Margaretha; Iversen, Per Ole & Veierød, Marit Bragelien (2014). Dietary changes during first trimester pregnancy for women with nausea and vomiting in the Norwegian mother and child cohort study. Norsk Epidemiologi. ISSN 0803-2491. 24(1-2), p. 147–153. doi: 10.5324/nje.v24i1-2.1816. Full text in Research Archive Show summary

  Objective: Examine responses given to questions addressing whether pregnancy had caused women with nausea and vomiting (NVP) or symptom-free (SF) to alter their food habits in the first trimester in order to better understand the dietary changes taking place in women with NVP. Method: Using questions featured in the Norwegian Mother and Child Cohort Study (MoBa) specifically asking participants about alterations in diet and episodes of nausea and vomiting. The final sample used included 30,072 women. Results: We found 46% with no symptoms of nausea and/or vomiting in pregnancy, whilst 54% reported both nausea and vomiting. The NVP group of women were the group most affected with changes in food consumption, having the lowest proportion reporting to eat as before pregnancy, as well as the highest proportion reporting ‘eating more’ and ‘reduced eating’. The SF group reported eating more than NVP group in one instance, that being for chocolate (SF 17.7% vs NVP 16.3%). Conclusion: We have shown a higher degree of dietary change in women with NVP compared to SF women. We also found chocolate as the only exception, with a higher proportion of SF women eating more of this food item.

• Mundal, Liv Jorunn; Sarancic, Mirza; Ose, Leiv; Iversen, Per Ole; Borgan, Jens-Kristian & Veierød, Marit Bragelien [Show all 8 contributors for this article] (2014). Mortality among patients with familial hypercholesterolemiaA registry-based study in Norway 1992-2010. Journal of the American Heart Association (JAHA). 3:e001236(6). doi: 10.1161/JAHA.114.001236. Full text in Research Archive Show summary

  Background Untreated patients with familial hypercholesterolemia are at increased risk of premature cardiovascular death. The primary aim of this study was to investigate whether this is also the case in the statin era. Methods and Results In this registry‐based study, 4688 male and female patients from the Unit for Cardiac and Cardiovascular Genetics (UCCG) Registry with verified molecular genetic diagnosis of familial hypercholesterolemia in the period 1992–2010 were linked to the Norwegian Cause of Death Registry. Standardized mortality ratios and 95% CIs were estimated. There were 113 deaths. Mean age of death was 61.1 years. Cardiovascular disease was the most common cause of death (46.0%), followed by cancer (30.1%). Compared with the Norwegian population, cardiovascular disease mortality was significantly higher in the UCCG Registry in all age groups younger than 70 years (standardized mortality ratio 2.29, 95% CI 1.65 to 3.19 in men and women combined; standardized mortality ratio 2.00, 95% CI 1.32 to 3.04 in men; standardized mortality ratio 3.03, 95% CI 1.76 to 5.21 in women). No significant differences were found in all‐cause mortality or cancer mortality. Conclusions Despite prescription of lipid‐lowering drugs, familial hypercholesterolemia patients still had significantly increased cardiovascular disease mortality compared with the general Norwegian population.

• Strømmen, Kenneth; Blakstad, Elin Wahl; Moltu, Sissel; Almaas, Astrid; Westerberg, Ane Cecilie & Amlien, Inge [Show all 16 contributors for this article] (2014). Enhanced Nutrient Supply to Very Low Birth Weight Infants is Associated with Improved White Matter Maturation and Head Growth. Neonatology. ISSN 1661-7800. 107(1), p. 68–75. doi: 10.1159/000368181. Full text in Research Archive
• Buonaccorsi, John P.; Laake, Petter & Veierød, Marit Bragelien (2014). On the power of the Cochran-Armitage test for trend in the presence of misclassification. Statistical Methods in Medical Research. ISSN 0962-2802. 23(3), p. 218–243. doi: 10.1177/0962280211406424. Full text in Research Archive
• Molven, Ingunn; Retterstøl, Kjetil; Andersen, Lene Frost; Veierød, Marit Bragelien; Narverud, Ingunn & Ose, Leiv [Show all 9 contributors for this article] (2013). Children and young adults with familial hypercholesterolemia have healthier food choices particularly with respect to dietary fat sources compared to non-FH children. Journal of Nutritional Science (JNS). 2, p. e32–e32. doi: 10.1017/jns.2013.27. Full text in Research Archive
• Frøslie, Kathrine Frey; Røislien, Jo; Qvigstad, Elisabeth; Godang, Kristin; Bollerslev, Jens & Voldner, Nanna [Show all 8 contributors for this article] (2013). Shape information from glucose curves: Functional data analysis compared with traditional summary measures. BMC Medical Research Methodology. 13. doi: 10.1186/1471-2288-13-6. Full text in Research Archive Show summary

  Background Plasma glucose levels are important measures in medical care and research, and are often obtained from oral glucose tolerance tests (OGTT) with repeated measurements over 2–3 hours. It is common practice to use simple summary measures of OGTT curves. However, different OGTT curves can yield similar summary measures, and information of physiological or clinical interest may be lost. Our mean aim was to extract information inherent in the shape of OGTT glucose curves, compare it with the information from simple summary measures, and explore the clinical usefulness of such information. Methods OGTTs with five glucose measurements over two hours were recorded for 974 healthy pregnant women in their first trimester. For each woman, the five measurements were transformed into smooth OGTT glucose curves by functional data analysis (FDA), a collection of statistical methods developed specifically to analyse curve data. The essential modes of temporal variation between OGTT glucose curves were extracted by functional principal component analysis. The resultant functional principal component (FPC) scores were compared with commonly used simple summary measures: fasting and two-hour (2-h) values, area under the curve (AUC) and simple shape index (2-h minus 90-min values, or 90-min minus 60-min values). Clinical usefulness of FDA was explored by regression analyses of glucose tolerance later in pregnancy. Results Over 99% of the variation between individually fitted curves was expressed in the first three FPCs, interpreted physiologically as “general level” (FPC1), “time to peak” (FPC2) and “oscillations” (FPC3). FPC1 scores correlated strongly with AUC (r=0.999), but less with the other simple summary measures (−0.42≤r≤0.79). FPC2 scores gave shape information not captured by simple summary measures (−0.12≤r≤0.40). FPC2 scores, but not FPC1 nor the simple summary measures, discriminated between women who did and did not develop gestational diabetes later in pregnancy. Conclusions FDA of OGTT glucose curves in early pregnancy extracted shape information that was not identified by commonly used simple summary measures. This information discriminated between women with and without gestational diabetes later in pregnancy.

• Chortatos, Athanasios; Haugen, Margaretha; Iversen, Per Ole; Vikanes, Åse Vigdis; Magnus, Per & Veierød, Marit Bragelien (2013). Nausea and vomiting in pregnancy: associations with maternal gestational diet and lifestyle factors in the Norwegian Mother and Child Cohort Study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 120(13), p. 1642–1653. doi: 10.1111/1471-0528.12406. Full text in Research Archive
• Parr, Christine Louise; Hjartåker, Anette; Lund, Eiliv & Veierød, Marit Bragelien (2013). Meat intake, cooking methods and risk of proximal colon, distal colon and rectal cancer: The Norwegian Women and Cancer (NOWAC) cohort study. International Journal of Cancer. ISSN 0020-7136. 133(5), p. 1153–1163. doi: 10.1002/ijc.28101. Full text in Research Archive
• Laake, Ida; Carlsen, Monica Hauger; Pedersen, Jan I; Weiderpass, Elisabete; Selmer, Randi & Kirkhus, Bente [Show all 8 contributors for this article] (2013). Intake of trans fatty acids from partially hydrogenated vegetable and fish oil and ruminant fat in relation to cancer risk. International Journal of Cancer. ISSN 0020-7136. 132(6), p. 1389–1403. doi: 10.1002/ijc.27737. Full text in Research Archive
• Helsing, Per; Togsverd-Bo, Katrine; Veierød, Marit Bragelien; Mørk, Gro & Hædersdal, Merete (2013). Intensified fractional CO2 laser-assisted photodynamic therapy vs. laser alone for organ transplant recipients with multiple actinic keratoses and wart-like lesions: a randomized half-side comparative trial on dorsal hands. British Journal of Dermatology. ISSN 0007-0963. 169(5), p. 1087–1092. doi: 10.1111/bjd.12507. Full text in Research Archive
• Moltu, Sissel; Strømmen, Kenneth; Blakstad, Elin Wahl; Almaas, Astrid; Westerberg, Ane Cecilie & Brække, Kristin [Show all 13 contributors for this article] (2013). Enhanced feeding in very-low-birth-weight infants may cause electrolyte disturbances and septicemia - A randomized, controlled trial. Clinical Nutrition. ISSN 0261-5614. 32(2), p. 207–212. doi: 10.1016/j.clnu.2012.09.004. Full text in Research Archive
• Valberg, Morten; Grotmol, Tom; Tretli, Steinar; Veierød, Marit Bragelien; Devesa, Susan & Aalen, Odd O. (2012). Frailty modeling of age-incidence curves of osteosarcoma and Ewing sarcoma among individuals younger than 40 years. Statistics in Medicine. ISSN 0277-6715. 31(28), p. 3731–3747. doi: 10.1002/sim.5441. Full text in Research Archive
• Samuelsen, Sven Ove & Veierød, Marit Bragelien (2012). Poisson regression. In Veierød, Marit Bragelien; Lydersen, Stian & Laake, Petter (Ed.), Medical statistics in clinical and epidemiological research. Gyldendal Akademisk. ISSN 9788205399594. p. 200–230. Full text in Research Archive
• Veierød, Marit Bragelien; Lydersen, Stian & Laake, Petter (2012). Design and analysis. In Veierød, Marit Bragelien; Lydersen, Stian & Laake, Petter (Ed.), Medical statistics in clinical and epidemiological research. Gyldendal Akademisk. ISSN 9788205399594. p. 23–44. Full text in Research Archive
• Stevens, GA; Singh, GM; Lu, Y; Danaei, G; Lin, JK & Finucane, MM [Show all 15 contributors for this article] (2012). National, regional, and global trends in adult overweight and obesity prevalence. Population Health Metrics. 10(22). doi: 10.1186/1478-7954-10-22. Full text in Research Archive
• Laake, Ida; Pedersen, Jan I; Selmer, Randi Marie; Kirkhus, Bente; Lindman, Anja Schou & Tverdal, Aage [Show all 7 contributors for this article] (2012). A prospective study of intake of trans-fatty acids from ruminant fat, partially hydrogenated vegetable oils, and marine oils and mortality from CVD. British Journal of Nutrition. ISSN 0007-1145. 108(4), p. 743–754. doi: 10.1017/S0007114511005897. Full text in Research Archive
• Hirji, Karim F.; Fagerland, Morten & Veierød, Marit Bragelien (2012). Meta-analysis. In Veierød, Marit Bragelien; Lydersen, Stian & Laake, Petter (Ed.), Medical statistics in clinical and epidemiological research. Gyldendal Akademisk. ISSN 9788205399594. p. 663–707. Full text in Research Archive
• Kristoffersen, Doris Tove; Helgeland, Jon; Clench-Aas, Jocelyne; Laake, Petter & Veierød, Marit Bragelien (2012). Comparing hospital mortality - how to count does matter for patients hospitalized for acute myocardial infarction (AMI), stroke and hip fracture. BMC Health Services Research. 12. doi: 10.1186/1472-6963-12-364. Full text in Research Archive Show summary

  Background Mortality is a widely used, but often criticised, quality indicator for hospitals. In many countries, mortality is calculated from in-hospital deaths, due to limited access to follow-up data on patients transferred between hospitals and on discharged patients. The objectives were to: i) summarize time, place and cause of death for first time acute myocardial infarction (AMI), stroke and hip fracture, ii) compare case-mix adjusted 30-day mortality measures based on in-hospital deaths and in-and-out-of hospital deaths, with and without patients transferred to other hospitals. Methods Norwegian hospital data within a 5-year period were merged with information from official registers. Mortality based on in-and-out-of-hospital deaths, weighted according to length of stay at each hospital for transferred patients (W30D), was compared to a) mortality based on in-and-out-of-hospital deaths excluding patients treated at two or more hospitals (S30D), and b) mortality based on in-hospital deaths (IH30D). Adjusted mortalities were estimated by logistic regression which, in addition to hospital, included age, sex and stage of disease. The hospitals were assigned outlier status according to the Z-values for hospitals in the models; low mortality: Z-values below the 5-percentile, high mortality: Z-values above the 95-percentile, medium mortality: remaining hospitals. Results The data included 48 048 AMI patients, 47 854 stroke patients and 40 142 hip fracture patients from 55, 59 and 58 hospitals, respectively. The overall relative frequencies of deaths within 30 days were 19.1% (AMI), 17.6% (stroke) and 7.8% (hip fracture). The cause of death diagnoses included the referral diagnosis for 73.8-89.6% of the deaths within 30 days. When comparing S30D versus W30D outlier status changed for 14.6% (AMI), 15.3% (stroke) and 36.2% (hip fracture) of the hospitals. For IH30D compared to W30D outlier status changed for 18.2% (AMI), 25.4% (stroke) and 27.6% (hip fracture) of the hospitals. Conclusions Mortality measures based on in-hospital deaths alone, or measures excluding admissions for transferred patients, can be misleading as indicators of hospital performance. We propose to attribute the outcome to all hospitals by fraction of time spent in each hospital for patients transferred between hospitals to reduce bias due to double counting or exclusion of hospital stays.

• Nilsen, Lill Tove; Aalerud, Tommy Nakken; Hannevik, Merete & Veierød, Marit Bragelien (2011). UVB and UVA irradiances from indoor tanning devices. Photochemical and Photobiological Sciences. ISSN 1474-905X. 10(7), p. 1129–1136. doi: 10.1039/c1pp05029j. Full text in Research Archive
• Frøslie, Kathrine Frey; Godang, Kristin; Bollerslev, Jens; Henriksen, Tore; Røislien, Jo & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2011). Correction of an unexpected increasing trend in glucose measurements during 7 years recruitment to a cohort study. Clinical Biochemistry. ISSN 0009-9120. 44(17-18), p. 1483–1486. doi: 10.1016/j.clinbiochem.2011.08.1150. Full text in Research Archive
• Finicane, Mariel; Stevens, Gretchen A; Cowan, Melanie J; Danaei, Goodarz; Lin, John K & Paciorek, Christopher J [Show all 15 contributors for this article] (2011). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9•1 million participant. The Lancet. ISSN 0140-6736. 377(9765), p. 557–567. doi: 10.1016/s0140-6736(10)62037-5. Full text in Research Archive
• Frøslie, Kathrine Frey; Godang, Kristin; Bollerslev, Jens; Henriksen, Tore; Røislien, Jo & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2011). Time-dependent trends in glucose values during long-term use of a glucose measurement system. Clinical Biochemistry. ISSN 0009-9120. 44(17-18), p. 1483–1486. doi: 10.1016/j.clinbiochem.2011.08.1150. Full text in Research Archive
• Yang, Ling; Veierød, Marit Bragelien; Löf, Marie; Sandin, Sven; Adami, Hans-Olov & Weiderpass, Elisabete (2011). Prospective Study of UV Exposure and Cancer Incidence Among Swedish Women. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 20(7), p. 1358–1367. doi: 10.1158/1055-9965.EPI-11-0071. Full text in Research Archive
• Yang, Ling; Lof, M; Veierød, Marit Bragelien; Sandin, Sven; Adami, Hans-Olov & Weiderpass, Elisabete (2011). Ultraviolet Exposure and Mortality among Women in Sweden. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 20(4), p. 683–690. doi: 10.1158/1055-9965.EPI-10-0982. Full text in Research Archive
• Edvardsen, Kåre; Veierød, Marit Bragelien; Brustad, Magritt; Braaten, Tonje; Engelsen, Ola & Lund, Eiliv (2011). Vitamin D-effective solar UV radiation, dietary vitamin D and breast cancer risk. International Journal of Cancer. ISSN 0020-7136. 128(6), p. 1425–1433. doi: 10.1002/ijc.25463. Full text in Research Archive
• Stocks, Tanja; Lukanova, Annekatrin; Bjørge, Tone; Ulmer, Hanno; Manjer, Jonas & Almquist, Martin [Show all 14 contributors for this article] (2011). Metabolic Factors and the Risk of Colorectal Cancer in 580,000 Men and Women in the Metabolic Syndrome and Cancer Project (Me-Can). Cancer. ISSN 0008-543X. 117(11), p. 2398–2407. doi: 10.1002/cncr.25772. Full text in Research Archive
• Westerberg, Ane Cecilie; Schei, Ragnhild; Henriksen, Christine; Smith, Lars; Veierød, Marit Bragelien & Drevon, Christian A [Show all 7 contributors for this article] (2011). Attention among very low birth weight infants following early supplementation with docosahexaenoic and arachidonic acid. Acta Paediatrica. ISSN 0803-5253. 100(1), p. 47–52. doi: 10.1111/j.1651-2227.2010.01946.x. Full text in Research Archive
• Robsahm, Trude Eid; Hestvik, Unn Elisabet; Veierød, Marit Bragelien; Fagerlie, Arne; Nystad, Wenche & Engebretsen, Lars [Show all 7 contributors for this article] (2010). Cancer risk in Norwegian world class athletes. Cancer Causes and Control. ISSN 0957-5243. 21(10), p. 1711–1719. doi: 10.1007/s10552-010-9600-z. Full text in Research Archive Show summary

  Background: Physical activity appears to be inversely related to cancer risk, although the evidence is convincing for colon cancer only. As physical activity levels are difficult to measure in the general population, we aimed to investigate how physical activity influences cancer risk using a cohort of Norwegian world class athletes. Methods: The cohort includes 3,428 athletes. Individual questionnaires gave information about physical activity and lifestyle variables until attained age. To elucidate the level of cancer risk, groups of athletes were compared to the general population (external comparisons) and to each other (internal comparisons). Results: A slightly reduced risk of total cancer was observed in the cohort of athletes, but stronger effects were observed for subgroups. The risk reduction was most pronounced for lung cancer and for leukemia/lymphoma. In women, a threefold increased risk of thyroid cancer was observed. Conclusion: This cohort of athletes seems to have a reduced risk of cancer. The beneficial association, however, is weak and may be attributed to healthy lifestyle as well as to physical activity. Prolonged strenuous exercise may also increase the risk of thyroid cancer in women.

• Veierød, MB; Adami, Hans-Olov; Lund, Eiliv; Armstrong, Bruce Konrad & Weiderpass, Elisabete (2010). Sun and Solarium Exposure and Melanoma Risk: Effects of Age, Pigmentary Characteristics, and Nevi. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 19(1), p. 111–120. doi: 10.1158/1055-9965.EPI-09-0567. Full text in Research Archive
• Westerberg, Ane C.; Henriksen, Christine; Ellingvåg, Asta; Veierød, Marit Bragelien; Juliusson, Petur & Nakstad, Britt [Show all 11 contributors for this article] (2010). First year growth among very low birth weight infants. Acta Paediatrica. ISSN 0803-5253. 99(4), p. 556–562. doi: 10.1111/j.1651-2227.2009.01667.x. Full text in Research Archive
• Laake, Ida; Thune, Inger; Selmer, Randi Marie; Tretli, Steinar; Slattery, Martha L & Veierød, Marit B (2010). A prospective study of body mass index, weight change, and risk of cancer in the proximal and distal colon. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 19(6), p. 1511–1522. doi: 10.1158/1055-9965.EPI-09-0813. Full text in Research Archive
• Lindman, Anja Schou; Veierød, Marit Bragelien; Tverdal, Aage; Pedersen, JI & Selmer, Randi Marie (2010). Nonfasting triglycerides and risk of cardiovascular death in men and women from the Norwegian Counties Study. European Journal of Epidemiology (EJE). ISSN 0393-2990. 25(11), p. 789–798. doi: 10.1007/s10654-010-9501-1. Full text in Research Archive
• Veierød, Marit Bragelien; Smedby, K; Lund, Eiliv; Adami, Hans-Olov & Weiderpass, Elisabete (2010). Pigmentary Characteristics, UV Radiation Exposure, and Risk of Non-Hodgkin Lymphoma: a Prospective Study among Scandinavian Women. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 19(6), p. 1569–1576. doi: 10.1158/1055-9965.EPI-10-0115. Full text in Research Archive
• Robinson, Hilde Stendal; Veierød, Marit Bragelien; Mengshoel, Anne Marit & Vøllestad, Nina Køpke (2010). Pelvic girdle pain - associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study. BMC Musculoskeletal Disorders. 11. doi: 10.1186/1471-2474-11-91. Full text in Research Archive Show summary

  Background Recent studies have shown high prevalence rates for pelvic girdle pain (PGP) in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30. Methods This is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30. Results Self-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4) test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR) test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity. Conclusions The results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies.

• Veierød, Marit Bragelien; Nilsen, Lill Tove Norvang & Robsahm, Trude Eid (2010). Solarier, vitamin D og hudkreft :. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 130(18), p. 1818–1821. Full text in Research Archive
• Robinson, Hilde Stendal; Mengshoel, Anne Marit; Veierød, Marit Bragelien & Vøllestad, Nina Køpke (2010). Pelvic girdle pain: Potential risk factors in pregnancy in relation to disability and pain intensity three months postpartum. Manual Therapy. ISSN 1356-689X. 15(6), p. 522–528. doi: 10.1016/j.math.2010.05.007. Full text in Research Archive
• Frøslie, Kathrine Frey; Røislien, Jo; Laake, Petter; Henriksen, Tore; Qvigstad, Elisabeth & Veierød, Marit Bragelien (2010). Categorisation of continuous exposure variables revisited. A response to the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study. BMC Medical Research Methodology. 10. doi: 10.1186/1471-2288-10-103. Full text in Research Archive Show summary

  Background Although the general statistical advice is to keep continuous exposure variables as continuous in statistical analyses, categorisation is still a common approach in medical research. In a recent paper from the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study, categorisation of body mass index (BMI) was used when analysing the effect of BMI on adverse pregnancy outcomes. The lowest category, labelled "underweight", was used as the reference category. Methods The present paper gives a summary of reasons for categorisation and methodological drawbacks of this approach. We also discuss the choice of reference category and alternative analyses. We exemplify our arguments by a reanalysis of results from the HAPO paper. Results Categorisation of continuous exposure data results in loss of power and other methodological challenges. An unfortunate choice of reference category can give additional lack of precision and obscure the interpretation of risk estimates. A highlighted odds ratio (OR) in the HAPO study is the OR for birth weight >90th percentile for women in the highest compared to the lowest BMI category ("obese class III" versus "underweight"). This estimate was OR = 4.55 and OR = 3.52, with two different multiple logistic regression models. When using the "normal weight" category as the reference, our corresponding estimates were OR = 2.03 and OR = 1.62, respectively. Moreover, our choice of reference category also gave narrower confidence intervals. Summary Due to several methodological drawbacks, categorisation should be avoided. Modern statistical analyses should be used to analyse continuous exposure data, and to explore non-linear relations. If continuous data are categorised, special attention must be given to the choice of reference category.

• Friis, Camilla Margrethe; Frøslie, Kathrine Frey; Røislien, Jo; Voldner, Nanna; Godang, Kristin & Ueland, Thor [Show all 9 contributors for this article] (2010). The interleukins IL-6 and IL-1Ra: a mediating role in the associations between BMI and birth weight? Journal of Developmental Origins of Health and Disease. ISSN 2040-1744. 1(5), p. 310–318. doi: 10.1017/S204017441000036X. Full text in Research Archive
• Emaus, Aina; Veierød, Marit Bragelien; Tretli, Steinar; Finstad, Sissi Espetvedt; Selmer, Randi Marie & Furberg, Anne Sofie [Show all 9 contributors for this article] (2010). Metabolic profile, physical activity, and mortality in breast cancer patients. Breast Cancer Research and Treatment. ISSN 0167-6806. 121(3), p. 651–660. doi: 10.1007/s10549-009-0603-y. Full text in Research Archive
• Emaus, Aina; Veierød, Marit Bragelien; Tretli, Steinar; Finstad, Sissi E; Selmer, Randi & Furberg, Anne Sofie [Show all 9 contributors for this article] (2009). Metabolic profile, physical activity and mortality in breast cancer patients. Breast Cancer Research and Treatment. ISSN 0167-6806. doi: 10.1007/s10549-009-0603-y. Full text in Research Archive
• Aune, Dagfinn; Ursin, Giske & Veierød, Marit Bragelien (2009). Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia. ISSN 0012-186X. 52(11), p. 2277–2287. doi: 10.1007/s00125-009-1481-x. Full text in Research Archive
• Henriksen, Christine; Westerberg, Ane Cecilie; Rønnestad, Arild Erlend; Nakstad, Britt; Veierød, Marit Bragelien & Drevon, Christian A [Show all 7 contributors for this article] (2009). Growth and nutrient intake among very-low-birth-weight infants fed fortified human milk during hospitalisation. British Journal of Nutrition. ISSN 0007-1145. 102(8), p. 1179–1186. doi: 10.1017/S0007114509371755. Full text in Research Archive
• Parr, CL; Hjartaker, A; Hjartåker, Anette; Laake, Petter; Lund, Eiliv & Veierod, MB [Show all 7 contributors for this article] (2009). Recall Bias in Melanoma Risk Factors and Measurement Error Effects: A Nested Case-Control Study Within the Norwegian Women and Cancer Study. American Journal of Epidemiology. ISSN 0002-9262. 169(3), p. 257–266. doi: 10.1093/aje/kwn363. Full text in Research Archive
• Emaus, Aina; Espetvedt, Sissi; Veierød, Marit Bragelien; Veierod, MB; Ballard-Barbash, R & Furberg, Anne Sofie [Show all 10 contributors for this article] (2008). 17-beta-Estradiol in relation to age at menarche and adult obesity in premenopausal women. Human Reproduction. ISSN 0268-1161. 23(4), p. 919–927. doi: 10.1093/humrep/dem432. Full text in Research Archive
• Nilsen, LTN; Hannevik, M; Aalerud, TN; Johnsen, B; Friberg, EG & Veierød, Marit Bragelien (2008). Trends in UV irradiance of tanning devices in Norway: 1983-2005. Photochemistry and Photobiology. ISSN 0031-8655. 84, p. 1100–1108. doi: 10.1111/j.1751-1097.2008.00330.x. Full text in Research Archive
• Emaus, A; Veierød, Marit Bragelien; Furberg, Anne Sofie; Espetvedt, S; Friedenreich, C & Ellison, PT [Show all 9 contributors for this article] (2008). Physical activity, heart rate, metabolic profile, and estradiol in premenopausal women. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 40(6), p. 1022–1030. doi: 10.1249/MSS.0b013e318167411f. Full text in Research Archive
• Selmer, Randi Marie; Lindman, Anja Schou; Tverdal, Aage; Pedersen, Jan I; Njølstad, Inger & Veierød, Marit B (2008). Modell for estimering av kardiovaskulær risiko i Norge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(3), p. 286–290. Full text in Research Archive
• Parr, CL; Hjartåker, Anette; Hjartaker, A; Scheel, Ida; Lund, Eiliv & Laake, Petter [Show all 8 contributors for this article] (2008). Comparing methods for handling missing values in food-frequency questionnaires and proposing k nearest neighbours imputation: effects on dietary intake in the Norwegian Women and Cancer study (NOWAC). Public Health Nutrition (PHN). ISSN 1368-9800. 11, p. 361–370. doi: 10.1017/S1368980007000365. Full text in Research Archive
• Veierod, MB; Veierød, Marit Bragelien; Parr, CL; Lund, Eiliv & Hjartaker, A (2008). Reproducibility of self-reported melanoma risk factors in a large cohort study of Norwegian women. Melanoma research. ISSN 0960-8931. 18, p. 1–9. Full text in Research Archive
• Lindman, AS; Veierød, Marit Bragelien; Pedersen, JI; Tverdal, Aage; Njølstad, Inger & Selmer, Randi (2007). The ability of the SCORE high-risk model to predict 10-year cardiovascular disease mortality in Norway. European Journal of Cardiovascular Prevention & Rehabilitation. ISSN 1741-8267. 14. Full text in Research Archive
• Øverby, Nina Cecilie; Flaaten, V.; Veierød, Marit Bragelien; Bergstad, Ingunn; MARGEIRSDOTTIR, HANNA DIS & Dahl-Jørgensen, Knut [Show all 7 contributors for this article] (2007). Children and adolescents with type 1 diabetes eat a more atherosclerosis-prone diet than healthy control subjects. Diabetologia. ISSN 0012-186X. 50, p. 307–316. doi: 10.1007/s00125-006-0540-9. Full text in Research Archive
• Laake, Petter; Thoresen, Magne & Veierød, Marit Bragelien (2007). Målefeilsproblemer. In Laake, Petter; Hjartåker, Anette; Thelle, Dag Steinar & Veierød, Marit Bragelien (Ed.), Epidemiologiske og kliniske forskningsmetoder. Gyldendal Akademisk. ISSN 9788205335059. p. 128–168. Full text in Research Archive
• Laake, Petter; Hjartåker, Anette; Thelle, Dag Steinar & Veierød, Marit Bragelien (2007). Epidemiologisk og klinisk forskning. In Laake, Petter; Hjartåker, Anette; Thelle, Dag Steinar & Veierød, Marit Bragelien (Ed.), Epidemiologiske og kliniske forskningsmetoder. Gyldendal Akademisk. ISSN 9788205335059. p. 33–44. Full text in Research Archive
• Veierød, Marit Bragelien & Laake, Petter (2007). Regresjonsmodeller og analyse av sammenheng mellom eksponering og sykdom. In Laake, Petter; Hjartåker, Anette; Thelle, Dag Steinar & Veierød, Marit Bragelien (Ed.), Epidemiologiske og kliniske forskningsmetoder. Gyldendal Akademisk. ISSN 9788205335059. p. 66–127. Full text in Research Archive
• Andersen, Merethe; Reseland, Janne Elin; Veierød, Marit Bragelien; Andersen, Sigmund; Jacobs, David & Urdal, Petter [Show all 8 contributors for this article] (2007). Effects of long-term exercise and diet intervention on plasma adipokine concentrations. American Journal of Clinical Nutrition. ISSN 0002-9165. 86, p. 1293–1301. Full text in Research Archive

View all works in NVA

• Aalen, Odd O.; Frigessi, Arnoldo; Moger, Tron Anders; Scheel, Ida; Skovlund, Eva & Veierød, Marit Bragelien (2018). Statistiske metoder i medisin og helsefag. 2. utgave. Gyldendal Akademisk. ISBN 9788205507647. 351 p. Full text in Research Archive
• Veierød, Marit Bragelien; Lydersen, Stian & Laake, Petter (2012). Medical statistics in clinical and epidemiological research. Gyldendal Akademisk. ISBN 9788205399594. 720 p. Full text in Research Archive
• Laake, Petter; Hjartåker, Anette; Thelle, Dag S. & Veierød, Marit B. (2007). Epidemiologiske og kliniske forskningsmetoder. Gyldendal Akademisk. ISBN 9788205335059. 551 p. Full text in Research Archive
• Laake, Petter; Hjartåker, Anette; Thelle, Dag Steinar & Veierød, Marit Bragelien (2007). Epidemiologiske og kliniske forskningsmetoder. Gyldendal Akademisk. ISBN 9788205335059. 551 p. Full text in Research Archive

View all works in NVA

• Perrier, Flavie; Rimal, Raju; Green, Adele C; Rueegg, Corina Silvia; Ghiasvand, Reza & Gjersvik, Petter [Show all 13 contributors for this article] (2026). Breslow thickness and melanoma-specific death in patients diagnosed with thin cutaneous melanoma in 1983-2019. Full text in Research Archive
• Klevmoen, Marianne; Mulder, Janneke W.C.M.; Bogsrud, Martin Prøven; Retterstøl, Kjetil; Vesterbekkmo, Elisabeth Kleivhaug & Pedersen, Eva Ringdal [Show all 16 contributors for this article] (2025). Prospective study on breastfeeding, lipid profile and cardiovascular risk markers in women with familial hypercholesterolaemia: study protocol for the FH-FEMINA study. doi: 10.1136/bmjopen-2024-092208. Full text in Research Archive
• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar; Nordby, Karl-Christian & Olsen, Raymond [Show all 9 contributors for this article] (2025). Occupational exposures of firefighting and prostate cancer risk in the Norwegian fire departments cohort. Occupational and Environmental Medicine. ISSN 1351-0711. 82(Suppl. 1). doi: 10.1136/oemed-2024-epicohabstracts.3. Full text in Research Archive Show summary

  Objectives: In their 2022 classification of firefighting as carcinogenic, the International Agency for Research on Cancer deemed the evidence of the association with prostate cancer (PC) ‘limited’, citing an inability to rule out that a medical surveillance bias fully explained firefighters’ excess PC incidence compared to the general population. Our aim was to compare PC risk within a firefighter cohort, applying indicators of exposures. Methods: We used employment duration and the indicators fire exposure score, inhalation score and diesel exhaust exposure score to examine PC risk among men in the Norwegian Fire Departments Cohort (n=4251). Incident PC cases, including clinical characteristics, were obtained from the Cancer Registry of Norway (1960–2021). Cox regression was used to estimate hazard ratios (HRs) by cumulative exposure in tertiles (reference: lowest) for all, aggressive, and indolent PCs, with adjustment for age and birth cohort. The cumulative incidence of PC across birth cohorts and diagnostic periods was examined. Results: During 123,835 person-years of follow-up, there were 268 PC cases (61 aggressive, 69 indolent, 138 unclassifiable). No clear associations emerged for any of the exposure indicators, although elevated HRs were observed for aggressive PCs in the highest tertile of fire exposure score compared to the lowest (1.51, 95% CI 0.63–2.72), and for indolent PCs in the highest tertile of inhalation score compared to the lowest (1.31, 95% CI 0.60–2.89). Assessment of cumulative incidence by stage demonstrated a greater number of diagnoses of indolent and unclassifiable PC at younger ages from 1990. Conclusions: We did not observe clear associations between our exposure indicators and PC risk. However, our study had few cases in analyses by clinical stage. Studies of PC risk among firefighters remain challenged by difficulties in exposure characterization and a limited understanding of PC etiology, as well as the unclear magnitude of a medical surveillance bias. Funding: This work was funded by the Foundation Dam (grant no: 2019/FO247424), Cancer Society of Norway, Norwegian Firefighters Fight Cancer, Norwegian Union of Municipal and General Employees, Norwegian Union of Marine Engineers, and the Fire Union in Delta. Acknowledgements: We wish to thank Jarle Jakobsen (Nordland Hospital, Bodø, Norway) for his work in the early stages of this study. We also wish to thank the fire departments that collected and shared their data that constitutes the Norwegian Fire Departments Cohort, as well as our project reference group (comprising representatives from firefighters’ unions, employers’ organisations, the volunteer organisation ‘Norwegian Firefighters Fighting Cancer’, the Norwegian Directorate for Civil Protection, the Norwegian Labour Inspection Authority, and the Norwegian Cancer Society) for their contributions to the project.

• Veierød, Marit Bragelien (2025). Én type kreftflekk øker kraftig. [Journal]. nettavisen.no. Full text in Research Archive
• Ahimbisibwe, Ashley; Perrier, Flavie; Valberg, Morten; Green, Adele C.; Ghiasvand, Reza & Rueegg, Corina Silvia [Show all 10 contributors for this article] (2024). The counterintuitive association of sun exposure and melanoma-specific mortality in a cohort of Norwegian women. Full text in Research Archive
• Veierød, Marit Bragelien & Rimal, Raju (2024). The incidence of thin melanoma is increasing the most. [Internet]. uio.no. Full text in Research Archive
• Veierød, Marit Bragelien & Rimal, Raju (2024). Forekomsten av tynne melanomer øker mest. [Internet]. uio.no. Full text in Research Archive
• Veierød, Marit Bragelien & Rimal, Raju (2024). Disse kreftflekkene øker mest. [Journal]. forskning.no. Full text in Research Archive
• Kardel, Kristin Reimers; Iversen, Per Ole; Kaaya, Archileo Natigo; Muhoozi, Grace Kyamazima Mehangye; Veierød, Marit Bragelien & Wangen, Knut Reidar [Show all 8 contributors for this article] (2024). A pragmatic randomized trial to examine the effect of combining healthy diet with mindfulness cognitive therapy to reduce depressive symptoms among university students in a low-resource setting: protocol for the NutriMind Project. BMC Psychiatry. 24, p. 1–8. doi: 10.1186/s12888-024-06056-9. Full text in Research Archive Show summary

  Background Mental health disorders still rank as leading causes of morbidity worldwide despite increasing awareness and improvements in treatment. Notably, low- and middle-income countries like Uganda, are disproportionately affected by such disorders. The burden of depressive symptoms in these countries is particularly high among students, aggravated by poverty, malnutrition, and inadequate public health governance, yet it is clearly under-researched, making it hard to achieve several of UN Sustainability Development Goals. Current treatment options are insufficient to tackle the increased burden of depressive disease. This is more challenging for low-resource regions especially in Sub-Saharan Africa, suggesting the need for alternative treatments that can swiftly be applied if proven effective. The main aim of this randomized controlled trial (RCT) is therefore to examine if a low-cost healthy diet (based on local Ugandan foods) combined with easy-to access mindfulness cognitive therapy can reduce depressive symptoms among university students in Uganda. Methods We will recruit female and male students at Makerere University, the largest public university in Uganda, to an open, intention-to-treat, two-armed RCT. Those who score above a predefined threshold on a self-reported assessment of depressive symptoms, measured by the Center for Epidemiological Studies – Depression score (CES-D), are eligible for study inclusion and will be randomized to either an intervention (n = 125) or a control (n = 125) group. The intervention group will receive educational group-based sessions on how to prepare a Mediterranean-type of healthy diet and how to adhere to the principles of mindfulness-based cognitive therapy. Outcome measures include self-reported depression symptoms, quality of life, and dietary intakes. In addition we will perform a cost-effectiveness analysis. The RCT intervention will last 9 months, followed by additional 15 months with regular data collections. Discussion We here describe a novel approach to treat depressive symptoms among university students living in resource constraint settings, by combining a healthy diet with low threshold psychotherapy. If this intervention succeeds, our project can be viewed as a step towards evidence-based behavior practices for young adults with a common mental disorder (depression) that are beneficial to public mental health initiatives and management. Trial registration The RCT is registered in ClinicalTrials.gov (ID: NCT05848973). The date of registration was August 14, 2023.

• Ahimbisibwe, Ashley; Perrier, Flavie; Valberg, Morten; Green, Adele C; Ghiasvand, Reza & Rueegg, Corina Silvia [Show all 10 contributors for this article] (2024). The counterintuitive association of sun exposure and melanoma-specific mortality in a cohort of Norwegian women. Full text in Research Archive
• Veierød, Marit Bragelien & Jelmini, Maria (2023). Forskare: Teorin att vänja huden långsamt vid solen stämmer inte. [Journal]. Svenska Dagbladet. Full text in Research Archive
• Veierød, Marit Bragelien & Jelmini, Maria (2023). Solkrämsanvändare tycks få hudcancer oftare - varför? [Journal]. Svenska Dagbladet. Full text in Research Archive
• Rimal, Raju; Robsahm, Trude Eid; Green, Adele C.; Ghiasvand, Reza; Rueegg, Corina Silvia & Bassarova, Assia Vassileva [Show all 12 contributors for this article] (2023). Melanoma survival by tumour thickness in Norway, 1983–2019. Full text in Research Archive
• Veierød, Marit Bragelien (2023). Risikofaktorer for melanom. Full text in Research Archive
• Troensegaard, Hannibal; Khoury, Janette; Westerberg, Ane Cecilie; Tonstad, Serena; Lennep, Jeanine Roeters van & Veierød, Marit Bragelien [Show all 9 contributors for this article] (2023). Protocol for a 20-year follow-up after a randomized controlled trial of a Mediterranean diet in pregnancy: maternal and offspring risk factors for cardiovascular disease. Frontiers in Pediatrics. 11. doi: 10.3389/fped.2023.1256815. Full text in Research Archive Show summary

  Background: An inadequate maternal diet during pregnancy can impair offspring health and may increase the risk of cardiovascular disease later in life. The purpose of the proposed study is to assess the risk factors associated with cardiovascular disease in both mothers and their offspring 20 years following their participation in a Mediterranean diet intervention trial during pregnancy. Methods: The “Cardiovascular Risk Reduction Diet In Pregnancy” (CARRDIP) study was a randomized controlled trial performed between 1999 and 2001. The participants were randomized to adhere to either a Mediterranean diet or their regular diet during pregnancy. An extensive amount of data such as diet information, ultrasound measurements, anthropometry, and biomarkers from these mothers during pregnancy and their offspring in the neonatal period were collected. The mother–offspring pairs (n = 269) from the CARRDIP study will be invited to participate in a clinical examination and blood sample collection. This follow-up study, conducted 20 years after the original CARRDIP study, will investigate cardiovascular risk factors in mothers and offspring. The primary outcome will be the blood pressure of the offspring. In addition, the study will explore various aspects of cardiovascular health, including metabolic and inflammatory status, clinical history, and body composition of the participants. Discussion: Previous studies investigating the effects of nutrition during pregnancy on maternal and offspring health have been either observational studies, animal studies, or randomized controlled trials with a follow-up period of less than 5 years. This project aims to study the long-term effects of dietary intervention during pregnancy on maternal and offspring cardiovascular risk markers.

• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnnie; Martinsen, Jan Ivar; Nordby, Karl-Christian & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2022). Cancer incidence and mortality in the Norwegian Fire Departments cohort: Are incidence versus mortality outcome measures contributing to variability in risk estimates? Full text in Research Archive
• Marjerrison, Niki; Jakobsen, Jarle; Grimsrud, Tom Kristian; Hansen, Johnnie; Martinsen, Jan Ivar & Nordby, Karl-Christian [Show all 8 contributors for this article] (2022). Cancer incidence and mortality in the Norwegian Fire Departments Cohort, 1960-2018. Full text in Research Archive
• Stenehjem, Jo Steinson; Grimsrud, Tom Kristian & Veierød, Marit Bragelien (2022). Vi kan fortsatt lære av Kielland-ulykken. Full text in Research Archive
• Veierød, Marit Bragelien (2022). Epidemiologisk hudkreftforskning. Full text in Research Archive
• Rimal, Raju; Robsahm, Trude Eid; Green, Adèle C.; Ghiasvand, Reza; Rueegg, Corina Silvia & Bassarova, Assia Vassileva [Show all 11 contributors for this article] (2022). Trends in melanoma tumour thickness in Norway, 1983–2019. Full text in Research Archive Show summary

  Aim: Describe the trends in melanoma tumour thickness in Norway by T category, overall and in important subgroups such as sex, age, anatomic site, and histopathological subtype, over 35-year.

• Veierød, Marit Bragelien (2022). Lifestyle and melanoma risk: what do we know, what do we counsel our patients? Full text in Research Archive
• Veierød, Marit Bragelien (2022). Epidemiological melanoma research. Full text in Research Archive
• Perrier, Flavie; Robsahm, Trude Eid; Ghiasvand, Reza; Borch, Kristin Benjaminsen; Braaten, Tonje & Weiderpass, Elisabete [Show all 9 contributors for this article] (2022). No association between physical activity and primary melanoma thickness in a cohort of Norwegian women. British Journal of Dermatology. ISSN 0007-0963. 188(5), p. 670–690. doi: 10.1093/bjd/ljac136. Full text in Research Archive Show summary

  Knowledge about factors associated with melanoma thickness, the most important prognostic factor for localized primary melanoma survival,1 may help reduce the risk of melanoma deaths. Previously reported associations of melanoma thickness with pigmentary characteristics, number of naevi, diet quality and body mass index (BMI)2–4 may be explained by behavioural and biological mechanisms. Physical activity (PA) has been associated with improved outcomes for several cancers,5 but its relation with melanoma thickness and prognosis is unknown.

• Veierød, Marit Bragelien (2021). Sunscreen use, indoor tanning and skin cancer. Full text in Research Archive
• Veierød, Marit Bragelien & Perrier, Flavie (2021). Physical activity does not increase the risk of melanoma/ aktivitet øker ikke risikoen for melanom (føflekkreft). [Internet]. https://www.med.uio.no/imb/english/research/news-and-events/. Full text in Research Archive
• Liu, Fei-Chih; Veierød, Marit Bragelien; Kjærheim, Kristina; Robsahm, Trude Eid; Ghiasvand, Reza & Babigumira, Ronnie [Show all 11 contributors for this article] (2021). Excess risk of male breast cancer in the Norwegian Offshore Petroleum Workers (NOPW) cohort: a possible link to extreme night shift work? Breast Cancer Research. ISSN 1465-5411. doi: 10.1186/s13058-021-01485-w. Full text in Research Archive
• Rimal, Raju; Robsahm, Trude Eid; Green, Adèle C.; Ghiasvand, Reza; Rueegg, Corina Silvia & Bassarova, Assia Vassileva [Show all 11 contributors for this article] (2021). Long-term trends in melanoma tumour thickness in Norway. Full text in Research Archive Show summary

  Norway has the second-highest mortality rate of cutaneous melanoma worldwide and ranks fifth in incidence. Tumour (Breslow) thickness at diagnosis is the primary determinant of the T category in the tumour, nodes, metastasis staging system, and the most important prognostic factor for survival after localized melanoma. This ongoing study investigates long-term trends in tumour thickness, and the corresponding T categories, overall and in important subgroups, in a nationwide case series over a 40-year time period. The population-based Cancer Registry of Norway (CRN) provided all first primary invasive melanoma cases for 1980-2019. Tumour thickness was available from the Norwegian Melanoma Registry (within the CRN) for all cases diagnosed in 2008-2019 and was manually extracted from the paper notifications archived in the CRN for the cases diagnosed in 1980-2007. Covariates include sex, age, residential geographical region, anatomic site, histopathological subtype, clinical stage, and ulceration. Descriptive summaries are presented as frequencies (numbers, %) and medians with interquartile ranges (IQR). In total, 47,439 morphologically verified first primary invasive melanoma cases were diagnosed in Norway in 1980-2019. In both men and women, median age at diagnosis increased from 1980-2000 to 2008-2019 (Table 1). Trunk was the most common anatomic site in men (59.5%), and trunk (32.3%) and lower extremities (35.9%) the most common sites in women. The dominant subtype was superficial spreading melanoma (54.8%), followed by nodular melanoma (18.4%). In total, 90.0% of the cases were diagnosed in a local stage, whereas 5.6% had regional metastases and 4.4% had distant metastases. Women were diagnosed at a thinner stage than men. In men, median (IQR) tumour thickness decreased from 1.4 mm (0.75–3) in 1980-1999 to 1 mm (0.6–2.3) in 2008-2019, and in women from 1 mm (0.6–2) to 0.9 mm (0.5–1.8) (Table 1). Tumour thickness was missing in the pathology reports for more than 25% of the cases until 1990. Reporting of ulceration started in 2000, but with a large proportion of missing values. After the Norwegian Melanoma Registry was established in 2008, the proportions of missing ulceration decreased dramatically. This unique time series of national melanoma tumour thickness data will identify trends in tumour thickness, overall and in subgroups of the population, as well as identify potential effects of changing exposure patterns and earlier detection.

• Perrier, Flavie; Ghiasvand, Reza; Lergenmuller, Simon; Robsahm, Trude Eid; Green, Adele C & Borch, Kristin Benjaminsen [Show all 10 contributors for this article] (2021). Physical activity and cutaneous melanoma risk: A Norwegian population-based cohort study. Full text in Research Archive
• Perrier, Flavie; Ghiasvand, Reza; Lergenmuller, Simon; Robsahm, Trude Eid; Green, Adele C. & Borch, Kristin Benjaminsen [Show all 10 contributors for this article] (2021). Physical activity and melanoma risk: a Norwegian population-based cohort study. Full text in Research Archive
• Liu, Fei-Chih; Veierød, Marit B.; Kjærheim, Kristina; Robsahm, Trude E.; Ghiasvand, Reza & Babigumira, Ronnie [Show all 11 contributors for this article] (2021). Excess risk of male breast cancer in the Norwegian Offshore Petroleum Workers (NOPW) cohort: a possible link to extreme night shift work? Breast Cancer Research. ISSN 1465-5411. 23(1). doi: 10.1186/s13058-021-01485-w. Full text in Research Archive
• Christensen, Jacob Juel; Bogsrud, Martin Prøven; Holven, Kirsten Bjørklund; Retterstøl, Kjetil; Veierød, Marit Bragelien & Nordeng, Hedvig Marie Egeland (2021). Maternal use of statins in pregnancy: a population based registry study. Full text in Research Archive
• Støer, Nathalie Charlotte; Botteri, Edoardo; Busund, Marit Katinka; Ghiasvand, Reza; Vangen, Siri & Lund, Eiliv [Show all 8 contributors for this article] (2021). Menopausal hormone therapy and risk of melanoma: a population-based cohort study. British Journal of Dermatology. ISSN 0007-0963. doi: 10.1111/bjd.20640. Full text in Research Archive
• Veierød, Marit Bragelien (2020). Risikofaktorer for melanom i hud. Full text in Research Archive
• Veierød, Marit Bragelien & Lergenmuller, Simon (2019). https://www.med.uio.no/imb/forskning/aktuelt/aktuelle-saker/2019/risiko-hudkreft-oker-solariumsbruk.html. [Internet]. https://www.med.uio.no/imb/forskning/aktuelt/aktuelle-saker/. Full text in Research Archive
• Øyri, Linn Kristin Lie; Bogsrud, Martin Prøven; Christensen, Jacob J.; Ulven, Stine Marie; Brantsæter, Anne Lise & Retterstøl, Kjetil [Show all 12 contributors for this article] (2019). Novel and comprehensive metabolite profiling in cord blood reveal sex differences: A sub-study from the Norwegian Mother, Father and Child Cohort study. Full text in Research Archive
• Veierød, Marit Bragelien (2019). Risikofaktorer for melanom. Full text in Research Archive
• Veierød, Marit Bragelien (2019). Føflekkreft - bedre forståelse av føflekkreft gir bedre forebygging. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Veierød, Marit Bragelien & Retterstøl, Kjetil (2018). THE IMPACT OF AGE AND SEX ON EXCESS RISK OF CORONARY HEART DISEASE IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA: A REGISTRY STUDY‎. Atherosclerosis. ISSN 0021-9150. ‏ 275 , p. E175–E175. Full text in Research Archive
• Kristoffersen, Doris Tove; Helgeland, Jon; Laake, Petter & Veierød, Marit Bragelien (2018). Hospitals with high or low 30-day mortality - which method should we use to identify outliers? Full text in Research Archive
• Skodje, Gry Irene; Henriksen, Christine; Veierød, Marit Bragelien; Gibson, Peter R. & Lundin, Knut Erik Aslaksen (2018). Reply. Gastroenterology. ISSN 0016-5085. 155(1), p. 228–228. doi: 10.1053/j.gastro.2018.06.032. Full text in Research Archive
• Øyri, Linn Kristin Lie; Narverud, Ingunn; Bogsrud, Martin P.; Hansson, Patrik; Leder, Lena & Byfuglien, Marte G. [Show all 9 contributors for this article] (2018). LOWER POSTPRANDIAL LDL RECEPTOR GENE EXPRESSION IN PBMC AFTER INTAKE OF SATURATED COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FH. Full text in Research Archive
• Øyri, Linn Kristin Lie; Narverud, Ingunn; Bogsrud, Martin P.; Hansson, Patrik; Leder, Lena & Byfuglien, Marte G. [Show all 9 contributors for this article] (2018). LOWER POSTPRANDIAL LDL RECEPTOR GENE EXPRESSION IN PBMC AFTER INTAKE OF SATURATED COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FH. Full text in Research Archive
• Øyri, Linn Kristin Lie; Narverud, Ingunn; Bogsrud, Martin P.; Hansson, Patrik; Leder, Lena & Byfuglien, Marte G. [Show all 9 contributors for this article] (2018). LOWER POSTPRANDIAL LDL RECEPTOR GENE EXPRESSION IN PBMC AFTER INTAKE OF SATURATED COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FH. Full text in Research Archive
• Øyri, Linn Kristin Lie; Narverud, Ingunn; Bogsrud, Martin P.; Hansson, Patrik; Leder, Lena & Byfuglien, Marte G. [Show all 9 contributors for this article] (2018). LOWER POSTPRANDIAL LDL RECEPTOR GENE EXPRESSION IN PBMC AFTER INTAKE OF SATURATED COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FH. Full text in Research Archive
• Halvorsen, Jon Anders; Løberg, Magnus; Gjersvik, Petter; Roscher, Ingrid; Veierød, Marit Bragelien & Robsahm, Trude Eid [Show all 9 contributors for this article] (2018). Why a randomized melanoma screening trial is not a good idea. British Journal of Dermatology. ISSN 0007-0963. 179, p. 532–533. doi: 10.1111/bjd.16784. Full text in Research Archive
• Øyri, Linn Kristin Lie; Hansson, Patrik; Bogsrud, Martin P.; Narverud, Ingunn; Florholmen, Geir & Leder, Lena [Show all 10 contributors for this article] (2017). DIFFERENT POSTPRANDIAL TRIGLYCERIDE PEAK AFTER INTAKE OF SATURATED FAT COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FAMILIAL HYPERCHOLESTEROLEMIA. Full text in Research Archive
• Øyri, Linn Kristin Lie; Hansson, Patrik; Bogsrud, Martin Prøven; Narverud, Ingunn; Florholmen, Geir & Leder, Lena [Show all 10 contributors for this article] (2017). DIFFERENT POSTPRANDIAL TRIGLYCERIDE PEAK AFTER INTAKE OF SATURATED FAT COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FAMILIAL HYPERCHOLESTEROLEMIA. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Veierød, Marit Bragelien; Tell, Grethe S.; Holven, Kirsten Bjørklund & Leren, Trond Paul [Show all 7 contributors for this article] (2017). Standardized incidence ratio of peripheral arterial disease and aortic stenosis in genotyped familial hypercholesterolemia in Norway during 2001-2009. Full text in Research Archive
• Robsahm, Trude Eid; Stenehjem, Jo Steinson & Veierød, Marit Bragelien (2017). 18-årsgrensen for solariebruk skal håndheves :. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(9), p. 608–608. doi: 10.4045/tidsskr.17.0130. Full text in Research Archive
• Retterstøl, Kjetil; Mundal, Liv; Igland, Jannicke; Tell, Grethe S.; Tell, Grethe Seppola & Veierød, Marit Bragelien [Show all 9 contributors for this article] (2017). Incidence of various types of atherosclerotic disease in patients with genotyped familial hypercholesterolemia. Full text in Research Archive
• Øyri, Linn Kristin Lie; Hansson, Patrik; Bogsrud, Martin P.; Narverud, Ingunn; Florholmen, Geir & Leder, Lena [Show all 10 contributors for this article] (2017). DIFFERENT POSTPRANDIAL TRIGLYCERIDE PEAK AFTER INTAKE OF SATURATED FAT COMPARED TO POLYUNSATURATED FAT IN SUBJECTS WITH AND WITHOUT FAMILIAL HYPERCHOLESTEROLEMIA. Full text in Research Archive
• Ghiasvand, Reza; Rueegg, Corina Silvia; Weiderpass, Elisabete; Green, Adele C.; Lund, Eiliv & Veierød, Marit Bragelien (2017). The authors reply. American Journal of Epidemiology. ISSN 0002-9262. 186(6), p. 749–749. doi: 10.1093/aje/kwx284. Full text in Research Archive
• Veierød, Marit Bragelien (2017). Studies of ultraviolet exposure and pigmentary characteristics in the Norwegian Women and Cancer cohort. ISM Skriftsserie. 184. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Tell, Grethe S.; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund & Retterstøl, Kjetil (2017). Incidence of acute myocardial infarction and coronary heart disease in patients with genotyped familial hypercholesterolemia in Norway during 2001-2009. Full text in Research Archive
• Ghiasvand, Reza; Rueegg, Corina Silvia; Weiderpass, Elisabete; Green, Adele C; Lund, Eiliv & Veierød, Marit Bragelien (2017). Ghiasvand et al. Respond to "Indoor Tanning-A Melanoma Accelerator?". American Journal of Epidemiology. ISSN 0002-9262. 185(3), p. 160–161. Full text in Research Archive
• Kristoffersen, Doris Tove; Helgeland, Jon; Clench-Aas, Jocelyne; Laake, Petter & Veierød, Marit Bragelien (2016). Type I error and power for detecting hospitals with high or low 30-day mortality. Full text in Research Archive
• Skodje, Gry Irene; Sarna, Vikas Kumar; Rolfsen, Kjersti Langballe; Minelle, Ingunn Hillestad; Muir, JG & Gibson, Peter R. [Show all 9 contributors for this article] (2016). A double-blind cross-over challenge in individuals with self-reported gluten sensitivity points towards fructans as symptom trigger. Full text in Research Archive
• Mundal, Liv; Veierød, Marit Bragelien; Halvorsen, Thomas; Holven, Kirsten Bjørklund; Ose, Leiv & Iversen, Per Ole [Show all 9 contributors for this article] (2016). CARDIOVASCULAR DISEASE IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA IN NORWAY. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Veierød, Marit Bragelien; Holven, Kirsten Bjørklund; Selmer, Randi & Wisløff, Torbjørn [Show all 8 contributors for this article] (2016). INCIDENCE OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH GENOTYPED FAMILIAL HYPERCHOLESTEROLEMIA IN NORWAY DURING 2001-2009. Circulation. ISSN 0009-7322. 134 (25), p. E711–E711. Full text in Research Archive
• Narverud, Ingunn; Lennep, Jeanine Roeters van; Christensen, Jacob J.; Versmissen, Jorie; Gran, Jon Michael & Iversen, Per Ole [Show all 14 contributors for this article] (2016). What is the impact of maternal inheritance of FH on lipids and CRP in children with FH? Full text in Research Archive
• Mansoor, Nadia; Vinknes, Kathrine; Veierød, Marit Bragelien & Retterstøl, Kjetil (2016). Low-carbohydrate diets increase LDL-cholesterol, and thereby indicate increased risk of CVD. British Journal of Nutrition. ISSN 0007-1145. 115(12), p. 2264–2266. doi: 10.1017/S0007114516001343. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Ose, Leiv; Holven, Kirsten Bjørklund; Veierød, Marit Bragelien & Leren, Trond Paul [Show all 7 contributors for this article] (2016). MORTALITY OF CARDIOVASCULAR DISEASE IN PATIENTS WITH GENETICALLY VERIFIED FAMILIAL HYPERCHOLESTEROLEMIA. Atherosclerosis. ISSN 0021-9150. 252, p. E38–E38. Full text in Research Archive
• Mundal, Liv; Igland, Jannicke; Ose, Leiv; Holven, Kirsten Bjørklund; Veierød, Marit Bragelien & Leren, Trond Paul [Show all 7 contributors for this article] (2016). MORTALITY OF CARDIOVASCULAR DISEASE IN PATIENTS WITH GENETICALLY VERIFIED FAMILIAL HYPERCHOLESTEROLEMIA. Full text in Research Archive
• Mundal, Liv; Sarancic, Mirza; Ose, Leiv; Iversen, Per Ole; Borgan, Jens-Kristian & Veierød, Marit Bragelien [Show all 8 contributors for this article] (2015). Økt dødelighet av familær hyperkolesterolemi. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(11), p. 1024–1025. doi: 10.4045/tidsskr.15.0244. Full text in Research Archive
• Chortatos, Arthur; Haugen, Margaretha; Iversen, Per Ole; Vikanes, Åse Vigdis; Eberhard-Gran, Malin & Bjelland, Elisabeth Krefting [Show all 8 contributors for this article] (2015). Erratum to Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the Norwegian Mother and Child Cohort Study. [BMC Pregnancy Childbirth, 15, (2015), 138] doi: 10.1186/s12884-015-0580-6. BMC Pregnancy and Childbirth. 15:167. doi: 10.1186/s12884-015-0596-y. Full text in Research Archive
• Veierød, Marit Bragelien (2015). Forekomsten av føflekkreft øker igjen. 135(5), p. 450–452. doi: 10.4045/tidsskr.14.1109. Full text in Research Archive
• Torvik, Krstin; Narverud, Ingunn; Retterstøl, Kjetil; Svilaas, Arne B; Andersen, Lene Frost & Veierød, Marit Bragelien [Show all 12 contributors for this article] (2014). Relation between diet and lipids in children with familial hypercholesterolemia (FH). Full text in Research Archive
• Narverud, Ingunn; Lennep, Jeanine Roeters van; Christensen, Jacob Juel; Versmissen, Jorie; Gran, Jon Michael & Iversen, Per Ole [Show all 15 contributors for this article] (2014). Cardiovascular risk markers in a large cohort of children and adolescents with genetically verified familial hypercholestelemia show no inheritance-related but LDL receptor mutation type- and family history of cardiovascular disease-related variance. Full text in Research Archive
• Blakstad, Elin Wahl; Strømmen, Kenneth; Moltu, Sissel; Wattam-Bell, J; Nordheim, Trond & Almaas, Astrid [Show all 14 contributors for this article] (2013). Enhanced feeding improved global motion visual event-related potentials in very low birth weight infants. Full text in Research Archive
• Strømmen, Kenneth; Blakstad, Elin Wahl; Moltu, Sissel; Almaas, Astrid; Amlien, Inge & Rønnestad, Arild Erlend [Show all 13 contributors for this article] (2013). Enhanced Nutrition to very low birth weight infants improves nutrition of cerebral connective tracts. Full text in Research Archive
• Moltu, Sissel; Blakstad, Elin Wahl; Strømmen, Kenneth; Almaas, Astrid; Nakstad, Britt & Rønnestad, Arild Erlend [Show all 11 contributors for this article] (2013). Enhanced nutritional support enables postnatal growth similar to normal in utero growth in very low birth weight infants. Full text in Research Archive
• Veierød, Marit Bragelien & Nilsen, Lill Tove (2012). Solarium er ikke sunt. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 132(11), p. 1320–1320. doi: 10.4045/tidsskr.12.0401. Full text in Research Archive
• Nilsen, Lill Tove; Aalerud, Tommy Nakken; Hannevik, Merete & Veierød, Marit Bragelien (2012). High UV-A exposure from sunbeds. Pigment Cell & Melanoma Research. ISSN 1755-1471. 25(5), p. 639–640. doi: 10.1111/j.1755-148X.2012.01035.x. Full text in Research Archive
• Strømmen, Kenneth; Blakstad, Elin Wahl; Moltu, Sissel; Almaas, Astrid; Westerberg, Ane Cecilie & Amlien, Inge [Show all 16 contributors for this article] (2012). Enhanced Nutrition to Very Low Birth Weight Infants Improves Maturation of Cerebral Connective Tracts. Full text in Research Archive
• Moltu, Sissel; Blakstad, Elin Wahl; Strømmen, Kenneth; Almaas, Astrid; Nakstad, Britt & Rønnestad, Arild Erlend [Show all 11 contributors for this article] (2012). Økt tilførsel av næring-stoffer gir bedret vekst hos svært premature barn. Full text in Research Archive
• Parr, Christine Louise; Hjartåker, Anette; Lund, Eiliv & Veierød, Marit Bragelien (2012). Meat intake and colorectal cancer risk before and after measurement error correction in the Norwegian Women and Cancer study (NOWAC). The 8th International Conference on Diet and Activity Methods, Rome, Italy, May 14-17, 2012, Abstract Book PP032. Full text in Research Archive
• Parr, Christine Louise; Hjartåker, Anette; Lund, E & Veierød, Marit Bragelien (2012). Meat intake and colorectal cancer risk before and after measurement error correction in the Norwegain Women and Cancer study (NOWAC). Norsk Epidemiologi, Supplement. ISSN 0803-4206. 21. Full text in Research Archive
• Weiderpass, Elisabete & Veierød, Marit Bragelien (2011). Ultraviolet exposure and women's health. Maturitas. ISSN 0378-5122. 70(3), p. 208–209. Full text in Research Archive
• Veierød, Marit Bragelien; Nilsen, Lill Tove Norvang & Robsahm, Trude Eid (2011). M.B. Veierød og medarbeidere svarer. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 131, p. 333–334. Full text in Research Archive
• Veierød, Marit Bragelien; Nilsen, Lill Tove Norvang & Robsahm, Trude Eid (2011). Oslo kommune etablerer solarier – hvorfor? Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116. p. 37–37. Full text in Research Archive
• Robsahm, Trude Eid; Nilsen, Lill Tove Norvang & Veierød, Marit Bragelien (2011). Solariebruk er kreftfremkallende. Dagbladet. ISSN 0805-3766. p. 50–50. Full text in Research Archive
• Parr, Christine Louise; Hjartåker, Anette; Laake, Petter; Lund, Eiliv & Veierød, Marit Bragelien (2009). Recall bias in melanoma risk factors and measurement error effects: a nested case-control study within the Norwegian Women and Cancer Study. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 19, p. 8–8. Full text in Research Archive
• Veierød, MB; Adami, HO; Lund, E; Armstrong, B & Weiderpass, E (2009). Indoor tanning and melanoma risk in a Norwegian-Swedish cohort study. Full text in Research Archive
• Veierød, MB; Adami, HO; Lund, E; Armstrong, B & Weiderpass, E (2009). Ultraviolet exposure in five life decades and risk of cutaneous malignant melanoma. Full text in Research Archive
• Veierød, Marit Bragelien; Veierod, MB; Parr, CL; Lund, Eiliv & Hjartaker, A (2009). Response: errors in assessing risk factors for melanoma. Melanoma research. ISSN 0960-8931. 19(1), p. 61–61. doi: 10.1097/CMR.0b013e3283199576. Full text in Research Archive
• Selmer, Randi Marie; Lindman, Anja Schou; Tverdal, Aage; Pedersen, Jan I; Veierød, Marit B & Njølstad, Inger (2009). Begrensninger ved datagrunnlaget for NORRISK. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 129(8), p. 771–771. doi: 10.4045/tidsskr.09.0203. Full text in Research Archive
• Parr, CL; Hjartaker, A; Hjartåker, Anette; Laake, Petter; Lund, Eiliv & Veierod, MB [Show all 7 contributors for this article] (2009). Parr et al. Respond to "Recall Bias in Melanoma". American Journal of Epidemiology. ISSN 0002-9262. 169(3), p. 271–272. doi: 10.1093/aje/kwn356. Full text in Research Archive
• Babigumira, Ronnie; Stenehjem, Jo; Veierød, Marit B. & Grimsrud, Tom Kristian (2026). Cohort Profiling, Data Harmonization and Epidemiological Analysis of Benzene Exposure and Cancer Risk in the Norwegian Offshore Petroleum Workers Cohort. Universitetet i Oslo. ISSN 9788234808708. Full text in Research Archive Show summary

  This thesis is situated within occupational cancer epidemiology and examines occupational exposures and cancer incidence among Norwegian offshore petroleum workers. It aimed to profile the Norwegian Offshore Petroleum Workers (NOPW) cohort and evaluate cancer incidence compared to the general population, harmonize work histories for exposure quantification, and examine associations between benzene exposure and risk of lung and colorectal cancer (CRC). The NOPW cohort comprises approximately 28,000 offshore petroleum workers who completed a survey containing information on work history, sociodemographic characteristics, and lifestyle factors. Cancer incidence was assessed through linkage with the Cancer Registry of Norway. To improve exposure assessment, a harmonization method was developed to address overlapping employment records before linkage to job exposure matrices. Associations between occupational benzene exposure and cancer risk were examined prospectively among male cohort members. The findings showed a small excess of overall cancer risk compared with the Norwegian general population, with increases of 7% among males and 13% among females. Elevated risks were observed for pleural mesothelioma, breast cancer, and prostate cancer in males, and for melanoma and acute myeloid leukaemia in females. Harmonization of overlapping employment records reduced the cohort's total employment duration by 10%, demonstrating the importance of this procedure for accurate exposure assessment. For lung cancer, a pattern of increased risk was observed with increasing benzene exposure, although these associations were not statistically significant for lung cancer overall. Positive associations were identified between duration of benzene exposure and lung adenocarcinoma. For CRC, positive associations were found for overall CRC, right sided colon cancer, and rectal cancer with respect to both average exposure intensity and duration. No clear associations were found for left sided colon cancer, although an increased risk was observed in the highest quartile of average intensity compared with unexposed workers. Overall, the thesis provides a detailed profile of the NOPW cohort, presents a method for handling overlapping employment records, and contributes with new insights into benzene’s etiological role for lung cancer and CRC.

• Marjerrison, Niki; Kjærheim, Jenny Kristina; Stenehjem, Jo; Grimsrud, Tom Kristian; Veierød, Marit Bragelien & Martinsen, Jan Ivar [Show all 9 contributors for this article] (2025). Kreftrisiko blant brannkonstabler 2015–2024. Folkehelseinstituttet. Full text in Research Archive Show summary

  Rapporten undersøker kreftrisiko blant norske brannkonstabler basert på en stor kohortstudie med nær 4700 ansatte fra 15 brannvesen. Studien viser at brannkonstabler har høyere forekomst av enkelte kreftformer enn den generelle befolkningen, særlig urinveiskreft, mesoteliom (brysthinnekreft), strupekreft, prostatakreft og tarmkreft. Risikoen var størst blant personer med lang ansettelsestid og blant dem som arbeidet i de tidligste periodene. Funnene gir særlig støtte til en sammenheng mellom yrkeseksponering ved brannslokking og risiko for urinveiskreft og mesoteliom. For prostatakreft kan den økte forekomsten delvis forklares av tidligere og hyppigere diagnostisering. Rapporten konkluderer med at resultatene støtter IARCs vurdering av brannyrket som kreftfremkallende, og understreker behovet for fortsatt forebygging og videre forskning på helsekonsekvenser av brannyrket

View all works in NVA