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@ARTICLE{Hemminki:168973,
      author       = {K. Hemminki$^*$ and A. Försti$^*$ and A. Hemminki and B.
                      Ljungberg and O. Hemminki},
      title        = {{I}ncidence trends in bladder and lung cancers between
                      {D}enmark, {F}inland and {S}weden may implicate oral tobacco
                      (snuff/snus) as a possible risk factor.},
      journal      = {BMC cancer},
      volume       = {21},
      number       = {1},
      issn         = {1471-2407},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2021-01169},
      pages        = {604},
      year         = {2021},
      abstract     = {The dominant risk factor for urinary bladder cancer has
                      been cigarette smoking, but, as smoking prevalence is
                      decreasing in many populations, other risk factors may
                      become uncovered. Such new risk factors could be responsible
                      for halting the declining incidence of bladder cancer. We
                      hypothesize that snuff use by Swedish men may increase the
                      rate for bladder cancer, as snuff contains carcinogenic
                      nitrosamines.We carried out an ecological study by comparing
                      incidence trends in lung and bladder cancers between Danish,
                      Finnish and Swedish men in order to test if the Swedish
                      bladder cancer rate deviates from the Danish and Finnish
                      ones. We used the NORDCAN database for cancer data from 1960
                      through 2016 to test the hypothesis.In the three countries,
                      the incidence of lung cancer started to decrease after a
                      peak incidence, and this was later followed by declining
                      incidence in bladder cancer in Denmark from 1990 to 2016 by
                      $14.3\%,$ in Finland by $8.3\%$ but not in Sweden (the
                      decline of $1.4\%$ was not significant). The difference in
                      trends can be partly explained by the increasing incidence
                      in Swedish men aged 70 or more years. Sweden differs from
                      the two other countries by low male smoking prevalence but
                      increasing use of snuff recorded by various surveys.The
                      stable bladder cancer trend for Swedish men was opposite to
                      the declining trends in Denmark, Finland and globally. We
                      suggest that this unusual finding may be related to the
                      increasing use of snuff by Swedish men. Average users of
                      snuff are exposed to at least 3 times higher levels of
                      carcinogenic tobacco-specific nitrosamines than a smoker of
                      one daily pack of cigarettes.},
      keywords     = {Incidence trend (Other) / Risk factors (Other) / Sex
                      difference (Other) / Snuffing (Other) / Tobacco products
                      (Other)},
      cin          = {B062 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)B062-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34034676},
      doi          = {10.1186/s12885-021-08371-w},
      url          = {https://inrepo02.dkfz.de/record/168973},
}