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Women's health status may affect their opportunities and preferences for children through various mechanisms. We examine the relationship between health and fertility using Norwegian registry data (2004–18). Measuring verifiable and persistent health problems, we use uptake of doctor-certified sickness absence and long-term health-related benefits as proxies for health. In contrast to the expectation that poor health limits women's opportunities for children, our results show that sickness absence is positively associated with transitions to parenthood. The uptake of long-term benefits is, however, negatively associated with fertility. The selection of healthy women into parenthood weakens the association for higher-order births. The impact of long-term health indicators on fertility is comparable in magnitude to that observed for more conventional predictors, such as education and income. With continued postponement of childbearing and thus higher maternal ages, the influence of health as a fertility determinant is likely to grow and further research appears warranted. Supplementary material for this article is available at: [ABSTRACT FROM AUTHOR]

Background: Future demographic and economic changes warrant a better understanding of older persons' need for health-related long-term care services (LTC). LTC uptake among older people is likely to be influenced by the presence or absence of family members, but there is scarce research on the role played by partners with different caregiving potential. There is even less research on the contributions of adult children and their caregiving potential. The current study examines the extent to which transitions into LTC in older men and women differ according to the presence and caregiving potential of partners and children. Methods: Linked registry data for Norway on older persons (aged 65+), their partners, and their adult children are used to examine how characteristics of these family members influence transitions into LTC from 2010 to 2016, using logistic discrete-time hazard regression models. We observed around 215,000 transitions to LTC, corresponding to around 26.3% of individuals and 5.4% of the total person-years (4.0 million). Caregiving potential is measured in terms of employment, income, health and educational attainment for partners and education and geographical proximity for children. Results: Personal, partner and child(ren)'s resources are all associated with older persons' LTC uptake. Unpartnered and/or childless older people are more likely to use LTC than those with partners and/or child(ren). Older persons with resourceful partners and children are the least likely to transition into LTC. The geographical proximity of adult children appears to have only a minor influence on LTC use among older people. Conclusions: Population ageing and strained public resources will likely challenge the future provision of formal old-age care. The role of family networks in the future provision of formal old-age care is expected to become progressively important in the years to come. Inequalities in the health, care and welfare of older persons with and without resourceful family members are likely to increase. [ABSTRACT FROM AUTHOR]

Projection studies have often focused on mortality and, more recently, migration. Fertility is less studied, although even small changes can have significant repercussions for the size and age structure of future populations. Across Europe, there is no consensus on how fertility is best projected. In this article, we identify different approaches used to project fertility among statistical agencies in Europe and provide an assessment of the different approaches according to the producers themselves. Data were collected using a mixed-method approach. First, European statistical agencies answered a questionnaire regarding fertility projection practices. Second, an in-depth review of select countries was performed. Most agencies combine formal models with expert opinion. While many attempt to maximise the use of relevant inputs, there is more variation in the detail of outputs, with some agencies unable to account for changing age patterns. In a context of limited resources, most are satisfied with their approaches, though some are assessing alternative methodologies to improve accuracy and increase transparency. This study highlights the diversity of approaches used in fertility projections across Europe. Such knowledge may be useful to statistical agencies as they consider, test and implement different approaches, perhaps in collaboration with other agencies and the wider scientific community. [ABSTRACT FROM AUTHOR]

Aims: United States' (US) colorectal cancer (CRC) screening and treatment practices seek to reduce mortality. We examined the survival of US patients compared with patients in the virtually unscreened Norwegian population. Methods: We compared short-term survival after CRC between the US and Norway using relative survival (RS) and excess mortality (EMR) analyses. The CRC patients were aged 50 and older diagnosed in the US (Surveillance, Epidemiology and End Results registry, 2004, N=9511) and in Norway (Cancer Registry of Norway, 2003–2005, N=8256). Results: Death occurred within three years for 39% of the CRC patients. Stage distributions were more favorable for US patients. Stage-specific survival was similar for localized and regional cancers, but more favorable for US distant cancers. In multivariate models of patient, tumor and treatment characteristics, patients (especially below age 80) in the US experienced longer survival (EMR 0.9, CI 0.8–0.9). Stage-specific analyses showed, however, that survival for localized cancers was relatively shorter in the US than in Norway (EMR 1.4, CI 1.1–1.8), but longer for distant cancers (EMR 0.8, CI 0.7–0.8). Conclusions: The enhanced survival for US CRC patients likely reflects a screening-related earlier diagnostic stage distribution, as well as prioritized life extension for patients with metastatic cancers, reflecting vastly different health care systems in the two countries. CRC screening is currently under consideration in Norway. For survival outcomes, the current findings do not discourage such an implementation. Other screening-related aspects such as feasibility and cost-benefit are, however, also relevant and warrant further research within a socialized health system. [ABSTRACT FROM AUTHOR]

Research on the correspondence between retirement intentions and subsequent behaviour is scarce. We aimed to explore possible associations between retirement intentions and behaviour, using five-year high-quality quantitative panel data on Norwegian senior workers. Retirement intentions operate at different levels of firmness: (a) considerations; (b) preferences; and (c) decisions. Compared to work continuation considerations, a targeted age for retirement improved predictive power whether the target was preferred or decided, and particularly so if the target (i.e. the preferred or decided age of retirement), corresponded with a normative retirement age. Because more workers are able to state a preferred age of retiring than a decision about when to retire, preferences may be better proxies for retirement behaviour than decisions, when the issue is planning for policies. The correspondence between intentions and behaviour varies primarily by health, education and type of work. Older workers with poor health, and workers with low education, often retire earlier than they prefer. Blue-collar workers often retire earlier than they had decided. These findings illustrate the possible effect of labour market resources, not only for senior workers' labour market participation, but also for their opportunities to work up to the age they prefer or had decided. Even for white-collar workers and those in good health, constraints seem to apply when they wish to retire late. [ABSTRACT FROM PUBLISHER]

Research on spouses’ joint work exits is scarce, although household factors such as spouses’ work status, marital quality, and caregiving burdens are likely to affect seniors’ work engagement. We therefore examine whether the work exit probability of one spouse affects that of the other. Discrete-time hazard regression analyses of survey data linked to later registry information including all gainfully employed married respondents aged 50–74 with a working spouse (N = 1,764) were used to assess subsequent work exits. A spouse’s work exit is a strong predictor of a respondent’s work exit (hazard ratio 3.1, 95% confidence interval [2.5, 4.0]). Educational attainment, poor marital quality, and spouses’ health and care needs do not predict work exits. Surprisingly, no gender differences are observed. Research on larger survey samples to distinguish different work exit routes and reasons for spouses’ joint work exits appears warranted. To account for cultural and welfare state characteristics, cross-national studies ought to be undertaken. [ABSTRACT FROM PUBLISHER]

Background: Cancer is a disease closely associated with aging. Aging populations will thus lead to a pronounced increase in the absolute number of elderly persons with cancer, resulting in profound public health challenges in the coming decades. Older patients have distinct treatment and care needs, but are nevertheless largely overlooked in studies. We therefore examine cancer incidence, prevalence and survival among older cancer patients to help guide various stakeholders in the acute and more long-term handling of this patient group. Data and methods: >400 000 cancers diagnosed in individuals age 65+ in 1975-2009 were extracted from the Cancer Registry of Norway. Descriptive analyses of incidence and prevalence were undertaken, and survival analysis was used to model survival. Results: The absolute number of elderly (65-79 years) and oldest old (80+ years) patients has more than doubled since 1975, and will continue to grow towards 2030. A more than threefold increase in patients 80+ years has taken place. The largest patients groups comprise colorectal, prostate, lung and breast cancer. For all patients 65 and older, the median survival has increased with 135%. The increase has been most pronounced for the elderly patients. Surgical resection rates decline with increasing patient age. The difference in relative survival is around 8 percentage points at three years (60% vs 52%). It has been constant over time. Conclusion: "Best practice" guidelines for the large and increasing group of older cancer patients remain to be established. The gain in length of lives must be balanced against patients' quality of life, and considered in a cost-benefit perspective for society at large. [ABSTRACT FROM AUTHOR]

Objectives: To assess five-year changes in health behaviours in later life and associations with onset of chronic health problems. The results may inform policy and interventions to promote healthy life years in ageing populations. Methods: Data are derived from the Norwegian study on Life-course, Ageing and Generation (NorLAG), a five-year (2002-2007) panel survey comprising a nation wide community sample. The present analyses include a sample of 1,019 respondents aged 60 years and older. Five-year changes in smoking, alcohol use, physical exercise and Body Mass Index (BMI) are assessed according to prevalent and incident chronic health problems. Multivariate logistic analyses of "healthy" behavioural changes are conducted. Results: A total of 453 respondents (45%) reported at least one chronic condition and 13% (N=133) re- ported onset of chronic conditions in the course of the past five years. Over a five-year period, there was an overall reduction in smoking rates and a decrease in regular physical activity. Alcohol consumption in older people slightly increased over time, but the incidence of chronic health problems tended to reduce alcohol intake. Older persons experiencing chronic health problems were less likely to initiate physical activity. Conclusions: The results provide limited support for the assumption that the onset of a chronic health condition triggers improved health behaviours. This suggests that the health care system could do more in targeting a potential "window of opportunity" for individuals to adopt new healthy behaviours in later life. [ABSTRACT FROM AUTHOR]

Background. At a group level, cancer results in reduced labor earnings. Public benefits common to welfare states may, however, compensate for all or parts of the decline in earnings. Norwegian cancer survivors' incomes, including both labor earnings and compensatory welfare benefits, were compared to those of the cancer-free population to assess potential welfare consequences of cancer. Possible modifying effects of parental and marital status, education, prior earnings and age were assessed in depth. Material and methods. Log-linear regression models were used to estimate incomes across different sociodemographic variables using register data covering the entire Norwegian population 40-59 years old with any income in 2008, 536 600 men and 502 500 women, of whom more than 17 000 were diagnosed with cancer in 2000-2007. Results. Compared to the cancer-free general population, cancer was associated with a modest 7% decline in incomes overall. The decline was, however, significantly associated with sociodemographic factors, marital status exempted. Childless men with low education and low prior earnings were most adversely affected. Lymphomas and lung cancer accounted largely for these unfavorable effects. Conclusions. Declines in earnings after cancer are to a large degree compensated by the Norwegian welfare state, and incomes overall are only modestly decreased among cancer survivors compared to the general population. Persons with multiple unfavorable sociodemographic characteristics experience particularly low incomes after cancer. This is of concern in a supposedly egalitarian society with public health care and antidiscrimination acts in place. Welfare state interventions, i.e. work reintegration efforts and/or compensations for labor earning drops, directed specifically towards these subgroups might be warranted. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Cancer in a child may adversely affect parents’ work opportunities due to enlarged care burdens and/or altered priorities. Few studies exist, and possible effects on parental employment and earnings were therefore explored. Materials and methods: Data on the entire Norwegian population aged 27–65 with children under the age of 20 in 1990–2002 (N =1.2 million) was retrieved from national registries. Employment rates for parents of 3263 children with cancer were compared to those of parents with children without cancer by means of logistic regression models. Log-linear regression models were used to explore childhood cancer''s effect on parental earnings for the large majority of parents who remained employed. Results: Cancer in a child was in general not associated with a reduced risk of employment, although some exceptions exist among both mothers and fathers. For employed mothers, CNS cancers, germinal cell cancers, and unspecified leukemia were associated with significant reductions in earnings (10%, 21%, and 60%, respectively). Reductions were particularly pronounced for mothers with a young and alive child, and became more pronounced with time elapsed from diagnosis. Fathers’ earnings were not affected significantly. Discussion and conclusion: Parents’ employment is not adversely affected by a child''s cancer in Norway. Earnings are reduced in certain instances, but the overall effects are minor. Generous welfare options and flexible labor markets typical for Nordic welfare states may account for this. In line with traditional caregiving responsibilities, reductions in earnings were most pronounced for mothers. [Copyright &y& Elsevier]

Cancer survivorship research includes the study of physical, psychosocial, and economic consequences of cancer diagnosis and treatment among pediatric and adult cancer survivors. Historically, the majority of cancer survivorship studies were from the United States, but survivorship issues are increasingly being addressed in other developed countries. Cross-cultural studies remain, however, scarce. The degree to which knowledge attained may or may not be transferred across cultures, countries, or regions is not known. Some important challenges for comparative research are therefore discussed in a cross-cultural perspective. Several substantive and methodological challenges that complicate the execution of cross-cultural cancer survivorship research are presented with examples and discussed to facilitate comparative research efforts in the establishment of new survivorship cohorts and in the planning and implementation of survivorship studies. Comparative research is one key to understanding the nature of cancer survivorship, distinguishing modifiable from nonmodifiable factors at individual, hospital, societal, and system levels and may thus guide appropriate interventions. Lastly, suggested future courses of action within the field of comparative cancer survivorship research are provided. [ABSTRACT FROM AUTHOR]

The article discusses a study which explored the impact of cancer on the labor earnings of spouses in Norway. The study analyzed the effect of cancer on patients' income and the difference between their labor earnings before cancer diagnosis and with those people without cancer. The subjects of the study were 1.1 married persons aged 35 to 39. The study found that married men have lower earnings two to five years after diagnosis, and cancer in wives has no impact on men's earnings.

Many cancer forms today have good prognosis, and parenthood after cancer diagnosis and treatment has become a central research topic. Previous research has mainly focused on reproductive cancers, and few population-based studies exist. The effect of several cancer forms on fertility at a population level was explored. Discrete-time hazard regression models were used to analyse register and census data for complete Norwegian birth cohorts. Men and women 17–44 years in the period 1965–2001 were included. Models for first- and higher-order birth rates, for men and women, were estimated. Overall, first-birth rates among persons with cancer were reduced by only about 25% when compared with the general population. Male cancer survivors' second- and third-birth rates were similarly reduced, whereas higher-order birth rates for females were 36% below those of the general population. Significant decreases in cancer survivors' fertility disadvantage relative to the general population were seen from 1965 to 2001. Reductions in fertility were most pronounced for reproductive cancer forms, presumably related to subfecundity. However, also cancer forms unrelated to reproductive function led to reduced fertility, perhaps suggesting underlying social mechanisms. This is further supported by the difference in probability between first and subsequent births observed for women. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims: Studies of the association between self-rated health and persons' income and education have almost invariably shown that people with higher education and incomes report better health. Less is known of the influence of household members' socioeconomic characteristics on individuals' health. This study thus aimed to assess the extent to which the socioeconomic characteristics of partners may contribute to explaining the variation in the respondents' self-rated health (SRH). Methods: Using an observational design, we analysed cross-sectional Norwegian survey data on SRH (2015 and 2019), linked to register data on education and income for respondents (N = 7082) and their opposite-sex coresident spouse or partner. We employed logistic regression models to assess the associations between respondents' SRH and the relative income and education of their partner. Average marginal effects were calculated to enable cross-model comparisons. Results: Net of individual characteristics, having a higher-educated partner was positively associated with SRH for both male (OR = 1.56) and female (OR = 1.36) respondents. Having a partner with an above median income (by age and sex) was positively associated with SRH for female (OR = 1.29) respondents only. For education, the positive SRH associations were roughly similar for respondents and partners. For income, the associations were more pronounced for respondents than partners. Conclusions: Our findings suggest that health is affected by the resources (or lack thereof) in one's immediate networks. To reduce social inequalities in health, health personnel might customise interactions to account for household resources. Such knowledge could also be used in health-promoting activities to enhance participation and health competency. [ABSTRACT FROM AUTHOR]

Caring for a disabled child involves both indirect and direct economic costs, which in turn may create a financial burden for the family. Using Norway as a case, we examine if public compensatory measures reach those most in need, by assessing whether socioeconomic disadvantages and immigrant background impact adversely on the uptake of a nationally available cash benefits eligible for parents caring for a child with a disability. We take advantage of national administrative register data on children with a selection of well‐defined diagnoses born between 2009 and 2017 (N = 14,469). Our results show nonnegligible, but relatively minor, social inequalities in the uptake of cash benefits related to socioeconomic and immigrant background. Our findings indicate that this state's financial support seems to reach those most in need. However, it is essential to deepen our understanding of how socioeconomic and immigrant backgrounds influence access to and utilization of municipal healthcare services. Notably, the application process for these services often involves a greater degree of discretion on the part of welfare professionals. Further research is needed to illuminate the nuanced dynamics of these factors in the context of accessing healthcare services at the local level. [ABSTRACT FROM AUTHOR]

The role of intergenerational geographic proximity in individuals' migration decisions has been well-established. The circumstances under which parents and their adult children move away from or remain close to each other are, however, less clear. Drawing on Norwegian register data for 2014-2016 and three-level logistic regression models, we examine whether formal care needs of older parents (aged ≥65) deter parent-child geographic divergence and whether variation in the likelihood of divergence is associated with municipal-level characteristics. After accounting for location-specific capital and parents' and children's sociodemographic characteristics, parents and children were less likely to diverge after the onset of parental care needs. Utilising in-home nursing decreased the likelihood of divergence for mothers while utilising institutionalised care decreased the likelihood of divergence for fathers. The use of in-home nursing care among single mothers further reduced the likelihood of divergence. Parents and adult children living in central areas were the least likely to diverge geographically. The likelihood of intergenerational divergence was lower for fathers and children living in municipalities with high healthcare spending. [ABSTRACT FROM AUTHOR]

Background: Knowledge of mortality differentials in immigrant groups depending on their reason for migration, length of stay in host countries and characteristics of sending countries may be beneficial for policy interventions aimed to improve various immigrant groups' health and welfare.Methods: We employed discrete-time hazard regression models with time-varying covariates to compare the death risk of immigrants to those of Norwegian-born natives using linked register data on the Norwegian population aged 25-79 during 1990-2015. More than 492,000 deaths occurred in around 4.6 million individuals. All analyses were adjusted for sex, age, calendar time and sociodemographic characteristics.Results: Immigrants had an 11% survival advantage overall. Those immigrating due to work or education had the lowest death risk, whereas refugees had the highest death risk (albeit lower than that of natives). Death risks increased markedly with length of stay, and were most pronounced for those having spent more than 40% of their lives in Norway. Net of reason for migration, only minor differences were observed depending on Human Development Index characteristics of sending countries.Conclusion: Independent of reason for migration and characteristics of sending countries, those who immigrate to Norway in adulthood appear to be particularly healthy. The higher death risk associated with prolonged lengths of stay suggests that disadvantageous 'acculturation' or stress factors related to the post-migration period may play a role in the long run. The health and welfare of long-term immigrants thus warrants further research. [ABSTRACT FROM AUTHOR]

Daughters of elderly women are more likely to provide informal care than sons. If care managers take this into account and view informal care as a substitute for formal care, they will statistically discriminate against the mothers of daughters. Using a survey experiment among professional needs assessors for long-term care services in Norway, we find that if a woman with a daughter had a son instead, she would receive 34 percent more formal care. On the other hand, daughters do not provide more care for fathers. Correspondingly, we find no effect of child gender for fathers in the experiment. [ABSTRACT FROM AUTHOR]

To study relations between childhood residential mobility and early adult outcomes, we use detailed longitudinal data on complete cohorts born in Norway between 1965 and 1980 (N = 967 151) and information on all their relocations between municipalities. Results from models with and without sibling-fixed effects show that children with more residential moves are more likely to drop out of high school, to have a lower adult income and to experience early parenthood, although most of these associations are weaker in the sibling fixed effects models. We also find that age at moving matters: the outcomes are similar for children who move or remain in place prior to elementary school, whereas those who move in adolescence are worse off than those who do not. [ABSTRACT FROM AUTHOR]

All political parties in Norway agree that social inequalities in health comprise a public health problem and should be reduced. Against this background, the Council on Social Inequalities in Health has taken action to provide specific advice to reduce social health differences. Our recommendations focus on the entire social gradient rather than just poverty and the socially disadvantaged. By proposing action on the social determinants of health such as affordable child-care, education, living environments and income structures, we aim to facilitate a possible re-orientation of policy away from redistribution to universalism. The striking challenges of the causes of health differences are complex, and the 29 recommendations to combat social inequality of health demand cross sectorial actions. The recommendations are listed thematically and have not been prioritized. Some are fundamental and require pronounced changes across sectors, whereas others are minor and sector-specific. [ABSTRACT FROM AUTHOR]

Background: The impact of cancer on socioeconomic outcomes is attracting attention as the number of survivors of cancer in young age continues to rise. This study examines economic independence in a national cohort of survivors of cancer at a young age in Norway.Methods: Through the linkage of several national registries, the study cohort comprised 1,212,013 individuals born in Norway during 1965 through 1985, of which 5440 had received a cancer diagnosis before age 25 years. Follow-up was through 2007, and the main outcomes were receipt of governmental financial assistance, employment, income, and occupation. Analytic methods included Cox proportional hazard regression, log-binomial regression, and quantile regression models.Results: Individuals in the cancer survivor group had an increased probability of receiving governmental financial assistance (men: hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.3-1.5; women: HR, 1.5; 95% CI, 1.3-1.6) and of not being employed (men: HR, 1.4; 95% CI, 1.2-1.7; women: HR, 1.4; 95% CI, 1.2-1.6) compared with those in the noncancer group. Income discrepancies were particularly pronounced for survivors of central nervous system tumors. There was no difference in representation in higher skilled occupations.Conclusions: Survivors of cancer at a young age in Norway had an increased risk of being economically dependent and unemployed. This was evident in several tumor groups and was most pronounced in female survivors. There were only small differences in income or representation in higher skilled occupations for most employed survivors compared with the noncancer group. The current results are important for understanding the impact of a cancer diagnosis at a young age on subsequent job market outcomes. Cancer 2016;122:3873-3882. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. [ABSTRACT FROM AUTHOR]

Abstract: The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that (i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and (ii) the use of such treatment improved these patients’ survival. [Copyright &y& Elsevier]

Background Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers. Methods All invasive cutaneous malignant melanomas (CMM, N = 28 069) and squamous cell carcinomas (SCC, N = 24 620) diagnosed in Norway during 1955-2008 were included. Rates of new primary cancers in skin cancer survivors were compared to rates of primary malignancies in the general population using standardized incidence ratios (SIR). Discrete-time logistic regression models were applied to individual-level data to estimate cancer risk among those with and without a prior skin cancer, accounting for residential region, education, income, parenthood, marital status and parental cancer status, using a 20% random sample of the entire Norwegian population as reference. Further analyses of the skin cancer cohort were undertaken to determine risk factors related to subsequent cancers. During follow-up, 9608 new primary cancers occurred after an initial skin cancer. SIR analyses showed 50% and 90% increased risks for any cancer after CMM and SCC, respectively (p < 0.01). The logistic regression model suggested even stronger increase after SCC (130%). The highest risk was seen for subsequent skin cancers, but several non-skin cancers were also diagnosed in excess: oral, lung, colon, breast, prostate, thyroid, leukemia, lymphoma and central nervous system. Factors that were associated with increased risk of subsequent cancers include male sex, older age, lower residential latitude, being married and low education and income. Parental cancer did not increase the risk of a subsequent cancer after SCC, but was a significant predictor among younger CMM survivors. Conclusions Our results provide information on shared environmental and genetic risk factors for first and later cancers and may help to identify individuals at high risk for subsequent cancers, which will be important as skin cancer incidence continues to rise. [ABSTRACT FROM AUTHOR]

Background: Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers. Methods: All invasive cutaneous malignant melanomas (CMM, N = 28 069) and squamous cell carcinomas (SCC, N = 24 620) diagnosed in Norway during 1955-2008 were included. Rates of new primary cancers in skin cancer survivors were compared to rates of primary malignancies in the general population using standardized incidence ratios (SIR). Discrete-time logistic regression models were applied to individual-level data to estimate cancer risk among those with and without a prior skin cancer, accounting for residential region, education, income, parenthood, marital status and parental cancer status, using a 20% random sample of the entire Norwegian population as reference. Further analyses of the skin cancer cohort were undertaken to determine risk factors related to subsequent cancers. Results: During follow-up, 9608 new primary cancers occurred after an initial skin cancer. SIR analyses showed 50% and 90% increased risks for any cancer after CMM and SCC, respectively (p < 0.01). The logistic regression model suggested even stronger increase after SCC (130%). The highest risk was seen for subsequent skin cancers, but several non-skin cancers were also diagnosed in excess: oral, lung, colon, breast, prostate, thyroid, leukemia, lymphoma and central nervous system. Factors that were associated with increased risk of subsequent cancers include male sex, older age, lower residential latitude, being married and low education and income. Parental cancer did not increase the risk of a subsequent cancer after SCC, but was a significant predictor among younger CMM survivors. Conclusions: Our results provide information on shared environmental and genetic risk factors for first and later cancers and may help to identify individuals at high risk for subsequent cancers, which will be important as skin cancer incidence continues to rise. [ABSTRACT FROM AUTHOR]

Background: Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers.Methods: All invasive cutaneous malignant melanomas (CMM, N = 28 069) and squamous cell carcinomas (SCC, N = 24 620) diagnosed in Norway during 1955-2008 were included. Rates of new primary cancers in skin cancer survivors were compared to rates of primary malignancies in the general population using standardized incidence ratios (SIR). Discrete-time logistic regression models were applied to individual-level data to estimate cancer risk among those with and without a prior skin cancer, accounting for residential region, education, income, parenthood, marital status and parental cancer status, using a 20% random sample of the entire Norwegian population as reference. Further analyses of the skin cancer cohort were undertaken to determine risk factors related to subsequent cancers.Results: During follow-up, 9608 new primary cancers occurred after an initial skin cancer. SIR analyses showed 50% and 90% increased risks for any cancer after CMM and SCC, respectively (p < 0.01). The logistic regression model suggested even stronger increase after SCC (130%). The highest risk was seen for subsequent skin cancers, but several non-skin cancers were also diagnosed in excess: oral, lung, colon, breast, prostate, thyroid, leukemia, lymphoma and central nervous system. Factors that were associated with increased risk of subsequent cancers include male sex, older age, lower residential latitude, being married and low education and income. Parental cancer did not increase the risk of a subsequent cancer after SCC, but was a significant predictor among younger CMM survivors.Conclusions: Our results provide information on shared environmental and genetic risk factors for first and later cancers and may help to identify individuals at high risk for subsequent cancers, which will be important as skin cancer incidence continues to rise. [ABSTRACT FROM AUTHOR]