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Abstract: Period analysis has been shown to provide more up-to-date estimates of long-term cancer survival rates than traditional cohort-based analysis. Here, we provide detailed period estimates of 5- and 10-year relative survival by cancer site, country, sex and age for calendar years 2000–2002. In addition, pan-European estimates of 1-, 5- and 10-year relative survival are provided. Overall, survival estimates were mostly higher than previously available cohort estimates. For most cancer sites, survival in countries from Northern Europe, Central Europe and Southern Europe was substantially higher than in the United Kingdom and Ireland and in countries from Eastern Europe. Furthermore, relative survival was also better in female than in male patients and decreased with age for most cancer sites. [Copyright &y& Elsevier]

• Frailty is rare (2.3 %) and polypharmacy common (18.3 %) in adults aged 40–69 years. • Frailty and polypharmacy are associated with cardiovascular disease and all-cause mortality, and major cardiovascular events. • Frailty and polypharmacy are independently associated with these outcomes. • The strongest association of polypharmacy with these outcomes is among (pre-)frail people. • Polypharmacy should be avoided in middle-aged adults, especially if they are (pre-)frail. Studies of the associations of polypharmacy and frailty with adverse health outcomes in middle-aged adults are limited. Furthermore, a potentially stronger association of polypharmacy with adverse health outcomes in frail than in non-frail adults is of interest. To evaluate associations of frailty (assessed using a frailty index) and polypharmacy (defined as taking five or more drugs) with major cardiovascular events, cancer incidence, all-cause, cardiovascular disease-specific, and cancer-specific mortality. Cox proportional hazards regression models were used to analyze 501,548 participants of the UK Biobank cohort study aged 40–69 years who were followed up for an average of 12 years. The prevalence of pre-frailty and frailty were 43.2 % and 2.3 %, respectively, and that of polypharmacy was 18.3 %. Although strongly associated with each other, frailty and polypharmacy were independently, statistically significantly associated with major cardiovascular events, cardiovascular disease-specific, and all-cause mortality. In addition, the hazard ratios of polypharmacy were stronger among (pre-)frail than non-frail study participants. No profound associations with cancer incidence and cancer mortality were observed. No sex and age differences were observed. This large cohort study showed that polypharmacy and frailty are independent risk factors for major cardiovascular events, cardiovascular disease-specific and all-cause mortality in both middle-aged (40–64 years) and older people (≥ 65 years). In addition, the hazard ratios of polypharmacy were stronger among (pre-)frail than non-frail study participants. This underlines the need to avoid polypharmacy as far as possible not only in older but also in middle-aged subjects (40–64 years), especially if they are pre-frail or frail. [ABSTRACT FROM AUTHOR]

Although the associations of serum 25-hydroxyvitamin D (25(OH)D) levels and vitamin D supplementation with total cancer mortality are well-known, evidence regarding the association of 25(OH)D and cancer site-specific mortality is predominantly limited to common cancer types, and most studies on vitamin D supplementation use have limitations on sample size and the adjustment of important confounding factors. We used cause-specific Cox regression models adjusted for 48 covariates to assess the associations of vitamin D deficiency, insufficiency, and vitamin D supplementation use with mortality from any cancer and 18 specific cancers in 411,436 United Kingdom Biobank participants, aged 40–69 years. The majority of the study population had either vitamin D deficiency (21.1%) or insufficiency (34.4%). Furthermore, 4.1% and 20.3% of the participants regularly took vitamin D or multivitamin supplements, respectively. During a median follow-up of 12.7 years, vitamin D deficiency was associated with significantly increased mortality from total cancer and four specific cancers: stomach (hazard ratio, 95% confidence interval: 1.42, 1.05–1.92), colorectal (1.27, 1.07–1.50), lung (1.24, 1.10–1.40), and prostate (1.36, 1.06–1.75). Vitamin D insufficiency was associated with increased colorectal (1.14, 1.00–1.30) and lung cancer mortality (1.19, 1.08–1.32). Compared to non-users, vitamin D use was associated with lower lung cancer (0.75, 0.60–0.95) and total cancer mortality. Multivitamin use was associated with lower mortality from melanoma (0.64, 0.43–0.97). Vitamin D deficiency and insufficiency were associated with increased mortality from multiple common cancers. The potential to reduce cancer mortality by vitamin D supplementation in populations with low 25(OH)D levels should be further explored. • Deaths due to 18 specific cancers were the outcomes of interest in the UK Biobank. • Vitamin D deficiency (VITD_D) and vitamin D supplements use (VITD_S) were assessed. • VITD_D was associated with lung, colorectal, prostate, and stomach cancer mortality. • VITD_S was significantly associated with a 25% lower lung cancer mortality. • Many lung cancer deaths may be preventable by VITD_S in people with VITD_D. [ABSTRACT FROM AUTHOR]