Frank De Smet

Publications (42) View all

• Article: Like mother, like daughter? Mother's history of cervical cancer screening and daughter's Human Papillomavirus vaccine uptake in Flanders (Belgium).

  Eva Lefevere, Niel Hens, Heidi Theeten, Karel Van den Bosch, Philippe Beutels, Frank De Smet, Pierre Van Damme
  [show abstract] [hide abstract]
  ABSTRACT: We investigated whether and to what extent the uptake of the Human Papillomavirus (HPV) vaccine by girls aged 12-18 was related to the cervical cancer screening history of age-appropriate older female household members (assumed to be their mothers) in Flanders (Belgium). We studied administrative records on 127,854 female members of the National Alliance of Christian Mutualities, which is the largest health insurance fund in Flanders. Reimbursement data for HPV vaccination of girls for the period 2007-2009 were linked with reimbursement data for cervical cancer screening of their mothers in the three preceding years. A multilevel logit model was used to study associations between both preventive behaviors. In the model we controlled for both the girl's and the mother's age, the province of residence and the socio-economic background of the family. A clear association between a mother's history of participation in cervical cancer screening and her daughter's HPV vaccination initiation was found. The conditional odds of HPV vaccination initiation were more than 4 times higher for girls whose mother had one Pap test than for girls whose mother had none (odds ratio [OR]=4.5; 95% confidence interval [CI]=3.5-5.9). For girls whose mother had three or more Pap tests, the conditional odds were 16 times higher than for girls whose mother did not have any pap tests ([OR]=16.0; 95% [CI]=12.1-21.2). The effect of screening (having received 1 pap smear as compared to none) was larger for girls living in neighborhoods with the lowest median income ([OR]=6.0, 95% [CI]=3.6-10.1). In a situation where both cervical cancer screening and HPV vaccination are opportunistic, we found evidence that these preventive behaviors cluster within families.
  Vaccine 08/2011; 29(46):8390-6. · 3.77 Impact Factor
• Source

  Available from: Niel Hens

  Article: Dynamics of HPV vaccination initiation in Flanders (Belgium) 2007-2009: a Cox regression model.

  Eva Lefevere, Niel Hens, Frank De Smet, Pierre Van Damme
  [show abstract] [hide abstract]
  ABSTRACT: We investigated dynamic patterns and predictors of HPV vaccination initiation in Flanders (Belgium) by girls aged 12 to 18, between 2007 and 2009, the period immediately after the introduction of the HPV vaccines on the Belgian market. During this period the initiative for vaccination was taken by the girl, her family or the general practitioner/pediatrician/gynecologist. We used a Cox regression model with time constant and time varying predictors to model hazard rates of HPV vaccination initiation. The sample existed of 117,151 female members of the National Alliance of Christian Mutualities, the largest sickness fund in Flanders. The study showed that the hazard of HPV vaccination initiation was higher (1) for older girls, (2) for girls with a more favorable socio-economic background, (3) under more generous reimbursement regimes (with this effect being more pronounced for girls with weak socioeconomic backgrounds), (4) for girls that were informed personally about the reimbursement rules. When the initiative for HPV vaccination lies with the girls, their families or the physicians (no organized setting) the uptake of the vaccines is affected by both individual and organizational factors.
  BMC Public Health 06/2011; 11:470. · 2.00 Impact Factor
• Article: Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes.

  Kristel Van Calsteren, Liesbeth Heyns, Frank De Smet, Liesbet Van Eycken, Mina Mhallem Gziri, Willemijn Van Gemert, Michael Halaska, Ignace Vergote, Nelleke Ottevanger, Frédéric Amant
  [show abstract] [hide abstract]
  ABSTRACT: The aim of this study was to assess the management and the obstetrical and neonatal outcomes of pregnancies complicated by cancer. In an international collaborative setting, patients with invasive cancer diagnosed during pregnancy between 1998 and 2008 were identified. Clinical data regarding the cancer diagnosis and treatment and the obstetric and neonatal outcomes were collected and analyzed. Of 215 patients, five (2.3%) had a pregnancy that ended in a spontaneous miscarriage and 30 (14.0%) pregnancies were interrupted. Treatment was initiated during pregnancy in 122 (56.7%) patients and postpartum in 58 (27.0%) patients. The most frequently encountered cancer types were breast cancer (46%), hematologic malignancies (18%), and dermatologic malignancies (10%). The mean gestational age at delivery was 36.3 +/- 2.9 weeks. Delivery was induced in 71.7% of pregnancies, and 54.2% of children were born preterm. In the group of patients prenatally exposed to cytotoxic treatment, the prevalence of preterm labor was increased (11.8%; P = .012). Furthermore, in this group a higher proportion of small-for-gestational-age children (birth weight below 10th percentile) was observed (24.2%; P = .001). Of all neonates, 51.2% were admitted to a neonatal intensive care unit, mainly (85.2%) because of prematurity. There was no increased incidence of congenital malformations. Pregnant cancer patients should be treated in a multidisciplinary setting with access to maternal and neonatal intensive care units. Prevention of iatrogenic prematurity appears to be an important part of the treatment strategy.
  Journal of Clinical Oncology 10/2009; 28(4):683-9. · 18.37 Impact Factor
• Source

  Available from: Germaine Hanquet

  Article: The health and economic burden of rotavirus disease in Belgium.

  Joke Bilcke, Pierre Van Damme, Frank De Smet, Germaine Hanquet, Marc Van Ranst, Philippe Beutels
  [show abstract] [hide abstract]
  ABSTRACT: For health economic evaluations of rotavirus vaccination, estimates of the health and cost burden of rotavirus are required. Due to differences in health care systems and surveillance organisations, this is difficult to achieve by imputing estimates from one country to others. This study aimed to estimate the burden of rotavirus disease in Belgium. In children younger than 7 years of age, rotavirus is predicted to account annually for about 5,600 hospitalisations (676:100,000 children); 26,800 outpatient, general practitioner and paediatrician visits; and about 44,600 episodes for which no medical care is sought. This burden is estimated to represent direct costs of 7.7 million Euro and indirect costs of 12.8 million Euro. Rotavirus disease causes a substantial health and economic burden in Belgium.
  European Journal of Pediatrics 04/2008; 167(12):1409-19. · 1.88 Impact Factor
• Source

  Available from: Olivier Gevaert

  Article: Expression profiling to predict the clinical behaviour of ovarian cancer fails independent evaluation.

  Olivier Gevaert, Frank De Smet, Toon Van Gorp, Nathalie Pochet, Kristof Engelen, Frederic Amant, Bart De Moor, Dirk Timmerman, Ignace Vergote
  [show abstract] [hide abstract]
  ABSTRACT: In a previously published pilot study we explored the performance of microarrays in predicting clinical behaviour of ovarian tumours. For this purpose we performed microarray analysis on 20 patients and estimated that we could predict advanced stage disease with 100% accuracy and the response to platin-based chemotherapy with 76.92% accuracy using leave-one-out cross validation techniques in combination with Least Squares Support Vector Machines (LS-SVMs). In the current study we evaluate whether tumour characteristics in an independent set of 49 patients can be predicted using the pilot data set with principal component analysis or LS-SVMs. The results of the principal component analysis suggest that the gene expression data from stage I, platin-sensitive advanced stage and platin-resistant advanced stage tumours in the independent data set did not correspond to their respective classes in the pilot study. Additionally, LS-SVM models built using the data from the pilot study - although they only misclassified one of four stage I tumours and correctly classified all 45 advanced stage tumours - were not able to predict resistance to platin-based chemotherapy. Furthermore, models based on the pilot data and on previously published gene sets related to ovarian cancer outcomes, did not perform significantly better than our models. We discuss possible reasons for failure of the model for predicting response to platin-based chemotherapy and conclude that existing results based on gene expression patterns of ovarian tumours need to be thoroughly scrutinized before these results can be accepted to reflect the true performance of microarray technology.
  BMC Cancer 02/2008; 8:18. · 3.01 Impact Factor