Alexander Ploner

Karolinska Institutet | KI · Department of Medical Epidemiology and Biostatistics

Background Adolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia. Methods We...

Differences in gene-wide DNA methylation of the Alzheimer’s disease (AD) associated genes BIN1 , HLA-DRB5, SORL1 , SLC24A4 , and ABCA7 are reported to be associated with AD in post-mortem brain samples. We investigated whether the same associations could be found in leukocytes collected pre-mortem. Using cohort data of 544 Swedish twins (204 dement...

Background: There is continued uncertainty regarding the risks of hepato-pancreato-biliary cancers in patients with inflammatory bowel disease (IBD) with or without concomitant primary sclerosing cholangitis (PSC). Objective: To give updated estimates on risk of hepato-pancreato-biliary cancers in patients with IBD, including pancreatic cancer,...

Importance Parkinson disease (PD) and inflammatory bowel disease (IBD) have been associated, implying shared pathophysiology. Characterizing genetic pleiotropy between the two conditions aids the exploration of common etiology. Objective To estimate the genetic correlation between PD and IBD and to identify specific loci influencing both conditions...

Schizophrenia is a serious mental disorder with considerable somatic and psychiatric morbidity. It is unclear whether comorbid health conditions predominantly arise due to shared genetic risk or consequent to having schizophrenia. To explore the contribution of genetic risk for schizophrenia, we analysed the effect of schizophrenia polygenic risk s...

Background: It remains open whether gastric precancerous lesions are associated with an elevated risk of pancreatic cancer. Our aim was to investigate the association between gastric mucosal status and pancreatic cancer risk. Methods: Patients with gastric biopsies (normal, minor changes, superficial gastritis, and atrophic gastritis/intestinal...

A high proportion of those with schizophrenia experience treatment non-response, placing them at higher risk for mortality and suicide attempts, compared to treatment responders. The clinical, social, and economic burden of treatment-resistant schizophrenia (TRS) are substantial. Previous genomic and epidemiological studies of TRS were often limite...

Background Dietary factors, such as consumption of preserved foods, fresh vegetables, and fruits, have been linked to the risk of nasopharyngeal carcinoma (NPC). However, little is known about associations between dietary patterns and the risk of NPC in NPC-endemic areas. Objectives We aimed to evaluate whether dietary patterns are associated with...

Background Biomarker-disease relationships are extensively investigated. However, associations between common clinical biomarkers and healthspan, the disease-free lifespan, are largely unknown. We aimed to explore the predictive values of ten biomarkers on healthspan and lifespan, and to identify putative causal mechanisms. Methods Using data from...

Background: Adolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia. Methods: We...

Background: Gastrointestinal inflammation has been linked with Parkinson's disease (PD). Microscopic colitis (MC) is an intestinal inflammatory disease with unknown relationship with PD. Objective: This study aimed to examine the association of MC with PD risk. Methods: In this nationwide matched cohort study in Sweden, PD incidence was compar...

Objective: To evaluate the effects of long-term tumor necrosis factor (TNF) inhibition on the risk and age at onset of Parkinson disease (PD), we performed a two-sample Mendelian randomization study using genome-wide association studies (GWAS) summary statistics. Methods: Genetic variants in the vicinity of TNFRSF1A, the gene encoding TNF recept...

Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, mainly due to late diagnosis at advanced tumor stages. In this study, we aimed to identify plasma protein biomarkers for early detection of PDAC. Totally, 135 PDAC patients (early PDAC, stage I/II, n = 71; advanced PDAC, stage III/IV, n = 64), 13 benign lesions/chronic pancreatitis patie...

Background: We investigated notification trends of sexually acquired chlamydia (chlamydia) and its association with testing in Sweden prior to (1992-2004) and after (2009-2018) the discovery of a new variant of C. trachomatis (nvCT). Methods: We applied monthly time series analysis to study chlamydia trends and annual time series to study chlamy...

Background: The efficacy and effectiveness of the quadrivalent human papillomavirus (HPV) vaccine in preventing high-grade cervical lesions have been shown. However, data to inform the relationship between quadrivalent HPV vaccination and the subsequent risk of invasive cervical cancer are lacking. Methods: We used nationwide Swedish demographic...

Background Use of immunohistochemistry (IHC) based surrogates of molecular breast cancer subtypes is common in research and clinical practice, but information on their comparative validity and prognostic capacity is scarce. Methods Data from two PAM50-subtyped Swedish breast cancer cohorts were used; STO-3 with 561 patients diagnosed 1976-1990, an...

s The human commensal microbiome has been suggested to be involved in the regulation of response to anticancer therapies. However, little is known regarding changes in commensal microbes in cancer patients during radiotherapy. We conducted a prospective, longitudinal proof-of-concept cohort study with newly diagnosed nasopharyngeal carcinoma (NPC)...

Abstract INTRODUCTION: Non–Helicobacter pylori microbiota might account for some cases with unexplained chronic gastritis that may in a minority eventually progress to gastric cancer through the Correa cascade. We characterized gastric microbiota by describing the normal stomach, compared it with early precancerous lesions and other disease state...

Polygenic risk scores (PRSs) have become an increasingly popular approach for demonstrating polygenic influences on complex traits and for establishing common polygenic signals between different traits. PRSs are typically constructed using pruning and thresholding (P+T), but the best choice of parameters is uncertain; thus multiple settings are use...

The relationship between oral health and the risk of nasopharyngeal carcinoma (NPC) was previously established. However, the role of oral microbiome has not been evaluated in the disease in a large epidemiological study. This paper clearly establishes a difference in the oral microbiomes between NPC patients and healthy controls which cannot be exp...

Background Gastrointestinal inflammation has been implicated in Parkinson’s disease (PD). This study examined whether individuals with a history of Clostridium difficile infection (CDI) are at elevated risk of PD. Methods We performed a population‐based cohort study using Swedish national register data. Adults aged ≥ 35 years were identified from...

Human papillomavirus (HPV) vaccination is predicted to lower the positive predictive value (PPV) of cytology. We included 153,250 girls born between 1989 and 1993, resident in Sweden since the introduction of HPV vaccines (October 2006) and attending cervical screening at age 23 years. We assessed their first cytology and following histopathologica...

s The human microbiome has been suggested to be involved in the regulation of response to anticancer therapies. However, little is known regarding changes of commensal microbes in cancer patients during radiotherapy and whether these changes are associated with response to treatment. We conducted a prospective, longitudinal cohort with sixty-two ne...

Biological age measurements (BAs) assess aging-related physiological change and predict health risks among individuals of the same chronological age (CA). Multiple BAs have been proposed and are well studied individually but not jointly. We included 845 individuals and 3973 repeated measurements from a Swedish population-based cohort and examined l...

Oral health and changes in the oral microbiome have been associated with both local and systemic cancer. Poor oral hygiene is a known risk factor for Nasopharyngeal Carcinoma (NPC), a virally-associated head and neck cancer endemic to southern China. We explored the relationship between NPC and the oral microbiome using 16s rRNA sequencing in a stu...

Background The human microbiome has been suggested to be involved in the regulation of response to anticancer strategies, however, information about how commensal microbes in a cancer patient change during radiotherapy is limited and the relationship between the microbiome and response to radiotherapy is poorly studied. Methods Sixty-two patients...

Objective Case-fatality rates (CFRs) for myocardial infarction (MI) and ischaemic stroke (IS) have decreased over time due to better prevention, medication and hospital care. It is unclear whether these improvements have been equally distributed according to socioeconomic position (SEP) and sex. The aim of this study is to analyse differences in sh...

Background: Chinese-style salted fish intake in early life is considered an established risk factor for nasopharyngeal carcinoma (NPC). However, results for adult intakes of salted fish and preserved foods are inconsistent. Objective: The aim of this study was to ascertain the relations of Chinese-style hard and soft salted fish and preserved fo...

5525 Background: The role of human papillomavirus (HPV) in development from oncogenic infection to invasive cervical cancer (ICC) has been well established. However, the association of HPV genotypes and prognosis of ICC is controversial. Methods: We identified all ICC diagnosed in Sweden during the years 2002-2011 (4254 confirmed cases after clinic...

Background Frailty index (FI) is a well-established predictor of all-cause mortality, but less is known for cause-specific mortality and whether familial effects influence the associations. Middle-aged individuals are also understudied for the association between FI and mortality. Furthermore, the population mortality impact of frailty remains unde...

This study used a refined case‐control cervical cancer Audit framework to investigate effectiveness of cervical screening, with measures of three screening failures: irregular‐participation, cervical cancer developed after cytological abnormalities, and after normal screening results. The register‐based study included 4254 cervical cancer cases dia...

Objectives To examine the association of cervical cytology screening with the risk of adenosquamous cell carcinoma (ASC) and rare histological types of invasive cervical carcinoma (RICC), using comprehensive registry data, and to assess tumour human papillomavirus status of ASC and RICC. Design Nationwide, population based, nested case-control stu...

Background Postpartum Depression (PPD), a subtype of Major Depressive Disorder (MDD), has a lifetime prevalence of 10–15% and is one of the most frequent complications of childbirth. PPD is particularly suited to genetic investigation as it is a more homogenous phenotype than MDD occurring outside of the perinatal period (i.e., women of childbearin...

Background: Frailty index (FI) is a well-established predictor of all-cause mortality, but less is known for cause-specific mortality and whether familial effects influence the associations. Furthermore, the population mortality impact of frailty remains understudied. Objectives: To estimate the predictive value of frailty for all-cause and cause-s...

Ten years after its introduction, equity in human papillomavirus (HPV) vaccine uptake remains unattained, not least for the groups at highest risk of cervical cancer. In Sweden, three different delivery modes of the vaccine have been in effect since May 2007. We used this as a natural experiment to investigate girls’ HPV vaccine uptake in relation...

Postpartum depression (PPD) is one of the most frequent complications of childbirth and particularly is suited to genetic investigation as it is more homogenous than major depression outside of the perinatal period. We developed an iOS app (PPD ACT) to recruit, consent, screen, and enable DNA collection from women with a lifetime history of PPD to...

Objective:: Both rare copy number variants (CNVs) and common single-nucleotide polymorphisms (SNPs) contribute to liability to schizophrenia, but their etiological relationship has not been fully elucidated. The authors evaluated an additive model whereby risk of schizophrenia requires less contribution from common SNPs in the presence of a rare C...

Background High-risk human papillomavirus (hrHPV) infection is established as the major cause of invasive cervical cancer (ICC). However, whether hrHPV status in the tumor is associated with subsequent prognosis of ICC is controversial. We aim to evaluate the association between tumor hrHPV status and ICC prognosis using national registers and comp...

Characteristics of confirmed cases by availability of valid blocks. (DOCX)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status, by age at cancer diagnosis. (DOCX)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status, by FIGO stage. (DOCX)

One-year, 3-year, 5-year, and 10-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status. (DOCX)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status, in high-grade tumors. (DOCX)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status, by mode of detection. (DOCX)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status based on L1 region and HPV16-E7/HPV18-E6. (DOCX)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status based on L1 region and HPV16-E7/HPV18-E6, by FIGO stage. (DOCX)

Other supporting tables and figures. (PDF)

Five-year relative survival ratios (RSRs) and 5-year excess hazard ratios (EHRs) in relation to high-risk human papillomavirus (hrHPV) status based on L1 region and HPV16-E7/HPV18-E6, by age at cancer diagnosis. (DOCX)

Tumor human papillomavirus (HPV) status and pre-diagnostic HPV testing results. (DOCX)

Background: Based on immunogenicity studies, a 2 dose HPV vaccination-schedule was recently recommended for girls younger than 15 years. We aimed to investigate the effectiveness of quadrivalent HPV (qHPV) vaccination against CIN2 or worse (CIN2+), by age at vaccination, number of doses, and to test whether optimal timing of 2 doses of qHPV vaccin...

Background: This study aims to investigate if DNA methylation of the apolipoprotein E (APOE) locus affects the risks of dementia, Alzheimeŕs disease (AD) or cardiovascular disease (CVD). Methods: DNA methylation across the APOE gene has previously been categorized into three distinct regions: a hypermethylated region in the promoter, a hypomethy...

Background: Between 2007 and 2011, opportunistic HPV-vaccination was available in Sweden and partially subsidized to girls aged 13-17, reaching a ∼30% overall coverage. Methods: All Swedish women/men aged 15-44 were followed between 2006 and 2012 for condyloma. Average annual percent changes (AAPCs) in incidence were estimated. Results: Substa...