Personnummeret – brug i epidemiologisk forskning Elsebeth Lynge Københavns Universitet København 12 November 2009

DEN STORE DANSKE Gyldendals åbne encyklopædi Danmark fødte og døde

PERSONNUMMERET 1947 Sverige 1964 Norge 1967 Finland 1968 Danmark

Population register CensusDeath register Personal identification number

DØDELIGHED OG ERHVERV MÆND

OCCUPATIONAL CANCER Denmark, Finland, Iceland, Norway, Sweden 385,000,000 risk-years 15,000,000 persons 2,800,000 cases

HYPOTESIS: Mammography screening reduces breast cancer mortality DESIGN: Screening region change in breast cancer mortality controlled for change in non-screening regions DATA: Population Register Mammography screening register Cause of death register RESULT: Screening gave 25% reduction in Breast cancer mortality, RR 0.75 (95% CI ) Olsen et al, 2005 ?

? HYPOTHESIS: Hormones  Breast cancer Placenta weight  Hormones DESIGN: Placenta weight  Breast cancer DATA: Swedish Birth Register Swedish Cancer Register Swedish Cause of Death Register Swedish Population Register RESULT: Placenta weight 2 x >700g gave double risk of breast cancer (baseline placenta weight 2 x <500g) Cnattingius et al, 2005

FUTURE DANISH HEALTH DATA NETWORK National Strategy for Digitalisation of the Danish Healthcare Service, 2008

HYPOTHESIS: Intra-uterine exposure to viruses is associated with later risk of schizofrenia DATA: Central Population Register Danish Psychiatric Case Register PKU Data Bank DESIGN: Immunoglobulin G (IgG) antibodies to Tg from neonatal heal stick blood samples stored on filter paper RESULT: Maternal Tg infection and schizofrenia in offspring, RR 1.79 (95%CI ) Mortensen et al, 2007 ?

NORWEGIAN WOMEN AND CANCER POSTGENOME COHORT STUDY DESIGN Dumeaux et al, 2008

15 millioner biologiske prøver Danmark får national biobank i verdensklasse En forskningsbevilling til Statens Serum Institut på 121 mio. kr. fra Videnskabsministeriet og Novo Nordisk Fonden skal styrke dansk sundhedsforskning. Initiativet er til gavn for forskning i sygdommes årsager, deres forebyggelse og behandling. – Med etableringen af en national biobank vil Danmark på endnu et forskningsområde lægge sig helt i front, siger videnskabsminister Helge Sander. 24. februar 2009

Don’t throw out the baby with the bathwater Update, accuracy and completeness of traditional registers Secure and non-bureaucratic access

Privatization and registration ”At present private hospitals provide 2% of health services. For me it is not decisive whether this percentage remains at 2% or it increases to 10, 20 or maybe 50%” Jakob Axel Nielsen Danish Minister of Health 10 Oct 2008:

Men selv nordiske lande kan have problemer - Eksempel fra Norge

TAK FOR OPMÆRKSOMHEDEN University of Copenhagen, Kommunehospitalet