AIMS OF THE STUDY: Overweight and obesity in children and the harmful health consequences of these conditions throughout the course of their lives is a growing, worldwide public health problem. The purpose of this study is to evaluate the evolution of the prevalence of being overweight and obese among 5- to 6-year-old schoolchildren in Geneva from 2003 to 2018, and to compare it to other areas of Switzerland.

METHODS: A cross-sectional study at nine points in time, conducted in public schools from 2003–2004 to 2017–2018. During a systematic health check at school, data on the height and body weight of 5- to 6-year-old children attending public schools in the canton of Geneva were obtained. 12,918 girls and 13,395 boys were recruited for the study. Cole’s references were used to classify the body mass index.

RESULTD: In 2017–18 the combined prevalence of overweight and obesity was 14.6%, of which 10.3% were overweight (14.5% for girls and 5.9% for boys) and 4.3% were obese (4.5% for girls and 4.2% for boys). For girls, we observed a non-significant increase in the prevalence of overweight of 2.5 points (p = 0.14) between 2003–04 and 2017–18, as opposed to boys, where we observed a non-significant downward trend (−2.7 points, p = 0.06) over the same period. A relatively marked and statistically significant increase in the prevalence of obesity (1.9 points, p = 0.0130) since 2010 was observed for both sexes in this age group.

CONCLUSION: From 2003 to 2018 we observed a stabilisation in the prevalence of overweight and obesity in childhood, which is consistent with results from other Swiss cities, as well as in some other countries worldwide. The significant increase in obesity observed since 2010 will have to be monitored and justifies pursuing public health policies and potentially some more aggressive approaches.

BACKGROUND: Emergency departments (EDs) are crowded with critically ill patients, many of whom are no longer able to communicate with the emergency staff. Substitute decision makers are often unknown or not reachable in time. The availability of advance directives (ADs) among Swiss ED patients has not yet been evaluated. The purpose of this prospective survey was to investigate the prevalence of ADs among ED patients and to identify factors associated with the existence or absence of ADs.

METHODS: In a prospective survey, we enrolled consecutive patients from 10–30 July 2017 who visited a tertiary care ED. Patients completed a written, standardised and self-administrated questionnaire during the waiting time. The primary endpoint was the prevalence of ADs in ED patients. Secondarily, we defined predictors associated with the existence or absence of ADs. Two months after the first survey, there was a written follow-up survey asking patients without ADs whether they had completed an AD in the meantime.

RESULTS: Fifty-eight of 292 enrolled ED patients (19.9%) had a completed AD. Overall, 49.3% of the survey population was female. Patients having an AD were older (69.5 years, interquartile range [IQR] 57–81 vs 39 years, IQR 27–56) and had more comorbidities (67.2% vs 38.9%) compared with patients without ADs. The four leading reasons given for not having an AD were: 33.6% never considered completing one, 26% did not know about ADs, 14% preferred family to make decisions, 11.6% felt it was too early to make such a decision. Predictors for having an AD were older age (p <0.001), being in long-term medical treatment by a specialist (p = 0.050), being Swiss (p = 0.021) and living with nursing care (p = 0.043). Of the ED patients with ADs, 46.6% discussed their AD with the family and 31% with their general practitioner. Results of the follow-up survey showed that eight participants had completed an AD in the meantime. The prevalence of ADs increased from 19.9% to 22.6%.

DISCUSSION: During the last 20 years, the percentage of patients having an AD has not changed. Even today, only every fifth ED patient has a completed AD. Nearly two thirds of ED patients never considered completing one or did not know about ADs. Therefore, there is an urgent need to better inform and sensitise the public, so that they will define in a timely manner legally valid and specifically defined decisions about future medical treatments and wishes by completing individual directives.

OBJECTIVE: Behçet’s syndrome is a rare systemic autoimmune/autoinflammatory disease affecting mucocutaneous tissues, the skin and the eyes, as well as the joints, the central nervous system, the gastrointestinal tract and blood vessels. Because of the lack of clinical data in Switzerland, the aims of this cohort study were to calculate the disease prevalence and to analyse the disease manifestations and the immune-suppressive medication.

METHODS: Data were extracted from 52 patient charts. Thereafter, all patients were interviewed with a questionnaire and 46 had an additional physical examination and laboratory analyses. For calculation of prevalence, data of the national statistical bureau were used.

RESULTS: A disease prevalence of 4.03/100,000 inhabitants was calculated. The mean delay between first disease manifestation and diagnosis was 8 years. It was 2 years longer for Swiss than for non-Swiss individuals (p = 0.45). The time intervals between diagnosis and occurrence of different organ manifestations ranged from +8 to -11 years. There was no difference in organ involvement between different ethnicities. Colchicine was prescribed for 52% of patients only, whereas tumour necrosis factor (TNF) inhibitors and glucocorticoids were most frequently prescribed (80 and 64%, respectively). In almost half of the patients, TNF blockers could be stopped and replaced by conventional immunosuppressive drugs.

CONCLUSION: The data from this cohort of Behçet’s syndrome patients, the largest in Switzerland, documents a prevalence higher than anticipated. The diagnostic delay underlines an urgent need to improve awareness of the disease and allow timely treatment.

AIMS: We explored the trend in lung cancer incidence rates among a young Swiss population (30–54 years old) by sex from 1990 to 2014 to investigate the birth cohort effect on lung cancer. We evaluated smoking rates from 1992 to 2012 to explain sex differences in lung cancer incidence rates.

METHODS: The data of the Swiss National Institute for Cancer Epidemiology and Registration (NICER) were used. We extracted the data of age-standardized (world) and age-specific incidence rates (per 100,000 people at risk) of trachea, bronchus, and lung cancers by sex and year of diagnosis from 1990 to 2014. The data on tobacco consumption were generated from the Swiss Federal Statistical Office. These data were based on Swiss Health Surveys, involving 5-year intervals from 1992 to 2012.

RESULTS: Incidence rates decreased among men in the age groups 40–44, 45–49, and 50–54 years. An increased rate was seen among women in age group 50–54 years. Among men, rates generally decreased in successive birth cohorts, whereas among women, the rates increased from the cohort born in 1935–1939 up to the 1950s, and then were steady. In the cohort born in 1940–1944 an increased rate was seen until the 1960s, and then they decreased. In the cohort born in 1945–1949 the rates remained steady. Smoking prevalence was higher among men than among women in all age and birth groups. Among men born in the mid-1950s or mid-1960s, smoking prevalence has become higher for younger compared to older men. This pattern was only seen among younger women born in the mid-1960s.

CONCLUSIONS: Decreasing lung cancer incidence rates in young Swiss men but increasing rates in young women reflect the evolution of the smoking epidemic in the world. Our findings indicate an urgent need for implementing prevention strategies that target tobacco cessation and prevention among young women.