Dreyer L, Olsen J H
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen.
Cancer Epidemiol Biomarkers Prev. 1999 Oct;8(10):915-8.
Some studies have suggested that the pathogenesis of atherosclerosis and that of cancer have common features, and in addition to tobacco smoking, oxidative stress, diet, and sex hormones have been considered as common etiological factors. To investigate whether there is an association between atherosclerosis and cancer, we evaluated the cancer pattern of patients with atherosclerosis of the aorta and of peripheral and cerebral vessels. A total of 69,485 patients with atherosclerosis were identified through the Danish National Registry of Patients between 1977 and 1989, and the incidence of cancer in this group was calculated by linkage to the Danish Cancer Registry for the period 1977-1993. No consistent excesses over the expected figures were seen for cancer at any site unrelated to tobacco smoking in either the total cohort or in subgroups. Specifically, we found no association at the individual level between atherosclerosis and colorectal cancers or hormone-related cancers, except from a decreased standardized incidence ratio of 0.7 (95% confidence interval, 0.5-0.9) for endometrial cancer. The standardized incidence ratio for cancers of the brain and nervous system was 1.1 (95% confidence interval, 0.9-1.3) for all patients combined, whereas patients with atherosclerosis of precerebral or cerebral arteries had a slightly increased risk (40%) for cancers of the brain and nervous system. The excess was seen only during the initial 3 years after discharge from hospital, and the likely explanation was a missed diagnosis. The study does not support the view that patients with atherosclerotic diseases represent a high-risk group for prostate cancer and potential future targets for prostate cancer screening interventions.
一些研究表明，动脉粥样硬化与癌症的发病机制具有共同特征，除吸烟外，氧化应激、饮食和性激素也被视为共同的病因。为了研究动脉粥样硬化与癌症之间是否存在关联，我们评估了主动脉、外周血管和脑血管发生动脉粥样硬化的患者的癌症模式。通过丹麦国家患者登记处，在1977年至1989年间共识别出69485例动脉粥样硬化患者，并通过与丹麦癌症登记处的数据链接计算了该组在1977 - 1993年期间的癌症发病率。在整个队列或亚组中，与吸烟无关的任何部位的癌症发病率均未出现一致高于预期数字的情况。具体而言，我们发现动脉粥样硬化与结直肠癌或激素相关癌症在个体层面上没有关联，不过子宫内膜癌的标准化发病率比为0.7（95%置信区间，0.5 - 0.9），呈下降趋势。所有患者合并计算时，脑和神经系统癌症的标准化发病率比为1.1（95%置信区间，0.9 - 1.3），而脑前动脉或脑动脉发生动脉粥样硬化的患者患脑和神经系统癌症的风险略有增加（40%）。这种增加仅在出院后的最初3年内出现，可能的解释是漏诊。该研究不支持动脉粥样硬化疾病患者是前列腺癌高危人群以及未来前列腺癌筛查干预潜在目标人群的观点。
