Heflin Lara H, Meyerowitz Beth E, Hall Per, Lichtenstein Paul, Johansson Boo, Pedersen Nancy L, Gatz Margaret
Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
J Natl Cancer Inst. 2005 Jun 1;97(11):854-6. doi: 10.1093/jnci/dji137.
Previous studies have shown that cancer survivors frequently experience short-term cognitive deficits, but it is unknown how long these deficits last or whether they worsen over time. Using a co-twin control design, the cognitive function of 702 cancer survivors aged 65 years and older was compared with that of their cancer-free twins. Dementia rates were also compared in 486 of the twin pairs discordant for cancer. Cancer survivors overall, as well as individuals who had survived cancer for 5 or more years before cognitive testing, were more likely than their co-twins to have cognitive dysfunction (odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.36 to 3.24; P<.001; and OR = 2.71, 95% CI = 1.47 to 5.01; P<.001, respectively). Cancer survivors were also twice as likely to be diagnosed with dementia as their co-twins, but this odds ratio did not reach statistical significance (OR = 2.0, 95% CI = 0.86 to 4.67; P = .10). These results suggest that cancer patients are at increased risk for long-term cognitive dysfunction compared with individuals who have never had cancer, even after controlling for the influence of genetic factors and rearing environment.
以往的研究表明，癌症幸存者经常会出现短期认知缺陷，但目前尚不清楚这些缺陷会持续多久，或者它们是否会随着时间的推移而恶化。采用同卵双胞胎对照设计，对702名65岁及以上的癌症幸存者及其未患癌症的双胞胎的认知功能进行了比较。还对486对患癌情况不一致的双胞胎的痴呆症发病率进行了比较。总体而言，癌症幸存者以及在认知测试前已患癌5年或更长时间的个体，比其双胞胎更有可能出现认知功能障碍（优势比[OR]=2.10，95%置信区间[CI]=1.36至3.24；P<0.001；以及OR=2.71，95%CI=1.47至5.01；P<0.001）。癌症幸存者被诊断为痴呆症的可能性也是其双胞胎的两倍，但这一优势比未达到统计学显著性（OR=2.0，95%CI=0.86至4.67；P=0.10）。这些结果表明，与从未患过癌症的个体相比，癌症患者长期认知功能障碍的风险增加，即使在控制了遗传因素和成长环境的影响之后。
