Srinivasan Radhika, Yang Yu-Xiao, Rubin Stephen C, Morgan Mark A, Lewis James D
Department of Medicine, Division of Gastroenterology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
J Clin Gastroenterol. 2007 Mar;41(3):291-6. doi: 10.1097/01.mcg.0000225587.85953.06.
Earlier studies regarding the risk of colorectal cancer (CRC) in women with a prior diagnosis of gynecologic malignancies have revealed conflicting results. We sought to further clarify this association.
A retrospective cohort study was performed using the General Practice Research Database of the United Kingdom. Patients with a prior diagnosis of ovarian, uterine, or cervical cancers were compared with control patients without a prior gynecologic malignancy. The primary outcome was a diagnosis of CRC. Poisson regression analysis was used to assess the effects of potential confounders.
The study included 1995 ovarian, 1348 uterine, and 1101 cervical cancer patients and 7980, 5392, and 4404 matched control patients, respectively. The adjusted incidence rate ratio (IRR) of CRC among ovarian cancer patients was 2.90 [95% confidence intervals (CI) 1.45-5.82]. Five of 10 cases of CRC in ovarian cancer patients were diagnosed within 6 months of the cancer diagnosis with an adjusted IRR of 8.0 (95% CI 1.9-33.6). Excluding the initial 6 months of follow-up after the diagnosis of ovarian cancer, the adjusted IRR was 1.6 (95% CI 0.76-5.03). The adjusted IRR of CRC in patients with a prior diagnosis of uterine and cervical cancer was 0.79 (95% CI 0.24-2.61) and 1.50 (95% CI 0.43-5.21), respectively.
Women with a prior diagnosis of ovarian cancer are at an increased risk of CRC. The risk of CRC was not increased among patients with a prior history of uterine and cervical cancer.
既往关于先前诊断为妇科恶性肿瘤的女性患结直肠癌(CRC)风险的研究结果相互矛盾。我们试图进一步阐明这种关联。
利用英国全科医疗研究数据库进行一项回顾性队列研究。将先前诊断为卵巢癌、子宫癌或宫颈癌的患者与无先前妇科恶性肿瘤的对照患者进行比较。主要结局是CRC诊断。采用泊松回归分析评估潜在混杂因素的影响。
该研究分别纳入了1995例卵巢癌、1348例子宫癌和1101例宫颈癌患者,以及7980例、5392例和4404例匹配的对照患者。卵巢癌患者中CRC的校正发病率比(IRR)为2.90[95%置信区间(CI)1.45 - 5.82]。卵巢癌患者中10例CRC病例中有5例在癌症诊断后6个月内被诊断出,校正IRR为8.0(95%CI 1.9 - 33.6)。排除卵巢癌诊断后的最初6个月随访期,校正IRR为1.6(95%CI 0.76 - 5.03)。先前诊断为子宫癌和宫颈癌的患者中CRC的校正IRR分别为0.79(95%CI 0.24 - 2.61)和1.50(95%CI 0.43 - 5.21)。
先前诊断为卵巢癌的女性患CRC的风险增加。先前有子宫癌和宫颈癌病史的患者患CRC的风险未增加。