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英国普通人群和特应性皮炎患者中癌症的发病率

Incidence of cancer in the general population and in patients with or without atopic dermatitis in the U.K.

机构信息

Risk Management Resources, Pharmacovigilance Services SL, 50001 Zaragoza, Spain.

出版信息

Br J Dermatol. 2010 Nov;163(5):1036-43. doi: 10.1111/j.1365-2133.2010.09887.x.

Abstract

BACKGROUND

Atopic dermatitis (AD) affects approximately 20% of children and 1-3% of adults in developed countries.

OBJECTIVE

To study the incidence of cancer in patients with AD in the U.K. general population.

METHODS

We conducted a follow-up study in the U.K. using The Health Improvement Network (THIN) database. We calculated the incidence rate (IR) of the first occurrence of overall cancer, lymphoma, melanoma and nonmelanoma skin cancer (NMSC) in the general population, in patients with AD and in individuals without AD. In addition we calculated the IR ratio (IRR) of overall cancer and subtypes of cancer in patients with AD vs. those without.

RESULTS

The study population included 4,518,131 patients [2,336,230 (51·7%) female]. There were 129,972 subjects [68,688 (52·8%) female] with a diagnosis of cancer (excluding NMSC). The IR (per 10,000 person-years) of cancer (excluding NMSC) was 42·41 [95% confidence interval (CI) 42·18-42·64]; of lymphoma 1·70 (95% CI 1·65-1·74); of skin melanoma 1·71 (95% CI 1·67-1·76) and of NMSC 11·76 (95% CI 11·64-11·88). The age- and sex-adjusted IRR for cancer (excluding NMSC) was 1·49 (95% CI 1·39-1·61); for lymphoma 2·21 (95% CI 1·65-2·98); for melanoma 1·74 (95% CI 1·25-2·41); and for NMSC 1·46 (95% CI 1·27-1·69).

CONCLUSIONS

Our results indicate an increased incidence of cancer overall as well as of specific cancer subtypes, including lymphoma, in patients with AD. Further studies are needed to disentangle the effects of treatment for AD from AD itself.

摘要

背景

特应性皮炎(AD)影响大约 20%的儿童和发达国家 1-3%的成年人。

目的

研究英国普通人群中 AD 患者的癌症发病率。

方法

我们在英国使用健康改善网络(THIN)数据库进行了一项随访研究。我们计算了普通人群、AD 患者和无 AD 个体中总体癌症、淋巴瘤、黑色素瘤和非黑色素瘤皮肤癌(NMSC)首次发生的发病率(IR)。此外,我们还计算了 AD 患者与无 AD 患者的总体癌症和癌症亚型的发病率比(IRR)。

结果

研究人群包括 4518131 名患者[2336230 名(51.7%)为女性]。有 129972 名患者[68688 名(52.8%)为女性]被诊断患有癌症(不包括 NMSC)。癌症(不包括 NMSC)的发病率(每 10000 人年)为 42.41[95%置信区间(CI)42.18-42.64];淋巴瘤为 1.70[95%CI 1.65-1.74];皮肤黑色素瘤为 1.71[95%CI 1.67-1.76];NMSC 为 11.76[95%CI 11.64-11.88]。癌症(不包括 NMSC)的年龄和性别调整发病率比(IRR)为 1.49[95%CI 1.39-1.61];淋巴瘤为 2.21[95%CI 1.65-2.98];黑色素瘤为 1.74[95%CI 1.25-2.41];NMSC 为 1.46[95%CI 1.27-1.69]。

结论

我们的结果表明,AD 患者的总体癌症发病率以及特定癌症亚型(包括淋巴瘤)均升高。需要进一步研究来阐明 AD 治疗与 AD 本身的影响。

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