Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan County, Guishan Township 333, Taiwan.
Joint Bone Spine. 2012 Jul;79(4):375-8. doi: 10.1016/j.jbspin.2011.09.011. Epub 2011 Nov 15.
Few studies have investigated the association between gout and cancer. The present study examined the relative risk of cancer in a nationwide cohort.
The primary data source was the National Health Insurance database of Taiwan. Data recorded between 2000 and 2008 for subjects ≥20 years and with no history of malignancy were included for the analysis. A gout case definition was defined by records of gout diagnosis and anti-gout treatment (urate-lowering drugs, including allopurinol, benzbromazone, probenacid and sulfinpyrazone, and colchicine). Cox proportional hazards models were used to examine the association between gout and cancer.
A total of 694,361 patients (355,278 men, 339,083 women) were included; among them, 25,943 had a history of gout. Mean age (±standard deviation) was 42.3±16.3 years. During 5,471,272 patient-years of follow-up, cancer was detected in 24,088 patients (1745 with gout and 22,343 controls). The most cancers were liver, lung, and colonic cancers. The overall incidence of cancer was significantly higher among gout patients than controls (8.7 vs. 4.2 cases per 1000 patient-years, P<0.001). After adjustment for age and sex, gout was found to be associated with a hazard ratio (HR) of 1.15 (95% confidence interval [CI], 1.10-1.21; P<0.001) for cancer. Gout was most closely associated with prostate cancer, with an age- and sex-adjusted HR of 1.71 (1.45-2.02). On the other hand, gout tended to have an inverse, albeit insignificant, association with breast cancer (adjusted HR, 0.81; 95% CI, 0.63-1.04).
Gout was associated with increased risk of cancer, particularly that of prostate cancer in males.
鲜有研究调查痛风与癌症之间的关联。本研究旨在对全国队列人群中癌症的相对风险进行检验。
原始数据来源于台湾全民健康保险数据库。纳入分析的对象为年龄≥20 岁且无恶性肿瘤病史的 2000 年至 2008 年期间的数据。痛风的病例定义为痛风诊断和抗痛风治疗（包括别嘌醇、苯溴马隆、丙磺舒和秋水仙碱）的记录。使用 Cox 比例风险模型来检验痛风与癌症之间的关联。
共纳入 694361 例患者（男性 355278 例，女性 339083 例），其中 25943 例患者有痛风病史。平均年龄（±标准差）为 42.3±16.3 岁。在 5471272 人年的随访期间，共有 24088 例患者确诊癌症（痛风患者 1745 例，对照组患者 22343 例）。最常见的癌症是肝癌、肺癌和结肠癌。痛风患者的总体癌症发病率显著高于对照组（8.7 例/1000 人年 vs. 4.2 例/1000 人年，P<0.001）。在校正年龄和性别后，痛风与癌症的风险比（HR）为 1.15（95%置信区间 [CI]，1.10-1.21；P<0.001）。痛风与前列腺癌的相关性最为密切，校正年龄和性别后 HR 为 1.71（1.45-2.02）。另一方面，痛风与乳腺癌呈负相关（校正 HR，0.81；95%CI，0.63-1.04），但这种相关性无统计学意义。
痛风与癌症风险增加相关，特别是男性的前列腺癌风险增加。
