Division of Ophthalmology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University College of Medicine, Taichung, Taiwan.
Cancer Sci. 2014 Apr;105(4):431-6. doi: 10.1111/cas.12360. Epub 2014 Mar 11.
Early-onset cataracts are associated with insufficient antioxidative activity, and, therefore, a potential risk of cancer. This study investigated the risk of cancer after being diagnosed with early-onset cataracts. Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. Study subjects were comprised of patients with early-onset cataracts, aged 20-55 years (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 366.00, 366.01, 366.02, 366.03, 366.04, 366.09, 366.17 and 366.18) and newly diagnosed between 1997 and 2010 (n = 1281), and a comparison cohort without the disease (n = 5124). Both cohorts were followed up until 2010 to estimate the incidences of cancer. We used the Poisson regression model to compare incidence rate ratios and the 95% confidence interval (CI). Cox proportional hazards regression was used to assess the hazard ratio (HR) of cancer associated with early-onset cataracts. The overall incidence rate of all cancers was 2.19-fold higher in the early-onset cataract cohort than in the comparison cohort (8.06 vs 3.68 per 1000 person-years) with an adjusted HR of 2.13 (95% CI = 1.48, 3.07). The site-specific analysis also showed a strong relationship, with adjusted HR of 3.24 ((95% CI = 1.30, 8.10) for head and neck cancer, 3.29 (95% CI 1.16, 9.31) for hepatoma and 3.19 (95% CI 1.34, 7.58) for breast cancer. The present study suggests that patients with early-onset cataracts are at an increased risk of being diagnosed with cancer in subsequent years.
早发性白内障与抗氧化活性不足有关，因此存在癌症的潜在风险。本研究调查了早发性白内障诊断后癌症的发病风险。分析了来自台湾全民健康保险研究数据库的回顾性理赔数据。研究对象包括年龄在 20-55 岁之间的早发性白内障患者（国际疾病分类，第 9 修订版，临床修正 [ICD-9-CM] 代码 366.00、366.01、366.02、366.03、366.04、366.09、366.17 和 366.18），他们于 1997 年至 2010 年间新诊断出患有该疾病（n = 1281），并与无该疾病的对照组（n = 5124）进行了比较。两组均随访至 2010 年，以估计癌症的发病率。我们使用泊松回归模型比较发病率比值和 95%置信区间（CI）。使用 Cox 比例风险回归评估与早发性白内障相关的癌症的风险比（HR）。早发性白内障组的所有癌症总发病率是对照组的 2.19 倍（8.06 比 3.68/1000 人年），调整后的 HR 为 2.13（95%CI=1.48，3.07）。特定部位分析也显示出较强的相关性，调整后的 HR 分别为 3.24（95%CI=1.30，8.10）（头颈部癌症）、3.29（95%CI 1.16，9.31）（肝癌）和 3.19（95%CI 1.34，7.58）（乳腺癌）。本研究表明，早发性白内障患者在随后的几年中被诊断患有癌症的风险增加。
