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年龄增长导致静脉血栓栓塞风险增加,不能归因于老年人癌症发病率较高:特罗姆瑟研究。

The increased risk of venous thromboembolism by advancing age cannot be attributed to the higher incidence of cancer in the elderly: the Tromsø study.

机构信息

Hematological Research Group, Department of Clinical Medicine, University of Tromsø, 9037, Tromsø, Norway,

出版信息

Eur J Epidemiol. 2014 Apr;29(4):277-84. doi: 10.1007/s10654-014-9902-7. Epub 2014 Apr 19.

Abstract

UNLABELLED

Whether the high incidence of venous thromboembolism (VTE) in the elderly can be attributed to cancer is not well studied. We assessed the impact of cancer on risk of VTE in young, middle-aged and elderly. 26,094 subjects without a history of cancer or VTE were recruited from the Tromsø study. Incident cancer (n = 2,290) and VTE (n = 531) were recorded from baseline (1994-1995) through December 31st, 2009. Cox regression with cancer as time-varying exposure was used to calculate hazard ratios with 95 % confidence intervals (CI). Overt cancer was associated with a fivefold (95 %CI 4.3, 6.7) increased risk of VTE, with an age-dependent gradient from 26-fold (95 %CI 12.1, 56.5) increased in the young, ninefold (95 % CI 6.6, 12.7) increased in the middle-aged, and threefold (95 % CI 2.5, 4.5) increased risk in the elderly. The population attributable risks were 14, 27 and 18 %, respectively.

CONCLUSION

The relative risk of VTE by cancer were higher in young compared to elderly subjects, but the proportion of VTEs in the population due to cancer did not differ much across age groups. Our findings indicate that the increased risk of VTE by advancing age cannot be attributed to higher incidence of cancer in the elderly.

摘要

目的

研究老年人静脉血栓栓塞症(VTE)高发是否归因于癌症。

方法

我们评估了癌症对年轻、中年和老年人群 VTE 风险的影响。共招募了 26094 名无癌症或 VTE 病史的研究对象,来自 Tromsø 研究。从基线(1994-1995 年)开始至 2009 年 12 月 31 日记录新发癌症(n=2290)和 VTE(n=531)。使用 Cox 回归分析,以癌症为时间依赖性暴露因素,计算风险比及其 95%置信区间(CI)。显性癌症与 VTE 风险增加五倍相关(95%CI 4.3,6.7),呈年龄依赖性梯度,年轻人风险增加 26 倍(95%CI 12.1,56.5),中年人风险增加 9 倍(95%CI 6.6,12.7),老年人风险增加 3 倍(95%CI 2.5,4.5)。人群归因风险分别为 14%、27%和 18%。

结论

与老年人相比,年轻人癌症相关 VTE 的相对风险更高,但不同年龄组人群中因癌症导致的 VTE 比例差异不大。我们的研究结果表明,VTE 风险随年龄增长而增加不能归因于老年人癌症发病率的增加。

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