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2006 - 2010年慢性丙型肝炎感染者中癌症发病率及癌症相关死亡率上升。

Increased incidence of cancer and cancer-related mortality among persons with chronic hepatitis C infection, 2006-2010.

作者信息

Allison Robert D, Tong Xin, Moorman Anne C, Ly Kathleen N, Rupp Loralee, Xu Fujie, Gordon Stuart C, Holmberg Scott D

机构信息

Centers for Disease Control and Prevention, Atlanta, GA, USA.

Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

J Hepatol. 2015 Oct;63(4):822-8. doi: 10.1016/j.jhep.2015.04.021. Epub 2015 May 1.

Abstract

BACKGROUND & AIMS: Persons chronically infected with the hepatitis C virus (HCV) may be at higher risk for developing and dying from non-liver cancers than the general population.

METHODS

12,126 chronic HCV-infected persons in the Chronic Hepatitis Cohort Study (CHeCS) contributed 39,984 person-years of follow-up from 2006 to 2010 and were compared to 133,795,010 records from 13 Surveillance, Epidemiology and End Results Program (SEER) cancer registries, and approximately 12 million U.S. death certificates from Multiple Cause of Death (MCOD) data. Measurements included standardized rate ratios (SRR) and relative risk (RR).

RESULTS

The incidence of the following cancers was significantly higher among patients with chronic HCV infection: liver (SRR, 48.6 [95% CI, 44.4-52.7]), pancreas (2.5 [1.7-3.2]), rectum (2.1 [1.3-2.8]), kidney (1.7 [1.1-2.2]), non-Hodgkin lymphoma (NHL) (1.6 [1.2-2.1]), and lung (1.6 [1.3-1.9]). Age-adjusted mortality was significantly higher among patients with: liver (RR, 29.6 [95% CI, 29.1-30.1]), oral (5.2 [5.1-5.4]), rectum (2.6 [2.5-2.7]), NHL (2.3 [2.2-2.31]), and pancreatic (1.63 [1.6-1.7]) cancers. The mean ages of cancer diagnosis and cancer-related death were significantly younger among CHeCS HCV cohort patients compared to the general population for many cancers.

CONCLUSIONS

Incidence and mortality of many types of non-liver cancers were higher, and age at diagnosis and death younger, in patients with chronic HCV infection compared to the general population.

摘要

背景与目的

慢性丙型肝炎病毒(HCV)感染者患非肝癌及死于非肝癌的风险可能高于普通人群。

方法

慢性丙型肝炎队列研究(CHeCS)中的12,126例慢性HCV感染者在2006年至2010年期间提供了39,984人年的随访数据,并与13个监测、流行病学和最终结果计划(SEER)癌症登记处的133,795,010条记录以及来自多死因(MCOD)数据的约1200万份美国死亡证明进行了比较。测量指标包括标准化率比(SRR)和相对风险(RR)。

结果

慢性HCV感染患者中以下癌症的发病率显著更高:肝癌(SRR,48.6 [95% CI,44.4 - 52.7])、胰腺癌(2.5 [1.7 - 3.2])、直肠癌(2.1 [1.3 - 2.8])、肾癌(1.7 [1.1 - 2.2])、非霍奇金淋巴瘤(NHL)(1.6 [1.2 - 2.1])和肺癌(1.6 [1.3 - 1.9])。年龄调整后的死亡率在以下癌症患者中显著更高:肝癌(RR,29.6 [95% CI,29.1 - 30.1])、口腔癌(5.2 [5.1 - 5.4])、直肠癌(2.6 [2.5 - 2.7])、NHL(2.3 [2.2 - 2.31])和胰腺癌(1.63 [1.6 - 1.7])。与普通人群相比,CHeCS HCV队列患者中许多癌症的癌症诊断平均年龄和癌症相关死亡平均年龄显著更年轻。

结论

与普通人群相比,慢性HCV感染患者中多种非肝癌的发病率和死亡率更高,诊断和死亡年龄更年轻。

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