Sun Li-Min, Liang Ji-An, Lin Cheng-Li, Lin Ming-Chia, Chang Nai-Jen, Kao Chia-Hung
a Department of Radiation Oncology , Zuoying Branch of Kaohsiung Armed Forces General Hospital , Kaohsiung , Taiwan.
b Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University , Taichung , Taiwan.
Curr Med Res Opin. 2017 Apr;33(4):733-739. doi: 10.1080/03007995.2017.1278681. Epub 2017 Jan 31.
Osteoporosis has been associated with cancer development. We conducted a nationwide population-based cohort study in Taiwan to evaluate this possible association of osteoporosis with subsequent cancer development.
A total of 35,979 patients diagnosed with osteoporosis between 2000 and 2010 identified from the National Health Insurance Research Database comprised the osteoporosis cohort, and each patient was randomly frequency matched with one individual from the general population (without osteoporosis) based on age, sex, and year of osteoporosis diagnosis to form the non-osteoporosis (control) cohort. Cox proportional hazard regression analysis was used to calculate adjusted hazard ratios and 95% confidence intervals and determine the effect of osteoporosis on cancer risk.
Patients with osteoporosis showed a significantly higher risk of developing liver and thyroid cancers and lower risk of colorectal cancer than did individuals without osteoporosis. Male patients with osteoporosis had a significantly increased risk for liver cancer, whereas female patients with osteoporosis had a significantly increased risk for thyroid cancer, but a significantly decreased risk for overall and colorectal cancers. In addition, more significant findings were observed when age ≤64 years or the follow-up duration was ≤5 years; however, a significantly lower risk for colorectal cancer was observed when follow-up duration was >5 years. Study limits including lack of data for some health-related behaviors, inclusion criteria of osteoporosis and potential selection bias have been discussed.
Patients with osteoporosis showed a higher risk for liver and thyroid cancers and a lower risk for colorectal cancer than did control individuals. Stratified analyses by sex, age, and follow-up duration showed various patterns in different cancers.
骨质疏松症与癌症发生有关。我们在台湾进行了一项基于全国人口的队列研究，以评估骨质疏松症与后续癌症发生之间的这种可能关联。
从国民健康保险研究数据库中识别出2000年至2010年间诊断为骨质疏松症的35979名患者组成骨质疏松症队列，根据年龄、性别和骨质疏松症诊断年份，将每位患者与一名来自普通人群（无骨质疏松症）的个体进行随机频率匹配，以形成非骨质疏松症（对照）队列。采用Cox比例风险回归分析来计算调整后的风险比和95%置信区间，并确定骨质疏松症对癌症风险的影响。
与无骨质疏松症的个体相比，骨质疏松症患者患肝癌和甲状腺癌的风险显著更高，患结直肠癌的风险更低。男性骨质疏松症患者患肝癌的风险显著增加，而女性骨质疏松症患者患甲状腺癌的风险显著增加，但患总体癌症和结直肠癌的风险显著降低。此外，当年龄≤64岁或随访时间≤5年时，观察到更显著的结果；然而，当随访时间>5年时，观察到患结直肠癌的风险显著降低。已讨论了研究局限性，包括一些与健康相关行为的数据缺失、骨质疏松症的纳入标准和潜在的选择偏倚。
与对照个体相比，骨质疏松症患者患肝癌和甲状腺癌的风险更高，患结直肠癌的风险更低。按性别、年龄和随访时间进行的分层分析显示，不同癌症呈现出不同模式。
