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患有和未患慢性肾脏病的女性发生女性生殖道相关癌症(妇科癌症)或乳腺癌的风险:台湾一项基于人群的队列研究

Risks of female genital tract related cancers (gynecological cancers) or breast cancer in women with and without chronic kidney disease: A population-based cohort study in Taiwan.

作者信息

Chang Wen-Hsun, Horng Huann-Cheng, Yeh Chang-Ching, Guo Chao-Yu, Chou Yiing-Jeng, Huang Nicole, Huang Hsin-Yi, Chen Yi-Jen, Lee Wen-Ling, Wang Peng-Hui

机构信息

Department of Obstetrics and Gynecology.

Department of Nursing.

出版信息

Medicine (Baltimore). 2018 Mar;97(12):e0157. doi: 10.1097/MD.0000000000010157.

Abstract

This article aims to test the hypothesis that the risk of female genital tract related cancer (gynecological cancer: GC) or breast cancer (BC) of women with chronic kidney disease (CKD) might be different from that of those women without CKD.A nationwide 17-year historic cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan and the Registry for Catastrophic Illness Patients was conducted. A total of 3045 women with a diagnosis of CKD from 1996 to 2013 and 3045 multivariable-matched controls (1:1) were selected. We used Cox regression, and computed hazard ratios (HRs) with 95% confidence intervals (95% CIs) to determine the risk of GC or BC in women.The GC incidence rates (IRs, per 10,000 person-years) of the CKD and non-CKD women were 11.02 and 19.09, respectively, contributing to a significantly decreased risk of GCs (crude HR 0.57, 95% CI 0.39-0.81; adjusted HR 0.44, 95% CI 0.30-0.65) in the CKD women. The GC IR was relatively constant in the CKD women among the different age categories (IR ranged from 8.10 to 12.29). On contrast, the non-CKD women had a progressive and continuous increase of GC IR in the advanced age, which was more apparent at age ≥50 years (IR 17.16 for 50-59; IR 23.05 for 60-69; and IR 31.62 for ≥70, respectively), contributing to the lower risk of GC in the CKD women than that in the non-CKD women. There was no difference of BC incidence between women with and without CKD.The findings of the lower risk of GCs in the CKD women in Taiwan are worthy of further evaluation.

摘要

本文旨在检验以下假设

慢性肾脏病(CKD)女性患女性生殖道相关癌症(妇科癌症:GC)或乳腺癌(BC)的风险可能与无CKD的女性不同。我们利用台湾地区国民健康保险研究数据库(NHIRD)和重大伤病患者登记系统进行了一项为期17年的全国性历史性队列研究。共选取了1996年至2013年间诊断为CKD的3045名女性以及3045名多变量匹配对照(1:1)。我们采用Cox回归分析,并计算风险比(HRs)及95%置信区间(95% CIs)来确定女性患GC或BC的风险。CKD组和非CKD组女性的GC发病率(IRs,每10000人年)分别为11.02和19.09,这使得CKD组女性患GC的风险显著降低(粗HR 0.57,95% CI 0.39 - 0.81;调整后HR 0.44,95% CI 0.30 - 0.65)。在不同年龄组的CKD女性中,GC发病率相对稳定(IR范围为8.10至12.29)。相比之下,非CKD女性的GC发病率在高龄时呈渐进性持续上升,在年龄≥50岁时更为明显(50 - 59岁时IR为17.16;60 - 69岁时IR为23.05;≥70岁时IR为31.62),这导致CKD组女性患GC的风险低于非CKD组女性。有或无CKD的女性之间BC发病率无差异。台湾地区CKD女性患GC风险较低这一研究结果值得进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7898/5895333/6cacb93db1f5/medi-97-e0157-g001.jpg

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