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癌症诊断后长达 13 年的心血管疾病发病率:32757 例癌症幸存者匹配队列研究。

Incidence of cardiovascular disease up to 13 year after cancer diagnosis: A matched cohort study among 32 757 cancer survivors.

机构信息

CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical psychology, Tilburg University, Tilburg, The Netherlands.

Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.

出版信息

Cancer Med. 2018 Oct;7(10):4952-4963. doi: 10.1002/cam4.1754. Epub 2018 Sep 15.

Abstract

We examined the incidence of cardiovascular disease (CVD) among 32 757 cancer survivors and age-, gender-, and geographically matched cancer-free controls during a follow-up period of 1-13 years, and explored whetherCVD incidence differed by received cancer treatment, traditional cardiovascular risk factors, age, or gender. Adult 1-year cancer survivors without a history ofCVD diagnosed with breast (n = 6762), prostate (n = 4504), non-Hodgkin (n = 1553), Hodgkin (n = 173), lung and trachea (n = 2661), basal cell carcinoma (BCC; n = 12 476), and colorectal (n = 4628) cancer during 1999-2011 were selected from the Netherlands Cancer Registry and matched to cancer-free controls without a history ofCVD. Drug dispenses and hospitalizations from thePHARMO Database Network were used as proxy forCVD. Data were analyzed using Cox regression analyses. Prostate (HR: 1.17; 95%CI: 1.01-1.35) and lung and trachea (HR: 1.48; 95%CI: 1.10-1.97) cancer survivors had an increased risk for developingCVD compared to cancer-free controls. This increased risk among lung and trachea cancer survivors remained statistically significant after including traditional cardiovascular risk factors and cancer treatment information (HR: 1.41; 95%CI: 1.06-1.89). Among prostate cancer survivors, the increased risk of incidentCVD was limited to those who received hormones and those without traditional cardiovascular risk factors. Breast, non-Hodgkin,BCC, and colorectal cancer survivors showed no increasedCVD risk compared to cancer-free controls. There was an increased risk of incidentCVD among prostate, and lung and trachea cancer survivors compared to age-, gender- and geographically matched cancer-free controls. Studies including longer follow-up periods are warranted to examine whether cancer survivors are at increased risk of long-term incidentCVD.

摘要

我们在 1-13 年的随访期间,检查了 32757 例癌症幸存者和年龄、性别和地理位置匹配的无癌症对照组的心血管疾病(CVD)发病率,并探讨了 CVD 发病率是否因接受的癌症治疗、传统心血管危险因素、年龄或性别而有所不同。1 年内无 CVD 病史的成年癌症幸存者,诊断患有乳腺癌(n=6762)、前列腺癌(n=4504)、非霍奇金淋巴瘤(n=1553)、霍奇金淋巴瘤(n=173)、肺癌和气管癌(n=2661)、基底细胞癌(BCC;n=12476)和结直肠癌(n=4628),这些患者均来自 1999-2011 年荷兰癌症登记处,并与无 CVD 病史的无癌症对照组相匹配。PHARMO 数据库网络中的药物配药和住院记录被用作 CVD 的替代指标。使用 Cox 回归分析来分析数据。与无癌症对照组相比,前列腺癌(HR:1.17;95%CI:1.01-1.35)和肺癌和气管癌(HR:1.48;95%CI:1.10-1.97)幸存者发生 CVD 的风险增加。在纳入传统心血管危险因素和癌症治疗信息后,肺癌和气管癌幸存者的这种风险仍然具有统计学意义(HR:1.41;95%CI:1.06-1.89)。在前列腺癌幸存者中,CVD 发病风险的增加仅限于接受激素治疗且无传统心血管危险因素的患者。与无癌症对照组相比,乳腺癌、非霍奇金淋巴瘤、BCC 和结直肠癌幸存者没有增加 CVD 风险。与年龄、性别和地理位置匹配的无癌症对照组相比,前列腺癌和肺癌和气管癌幸存者发生 CVD 的风险增加。需要进行更长随访期的研究来检查癌症幸存者是否存在 CVD 长期发病风险增加的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7ea/6198235/a8cb723cf39d/CAM4-7-4952-g001.jpg

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