Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Dis Colon Rectum. 2018 Nov;61(11):1250-1257. doi: 10.1097/DCR.0000000000001203.
The risk of a second primary cancer has increased along with the increasing life expectancies of colorectal cancer survivors.
We aimed to evaluate the incidence rate and risk factors of breast and gynecological (ovarian, uterine cervix/corpus) cancers among female colorectal cancer survivors.
This is a retrospective population-based cohort study.
This study used data from the National Health Insurance Corporation of Korea.
Each patient with colorectal cancer diagnosed from 2007 to 2012 was followed until 2015 and compared with age-matched women without colorectal cancer at a 1:5 ratio.
The primary outcome was de novo breast/gynecological cancer. Patients with available medical checkup data were included in an additional analysis.
We analyzed 56,682 patients with colorectal cancer and 288,119 age-matched noncolorectal cancer controls. The risk of breast/gynecological cancer was higher among patients with colorectal cancer than among controls (HR, 2.91; p < 0.001). The association with colorectal cancer was the highest for ovarian cancer (HR, 6.72), followed by uterine corpus cancer (HR, 3.99), cervical cancer (HR, 2.82), and breast cancer (HR, 1.85). This association remained consistent in the subgroup analysis of medical checkup data (14,190 patients with colorectal cancer, 71,933 controls). Among patients with colorectal cancer, those aged <55 years had a higher risk of breast/gynecological cancers than those aged >55 years (HR, 3.51 vs 2.59), and those with dyslipidemia had a higher risk of breast cancer than those without dyslipidemia (HR, 2.66 vs 2.06).
This was a retrospective, population-based study. A prospectively designed study is needed to validate our conclusions.
Compared with the general population, patients with colorectal cancer carry a higher risk of developing secondary breast, ovarian, and uterine cancers. See Video Abstract at http://links.lww.com/DCR/A731.
随着结直肠癌幸存者预期寿命的延长，第二原发癌的风险也有所增加。
我们旨在评估女性结直肠癌幸存者中乳腺癌和妇科（卵巢、子宫颈/子宫体）癌症的发病率和危险因素。
这是一项回顾性基于人群的队列研究。
本研究使用了韩国国家健康保险公司的数据。
每位 2007 年至 2012 年期间诊断为结直肠癌的患者均接受随访，直至 2015 年，并与年龄匹配的无结直肠癌女性患者按 1:5 的比例进行比较。
主要结局为新发乳腺癌/妇科癌症。对有可用体检数据的患者进行了额外分析。
我们分析了 56682 例结直肠癌患者和 288119 例年龄匹配的非结直肠癌对照组。结直肠癌患者发生乳腺癌/妇科癌症的风险高于对照组（HR，2.91；p<0.001）。与结直肠癌的关联最高的是卵巢癌（HR，6.72），其次是子宫体癌（HR，3.99）、宫颈癌（HR，2.82）和乳腺癌（HR，1.85）。在体检数据的亚组分析中（14190 例结直肠癌患者，71933 例对照组），这种关联仍然一致。在结直肠癌患者中，年龄<55 岁的患者发生乳腺癌/妇科癌症的风险高于年龄>55 岁的患者（HR，3.51 比 2.59），血脂异常的患者发生乳腺癌的风险高于血脂正常的患者（HR，2.66 比 2.06）。
这是一项回顾性、基于人群的研究。需要前瞻性设计的研究来验证我们的结论。
与一般人群相比，结直肠癌患者发生继发性乳腺癌、卵巢癌和子宫癌的风险更高。详见视频摘要，网址：http://links.lww.com/DCR/A731。
