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癌症作为尿路结石的风险因素:使用“健康改善网络”的回顾性队列研究:癌症与尿路结石。

Cancer as a risk factor for urinary tract calculi: a retrospective cohort study using 'The Health Improvement Network' : Cancer and urinary tract calculi.

机构信息

Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.

Department of Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.

出版信息

Urolithiasis. 2019 Dec;47(6):541-547. doi: 10.1007/s00240-019-01127-z. Epub 2019 Mar 16.

Abstract

PURPOSE

Urolithiasis is a common condition that poses significant morbidity to patients. There are similarities in the development of certain cancers and urinary tract calculi (UTC), however, little is known about their temporal relationship. This study aims to identify if cancer is a risk factor for the development of UTC.

METHODS

A population-based retrospective cohort study was conducted for the period 1st January 1990 to 1st May 2016. 124,901 exposed patients identified using clinical codes with newly diagnosed cancer were matched to 476,203 unexposed controls by age, gender, BMI, and general practice. The main outcome measure was the risk of developing UTC described by hazard ratios.

RESULTS

There were 512 incident UTC events in the cancer group compared to 1787 in the unexposed controls. This translated to an adjusted hazard ratio of 1.26 (95% CI 1.14-1.39; p < 0.001). A sub-analysis assessing cancer-specific effects demonstrated increased risks for 10 out of 12 common cancers, most significantly in bladder, colorectal and prostate cancer.

CONCLUSION

This study demonstrated a 26% increased risk of UTC in cancer patients suggesting wider recognition of this risk amongst clinicians could improve diagnosis and prevention of UTC, as well as encourage further research exploring this association.

摘要

目的

尿石症是一种常见病症,会给患者带来很大的发病率。某些癌症和尿路结石(UTC)的发展存在相似之处,然而,它们之间的时间关系知之甚少。本研究旨在确定癌症是否是 UTC 发展的危险因素。

方法

进行了一项基于人群的回顾性队列研究,时间范围为 1990 年 1 月 1 日至 2016 年 5 月 1 日。使用临床代码确定了 124901 名患有新诊断癌症的暴露患者,并按年龄、性别、BMI 和全科医生与 476203 名未暴露对照进行匹配。主要观察指标是描述风险比的 UTC 发展风险。

结果

癌症组中有 512 例 UTC 事件,而未暴露对照组中有 1787 例。这转化为调整后的风险比为 1.26(95%CI 1.14-1.39;p<0.001)。一项评估癌症特异性影响的亚分析表明,12 种常见癌症中有 10 种癌症的风险增加,膀胱癌、结直肠癌和前列腺癌的风险增加最为显著。

结论

本研究表明癌症患者 UTC 的风险增加了 26%,这表明临床医生更广泛地认识到这种风险,可以改善 UTC 的诊断和预防,并鼓励进一步研究探索这种关联。

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