Lee Ji Eun, Kim DongWook, Lee Jun Hong
Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Institute of Health Insurance & Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Dement Neurocogn Disord. 2018 Dec;17(4):137-147. doi: 10.12779/dnd.2018.17.4.137. Epub 2019 Jan 21.
Previous studies have suggested a decreased cancer risk among patients with Alzheimer's disease (AD). There remains a lack of data on the specific types of cancer and risk factors for developing cancer in AD. We evaluated the association between AD and cancer risk, and we examined specific types of cancer.
A population-based longitudinal study was conducted using the National Health Insurance Service-Senior cohort for 2002-2013. A total of 4,408 AD patients were included in the study, as were 19,150 matched controls. Potential associations between the risk of cancer and AD were analyzed using Cox proportional hazard regressions.
Cancer developed in 12.3% of the AD group patients and in 18.5% of control group subjects. AD was associated with a reduced risk of cancer (hazard ratio [HR], 0.70; 95% confidence intervals, 0.64-0.78). The risk of head and neck cancers was significantly reduced (HR, 0.49), as were risks for cancers of the digestive tract, including stomach cancer (HR, 0.42), colorectal cancer (HR, 0.61), liver and biliary tract cancers (HR, 0.68), and pancreatic cancer (HR, 0.55). Lung and prostate cancer risks were also significantly lower for the AD group (HR, 0.52 and HR, 0.72, respectively).
Our results showed an inverse association between AD and cancer. Further research involving a large number of patients in a hospital based-study is needed to address the biological associations between cancer development and dementia, including AD.
既往研究提示阿尔茨海默病（AD）患者患癌风险降低。目前仍缺乏关于AD患者患癌的具体类型及危险因素的数据。我们评估了AD与患癌风险之间的关联，并研究了特定类型的癌症。
利用2002 - 2013年国民健康保险服务老年队列进行了一项基于人群的纵向研究。该研究共纳入4408例AD患者以及19150例匹配的对照。使用Cox比例风险回归分析癌症风险与AD之间的潜在关联。
AD组患者中有12.3%发生癌症，对照组中有18.5%发生癌症。AD与患癌风险降低相关（风险比[HR]，0.70；95%置信区间，0.64 - 0.78）。头颈部癌症风险显著降低（HR，0.49），消化道癌症风险也显著降低，包括胃癌（HR，0.42）、结直肠癌（HR，0.61）、肝胆管癌（HR，0.68）和胰腺癌（HR，0.55）。AD组的肺癌和前列腺癌风险也显著较低（分别为HR，0.52和HR，0.72）。
我们的结果显示AD与癌症之间存在负相关。需要在医院开展进一步的大规模患者研究，以探讨癌症发生与痴呆（包括AD）之间的生物学关联。
