Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
Br J Cancer. 2020 Feb;122(4):595-600. doi: 10.1038/s41416-019-0692-2. Epub 2019 Dec 20.
We examined if syncope was a marker of an occult cancer by comparing the risk in patients with a syncope episode with that of the general population.
Using Danish population-based medical registries, we identified all patients diagnosed with syncope during 1994-2013 and followed them until a cancer diagnosis, emigration, death or end of follow-up, whichever came first. We computed cumulative risks and standardised incidence ratios (SIR) with 95% confidence intervals (CI).
Among 208,361 patients with syncope, 20,278 subsequent cancers were observed. The 6-month cumulative risk of any cancer was 1.2%, increasing to 17.9 % for 1-20 years of follow-up. The highest cumulative risks after 6 months of follow-up were lung cancer (0.2%), colorectal cancer (0.2%), prostate cancer (0.1%) and brain cancer (0.1%). The 6-month SIR were 2.7 (95% CI: 2.4-3.0) for lung cancer, 2.0 (95% CI: 1.8-2.2) for colorectal cancer, 1.7 (95% CI: 1.5-1.9) for prostate cancer and 10.0 (95% CI: 8.6-11.4) for brain cancer.
Syncope was a weak marker of an occult cancer. In short-term the highest cumulative risks were observed for lung, colorectal, prostate and brain cancers. An aggressive search for occult cancer in a patient with syncope is probably not warranted.
我们通过比较有晕厥发作的患者和普通人群的风险，来研究晕厥是否是隐匿性癌症的一个标志物。
我们利用丹麦基于人群的医疗登记系统，确定了在 1994 年至 2013 年期间被诊断为晕厥的所有患者，并对他们进行随访，直到发生癌症诊断、移民、死亡或随访结束，以先发生者为准。我们计算了累积风险和标准化发病比（SIR）及其 95%置信区间（CI）。
在 208361 例有晕厥的患者中，观察到 20278 例后续癌症。任何癌症的 6 个月累积风险为 1.2%，在随访 1-20 年时增加到 17.9%。随访 6 个月后，累积风险最高的癌症是肺癌（0.2%）、结直肠癌（0.2%）、前列腺癌（0.1%）和脑癌（0.1%）。6 个月时的 SIR 分别为肺癌 2.7（95%CI：2.4-3.0）、结直肠癌 2.0（95%CI：1.8-2.2）、前列腺癌 1.7（95%CI：1.5-1.9）和脑癌 10.0（95%CI：8.6-11.4）。
晕厥是隐匿性癌症的一个微弱标志物。在短期随访中，肺癌、结直肠癌、前列腺癌和脑癌的累积风险最高。在有晕厥的患者中，对隐匿性癌症进行积极的检查可能没有必要。
