Sun Ming, Wang Youxin, Sundquist Jan, Sundquist Kristina, Ji Jianguang
Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
Center for Primary Health Care Research, Lund University/Region Skåne, Lund, Sweden.
Front Oncol. 2020 Feb 4;10:73. doi: 10.3389/fonc.2020.00073. eCollection 2020.
Previous studies have found that the incidence of dementia is lower in patients with cancer. However, the impact of survival bias, as well as the confounding by medical treatment, have not been fully addressed. We aimed to explore the subsequent risk of dementia in different follow-up intervals among patients with cancer, as well as the risk before the diagnosis of cancer. By using the Swedish Cancer Register and the Swedish Hospital Discharge Register, we systematically examined the risk of dementia among patients diagnosed with 35 different types of cancer. Standardized incidence ratios (SIRs) were used to calculate the relative risk. The subsequent risk of dementia in patients with cancer decreased by 21% compared to matched cancer-free controls (SIR = 0.79, 95% CI 0.78-0.80). For specific cancer sites, 21 of them had a significantly lower risk of subsequent dementia. The decreased risk of dementia was also significant before the diagnosis of cancer. However, the risk was higher among patients with cancer who survived for more than 10 years' post-diagnosis (SIR = 1.37, 95% CI 1.32-1.41). In this population-based study, we found that the risk of dementia was lower among patients with cancer, and the risk was also lower before the diagnosis of cancer. This suggests that lower dementia risk is not simply due to bias. However, the underlying mechanisms need to be explored further.
以往的研究发现,癌症患者中痴呆症的发病率较低。然而,生存偏差的影响以及医疗治疗的混杂因素尚未得到充分解决。我们旨在探讨癌症患者在不同随访间隔中患痴呆症的后续风险,以及癌症诊断前的风险。通过使用瑞典癌症登记册和瑞典医院出院登记册,我们系统地检查了被诊断患有35种不同类型癌症的患者患痴呆症的风险。标准化发病率(SIR)用于计算相对风险。与匹配的无癌对照组相比,癌症患者患痴呆症的后续风险降低了21%(SIR = 0.79,95%CI 0.78 - 0.80)。对于特定的癌症部位,其中21个部位后续患痴呆症的风险显著较低。在癌症诊断前,患痴呆症的风险降低也很显著。然而,在癌症诊断后存活超过10年的患者中风险较高(SIR = 1.37,95%CI 1.32 - 1.41)。在这项基于人群的研究中,我们发现癌症患者患痴呆症的风险较低,在癌症诊断前风险也较低。这表明较低的痴呆症风险不仅仅是由于偏差。然而,潜在机制需要进一步探索。