2010-2016 年匈牙利溃疡性结肠炎患者结直肠癌的流行病学、死亡率和流行率：一项基于人群的研究。
Epidemiology, mortality and prevalence of colorectal cancer in ulcerative colitis patients between 2010-2016 in Hungary - a population-based study.
机构信息
Janssen Global Commercial Strategy Organization, Budapest, Hungary.
First Department of Internal Medicine, University of Szeged, Szeged, Hungary.
出版信息
PLoS One. 2020 May 14;15(5):e0233238. doi: 10.1371/journal.pone.0233238. eCollection 2020.
BACKGROUND
The incidence and prevalence of ulcerative colitis (UC) varies geographically. The risk of colorectal cancer (CRC) and possibly some other malignancies is increased among patients with UC. It is still debated if patients with UC are at a greater risk of dying compared with the general population. Our aim was to describe the epidemiology and mortality of the Hungarian UC population from 2010 to 2016 and to analyze the associated malignancies with a special focus on CRC.
METHODS
This is an observational, descriptive, epidemiological study based on the National Health Insurance Fund social security databases from 2010 to 2016. All adult patients who had at least two events in outpatient care or at least two medication prescriptions, or at least one inpatient event with UC diagnosis were analyzed. Malignancies and CRC were defined using ICD-10 codes. We also evaluated the survival of patients suffering from UC compared with the general population using a 3 to 1 matched random sample (age, gender, geography) from the full population of Hungary.
RESULTS
We found the annual prevalence of UC 0.24-0.34%. The incidence in 2015 was 21.7/100 000 inhabitants. Annual mortality rate was 0.019-0.023%. In this subpopulation, CRC was the most common cancer, followed by non-melanotic skin and prostate cancer. 8.5% of the UC incident subpopulation was diagnosed with CRC. 470 (33%) of the CRC patients died during the course of the study (25% of all deaths were due to CRC), the median survival was 9.6 years. UC patients had significantly worse survival than their matched controls (HR = 1.65, 95% CI: 1.56-1.75).
SUMMARY
This is the first population-based study from Eastern Europe to estimate the different malignancies and mortality data amongst Hungarian ulcerative colitis patients. Our results revealed a significantly worse survival of patients suffering from UC compared to the general population.
背景
溃疡性结肠炎（UC）的发病率和患病率在地理上有所不同。UC 患者结直肠癌（CRC）和其他一些恶性肿瘤的风险增加。目前仍存在争议，即与普通人群相比，UC 患者的死亡风险是否更高。我们的目的是描述 2010 年至 2016 年匈牙利 UC 人群的流行病学和死亡率，并分析相关恶性肿瘤，特别关注 CRC。
方法
这是一项基于 2010 年至 2016 年国家健康保险基金社会保障数据库的观察性、描述性、流行病学研究。分析了至少有两次门诊护理事件或至少两次药物处方，或至少有一次住院 UC 诊断事件的所有成年患者。使用 ICD-10 代码定义恶性肿瘤和 CRC。我们还使用匈牙利全部人群中年龄、性别、地理位置相匹配的 3:1 随机样本，评估了 UC 患者与普通人群的生存情况。
结果
我们发现 UC 的年患病率为 0.24-0.34%。2015 年的发病率为 21.7/10 万居民。年死亡率为 0.019-0.023%。在这个亚人群中，CRC 是最常见的癌症，其次是非黑色素瘤皮肤癌和前列腺癌。UC 发病亚人群中有 8.5%被诊断为 CRC。在研究过程中，470 名（33%）CRC 患者死亡（所有死亡中有 25%是由于 CRC），中位生存期为 9.6 年。UC 患者的生存情况明显差于匹配对照者（HR=1.65，95%CI：1.56-1.75）。
总结
这是东欧第一项基于人群的研究，旨在估计匈牙利溃疡性结肠炎患者的不同恶性肿瘤和死亡率数据。我们的结果表明，与普通人群相比，UC 患者的生存情况明显较差。
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