Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea.
Sci Rep. 2020 Jun 25;10(1):10313. doi: 10.1038/s41598-020-67029-y.
In this study using national health insurance data, we investigated the risk of ischemic heart disease (IHD) and stroke among prostate cancer (PC) survivors compared with the general population, as well as the risk of cardiovascular disease (CVD) according to primary treatment. A total of 48,298 PC patients diagnosed from 2007 to 2013 were included and matched to non-cancer controls. Compared to the general population, PC survivors had a slightly lower risk of IHD (adjusted hazard ratio [aHR] = 0.89, 95% confidence interval [CI] 0.83-0.96) or stroke (aHR 0.90, 95% CI 0.87-0.95). Especially, survivors who underwent surgery had lower risks of IHD (aHR 0.70, 95% CI 0.61-0.80) or stroke (aHR 0.73, 95% CI 0.67-0.81). Compared to survivors in the active surveillance/watchful waiting group, the androgen deprivation therapy (ADT) group had a significantly greater risk of stroke (aHR 1.16, 95% CI 1.02-1.32), but the IHD risk was not significantly elevated (aHR 1.06, 95% CI 0.88-1.29). In conclusion, PC survivors had a slightly lower risk of CVD compared to the general population, which was attributable to self-selection for PSA screening, specifically in the surgery-only group. CVD risk was dependent on treatment received, and attention should be given to patients who receive ADT.
在这项使用国民健康保险数据的研究中，我们调查了前列腺癌 (PC) 幸存者与普通人群相比发生缺血性心脏病 (IHD) 和中风的风险，以及根据主要治疗方法发生心血管疾病 (CVD) 的风险。共纳入了 2007 年至 2013 年间诊断出的 48298 例 PC 患者，并与非癌症对照组进行了匹配。与普通人群相比，PC 幸存者发生 IHD 的风险略低（调整后的危险比[aHR] = 0.89，95%置信区间[CI] 0.83-0.96）或中风（aHR 0.90，95% CI 0.87-0.95）。特别是接受手术的幸存者发生 IHD（aHR 0.70，95% CI 0.61-0.80）或中风（aHR 0.73，95% CI 0.67-0.81）的风险较低。与主动监测/观察等待组的幸存者相比，雄激素剥夺治疗 (ADT) 组中风的风险显著增加（aHR 1.16，95% CI 1.02-1.32），但 IHD 风险没有显著升高（aHR 1.06，95% CI 0.88-1.29）。总之，与普通人群相比，PC 幸存者发生 CVD 的风险略低，这归因于 PSA 筛查的自我选择，特别是在仅手术组。CVD 风险取决于所接受的治疗，应关注接受 ADT 的患者。
