Hoang Tung, Lee Jeonghee, Kim Jeongseon
Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea.
Cancers (Basel). 2020 Jul 8;12(7):1834. doi: 10.3390/cancers12071834.
The combined effects of comorbidities can cause cancer incidence, while the effects of individual conditions, alone, might not. This study was conducted to investigate the joint impact of comorbidities on cancer incidence. The dietary score for energy-adjusted intake was calculated by applying a Gaussian graphical model and was then categorized into tertiles representing light, normal, and heavy eating behaviors. The risk point for cancer, according to the statuses of blood pressure, total cholesterol, fasting glucose, and glomerular filtration rate was computed from a Cox proportional hazard model adjusted for demographics and eating behavior. The comorbidity risk score was defined as the sum of the risk points for four comorbidity markers. We finally quantified the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the strata of the comorbidity risk score and cancer incidence. A total of 13,644 subjects were recruited from the Cancer Screenee Cohort from 2007-2014. The comorbidity risk score was associated with cancer incidence in a dose-dependent manner (HR = 2.15, 95% CI = 1.39, 3.31 for those scoring 16-30 vs. those scoring 0-8, -trend < 0.001). Subgroup analysis still showed significant dose-dependent relationships (HR = 2.39, 95% CI = 1.18, 4.84 for males and HR = 1.99, 95% CI = 1.11, 3.59 for females, -trend < 0.05). In summary, there was a dose-dependent impact of comorbidities on cancer incidence; Highlights: Previous studies have generally reported that hypertension, hypercholesterolemia, diabetes, and chronic kidney disease might predispose patients to cancer. Combining these chronic diseases into a single score, this study found a dose-dependent association between the data-driven comorbidity risk score and cancer incidence.
合并症的综合影响可能导致癌症发病率，而单一病症的影响可能不会。本研究旨在调查合并症对癌症发病率的联合影响。通过应用高斯图形模型计算能量调整摄入量的饮食评分，然后将其分为代表轻度、正常和重度饮食行为的三分位数。根据血压、总胆固醇、空腹血糖和肾小球滤过率的状态，从调整了人口统计学和饮食行为的Cox比例风险模型中计算癌症风险点。合并症风险评分定义为四个合并症标志物风险点的总和。我们最终量化了合并症风险评分分层与癌症发病率之间关联的风险比（HRs）和95%置信区间（CIs）。2007年至2014年期间，从癌症筛查队列中招募了总共13644名受试者。合并症风险评分与癌症发病率呈剂量依赖性关联（评分为16 - 30分者与评分为0 - 8分者相比，HR = 2.15，95% CI = 1.39，3.31，-趋势<0.001）。亚组分析仍显示出显著的剂量依赖性关系（男性HR = 2.39，95% CI = 1.18，4.84；女性女性HR = 1.99，95% CI = 1.11，3.59，-趋势<0.05）。总之，合并症对癌症发病率有剂量依赖性影响；要点：先前的研究普遍报道高血压、高胆固醇血症、糖尿病和慢性肾脏病可能使患者易患癌症。本研究将这些慢性疾病合并为一个单一评分，发现数据驱动的合并症风险评分与癌症发病率之间存在剂量依赖性关联。
