Division of Coloproctology, Department of Surgery, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Cheonbo-ro 271, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea.
Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2020 Sep 24;10(1):15670. doi: 10.1038/s41598-020-72770-5.
An association between appendectomy and subsequent gastrointestinal (GI) cancer development has been postulated, although the evidence is limited and inconsistent. To provide clarification, we investigated the link between appendectomy and GI cancers in a large nationwide appendectomy cohort. This cohort was derived from the claims database of the National Health Insurance Service in South Korea and comprised 158,101 patients who had undergone appendectomy between 2007 and 2014. A comparison cohort of 474,303 subjects without appendectomy was selected after 1:3 matching by age and sex. The incidence of GI cancers after appendectomy was observed, and risk factors for GI cancers were determined by using a multivariable-adjusted proportional hazards model. Appendectomy did not significantly increase the incidence of GI cancers in the overall population (1.529 and 1557 per 1000 person-years in the non-appendectomy and appendectomy cohorts, respectively). However, appendectomy significantly increased the incidence of GI cancers in subgroups consisting of elderly (≥ 60 years) patients (adjusted HR, 1.102; 95% confidence interval, 1.011-1.201; p = 0.028) or women (adjusted HR, 1.180; 95% confidence interval, 1.066-1.306; p = 0.001).
已经有人提出阑尾切除术与随后的胃肠道（GI）癌症发展之间存在关联，尽管证据有限且不一致。为了澄清这一点，我们在一个大型全国性阑尾切除队列中研究了阑尾切除术与 GI 癌症之间的联系。该队列源自韩国国家健康保险服务的索赔数据库，包括 2007 年至 2014 年间接受阑尾切除术的 158101 名患者。在年龄和性别上按 1:3 匹配后，选择了 474303 名未接受阑尾切除术的对照组。观察阑尾切除术后 GI 癌症的发病率，并使用多变量调整比例风险模型确定 GI 癌症的危险因素。阑尾切除术并未显著增加总体人群中 GI 癌症的发病率（非阑尾切除术和阑尾切除术队列分别为每 1000 人年 1.529 和 1557 例）。然而，在由老年（≥60 岁）患者（调整后的 HR，1.102；95%置信区间，1.011-1.201；p=0.028）或女性（调整后的 HR，1.180；95%置信区间，1.066-1.306；p=0.001）组成的亚组中，阑尾切除术显著增加了 GI 癌症的发病率。
