Roderburg Christoph, Loosen Sven H, Kunstein Anselm, Mohr Raphael, Jördens Markus S, Luedde Mark, Kostev Karel, Luedde Tom
Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Cancers (Basel). 2021 Apr 22;13(9):2027. doi: 10.3390/cancers13092027.
Cancer is the second leading cause of death worldwide and incidence rates for several tumor entities are rising. In addition to a high cancer-specific mortality rate, many cancer patients also suffer from additional comorbidities. Among these, several psychological morbidities have been extensively studied in the past, but findings on the association between cancer and dementia have remained conflicting. In the present study, we evaluated the possibility of an association between cancer and dementia.
Based on data from the IQVIA Disease Analyzer database, a total of 92,868 cancer outpatients initially diagnosed between 2000 and 2018 were matched by age, gender, index year, and yearly consultation frequency to 92,868 individuals without cancer. Ten-year incidence rates of dementia were compared for the two cohorts.
The overall cumulative incidence of dementia was significantly higher in cancer patients (19.7%) than in non-cancer patients (16.7%, < 0.001). Cox regression models confirmed that this association was significant for both male (HR: 1.35 [1.30-1.41], < 0.001) and female (HR: 1.26 [1.21-1.31], < 0.001) patients and was consistent among all age groups analyzed (65-70, 71-75, 76-80, 81-85, and >85 years). In addition, the association between cancer and dementia was significant for all cancer entities analyzed (skin, digestive organs, prostate, breast, urinary tract, lymphoid and hematopoietic tissue, and lung cancer) and most pronounced in patients with lung cancer (HR: 1.44 [1.28-1.62], < 0.001).
Our data provide strong evidence for an increased incidence of dementia in a large cohort of patients with different cancer entities, which should raise awareness of this important comorbidity in cancer patients.
癌症是全球第二大死因，多种肿瘤实体的发病率正在上升。除了癌症特异性死亡率高之外，许多癌症患者还患有其他合并症。其中，过去对几种心理疾病进行了广泛研究，但关于癌症与痴呆症之间关联的研究结果仍存在矛盾。在本研究中，我们评估了癌症与痴呆症之间存在关联的可能性。
基于IQVIA疾病分析器数据库的数据，将2000年至2018年间最初诊断的92868名癌症门诊患者按年龄、性别、索引年份和年度就诊频率与92868名无癌症个体进行匹配。比较了两个队列的痴呆症十年发病率。
癌症患者的痴呆症总体累积发病率（19.7%）显著高于非癌症患者（16.7%，P<0.001）。Cox回归模型证实，这种关联在男性（HR：1.35[1.30-1.41]，P<0.001）和女性（HR：1.26[1.21-1.31]，P<0.001）患者中均显著，并且在所有分析的年龄组（65-70岁、71-75岁、76-80岁、81-85岁和>85岁）中一致。此外，癌症与痴呆症之间的关联在所有分析的癌症实体（皮肤、消化器官、前列腺、乳腺、泌尿系统、淋巴和造血组织以及肺癌）中均显著，在肺癌患者中最为明显（HR：1.44[1.28-1.62]，P<0.001）。
我们的数据为一大群患有不同癌症实体的患者中痴呆症发病率增加提供了有力证据，这应提高对癌症患者这一重要合并症的认识。
