铁超负荷相关疾病、血色病与监测、流行病学和最终结果（SEER）-医疗保险中的胰腺癌风险。
Hemochromatosis, Iron Overload-Related Diseases, and Pancreatic Cancer Risk in the Surveillance, Epidemiology, and End Results (SEER)-Medicare.
机构信息
Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland.
Information Management Services, Inc., Rockville, Maryland.
出版信息
Cancer Epidemiol Biomarkers Prev. 2021 Nov;30(11):2136-2139. doi: 10.1158/1055-9965.EPI-21-0476. Epub 2021 Sep 3.
BACKGROUND
Experimental studies suggest that iron overload might increase pancreatic cancer risk. We evaluated whether prediagnostic hemochromatosis and iron-overload diseases, including sideroblastic and congenital dyserythropoietic anemias, and non-alcoholic-related chronic liver disease (NACLD) were associated with pancreatic cancer risk in older adults.
METHODS
We conducted a population-based, case-control study within the U.S. Surveillance, Epidemiology, and End Results Program (SEER)-Medicare linked data. Incident primary pancreatic cancer cases were adults > 66 years. Controls were alive at the time cases were diagnosed and matched to cases (4:1 ratio) by age, sex, and calendar year. Hemochromatosis, iron-overload anemias, and NACLD were reported 12 or more months before pancreatic cancer diagnosis or control selection using Medicare claims data. Adjusted unconditional logistic regression models were used to calculate ORs and 95% confidence intervals (CI) between hemochromatosis, sideroblastic and congenital dyserythropoietic anemias, NACLD, and pancreatic cancer.
RESULTS
Between 1992 and 2015, 80,074 pancreatic cancer cases and 320,296 controls were identified. Overall, we did not observe statistically significant associations between hemochromatosis, sideroblastic anemia, or congenital dyserythropoietic anemia and pancreatic cancer; however, sideroblastic anemia was associated with later primary pancreatic cancer (OR, 1.30; 95% CI, 1.03-1.64). NACLD was associated with first (OR, 1.10; 95% CI, 1.01-1.19), later (OR, 1.17; 95% CI, 1.02-1.35), and all (OR, 1.12; 95% CI, 1.04-1.20) pancreatic cancer.
CONCLUSIONS
Overall hemochromatosis and iron-overload anemias were not associated with pancreatic cancer, whereas NACLD was associated with increased risk in this large study of older adults.
IMPACT
These results partly support the hypothesis that iron-overload diseases increase pancreatic cancer risk.
背景
实验研究表明，铁过载可能会增加胰腺癌的风险。我们评估了铁过载疾病（包括铁幼粒细胞性贫血和先天性难治性贫血）和非酒精性慢性肝病（NACLD）在老年人群中是否与胰腺癌风险相关。
方法
我们在美国监测、流行病学和最终结果计划（SEER）-医疗保险相关数据中进行了一项基于人群的病例对照研究。新发病例为年龄大于 66 岁的原发性胰腺癌患者。对照组为在病例诊断时存活并按年龄、性别和日历年份与病例（4:1 比例）匹配的人。使用医疗保险索赔数据，在胰腺癌诊断或对照选择前 12 个月或更长时间报告铁沉积症、铁过载性贫血和 NACLD。采用调整后的非条件逻辑回归模型计算铁沉积症、铁幼粒细胞性贫血和先天性难治性贫血、NACLD 与胰腺癌之间的比值比（OR）和 95%置信区间（CI）。
结果
1992 年至 2015 年间，共确定了 80074 例胰腺癌病例和 320296 例对照。总体而言，我们没有观察到铁沉积症、铁幼粒细胞性贫血或先天性难治性贫血与胰腺癌之间存在统计学显著关联；然而，铁幼粒细胞性贫血与晚期原发性胰腺癌有关（OR，1.30；95%CI，1.03-1.64）。NACLD 与首次（OR，1.10；95%CI，1.01-1.19）、晚期（OR，1.17；95%CI，1.02-1.35）和所有（OR，1.12；95%CI，1.04-1.20）胰腺癌有关。
结论
总体而言，铁沉积症和铁过载性贫血与胰腺癌无关，而 NACLD 与该老年人群的胰腺癌风险增加有关。
影响
这些结果部分支持铁过载疾病增加胰腺癌风险的假设。
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