时间依赖性倾向匹配的一般人群研究他汀类药物使用对间质性肺病和肺纤维化队列中癌症风险的影响。
Time-dependent propensity-matched general population study of the effects of statin use on cancer risk in an interstitial lung disease and pulmonary fibrosis cohort.
机构信息
Department of Family Medicine and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.
China Medical University, Taichung, Taiwan.
出版信息
BMJ Open. 2021 Oct 11;11(10):e047039. doi: 10.1136/bmjopen-2020-047039.
OBJECTIVE
To determine the effect of statins on risk of cancer in patients with interstitial lung disease (ILD) and pulmonary fibrosis.
SETTING
We retrospectively enrolled patients with ILD and pulmonary fibrosis and divided them into two cohorts by statin use (statin users (n=10 036) and statin non-users (n=10 036)).
PARTICIPANTS
We selected patients with ILD and pulmonary fibrosis (N=53 862) from Taiwan's National Health Insurance Research Database. Time-dependent Cox models were used to compare risk of cancer of propensity-matched statin users and non-users. Cumulative cancer incidence was analysed through Cox proportional regression. We calculated adjusted HRs (aHRs) and their 95% CIs for cancer after adjusting for sex, age, comorbidities, and use of inhaled corticosteroids, oral steroids and statins.
RESULTS
Compared with statin non-users, the aHRs (95% CIs) for statin users were 0.60 (0.55 to 0.65) for cancer, 0.52 (0.35 to 0.78) for haematological malignancy, 0.52 (0.38 to 0.72) for cancer of the head and neck, 0.73 (0.59 to 0.89) for colorectal cancer, 0.34 (0.26 to 0.43) for liver cancer, 0.39 (0.23 to 0.67) for pancreatic cancer, 0.40 (0.17 to 0.96) for skin cancer, 0.67 (0.52 to 0.87) for breast cancer, 0.27 (0.14 to 0.54) for cervical cancer, 0.37 (0.30 to 0.46) for other immunological cancers, 0.73 (0.54 to 0.98) for bladder/kidney cancer and 0.88 (0.71 to 1.09) for lung cancer.
CONCLUSION
Statin use is associated with lower risk of cancer in the ILD and pulmonary fibrosis cohort.
目的
确定他汀类药物对间质性肺疾病（ILD）和肺纤维化患者癌症风险的影响。
设置
我们回顾性纳入了ILD 和肺纤维化患者，并通过他汀类药物使用情况将他们分为两组（他汀类药物使用者（n=10036）和他汀类药物非使用者（n=10036））。
参与者
我们从台湾全民健康保险研究数据库中选择了ILD 和肺纤维化患者（N=53862）。采用时依 Cox 模型比较倾向评分匹配的他汀类药物使用者和非使用者的癌症风险。通过 Cox 比例风险回归分析累积癌症发生率。我们计算了调整后的 HR（aHR）及其 95%CI，用于调整性别、年龄、合并症以及吸入性皮质类固醇、口服皮质类固醇和他汀类药物使用后癌症的发生。
结果
与他汀类药物非使用者相比，他汀类药物使用者的癌症 aHR（95%CI）为 0.60（0.55 至 0.65），血液恶性肿瘤为 0.52（0.35 至 0.78），头颈部癌症为 0.52（0.38 至 0.72），结直肠癌为 0.73（0.59 至 0.89），肝癌为 0.34（0.26 至 0.43），胰腺癌为 0.39（0.23 至 0.67），皮肤癌为 0.40（0.17 至 0.96），乳腺癌为 0.67（0.52 至 0.87），宫颈癌为 0.27（0.14 至 0.54），其他免疫性癌症为 0.37（0.30 至 0.46），膀胱癌/肾癌为 0.73（0.54 至 0.98），肺癌为 0.88（0.71 至 1.09）。
结论
在ILD 和肺纤维化队列中，他汀类药物的使用与癌症风险降低相关。
Zotero 插件