van den Boom A L, Lavrijssen B D A, Fest J, Ikram M A, Stricker B H, van Eijck C H J, Ruiter R
Department of Surgery, Erasmus Medical Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands; Department of Surgery, University Medical Centre, Groningen, The Netherlands.
Department of Surgery, Erasmus Medical Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Cancer Epidemiol. 2022 Apr;77:102120. doi: 10.1016/j.canep.2022.102120. Epub 2022 Feb 26.
The appendix, an organ of immunological and microbiological importance, could be involved in the pathogenesis of cancers, but results are inconclusive. Our objective was to assess the association between appendectomy and the subsequent risk of cancer.
Data were obtained from the Rotterdam Study; a long-term prospective population-based study of individuals aged 55 years and older, of which the first cohort started in 1990 and included 7983 participants. Information on appendectomy was obtained through either medical interview at baseline or linkage with the national automated pathology center (PALGA). Cancer cases were pathology based. End of follow-up was January 1st, 2015. The association between appendectomy and risk of cancer was assessed using Cox proportional hazard models, adjusted for known confounders.
Of 7135 included participants, 1373 (19.2%) had undergone an appendectomy and 1632 individuals developed cancer. After adjustment for age, sex, socioeconomic status, BMI, smoking, prevalent diabetes mellitus and alcohol intake, a history of appendectomy was associated with a significantly lower risk of cancer [hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.75-0.98]. Subgroup analyses showed similar results for gastrointestinal cancer (HR 0.75, 95% CI 0.56-0.99), in particular colon cancer (HR 0.65, 95% 0.43-0.97), and cancer of the female reproductive organs (HR 0.35, 95% CI 0.15-0.80).
Participants who underwent an appendectomy had a reduced risk of cancer in general after adjustment for potential confounders. Therefore, these results contradict earlier studies suggestive of an increased risk. Further research is necessary to replicate these results and reveal its underlying mechanism.
阑尾是一个具有免疫和微生物学重要性的器官，可能参与癌症的发病机制，但结果尚无定论。我们的目的是评估阑尾切除术与随后患癌风险之间的关联。
数据来自鹿特丹研究；这是一项针对55岁及以上个体的长期前瞻性人群研究，第一个队列始于1990年，包括7983名参与者。关于阑尾切除术的信息通过基线时的医学访谈或与国家自动化病理中心（PALGA）的链接获得。癌症病例基于病理学诊断。随访截止于2015年1月1日。使用Cox比例风险模型评估阑尾切除术与患癌风险之间的关联，并对已知的混杂因素进行了调整。
在纳入的7135名参与者中，1373人（19.2%）接受了阑尾切除术，1632人患了癌症。在调整了年龄、性别、社会经济地位、体重指数、吸烟、糖尿病患病率和饮酒量后，阑尾切除术史与显著较低的患癌风险相关[风险比（HR）0.86，95%置信区间（CI）0.75 - 0.98]。亚组分析显示，胃肠道癌症（HR 0.75，95% CI 0.56 - 0.99），特别是结肠癌（HR 0.65，95% 0.43 - 0.97）以及女性生殖器官癌症（HR 0.35，95% CI 0.15 - 0.80）的结果相似。
在调整潜在混杂因素后，接受阑尾切除术的参与者总体患癌风险降低。因此，这些结果与早期提示风险增加 的研究相矛盾。有必要进行进一步研究以重复这些结果并揭示其潜在机制。
