乳腺癌后慢性病发病的时间模式:一项全国性基于人群的队列研究。

Temporal patterns of chronic disease incidence after breast cancer: a nationwide population-based cohort study.

机构信息

Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.

Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.

出版信息

Sci Rep. 2022 Mar 31;12(1):5489. doi: 10.1038/s41598-022-09542-w.

Abstract

We conducted a retrospective cohort study to evaluate the temporal pattern of incidence of chronic conditions after developing breast cancer using a population-based national registry. We selected 84,969 women with newly diagnosed breast cancer between 2002 and 2016 and a 1:10 sample of age-matched non-breast cancer controls (N = 1,057,674). The main study exposure was incident breast cancer, considered as a time-varying exposure. The outcomes were incident cases of leukemia, endometrial cancer, myeloma, cardiomyopathy, osteoporosis, end stage renal disease (ESRD), pulmonary fibrosis, hypothyroidism, type 2 diabetes, hypertension and hyperlipidemia. The development of breast cancer was associated with a significantly increased risk of all outcomes analyzed except for ESRD and hypertension. The fully-adjusted risks of leukemia (HR 3.09; 95% CI 2.11-4.51), cardiomyopathy (HR 2.65; 95% CI 1.90-3.68), endometrial cancer (HR 3.53; 95% CI 2.76-4.53), hypothyroidism (HR 1.29; 95% CI 1.19-1.40), pulmonary fibrosis (HR 1.84; 95% CI 1.12-3.02), and hyperlipidemia (HR 1.24; 95% CI 1.20-1.28) remained significantly elevated after more than 5 years since diagnosis. Optimal care for breast cancer survivors requires close collaboration between oncologists and allied health care professionals to identify and manage the long-term morbidity and mortality associated with these chronic conditions.

摘要

我们进行了一项回顾性队列研究,使用基于人群的国家登记处评估乳腺癌发病后慢性疾病的发病时间模式。我们选择了 2002 年至 2016 年间新诊断为乳腺癌的 84969 名女性和年龄匹配的非乳腺癌对照组(N=1057674 名)的 1:10 样本。主要研究暴露为乳腺癌新发病例,视为随时间变化的暴露。结局为白血病、子宫内膜癌、骨髓瘤、心肌病、骨质疏松症、终末期肾病(ESRD)、肺纤维化、甲状腺功能减退症、2 型糖尿病、高血压和高血脂的发病情况。乳腺癌的发生与所有分析的结局均显著相关,除 ESRD 和高血压外。白血病(HR 3.09;95%CI 2.11-4.51)、心肌病(HR 2.65;95%CI 1.90-3.68)、子宫内膜癌(HR 3.53;95%CI 2.76-4.53)、甲状腺功能减退症(HR 1.29;95%CI 1.19-1.40)、肺纤维化(HR 1.84;95%CI 1.12-3.02)和高血脂症(HR 1.24;95%CI 1.20-1.28)的风险在诊断后 5 年以上仍显著升高。对乳腺癌幸存者的最佳护理需要肿瘤学家和联合保健专业人员之间的密切合作,以识别和管理与这些慢性疾病相关的长期发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1496/8971484/520439a52f2f/41598_2022_9542_Fig1_HTML.jpg

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