慢性肾脏病患者与普通人群癌症发病情况的流行病学比较。

Epidemiology of Cancer Among Chronic Kidney Disease Patients Compared to The General Population.

机构信息

The Renal Medicine Department, the Royal Hospital, Muscat, Oman.

The Medicine Department, Oman Medical Specialty Board, Muscat, Oman.

出版信息

Gulf J Oncolog. 2022 May;1(39):7-15.

PMID:35695340

Abstract

BACKGROUND

Kidney disease has a major effect on global health, both as direct cause of morbidity and mortality and as an important factor for other comorbid diseases including malignancy. Different studies report a higher risk of cancer development in patients with chronic kidney disease (CKD), but the impact of less sever CKD on risk of cancer is uncertain. However, data concerning the cancer risk in Oman CKD including dialysis patients is scarce. More importantly, there is lack of information about the cancer-specific mortality in CKD and dialysis patients.

METHODS

During January 2006 to December 2019, all patients with CKD and those on regular dialysis who are admitted or follow up in Royal Hospital were included for evaluation of malignancy.

RESULTS

During the study, a total of 2500 patients with CKD were included, of which 25 patients were found to have different types of cancers, of which 13 were male (52%) and 12 were female (48%).Most of patients 13 (52%) were senior adult (>65 years), then 11 (44%) were adult (19:64- ys) and only one case (4%) was child (<18years.). Cancer was detected in the ovaries (16%), stomach, multiple myeloma and renal (12%) each, while breast and colorectal (1 male/1 female) (8%), parathyroid, thyroid, uterus, cervix, prostate, skin, liver, lymphoma, pituitary gland, and myelofibrosis were present in 4% each. In general population, the breast cancer is the most common cancer among females, followed by thyroid cancer, and colorectal cancer while the most common cancer types among males are colorectal cancer followed by the prostate and then the Non-Hodgkin lymphoma disease.

CONCLUSION

These epidemiologic findings should prompt clinicians and health authorities to assess strategies for cancer screening in high-risk population of CKD patients. Additional studies are needed to explain the reasons for this association and represent the potential use of cancer screening in patients with CKD in Oman.

KEY WORDS

cancer, chronic kidney disease, epidemiology, hemodialysis.

摘要

背景

肾脏疾病对全球健康有重大影响，既是发病率和死亡率的直接原因，也是包括恶性肿瘤在内的其他合并症的重要因素。不同的研究报告显示，慢性肾脏病（CKD）患者发生癌症的风险更高，但轻度 CKD 对癌症风险的影响尚不确定。然而，关于阿曼 CKD 患者（包括透析患者）的癌症风险数据却很少。更重要的是，缺乏关于 CKD 和透析患者癌症特异性死亡率的信息。

方法

2006 年 1 月至 2019 年 12 月，所有 CKD 患者和定期接受透析治疗并在皇家医院住院或随访的患者均被纳入评估恶性肿瘤。

结果

在研究期间，共纳入 2500 例 CKD 患者，其中发现 25 例患有不同类型的癌症，其中 13 例为男性（52%），12 例为女性（48%）。大多数患者（52%）为老年患者（>65 岁），其次为 11 例成年患者（19：64-74 岁），仅 1 例儿童（<18 岁）。卵巢（16%）、胃、多发性骨髓瘤和肾脏（12%）各发现 1 例癌症，乳腺癌和结直肠癌（1 例男性/1 例女性）（8%）各发现 1 例，甲状旁腺、甲状腺、子宫、宫颈、前列腺、皮肤、肝脏、淋巴瘤、垂体和骨髓纤维化各发现 4%。在一般人群中，乳腺癌是女性中最常见的癌症，其次是甲状腺癌和结直肠癌，而男性中最常见的癌症类型是结直肠癌，其次是前列腺癌，然后是非霍奇金淋巴瘤。