Loosen Sven H, Schöler David, Labuhn Simon, Mertens Alexander, Jördens Markus S, Luedde Mark, Kostev Karel, Luedde Tom, Roderburg Christoph
Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
KGP Bremerhaven, 27574 Bremerhaven, Germany.
Cancers (Basel). 2022 Aug 6;14(15):3825. doi: 10.3390/cancers14153825.
The prognosis of colorectal cancer (CRC) patients is determined to a decisive extent by comorbidities. On the other hand, anti-cancer treatments for CRC are associated with relevant toxicities and may therefore cause additional comorbidities. This retrospective cohort study assessed the prevalence of various diseases in patients 12 months before and 12 months after an initial diagnosis of colorectal cancer (ICD-10: C18, C20) in 1274 general practices in Germany between January 2000 and December 2018. The study is based on the Disease Analyzer database (IQVIA), which contains drug prescriptions, diagnoses, and basic medical and demographic data. Patients with and without CRC were matched by sex, age, and index year. We identified several diagnoses with a significantly higher prevalence among CRC patients 12 months prior to the index date compared to controls. These diagnoses included gastrointestinal hemorrhage, hemorrhoids, perianal venous thrombosis, and abdominal and pelvic pain, as well as functional intestinal disorders. In contrast, the prevalence of lipid metabolism disorder, depression, hypertension, coronary heart disease, or acute bronchitis was significantly lower in CRC cases. After diagnosis of CRC, we found a significantly higher prevalence of anemia, polyneuropathies, functional intestinal disorders, and chronic kidney disease among CRC patients compared to the control group, while the prevalence of acute upper respiratory infections of multiple and unspecified sites and acute bronchitis was significantly lower in CRC patients compared to non-CRC patients. In the present study, we identified a variety of diseases occurring at higher or lower frequencies in CRC patients compared to matched controls without CRC. This might help to select patients for early CRC screening and improve the clinical management of CRC patients.
结直肠癌（CRC）患者的预后在很大程度上取决于合并症。另一方面，CRC的抗癌治疗伴有相关毒性，因此可能导致额外的合并症。这项回顾性队列研究评估了2000年1月至2018年12月期间德国1274家普通诊所中，1274例初诊结直肠癌（国际疾病分类第十版：C18、C20）患者在确诊前12个月和确诊后12个月各种疾病的患病率。该研究基于疾病分析器数据库（IQVIA），其中包含药物处方、诊断以及基本医疗和人口统计学数据。患有和未患有CRC的患者按性别、年龄和索引年份进行匹配。我们发现，与对照组相比，在索引日期前12个月的CRC患者中，有几种诊断的患病率显著更高。这些诊断包括胃肠道出血、痔疮、肛周静脉血栓形成、腹部和盆腔疼痛以及功能性肠道疾病。相比之下，CRC患者中脂质代谢紊乱、抑郁症、高血压、冠心病或急性支气管炎的患病率显著较低。在CRC确诊后，我们发现与对照组相比，CRC患者中贫血、多发性神经病、功能性肠道疾病和慢性肾脏病的患病率显著更高，而CRC患者中多个未指定部位的急性上呼吸道感染和急性支气管炎的患病率显著低于非CRC患者。在本研究中，我们发现与匹配的未患CRC的对照组相比，CRC患者中各种疾病的发生频率更高或更低。这可能有助于选择早期CRC筛查的患者，并改善CRC患者的临床管理。
