Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, 12th WulumuqiZhong Road, Shanghai, 200040, China.
Alzheimers Res Ther. 2022 Oct 5;14(1):146. doi: 10.1186/s13195-022-01090-9.
Previous studies found that cancer survivors had a reduced risk of dementia compared with the general population. However, these findings were uncertain because of survivor bias and a lack of stratification by cancer types. This current cohort study used data from the UK Biobank to explore these associations.
Multivariable Cox regression analyses were used to examine the association of cancer status and the risk of dementia with its subtypes after adjusting for age and sex. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated as a measure of relative risk by comparing observed dementia incidence among cancer patients.
We included 263,151 participants in the observational analysis. During a median follow-up of 9.18 years, dementia was diagnosed in 472 individuals with cancer and 3685 individuals without cancer, respectively. Cancer patients had lower risks of dementia (hazard ratio: 0.89, confidence interval: 0.81-0.98) and its subtypes (Alzheimer's disease [AD]: 0.85 [0.74-0.98]; vascular dementia [VD]: 0.81 [0.66-0.99]) in the Cox regression adjusted for age and sex. Individuals with cancers in the male genital system had substantially reduced risks of dementia (0.66 [0.46-0.93]) and AD (0.53 [0.29-0.97]) than those with cancers in other systems. Moreover, non-melanoma skin cancer and prostate cancer were associated with a reduced risk of dementia (0.79 [0.62-0.99]; 0.69 [0.49-0.97]), but not with AD or VD (P>0.05).
The current study supported a negative association between cancer and dementia risk, and encourages further exploration of the mechanistic basis of this inverse relationship to improve understanding.
先前的研究发现，癌症幸存者患痴呆症的风险低于一般人群。然而，由于幸存者偏差和缺乏按癌症类型分层，这些发现并不确定。本队列研究使用英国生物库的数据来探讨这些关联。
使用多变量 Cox 回归分析，在调整年龄和性别后，研究癌症状态与痴呆症及其亚型风险之间的关联。通过比较癌症患者和无癌症患者的观察性痴呆症发病率，计算风险比（HR）及其 95%置信区间（CI）作为相对风险的衡量标准。
我们纳入了 263151 名参与者进行观察性分析。在中位随访 9.18 年期间，分别有 472 名癌症患者和 3685 名无癌症患者被诊断为痴呆症。在 Cox 回归模型中调整年龄和性别后，癌症患者的痴呆症（HR：0.89，95%CI：0.81-0.98）和其亚型（阿尔茨海默病[AD]：0.85[0.74-0.98]；血管性痴呆[VD]：0.81[0.66-0.99]）风险较低。与其他系统癌症相比，男性生殖系统癌症患者痴呆症（0.66[0.46-0.93]）和 AD（0.53[0.29-0.97]）的风险显著降低。此外，非黑色素瘤皮肤癌和前列腺癌与痴呆症（0.79[0.62-0.99]；0.69[0.49-0.97]）风险降低相关，但与 AD 或 VD 无关（P>0.05）。
本研究支持癌症与痴呆症风险之间存在负相关关系，并鼓励进一步探索这种反向关系的机制基础，以提高认识。
