Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
Department of Information and Statistics, RINS, Gyeongsang National University, Jinju, Korea.
Yonsei Med J. 2022 Nov;63(11):1043-1049. doi: 10.3349/ymj.2022.0273.
Chronic diseases and cardiovascular diseases (CVD) have been independently linked to poorer cancer outcomes. This study investigated whether gastric cancer patients with hypertension, diabetes, or dyslipidemia have higher mortality if diagnosed with CVD in the past year before cancer diagnosis.
Data were obtained from the National Health Insurance database for 2002 to 2019. The study population consisted of gastric cancer patients with hypertension, diabetes, or dyslipidemia. The outcome measure was 5-year mortality in relation to incident status of CVD within 1 year before cancer diagnosis. A survival analysis was conducted using the Cox proportional hazards model. Subgroup analysis was conducted according to age, economic status, and type of hospital first visited for cancer treatment.
Of a total of 6458 individuals, 2123 (32.7%) were diagnosed with CVDs in the past year before cancer diagnosis. Compared to participants without a history of CVD, those who were diagnosed with CVD showed a higher risk of 5-year mortality (hazard ratio 1.259, 95% confidence interval 1.138-1.394). The extent to which the mortality risk differed between those with and without CVD was greater for individuals of low economic status and in those receiving their initial cancer treatment in a general hospital.
Patients with gastric cancer and hypertension, diabetes, or dyslipidemia diagnosed with CVD within 1 year before their cancer diagnosis had a higher mortality risk, emphasizing the importance of managing cancer patients with chronic disease and subsequent incidence of CVDs.
慢性疾病和心血管疾病(CVD)已被独立地与较差的癌症结果相关联。本研究调查了在癌症诊断前一年过去是否患有高血压、糖尿病或血脂异常的胃癌患者,如果在过去一年内被诊断出患有 CVD,其死亡率是否更高。
数据来自 2002 年至 2019 年的国家健康保险数据库。研究人群由患有高血压、糖尿病或血脂异常的胃癌患者组成。结局指标是与癌症诊断前 1 年内发生 CVD 的情况相关的 5 年死亡率。使用 Cox 比例风险模型进行生存分析。根据年龄、经济状况和首次治疗癌症的医院类型进行亚组分析。
在总共 6458 人中,有 2123 人(32.7%)在癌症诊断前一年被诊断出患有 CVD。与没有 CVD 病史的参与者相比,被诊断出患有 CVD 的参与者 5 年死亡率的风险更高(风险比 1.259,95%置信区间 1.138-1.394)。对于经济状况较低的个体和在综合医院接受初始癌症治疗的个体,CVD 患者和无 CVD 患者之间的死亡率差异更大。
在癌症诊断前 1 年内被诊断出患有 CVD 的患有高血压、糖尿病或血脂异常的胃癌患者的死亡率风险更高,这强调了管理患有慢性疾病和随后发生 CVD 的癌症患者的重要性。