Oh Eun Hye, Kim Ye-Jee, Kim Minju, Park Seung Ha, Kim Tae Oh, Park Sang Hyoung
Department of Gastroenterology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul, Korea.
Intest Res. 2025 Apr;23(2):129-143. doi: 10.5217/ir.2023.00062. Epub 2023 Nov 9.
BACKGROUND/AIMS: We investigated the incidences of overall and site-specific malignancies and chemopreventive effects of statin, metformin, and aspirin in patients with ulcerative colitis.
We collected data using the Health Insurance Review and Assessment claims database from January 2007 to April 2020.
The overall malignancy risk among the 35,189 ulcerative colitis patients was similar to that of the general population (standardized incidence ratio, 0.94; 95% confidence interval, 0.88-1.00). In male patients, standardized incidence ratios were high for thyroid cancer and low for stomach cancer, colorectal cancer, liver cancer, and lung cancer. Concurrently, standard incidence ratios were high for liver cancer and central nervous system cancer in female patients. While 122 cases of colorectal cancer occurred in the study patients, the standardized incidence ratio was 0.83 (95% confidence interval, 0.69-0.99). Treatment for ulcerative colitis was not associated with an increased adjusted hazard ratio, while comorbidities increased it for all malignancies. Treatment for ulcerative colitis was associated with an increased adjusted hazard ratio, while comorbidities did not increase it for colorectal cancer. After adjusting for age, sex, comorbidities, and ulcerative colitis treatment, statins showed a dose-dependent chemopreventive effect for all malignancies (P=0.002), while metformin and aspirin did not show any.
In ulcerative colitis patients, standardized incidence ratios for all malignancies and colorectal cancer did not increase. Adjusted hazard ratios for all malignancies increased with comorbidities and those for colorectal cancer with ulcerative colitis treatment. Statins have a dose-dependent chemopreventive effect for all malignancies.
背景/目的：我们调查了溃疡性结肠炎患者中总体及特定部位恶性肿瘤的发病率，以及他汀类药物、二甲双胍和阿司匹林的化学预防作用。
我们使用健康保险审查与评估理赔数据库收集了2007年1月至2020年4月的数据。
35189例溃疡性结肠炎患者的总体恶性肿瘤风险与普通人群相似（标准化发病率比，0.94；95%置信区间，0.88 - 1.00）。在男性患者中，甲状腺癌的标准化发病率比高，而胃癌、结直肠癌、肝癌和肺癌的标准化发病率比低。同时，女性患者中肝癌和中枢神经系统癌的标准化发病率比高。虽然研究患者中发生了122例结直肠癌，但标准化发病率比为0.83（95%置信区间，0.69 - 0.99）。溃疡性结肠炎的治疗与调整后的风险比增加无关，而合并症会增加所有恶性肿瘤的风险比。溃疡性结肠炎的治疗与调整后的风险比增加有关，而合并症不会增加结直肠癌的风险比。在调整年龄、性别、合并症和溃疡性结肠炎治疗因素后，他汀类药物对所有恶性肿瘤显示出剂量依赖性的化学预防作用（P = 0.002），而二甲双胍和阿司匹林则未显示出任何作用。
在溃疡性结肠炎患者中，所有恶性肿瘤和结直肠癌的标准化发病率比没有增加。所有恶性肿瘤的调整后风险比随合并症增加，而结直肠癌的调整后风险比随溃疡性结肠炎治疗增加。他汀类药物对所有恶性肿瘤具有剂量依赖性的化学预防作用。
