Krieg Sarah, Krieg Andreas, Loosen Sven H, Roderburg Christoph, Kostev Karel
Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, 33617 Bielefeld, Germany.
Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, 32049 Herford, Germany.
Cancers (Basel). 2024 Mar 9;16(6):1103. doi: 10.3390/cancers16061103.
Individuals with Down syndrome are thought to have a unique tumor profile.
Using the IQVIA Disease Analyzer database, patients aged ≥18 years diagnosed with Down syndrome in German general practices between 2005 and 2021 were compared with patients without Down syndrome for cancer incidence, adjusting for age, sex, average annual visit frequency, and comorbidity. The 5-year cumulative incidence of cancer overall and specific cancers was analyzed using Kaplan-Meier curves and compared using the log-rank test. In addition, univariable Cox regression analysis was performed.
A total of 2438 patients with Down syndrome and 12,190 patients without Down syndrome were included; 3.9% of patients without Down syndrome and 3.1% of patients with Down syndrome were diagnosed with cancer ( = 0.143). Regression analysis showed no significant association between Down syndrome and subsequent cancer in the total population (HR: 0.79; 95% CI: 0.57-1.09), in women (HR: 0.89; 95% CI: 0.56-1.37), or in men (HR: 0.69; 95% CI: 0.43-1.11). Analyses by cancer type and sex showed a strong but not significant negative association between Down syndrome and breast cancer in women (HR: 0.33; 95% CI: 0.12-0.93).
Our results could form the basis for future studies to clarify whether and to what extent an adapted screening program needs to be modified for individuals with Down syndrome due to the particular cancer distribution pattern.
唐氏综合征患者被认为具有独特的肿瘤谱。
利用IQVIA疾病分析器数据库，将2005年至2021年间在德国普通诊所诊断为唐氏综合征的≥18岁患者与无唐氏综合征的患者进行癌症发病率比较，并对年龄、性别、年均就诊频率和合并症进行校正。使用Kaplan-Meier曲线分析总体癌症和特定癌症的5年累积发病率，并使用对数秩检验进行比较。此外，还进行了单变量Cox回归分析。
共纳入2438例唐氏综合征患者和12190例无唐氏综合征患者；无唐氏综合征患者中有3.9%被诊断为癌症，唐氏综合征患者中有3.1%被诊断为癌症（P = 0.143）。回归分析显示，在总人群（风险比：0.79；95%置信区间：0.57 - 1.09）、女性（风险比：0.89；95%置信区间：0.56 - 1.37）或男性（风险比：0.69；95%置信区间：0.43 - 1.11）中，唐氏综合征与后续癌症之间无显著关联。按癌症类型和性别进行的分析显示，唐氏综合征与女性乳腺癌之间存在强烈但不显著的负相关（风险比：0.33；95%置信区间：0.12 - 0.93）。
我们的结果可为未来研究奠定基础，以阐明是否以及在何种程度上需要因唐氏综合征患者特殊的癌症分布模式而调整筛查计划。
