Wu Wan-Chen, Wu Jia-Ling, Huang Tien-Shang, Li Chung-Yi, Li Hung-Yuan
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100229, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, 717018, Taiwan.
J Clin Endocrinol Metab. 2025 Apr 22;110(5):1419-1426. doi: 10.1210/clinem/dgae405.
Patients with Cushing syndrome (CS) have higher risk of obesity and diabetes, which are important risk factors of cancers. However, if patients with CS have a higher incidence of cancer remains unknown.
To investigate whether endogenous CS is associated with increased cancer incidence.
A nationwide cohort study analyzing data retrieved from Taiwan's National Health Insurance program in 2006-2017. Between 2006 and 2017, 1278 patients with newly diagnosed endogenous CS were identified. Among them, 1246 patients without a history of malignancy were enrolled in this study. The age- and sex-standardized incidence rate of all-cause cancer and age-, sex-, and calendar year-standardized incidence ratio (SIR) of cancer in association with endogenous CS.
The age- and sex-standardized incidences of CS decreased from 4.84 to 3.77 per million person-years between 2006 and 2017. The age at diagnosis of CS was 45.3 ± 14.8 years, and 80.0% of the patients were female. Cushing disease and adrenal CS accounted for 35.4% and 64.6% of patients with CS, respectively. The incidence rate of cancer in patients with CS was 7.77 (95% CI 5.84-10.14) per 1000 person-years, with a SIR of 2.08 (95% CI 1.54-2.75). The 3 most common cancer types were liver (27.7%), kidney (16.7%), and lung (13.0%).
Patients with endogenous CS have a higher incidence of cancer.
库欣综合征（CS）患者肥胖和糖尿病风险较高，而肥胖和糖尿病是癌症的重要危险因素。然而，CS患者癌症发病率是否更高尚不清楚。
探讨内源性CS是否与癌症发病率增加有关。
一项全国性队列研究，分析2006 - 2017年从台湾国民健康保险计划中检索的数据。2006年至2017年期间，共识别出1278例新诊断的内源性CS患者。其中，1246例无恶性肿瘤病史的患者纳入本研究。计算全因癌症的年龄和性别标准化发病率以及与内源性CS相关的癌症的年龄、性别和日历年标准化发病率比（SIR）。
2006年至2017年期间，CS的年龄和性别标准化发病率从每百万人年4.84降至3.77。CS的诊断年龄为45.3±14.8岁，80.0%的患者为女性。库欣病和肾上腺性CS分别占CS患者的35.4%和64.6%。CS患者的癌症发病率为每1000人年7.77（95%CI 5.84 - 10.14），SIR为2.08（95%CI 1.54 - 2.75）。最常见的3种癌症类型为肝癌（27.7%）、肾癌（16.7%）和肺癌（13.0%）。
内源性CS患者癌症发病率较高。
