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泌尿生殖系统癌症与家庭:泌尿生殖系统癌症诊断对一级亲属和配偶的心理和心血管的影响。

Genitourinary cancer and family: The reverberating psychological and cardiovascular effects of a genitourinary cancer diagnosis on first-degree relatives and spouses.

机构信息

Department of Urology, Mayo Clinic, Phoenix, Arizona, USA.

Division of Urology, University of Utah, Salt Lake City, Utah, USA.

出版信息

Cancer. 2024 Dec 1;130(23):4061-4070. doi: 10.1002/cncr.35486. Epub 2024 Sep 9.

Abstract

BACKGROUND

The psychological and cardiovascular health impacts on family members of patients who have been diagnosed with cancer have not been well characterized. The purpose of this study is to determine whether a family member's cancer diagnosis influences the risk of psychological illness and cardiovascular disease in first-degree relatives and spouses of patients affected by cancer.

METHODS

This retrospective cohort analysis evaluated the risk of psychological illness and cardiovascular disease in first-degree relatives and spouses of patients diagnosed with a genitourinary cancer between 1990 and 2015 compared to relatives of those not diagnosed with a genitourinary cancer. The Utah Population Database was used and familial linkage was determined. Follow-up included 1-, 3-, and 5-year intervals. Patients residing outside of Utah and first-degree relatives and spouses with psychological or cardiovascular disease diagnosed before a family member's cancer diagnosis were excluded.

RESULTS

A total of 49,284 patients with a genitourinary cancer were identified with 77,938 first-degree relatives and spouses. A matched control group included 246,775 patients with 81,022 first-degree relatives and spouses. Via Cox proportional hazards models, a 10% increased risk of developing a psychological illness (hazard ratio [HR], 1.10; 95% CI, 1.00-1.20) and a 28% increased risk of developing cardiovascular disease (HR, 1.28; 95% CI, 1.17-1.41) at 1 year after a family member's cancer diagnosis were found.

CONCLUSIONS

This study provides population-level evidence to support the hypothesis that cancer diagnoses will lead to adverse health outcomes for family members of patients with cancer. Increased clinical attention and support are needed to reduce the harm to families caused by cancer.

摘要

背景

患有癌症的患者的家庭成员的心理和心血管健康影响尚未得到充分描述。本研究的目的是确定家庭成员的癌症诊断是否会影响癌症患者的一级亲属和配偶患心理疾病和心血管疾病的风险。

方法

这项回顾性队列分析评估了 1990 年至 2015 年间被诊断患有泌尿生殖系统癌症的患者的一级亲属和配偶与未被诊断患有泌尿生殖系统癌症的患者的一级亲属和配偶相比,患心理疾病和心血管疾病的风险。使用了犹他州人群数据库,并确定了家族联系。随访包括 1 年、3 年和 5 年的间隔。排除居住在犹他州以外的患者以及在家庭成员癌症诊断之前被诊断出患有心理或心血管疾病的一级亲属和配偶。

结果

共确定了 49284 名患有泌尿生殖系统癌症的患者,其中有 77938 名一级亲属和配偶。一个匹配的对照组包括 246775 名患有 81022 名一级亲属和配偶的患者。通过 Cox 比例风险模型,发现家庭成员癌症诊断后 1 年内患心理疾病的风险增加 10%(风险比[HR],1.10;95%置信区间[CI],1.00-1.20),患心血管疾病的风险增加 28%(HR,1.28;95% CI,1.17-1.41)。

结论

本研究提供了人群水平的证据,支持癌症诊断会导致癌症患者的家庭成员出现不良健康结果的假设。需要增加临床关注和支持,以减少癌症对家庭造成的伤害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b245/11560680/5a973ad593a7/nihms-2014077-f0001.jpg

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