Westergaard T, Frisch M, Melbye M
Danish Epidemiology Science Centre, Statens Serum-Institut, Copenhagen, Denmark.
Cancer. 1995 Jul 1;76(1):106-9. doi: 10.1002/1097-0142(19950701)76:1<106::aid-cncr2820760116>3.0.co;2-w.
Previous studies have suggested an excess cancer risk in patients with carcinoid tumors. This association was reexamined using truly population-based data.
By means of data from the Danish Cancer Registry all carcinoid tumors diagnosed in Denmark between 1978 and 1989 were identified. All patients with primary carcinoid tumors were studied for the occurrence of subsequent cancers. The numbers of subsequent cancers observed in the follow-up period were compared with the expected numbers calculated from population rates.
A total of 1029 patients with carcinoid tumors were identified (464 men and 565 women). The annual age-adjusted incidence rates (world standardized) for carcinoid tumors during 1978-1989 were stable at about 1.1 per 100,000 person-years for both men and women. The patients were followed for the occurrence of subsequent cancers over a period comprising 2512 person-years. Thirty subsequent cancers were identified in 29 patients. The overall relative risk of subsequent cancers was 1.1 (95% CI, 0.8-1.6). Subsequent cancers of the thyroid were in excess (RR, 21.4; 95% CI, 2.4-77.1; n = 2), as were tumors of the brain and nervous system (RR, 5.4; 95% CI, 1.1-15.9; n = 3) and non-Hodgkin's lymphomas (RR, 5.8; 95% CI, 1.2-16.9; n = 3).
Overall, this population-based study does not support previous studies of an excess cancer risk in patients with carcinoid tumors. Increased risks of cancers of the thyroid, tumors of the brain and nervous system, and non-Hodgkin's lymphomas were observed, but these findings were based on few cases.
先前的研究表明类癌患者存在额外的癌症风险。本研究使用真实的基于人群的数据重新审视了这种关联。
通过丹麦癌症登记处的数据，确定了1978年至1989年间在丹麦诊断出的所有类癌肿瘤。对所有原发性类癌肿瘤患者进行后续癌症发生情况的研究。将随访期间观察到的后续癌症数量与根据人群发病率计算出的预期数量进行比较。
共确定了1029例类癌肿瘤患者（464例男性和565例女性）。1978 - 1989年间类癌肿瘤的年龄调整年发病率（世界标准化），男性和女性均稳定在每10万人年约1.1例。对患者进行了2512人年的随访以观察后续癌症的发生情况。在29例患者中发现了30例后续癌症。后续癌症的总体相对风险为1.1（95%可信区间，0.8 - 1.6）。甲状腺后续癌症数量过多（相对风险，21.4；95%可信区间，2.4 - 77.1；n = 2），脑和神经系统肿瘤（相对风险，5.4；95%可信区间，1.1 - 15.9；n = 3）以及非霍奇金淋巴瘤（相对风险，5.8；95%可信区间，1.2 - 16.9；n = 3）也是如此。
总体而言，这项基于人群的研究不支持先前关于类癌患者存在额外癌症风险的研究。观察到甲状腺癌、脑和神经系统肿瘤以及非霍奇金淋巴瘤的风险增加，但这些发现基于少数病例。
