Risk of Cancer in Patients with Iron Deficiency Anemia: A Nationwide Population-Based Study
Risk of Cancer in Patients with Iron Deficiency Anemia: A Nationwide Population-Based Study
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DOI：
10.1371/journal.pone.0119647
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发表时间：
2015-03-17
期刊：
影响因子：
3.7
通讯作者：
Liu, Chia-Jen
中科院分区：
文献类型：
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作者：
Hung, Ning;Shen, Cheng-Che;Liu, Chia-Jen
本研究评估了缺铁性贫血（IDA）患者患癌症的风险，通过使用一个全国性的人口为基础的dataset.Methodpatients新诊断IDA和无癌前病变之间的2000年和2010年，从台湾全民健康保险研究数据库招募。IDA患者中癌症类型的标准化发病率比（SIR）进行了calculated.ResultsPatients IDA表现出整体癌症风险增加（SIR：2.15）。亚组分析显示，所有年龄组的男女患者SIR均增加。在我们排除IDA诊断的第一年和前5年内诊断为癌症的患者后，SIR分别显著升高至1.43和1.30。此外，胰腺癌（SIR：2.31），肾癌（SIR：2.23），肝癌（SIR：1.94），膀胱癌（SIR：1.74）的风险仍然显着增加后，排除诊断为癌症的患者在IDA diagnosis.ConclusionThe整体癌症风险显着升高IDA患者之间。在我们排除了1年和5年内诊断为IDA和癌症的患者后，与普通人群相比，SIR仍显着升高。在排除前5年内诊断为IDA和癌症的患者后，胰腺癌、肾癌、肝癌和膀胱癌的SIR显著增加，癌症风险增加并不局限于胃肠道癌。这一发现可能是由IDA改变的免疫活动引起的。需要进一步研究以确定IDA与癌症风险之间的关联。
ObjectiveThis study evaluated the risk of cancer among patients with iron deficiency anemia (IDA) by using a nationwide population-based data set.MethodPatients newly diagnosed with IDA and without antecedent cancer between 2000 and 2010 were recruited from the Taiwan National Health Insurance Research Database. The standardized incidence ratios (SIRs) of cancer types among patients with IDA were calculated.ResultsPatients with IDA exhibited an increased overall cancer risk (SIR: 2.15). Subgroup analysis showed that patients of both sexes and in all age groups had an increased SIR. After we excluded patients diagnosed with cancer within the first and first 5 years of IDA diagnosis, the SIRs remained significantly elevated at 1.43 and 1.30, respectively. In addition, the risks of pancreatic (SIR: 2.31), kidney (SIR: 2.23), liver (SIR: 1.94), and bladder cancers (SIR: 1.74) remained significantly increased after exclusion of patients diagnosed with cancer within 5 years after IDA diagnosis.ConclusionThe overall cancer risk was significantly elevated among patients with IDA. After we excluded patients diagnosed with IDA and cancer within 1 and 5 years, the SIRs remained significantly elevated compared with those of the general population. The increased risk of cancer was not confined to gastrointestinal cancer when the SIRs of pancreatic, kidney, liver, and bladder cancers significantly increased after exclusion of patients diagnosed with IDA and cancer within the first 5 years. This finding may be caused by immune activities altered by IDA. Further study is necessary to determine the association between IDA and cancer risk.