The incidence of cancer in patients with idiopathic pulmonary fibrosis and sarcoidosis in the UK
The incidence of cancer in patients with idiopathic pulmonary fibrosis and sarcoidosis in the UK
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DOI：
10.1016/j.rmed.2007.07.012
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发表时间：
2007-12-01
影响因子：
4.3
通讯作者：
Hubbard, Richard
中科院分区：
文献类型：
--
作者：
Le Jeune, Ivan;Gribbin, Jonathan;Hubbard, Richard
背景：本研究的目的是使用纵向计算机化卫生保健数据集（健康改善网络）来提供有关特发性肺纤维化（IPF）和结节病患者的总体癌症发病率和器官特异性癌症发病率的信息，并与普通人群进行比较。方法：将IPF和结节病的病例与年龄、性别和一般情况相匹配的多达4例对照进行鉴定。采用Cox回归并校正年龄、性别和吸烟习惯，比较各组之间的癌症发病率。结果：共确诊IPF 1664例，平均诊断年龄71.5岁，男性62.4%。总体而言，与一般人群相比，IPF患者的癌症发病率增加（比率比1.51;95% Cl 1.20-1.90），但这主要是由于肺癌发病率显著增加（比率比4.96;95% Cl 3.00-8.18）。153例结节病（诊断时平均年龄47.0岁，男性47.2%）。结节病的总体癌症发病率增加（比率比1.65;95% Cl 1.22-2.24），这主要是由于皮肤癌发病率增加（比率比1.86;95% Cl 1.11-3.11）。结论：本研究提供了IPF患者肺癌发病率显著增加的进一步证据，但我们发现其他癌症的风险没有增加。患有结节病的人患皮肤癌的风险确实增加了，但其他部位的癌症却没有增加。(C) 2007 Elsevier Ltd.版权所有。
Background: The aim of this study was to use a longitudinal computerised health care dataset (The Health Improvement Network) to provide information on the overall incidence of cancer, and on the incidence of organ-specific cancers, in people with idiopathic pulmonary fibrosis (IPF) and sarcoidosis in comparison to the general population.Methods: Incident cases of IPF and sarcoidosis were identified with up to four controls matched by age, gender and general practice. Cancer incidence rates were compared between cohorts using Cox regression and adjusting for age, gender and smoking habit.Results: One thousand and sixty-four incident cases of IPF (mean age at diagnosis 71.5 years; 62.4% male) were identified. Overall, the incidence of cancer was increased in people with IPF compared to the general population (rate ratio 1.51; 95% Cl 1.20-1.90), but this was largely due to a marked increase in the incidence of lung cancer (rate ratio 4.96; 95% Cl 3.00-8.18). One thousand one hundred and fifty-three incident cases of sarcoidosis (mean age at diagnosis 47.0 years; 47.2% male) were identified. There was an overall increased incidence of cancer in sarcoidosis (rate ratio 1.65; 95% Cl 1.22-2.24) and this was largely explained by an increase in the incidence of skin cancers (rate ratio 1.86; 95% Cl 1.11-3.11).Conclusions: This study provides further evidence of a marked increase in the incidence of lung cancer in people with IPF, but we found no increase in the risk of other cancers. People with sarcoidosis did have an increase risk of skin cancers, but not cancers at other sites. (C) 2007 Elsevier Ltd. All rights reserved.