Risk of cancer following primary total hip replacement or primary resurfacing arthroplasty of the hip: a retrospective cohort study in Scotland.
Risk of cancer following primary total hip replacement or primary resurfacing arthroplasty of the hip: a retrospective cohort study in Scotland.
复制标题
DOI：
10.1038/bjc.2013.129
复制
发表时间：
2013-05-14
影响因子：
8.8
通讯作者：
Black, R. J.
中科院分区：
文献类型：
--
作者：
Brewster, D. H.;Stockton, D. L.;Reekie, A.;Ashcroft, G. P.;Howie, C. R.;Porter, D. E.;Black, R. J.
全髋关节置换术（THA）部件腐蚀和磨损引起的颗粒释放和分散引起了人们对可能增加癌症风险的担忧。最近金属对金属（MoM）髋关节假体的使用复兴加剧了人们的担忧。从出院、癌症登记和死亡记录的链接数据库中，我们选择了一组在苏格兰接受初次THA（1990-2009年）或初次表面置换关节成形术（主要是2000-2009年）的患者，随访至2010年底。可用的操作代码无法使我们区分MoM THA。通过年龄、性别、贫困和日历时期的标准化，计算了选定癌症的间接标准化发病率（SIRs）。该研究队列包括71990例患者，在随访期间诊断出547001人-年的风险（PYAR）和13946例癌症。对于合并的总观察期，所有癌症（SIR：1.05; 95% CI：置信区间1.04-1.07）、前列腺癌（SIR：1.07; 95% CI：1.01-1.14）和多发性骨髓瘤（SIR：1.22; 95% CI：1.06-1.41）的风险均增加。这些风险的适度增加是在有效的多重统计学显著性检验的背景下出现的，可能反映了对混杂因素的调整不足。在2000年至2009年期间接受初次表面置换关节成形术的1317例患者中（PYAR=5698），所有癌症（n=39）的SIR为1.23（95% CI：0.87-1.68）。在以前的研究背景下，这些结果并不意味着一个主要的关注原因。然而，接受最近推出的新一代MoM假体的患者的随访时间太短，无法完全排除癌症风险的真正增加。
Release and dispersion of particles arising from corrosion and wear of total hip arthroplasty (THA) components has raised concerns about a possible increased risk of cancer. Concerns have been heightened by a recent revival in the use of metal-on-metal (MoM) hip prostheses. From a linked database of hospital discharge, cancer registration, and mortality records, we selected a cohort of patients who underwent primary THA (1990–2009) or primary resurfacing arthroplasty (mainly 2000–2009) in Scotland, with follow-up to the end of 2010. Available operation codes did not enable us to distinguish MoM THAs. Indirectly standardised incidence ratios (SIRs) were calculated for selected cancers with standardisation for age, sex, deprivation, and calendar period. The study cohort included 71 990 patients yielding 547 001 person-years at risk (PYAR) and 13 946 cancers diagnosed during follow-up. For the total period of observation combined, the risks of all cancers (SIR: 1.05; 95% CI: confidence interval 1.04–1.07), prostate cancer (SIR: 1.07; 95% CI: 1.01–1.14), and multiple myeloma (SIR: 1.22; 95% CI: 1.06–1.41) were increased. These modest increases in risk emerged in the context of effectively multiple tests of statistical significance, and may reflect inadequate adjustment for confounding factors. For 1317 patients undergoing primary resurfacing arthroplasty between 2000 and 2009 (PYAR=5698), the SIR for all cancers (n=39) was 1.23 (95% CI: 0.87–1.68). In the context of previous research, these results do not suggest a major cause for concern. However, the duration of follow-up of patients receiving recently introduced, new-generation MoM prostheses is too short to rule out a genuinely increased risk of cancer entirely.
登录
查看更多内容
影响因子：
8.8
作者：
通讯作者：
--
DOI：
10.1111/j.1464-5491.2011.03432.x
发表时间：
2011-12
期刊：
Diabetic medicine : a journal of the British Diabetic Association
影响因子：
--
作者：
Anwar H;Fischbacher CM;Leese GP;Lindsay RS;McKnight JA;Wild SH;Scottish Diabetes Research Network Epidemiology Group
通讯作者：
Scottish Diabetes Research Network Epidemiology Group
DOI：
10.1302/0301-620x.70b4.3403594
发表时间：
1988-08-01
影响因子：
--
作者：
GILLESPIE, WJ;FRAMPTON, CMA;RYAN, PM
通讯作者：
RYAN, PM
影响因子：
254.7
作者：
Giovannucci, Edward;Harlan, David M.;Yee, Douglas
通讯作者：
Yee, Douglas
全髋关节置换术 - 100 多年的手术历史。
影响因子：
2.1
作者：
Knight, Stephen Richard;Aujla, Randeep;Biswas, Satya Prasad
通讯作者：
Biswas, Satya Prasad