Parkinson's disease and cancer risk: a systematic review and meta-analysis
Parkinson's disease and cancer risk: a systematic review and meta-analysis
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DOI：
10.1007/s10552-009-9497-6
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发表时间：
2010-05-01
影响因子：
2.3
通讯作者：
Schernhammer, Eva S.
中科院分区：
文献类型：
--
作者：
Bajaj, Archna;Driver, Jane A.;Schernhammer, Eva S.
旨在评估有关帕金森病 (PD) 患者癌症风险的现有文献，确定帕金森病 (PD) 患者的总体癌症风险比，探讨研究结果差异的原因，并评估发表偏倚的可能性。报告帕金森病 (PD) 患者癌症风险的研究是通过使用术语帕金森病、肿瘤和癌症搜索电子数据库来确定的，截至 2009 年 11 月 18 日。评审员单独进行数据提取，并使用质量评估工具对每项研究进行评分。在排除黑色素瘤和其他皮肤癌后，对所有 PD 患者的癌症风险进行了总体计算。我们测试了异质性和发表偏倚，并对性别、吸烟相关癌症与非吸烟相关癌症以及研究质量进行了分层。我们使用固定效应和随机效应模型汇总了效应大小。我们在总体分析中纳入了 29 项研究，涉及总共 107,598 名 PD 患者。与对照组相比，PD 患者的癌症总风险为 0.73（95% 置信区间 [CI]，0.63-0.83），排除皮肤肿瘤后为 0.69（95% CI，0.62-0.78）。这些风险因性别而异（男性，RR = 0.71，95% CI，0.57-0.88；女性，RR = 0.82；95% CI，0.68-0.98）。严格排除皮肤肿瘤后，PD患者中吸烟相关的（RR = 0.61；95% CI，0.58-0.65）和非吸烟相关的癌症发生率（RR = 0.76；95% CI，0.65-0.89）均显着降低。对PD患者癌症风险的研究总体显示，PD患者的癌症风险比显着降低。似乎有必要进行进一步的研究来解释其生物学机制，特别是与非吸烟相关癌症的关系。
To appraise the existing literature on cancer risk among patients with Parkinson's disease (PD), determine the overall cancer risk ratio among patients with PD, explore reasons for variations in study results, and assess the potential for publication bias.Studies reporting cancer risk in patients with PD were identified by searching electronic databases through 18 November 2009 using the terms PARKINSON DISEASE, NEOPLASM, and CANCER. Reviewers individually performed data extraction and scored each study using a quality assessment instrument. Cancer risk in all patients with PD was calculated overall, and after excluding melanoma and other skin cancers. We tested for heterogeneity and publication bias, and stratified for gender, smoking-related versus non-smoking-related cancers, and study quality. We pooled effect sizes using fixed-effects and random-effects models.We included 29 studies in the overall analysis for a total of 107,598 patients with PD. Compared to controls, the aggregate risk for cancer in patients with PD was 0.73 (95% confidence interval [CI], 0.63-0.83), and after excluding skin tumors, 0.69 (95% CI, 0.62-0.78). These risks varied by gender (males, RR = 0.71, 95% CI, 0.57-0.88; females, RR = 0.82; 95% CI, 0.68-0.98). After strictly excluding skin tumors, both smoking-related (RR = 0.61; 95% CI, 0.58-0.65) and non-smoking-related cancer rates (RR = 0.76; 95% CI, 0.65-0.89) were significantly lower among patients with PD .Studies on cancer risk among patients with PD collectively show significantly reduced cancer risk ratios. Further research to explain the biological mechanisms, particularly for the association with non-smoking-related cancers, appears warranted.