Cancer incidence in Finnish hip replacement patients from 1980 to 1995 - A nationwide cohort study involving 31,651 patients
Cancer incidence in Finnish hip replacement patients from 1980 to 1995 - A nationwide cohort study involving 31,651 patients
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DOI：
10.1016/s0883-5403(99)90051-7
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发表时间：
1999-04-01
影响因子：
3.5
通讯作者：
Visuri, T
中科院分区：
文献类型：
--
作者：
Paavolainen, P;Pukkala, E;Visuri, T
在全国范围内，1980年1月开始对芬兰进行的所有关节置换手术进行基于计算机的报告。使用这些记录中的数据，使用芬兰癌症登记数据，从1980年到1995年，对31,651名接受聚乙烯-金属全髋关节置换术(THA)的患者进行了癌症随访。在随访期间，观察到2367例癌症。THA患者的癌症发生率在统计学上显著减少(标准化发病率比[SIR]为0.90；95%可信区间[CI]为0.87-0.93)。肺癌的SIR(0.69)和胃癌的SIR(0.77)明显低于1。在任何地点，风险都没有显著增加。总体上，男性THA患者的SIR COR癌症在THA后的前3年低于团结，但此后又恢复了团结。男性在前3年的低SIR主要是因为肺癌SIR为0.47(95%CI，0.35-0.62)。在女性中，SIR在整个随访过程中保持在0.93左右。胃癌的SIR仅在女性低于统一(SIR，0.67；95%CI，0.51-0.86)。对于膀胱癌，术后前3年的SIR低于单位，但后来略高于单位(SIR，1.24相对于大于或等于3年的随访；95%CI，0.99~1.52)。对于骨髓瘤和白血病，SIRS仅在THA患者随访3~9年时大于1。这项研究结果与之前报道的结果不同，并不表明使用聚乙烯对金属假体的TI-IA术后血液系统癌症的风险有任何增加。与软组织癌和骨肉瘤相关的SIRS与USEN没有显著差异。假体部位未见肉瘤。THA似乎在癌症的病因中没有起到主要作用。
Nationwide, computer-based reporting of all arthroplasties performed in Finland was started in January 1980. Using data from these records, a cohort of 31,651 polyethylene-on-metal total hip arthroplasty (THA) patients was followed up for cancer, using Finnish Cancer Registry data, from 1980 to 1995. During follow-up, 2,367 cancers were observed. There were statistically significantly fewer cancers among the THA patients (standardized incidence ratio [SIR], 0.90; 95% confidence interval [CI], 0.87-0.93). SIRs for cancers of the lung (0.69) and stomach (0.77) were significantly below unity. There was no significantly increased risk at any site. The SIR Cor cancer overall in male THA patients was below unity during the first 3 years after THA but returned to unity thereafter. The low SIR among men during the first 3 years was largely because the lung cancer SIR was 0.47 (95% CI, 0.35-0.62). In women, the SIR remained around 0.93 throughout follow-up. The SIR for stomach cancer was below unity only in women (SIR, 0.67; 95% CI, 0.51-0.86). For cancer of the urinary bladder, the SIR during the first 3 years after THA was below unity but later slightly above it (SIR, 1.24 in relation to greater than or equal to 3 years of follow-up; 95% CI, 0.99-1.52). For myeloma and leukemia, SIRs were greater than unity only for THA patients followed up for 3 to 9 years. The study findings, in contrast to previously reported findings, do not indicate that there is any increased risk of hematopoietic cancers after TI-IA using polyethylene-on-metal prostheses. SIRs relating to soft tissue cancers and bone sarcomas did not differ significantly from unity. No sarcoma was observed at the site of a prosthesis. THA seems to play no major role in cancer causation.