Associations between cancer and Alzheimer's disease in a U.S. Medicare population.
Associations between cancer and Alzheimer's disease in a U.S. Medicare population.
复制标题
DOI：
10.1002/cam4.850
复制
发表时间：
2016-10
期刊：
影响因子：
4
通讯作者：
Pfeiffer, Ruth M.
中科院分区：
文献类型：
--
作者：
Freedman, Daryl Michal;Wu, Jincao;Chen, Honglei;Kuncl, Ralph W.;Enewold, Lindsey R.;Engels, Eric A.;Freedman, Neal D.;Pfeiffer, Ruth M.
几项研究报告了癌症和阿尔茨海默病（AD）之间的双向反向关联。这项研究评估了医疗保险人群中的这些关系。使用与1992-2005年医疗保险数据相关的监测、流行病学和最终结果（SEER），我们在一项836，947例癌症病例和142，869例对照的病例对照研究中评估了AD后的癌症风险，以及742，809例癌症患者和420，518例非癌症患者的癌症后AD风险。我们应用非条件logistic回归估计比值比（OR），应用考克斯比例风险模型估计风险比（HR）。我们还评估了与汽车损伤相关的癌症作为阴性对照，以探索潜在的研究偏倚。在病例对照分析中，癌症病例比对照组更不可能有AD的既往诊断（OR = 0.86; 95%CI = 0.81-0.92）。癌症病例也比对照组更不可能有相同程度的汽车事故损伤（OR = 0.83; 95%CI = 0.78-0.88）。在前瞻性队列中，观察到癌症幸存者的风险较低，HR = 0.87（95% CI = 0.84-0.90）。相比之下，癌症诊断与随后的汽车事故伤害之间没有关联（HR = 1.03; 95%CI = 0.98-1.07）。在AD和汽车受伤后，癌症风险也同样降低，这表明对检测患有无关医疗条件的人的癌症存在偏见。癌症幸存者中AD风险的适度降低可能反映了患有严重疾病的AD诊断不足。这项研究并不支持癌症和AD之间的关系。
Several studies have reported bidirectional inverse associations between cancer and Alzheimer's disease (AD). This study evaluates these relationships in a Medicare population. Using Surveillance, Epidemiology, and End Results (SEER) linked to Medicare data, 1992–2005, we evaluated cancer risks following AD in a case–control study of 836,947 cancer cases and 142,869 controls as well as AD risk after cancer in 742,809 cancer patients and a non‐cancer group of 420,518. We applied unconditional logistic regression to estimate odds ratios (ORs) and Cox proportional hazards models to estimate hazards ratios (HRs). We also evaluated cancer in relation to automobile injuries as a negative control to explore potential study biases. In the case–control analysis, cancer cases were less likely to have a prior diagnosis of AD than controls (OR = 0.86; 95% CI = 0.81–0.92). Cancer cases were also less likely than controls to have prior injuries from automobile accidents to the same degree (OR = 0.83; 95% CI = 0.78–0.88). In the prospective cohort, there was a lower risk observed in cancer survivors, HR = 0.87 (95% CI = 0.84–0.90). In contrast, there was no association between cancer diagnosis and subsequent automobile accident injuries (HR = 1.03; 95% CI = 0.98–1.07). That cancer risks were similarly reduced after both AD and automobile injuries suggest biases against detecting cancer in persons with unrelated medical conditions. The modestly lower AD risk in cancer survivors may reflect underdiagnosis of AD in those with a serious illness. This study does not support a relationship between cancer and AD.
登录
查看更多内容
影响因子：
2.4
作者：
Attner, Bo;Lithman, Thor;Olsson, Hakan
通讯作者：
Olsson, Hakan
影响因子：
3.7
作者：
Chen ST;Siddarth P;Ercoli LM;Merrill DA;Torres-Gil F;Small GW
通讯作者：
Small GW
影响因子：
6.4
作者：
Freedman, D. Michal;Wu, Jincao;Pfeiffer, Ruth M.
通讯作者：
Pfeiffer, Ruth M.
影响因子：
--
作者：
Raji, Mukaila A.;Kuo, Yong-Fang;Goodwin, James S.
通讯作者：
Goodwin, James S.
高龄心血管疾病和癌症的发病率：前瞻性队列研究。
DOI：
10.1136/bmj.a2467
发表时间：
2008-12-09
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Driver JA;Djoussé L;Logroscino G;Gaziano JM;Kurth T
通讯作者：
Kurth T