Increased risk of cancer in patients with early-onset cataracts: A nationwide population-based study
Increased risk of cancer in patients with early-onset cataracts: A nationwide population-based study
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DOI：
10.1111/cas.12360
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发表时间：
2014-04-01
期刊：
影响因子：
5.7
通讯作者：
Tsai, Yi-Yu
中科院分区：
文献类型：
--
作者：
Chiang, Chun Chi;Lin, Cheng-Li;Tsai, Yi-Yu
早发性白内障与抗氧化活性不足有关，因此有患癌症的潜在风险。这项研究调查了被诊断患有早发性白内障后患癌症的风险。本研究以台湾全民健康保险研究资料库中的理赔资料为分析对象。研究对象包括早发性白内障患者，年龄20- 55岁（国际疾病分类，第9次修订，临床修改[ICD-9-CM]代码366.00，366.01，366.02，366.03，366.04，366.09，366.17和366.18）和1997年至2010年期间新诊断（n=1281），以及无疾病的对照队列（n=5124）。两个队列都被随访到2010年，以估计癌症的发病率。我们使用泊松回归模型比较发病率比值和95%置信区间（CI）。考克斯比例风险回归用于评估早发性白内障相关癌症的风险比（HR）。早发性白内障队列中所有癌症的总体发病率是对照队列的2.19倍（8.06 vs 3.68/1000人-年），校正的HR为2.13（95% CI=1.48，3.07）。研究中心特异性分析也显示了较强的相关性，头颈部癌的校正HR为3.24（95% CI=1.30，8.10），肝癌为3.29（95% CI 1.16，9.31），乳腺癌为3.19（95% CI 1.34，7.58）。目前的研究表明，早发性白内障患者在随后的几年中被诊断患有癌症的风险增加。
Early-onset cataracts are associated with insufficient antioxidative activity, and, therefore, a potential risk of cancer. This study investigated the risk of cancer after being diagnosed with early-onset cataracts. Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. Study subjects were comprised of patients with early-onset cataracts, aged 20-55years (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 366.00, 366.01, 366.02, 366.03, 366.04, 366.09, 366.17 and 366.18) and newly diagnosed between 1997 and 2010 (n=1281), and a comparison cohort without the disease (n=5124). Both cohorts were followed up until 2010 to estimate the incidences of cancer. We used the Poisson regression model to compare incidence rate ratios and the 95% confidence interval (CI). Cox proportional hazards regression was used to assess the hazard ratio (HR) of cancer associated with early-onset cataracts. The overall incidence rate of all cancers was 2.19-fold higher in the early-onset cataract cohort than in the comparison cohort (8.06 vs 3.68 per 1000person-years) with an adjusted HR of 2.13 (95% CI=1.48, 3.07). The site-specific analysis also showed a strong relationship, with adjusted HR of 3.24 ((95% CI=1.30, 8.10) for head and neck cancer, 3.29 (95% CI 1.16, 9.31) for hepatoma and 3.19 (95% CI 1.34, 7.58) for breast cancer. The present study suggests that patients with early-onset cataracts are at an increased risk of being diagnosed with cancer in subsequent years.