scholarly journals The Cancer Risk among Physicians in Taiwan, a PopulationBased Propensity Score Matched Cohort Study

Author(s):  
Hsin-Yi YANG ◽  
Cheng-Ren CHEN ◽  
Shih-Yu LEE ◽  
Wen-Chen TSA ◽  
Yueh-Han HSU

Background: The field of physician health is gaining increasing attention; however, most research and interventions have concentrated on factors such as job stress, mental health, and substance abuse. The risks of major cancers in physicians remain unclear. We used a propensity score-matched analysis to investigate the risk of cancer in physicians relative to the general population who had no healthcare-related professional background. Methods: Data were obtained from the National Health Insurance system in Taiwan. The physician cohort contained 29,713 physicians, and each physician was propensity score-matched with a person from the general population. Results: The physicians demonstrated a 0.90-fold lower risk of all-cancers (95% confidence interval [CI] = 0.83 – 0.96) when compared with the general population. Female physicians had a higher risk of cancer than male physicians (adjusted hazard ratio [HR] = 1.59; 95% CI = 1.28 – 1.96). Physicians had higher risks of prostate (HR = 1.26; 95% CI = 1.00 – 1.59) and thyroid cancers (HR = 3.16; 95% CI = 1.69 – 5.90) when compared with the general population. Conclusion: Physicians have lower rates of overall cancer risk than the general population. Female physicians have higher cancer risks than male physicians. Male physicians have higher risks of thyroid and prostate cancer relative to the general population.

2007 ◽  
Vol 5 (4) ◽  
pp. 511-522 ◽  
Author(s):  
Lucy Semerjian ◽  
John Dennis

The toxicological risks and lifetime cancer risks of trihalomethanes through oral ingestion, dermal absorption, and inhalation exposure from tap water in selected regions in Lebanon are estimated. Existing trihalomethane concentrations do not pose any non-carcinogenic and developmental risks in the exposed population via oral ingestion. Among the three pathways, residents have a higher risk of cancer through oral ingestion than through the other two pathways. The lifetime cancer risk through oral ingestion for dibromochloromethane makes the highest contribution to total risks, followed by bromodichloromethane, bromoform, and chloroform. The total multipathway cancer risk analysis suggests that no cancer risks exist during the summer and winter seasons; however, in the spring the total cancer risks exceeds the USEPA acceptable level of 10−6 by a factor of 10.7.


2014 ◽  
Vol 205 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Yen-Ni Hung ◽  
Shu-Yu Yang ◽  
Ming-Chyi Huang ◽  
For-Wey Lung ◽  
Shih-Ku Lin ◽  
...  

BackgroundCancer is a serious public health problem worldwide, and its relationship with affective disorders is not clear.AimsTo investigate alcohol- and tobacco-related cancer risk among patients with affective disorders in a large Taiwanese cohort.MethodRecords of newly admitted patients with affective disorders from January 1997 through December 2002 were retrieved from the Psychiatric Inpatient Medical Claims database in Taiwan. Cancers were stratified by site and grouped into tobacco- or alcohol-related cancers. Standardised incidence ratios (SIRs) were calculated to compare the risk of cancer between those with affective disorders and the general population.ResultsSome 10 207 patients with bipolar disorder and 9826 with major depression were included. The risk of cancer was higher in patients with major depression (SIR = 2.01, 95% CI 1.85–2.19) than in those with bipolar disorder (SIR 1.39, 95% CI 1.26–1.53). The elevated cancer risk among individuals ever admitted to hospital for affective disorders was more pronounced in tobacco- and/or alcohol-related cancers.ConclusionsElevated cancer risk was found in patients who had received in-patient care for affective disorders. They require holistic approaches to lifestyle behaviours and associated cancer risks.


Hypertension ◽  
2020 ◽  
Vol 75 (4) ◽  
pp. 982-990 ◽  
Author(s):  
Jung Eun Yoo ◽  
Dong Wook Shin ◽  
Kyungdo Han ◽  
Dahye Kim ◽  
Seung-Pyo Lee ◽  
...  

To investigate the association between visit-to-visit variability in blood pressure and the incidence of dementia and its subtypes in a general population, we conducted a population-based retrospective cohort study using the Korean National Health Insurance System database. We identified 7 844 814 subjects without a history of any dementia who underwent ≥3 health examinations from 2005 to 2012 in the Korean National Health Insurance System cohort. Blood pressure variability (BPV) was measured using the variability independent of the mean, coefficient of variation, and SD. During the median follow-up of 6.2 years, there were 200 574 cases of all-cause dementia (2.8%), 165 112 cases of Alzheimer’s disease (2.1%), and 27 443 cases of vascular dementia (0.3%). There was a linear association between higher BPV and outcome measures. In the multivariable adjusted model, the hazard ratios and 95% CIs of all-cause dementia were 1.06 (1.04–1.07) for the highest quartile of variability independent of the mean of diastolic blood pressure only, 1.09 (1.08–1.11) for that of systolic blood pressure only, and 1.18 (1.16–1.19) for that of both systolic and diastolic blood pressure compared with subjects having no highest quartile for BPV. Consistent results were noted for Alzheimer’s disease and vascular dementia using other indices of variability and in various sensitivity and subgroup analyses. BPV is an independent predictor for developing dementia and its subtypes. A dose-response relationship was noted between higher BPV and dementia incidence. Reducing BPV may be a target for preventing dementia in the general population.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13132-e13132
Author(s):  
István Miklós ◽  
Eniko Rita Toke ◽  
Mónika Megyesi ◽  
Levente Molnar ◽  
József Tóth ◽  
...  

e13132 Background: Association between certain HLA types and cancer is well known. We hypothesized that the number of epitopes of tumor antigens presented by autologous HLAs characterizes a patient’s capacity to kill tumor cells. These CD8+ T cell epitopes are presented by 6 out of >13,000 known HLA class I alleles and induce extremely variable tumor-specific T-cell responses. Methods: We predicted HLA-binding epitopes from 48 frequently expressed tumor antigens in subjects characterized with 6 HLA class I alleles. To develop the “HLA Score” cancer risk predictor we used epitopes binding to multiple HLAs of a subject. The predictor was trained on 5,789 non-American subjects. To identify populations with high and low immunogenetic risk to develop cancer we compared the HLA Score of American cancer subjects to a general population of American subjects (1,400 subjects). The performance of the predictor was characterized with AUC and Risk Ratio. Due to Bonferroni correction, AUC values with p-value p<0.007 was accepted as significant. Results: “HLA Score” predictor significantly separated cancer patients from the general population in six out of the seven investigated cancer types. The Risk Ratios between the most protected and most at risk subpopulations ranged between 2.38 and 5.67 (Table). Cancer risk prediction with HLA Score. Conclusions: Subjects with certain HLA class I alleles have high risk of developing cancer. The novel “HLA Score” predictor we introduced here could complement current testing used for determination of the genetic risk of cancer.[Table: see text]


2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to a future increased cancer risk. Several different materials and metals are used in joint prosthesis, as well as different fixation techniques and types of articulation for the surface of the joint can lead to an increased escape of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular component). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender, and if the patient had additional THR-surgery in the same or the opposite hip. The study is according to the STROBE guidelines.Results When comparing patients with THR to the general population in Norway we found no differences in the risk. The overall SIR for the THR-patients after 10 years of follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years of follow-up was 0.99 (95% CI: 0.94-1.05), while it was 1.16 (95% CI: 1.02-1.30) for uncemented THRs, and 1.12 (95% CI: 0.91-1.33) for hybrid THRs. Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk of cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years of follow-up. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs. Conclusions We found that receiving an uncemented THR was associated with a small increased risk of cancer, in particular prostate cancer for younger men.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Spaan ◽  
M Goddijn ◽  
T Roseboom ◽  
C Lambalk ◽  
F Van Leeuwen

Abstract Study question Are children conceived by assisted reproductive technology (ART) at increased cancer risk, compared with the general population and with non-ART conceived offspring from subfertile women? Summary answer Overall cancer risk was not increased in ART-conceived offspring compared with non-ART conceived offspring from subfertile women (median follow-up, 17 years). What is known already There is growing evidence that ART procedures could perturb epigenetic processes during the pre-implantation period. Although the results of most studies are reassuring for children born after in vitro fertilization (IVF), recent studies showed (non-)significantly increased cancer risks after intracytoplasmic sperm injection (ICSI) and frozen embryo transfer (FET). Since the proportion of children born after these techniques increased dramatically over the past decades, it is important from a public health perspective to investigate cancer risk after ICSI and FET in larger studies. Study design, size, duration Data were used from the OMEGA-cohort, a historical nationwide cohort with prospective follow-up in the Netherlands. Offspring of women who were treated in one of the 13 IVF clinics or 2 regional fertility centers between 1983-2012 were included. Of 98,165 live-born children, 53,154 were ART-conceived and 45,211 were non-ART conceived (conceived naturally with or without ovarian hyperstimulation) by subfertile women. Participants/materials, setting, methods Data on type of fertility treatment and maternal risk factors were available from medical records from the mothers and the Dutch Perinatal registry. Cancer incidence was ascertained through linkage with the Netherlands Cancer Registry. Cancer risk in ART-conceived children was compared with risk in children not conceived by ART from subfertile women (hazard ratios [HRs]) and with children from the general population (standardized incidence ratios [SIRs]). Main results and the role of chance The median age at end of follow-up was 17 years and was shorter in ART-conceived children (16.1 years) compared with non-ART children (19.1 years). In total, 382 cancers were observed, 166 in the ART group and 222 in the non-ART group. In preliminary analyses, overall cancer risk was not increased in ART-conceived children, neither compared with children not conceived by ART from subfertile women (HR:0.98, 95% confidence interval (CI) = 0.79-1.22) nor compared with the general population (SIR:0.98, 95% CI = 0.81-1.11). Risks were also not significantly increased in children conceived by ICSI or FET (HR:1.20, 95%CI = 0.85-1.70; 1.25, 95%CI = 0.68-2.43, respectively). From 18 years of age onwards, the HR of cancer in ART-conceived versus non-ART individuals was 1.22 (95%CI = 0.86-1.74). There were no significantly increased site-specific cancer risks in ART-conceived children compared with non-ART children and the general population. Risk of lymphoblastic leukaemia was not increased in the ART group compared with the non-ART group (HR: 1.03, 95% CI = 0.58-1.82). Limitations, reasons for caution Despite the large cohort and long-term follow-up the number of cancer cases was limited which hampered some subgroup analyses, especially for analyses according to specific cancer types and children born after FET. Wider implications of the findings The results from this study importantly contribute to the current knowledge about health risks in ART-offspring. Physicians may inform parents who consider ART about potential health risks for ART-conceived children. Furthermore, pediatric oncologists caring for ART-conceived children/adolescents with cancer need evidence-based information about the association between ART and cancer risk. Trial registration number n.a.


Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 521 ◽  
Author(s):  
Andrew E. Grulich ◽  
Fengyi Jin ◽  
I. Mary Poynten ◽  
Claire M. Vajdic

As people with HIV age, they will experience increasing rates of all diseases of aging, including cancer. However, the pattern of higher cancer risk in people with HIV is mostly explained by the chronic effects of certain oncogenic infections, and is not consistent with a syndrome of accelerated aging. Many of those cancers that are most closely associated with aging do not occur at increased rates in people with HIV compared with the general population. The risk of many infection-associated cancers in people with HIV is closely related to the degree of immune deficiency, and for some types of cancer, it is also associated with ongoing HIV replication. Thus, if HIV therapy can provide durable HIV suppression and maintain near normal levels of immune function, the excess risk of cancer is likely to be minimised. While avoidance of profound immunity will greatly reduce cancer risk, it is unclear how close to normal immune function must be to minimise HIV-associated cancer risk. People with HIV are also at a high risk of cancer because they have high rates of lifestyle risks for cancer, in particular tobacco and alcohol exposure. For most cancers, it is appropriate to follow general population guidelines on cancer screening. The exception is cervical cancer, for which annual screening is recommended. In addition, active research is required to establish whether anal cancer screening would prevent the unacceptably high levels of morbidity caused by this disease in people with HIV, most particularly in gay men.


2018 ◽  
Vol 29 (2) ◽  
pp. 290-298
Author(s):  
Jennifer Rhoades ◽  
Monica Hagan Vetter ◽  
James L Fisher ◽  
David E Cohn ◽  
Ritu Salani ◽  
...  

ObjectiveTo evaluate the risk of a second primary cancer after endometrial cancer according to histological subtype.MethodsUsing data from the 13 National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registries we identified women diagnosed with a primary endometrial cancer between 1992 and 2014. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for second primary cancer risk (all anatomical sites combined and for individual anatomical sites) among patients with endometrial cancer compared with the general population, in the overall study population and according to histological subtype.ResultsAmong 96 256 women diagnosed with endometrial cancer, 8.4% (n=8083) developed a second primary cancer. The risk of second primary cancer was higher among patients with endometrial cancer than in the general population (SIR=1.05, 95% CI 1.03 to 1.07). We observed significantly higher second primary cancer risk among women with high grade endometrioid (SIR=1.12, 95% CI 1.05 to 1.19), serous (SIR=1.24, 95% CI 1.11 to 1.38), carcinosarcoma (SIR=1.18, 95% CI 1.02 to 1.35), mixed epithelial (SIR=1.22, 95% CI 1.06 to 1.40), and sarcoma (SIR=1.28, 95% CI 1.12 to 1.45) compared with the general population, but not for women with low grade endometrioid (SIR=1.01, 95% CI 0.98 to 1.03) or clear cell (SIR=1.09, 95% CI 0.88 to 1.33) endometrial cancer. Women with low grade endometrioid endometrial cancer had significantly lower second primary cancer risks in the gum and other mouth (SIR=0.57, 95% CI 0.30 to 0.97), lung and bronchus (SIR=0.72, 95% CI 0.66 to 0.77), and lymphocytic leukemia (SIR=0.71, 95% CI 0.54 to 0.93) while women with high risk endometrial cancer histological subtypes experienced significantly higher second primary cancer risk at several anatomical sites.ConclusionsRisk of developing second primary cancersat all anatomic sites combined and at individual anatomical sites varied according to histological subtype. Clinicians should be aware that women with different histological subtypes carry different second primary cancer risks .


2019 ◽  
Vol 56 (12) ◽  
pp. 838-843 ◽  
Author(s):  
Rosa M Xicola ◽  
Shuwei Li ◽  
Nicolette Rodriguez ◽  
Patrick Reinecke ◽  
Rachid Karam ◽  
...  

BackgroundThe clinical phenotype of CDH1 pathogenic variant carriers has mostly been studied in families that fulfil criteria of hereditary diffuse gastric cancer (HDGC). We aimed at determining cancer phenotype and cancer risk estimation among families with CDH1 pathogenic variants not selected by HDGC clinical criteria.MethodsPatients were all consecutively identified CDH1 pathogenic variant carriers from a clinical laboratory tested with multigene panel testing and from an academic cancer genetics programme. Clinical and demographic features, cancer phenotypes and genotype–phenotype correlations were determined among CDH1 families. Age-specific cumulative cancer risks (penetrance) were calculated based on 38 families with available pedigrees.ResultsWithin the 113 CDH1 pathogenic variant probands and 476 relatives, 113 had gastric cancer, 177 breast cancer and 196 other cancers. Mean age at diagnosis was 47 for gastric and 54 for breast cancer. Forty-six per cent fulfilled criteria of HDGC. While 36% of families had both gastric and breast cancers, 36% had breast but no gastric cancers and 16% had gastric but not breast cancers. Cumulative risk of cancer by age 80 was 37.2% for gastric and 42.9% for breast cancer.ConclusionIn unselected CDH1 pathogenic variant carrier families, gastric cancer risks were lower and age at diagnosis higher than previously reported in families pre-selected for HDGC criteria. A substantial proportion of families did not present with any gastric cancers and their cancers were limited to breast. Thus, clinical criteria for CDH1 testing should be widened, including breast cancer families only, and a consideration for delayed prophylactic gastrectomy/surveillance should be evaluated.


2012 ◽  
Vol 30 (9) ◽  
pp. 958-964 ◽  
Author(s):  
Aung Ko Win ◽  
Joanne P. Young ◽  
Noralane M. Lindor ◽  
Katherine M. Tucker ◽  
Dennis J. Ahnen ◽  
...  

Purpose To determine whether cancer risks for carriers and noncarriers from families with a mismatch repair (MMR) gene mutation are increased above the risks of the general population. Patients and Methods We prospectively followed a cohort of 446 unaffected carriers of an MMR gene mutation (MLH1, n = 161; MSH2, n = 222; MSH6, n = 47; and PMS2, n = 16) and 1,029 their unaffected relatives who did not carry a mutation every 5 years at recruitment centers of the Colon Cancer Family Registry. For comparison of cancer risk with the general population, we estimated country-, age-, and sex-specific standardized incidence ratios (SIRs) of cancer for carriers and noncarriers. Results Over a median follow-up of 5 years, mutation carriers had an increased risk of colorectal cancer (CRC; SIR, 20.48; 95% CI, 11.71 to 33.27; P < .001), endometrial cancer (SIR, 30.62; 95% CI, 11.24 to 66.64; P < .001), ovarian cancer (SIR, 18.81; 95% CI, 3.88 to 54.95; P < .001), renal cancer (SIR, 11.22; 95% CI, 2.31 to 32.79; P < .001), pancreatic cancer (SIR, 10.68; 95% CI, 2.68 to 47.70; P = .001), gastric cancer (SIR, 9.78; 95% CI, 1.18 to 35.30; P = .009), urinary bladder cancer (SIR, 9.51; 95% CI, 1.15 to 34.37; P = .009), and female breast cancer (SIR, 3.95; 95% CI, 1.59 to 8.13; P = .001). We found no evidence of their noncarrier relatives having an increased risk of any cancer, including CRC (SIR, 1.02; 95% CI, 0.33 to 2.39; P = .97). Conclusion We confirmed that carriers of an MMR gene mutation were at increased risk of a wide variety of cancers, including some cancers not previously recognized as being a result of MMR mutations, and found no evidence of an increased risk of cancer for their noncarrier relatives.


Sign in / Sign up

Export Citation Format

Share Document