scholarly journals Risk of Colorectal Cancer in Patients With Attention-Deficit Hyperactivity Disorder: A Nationwide, Population-Based Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Je-Ming Hu ◽  
Chia-Cheng Lee ◽  
Tzu-Chiao Lin ◽  
Chi-Hsiang Chung ◽  
Chao-Yang Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Health Insurance ◽  
Attention Deficit ◽  
Cumulative Incidence ◽  
Rank Test ◽  
Adhd Group ◽  
Research Database ◽  
Kaplan Meier ◽  
Increased Risk

Background: The association between attention-deficit hypersensitivity disorder (ADHD) and the risk of developing colorectal cancer (CRC) is, as yet, to be investigated, and thus, we have conducted this nationwide, cohort study to examine the association in patients from Taiwan.Methods: In this study, 798 individuals with newly diagnosed ADHD and 2,394 (1:3) age-, gender-, and index year- matched controls without ADHD were enrolled, between 2000 and 2013, from the Longitudinal Health Insurance Database, a subset of the National Health Insurance Research Database in Taiwan. The cumulative incidence of CRC was assessed in each cohort by the Kaplan–Meier method. The multivariate Cox proportional hazards model was used to estimate the crude, and the adjusted hazards ratios (HRs) with 95% confidence intervals (CIs), was conducted to estimate the association between ADHD and CRC.Results: The Kaplan–Meier analysis revealed that the cumulative incidence of CRC was significantly higher in patients with ADHD than in those without it (log rank test, p < 0.001). After adjustments for age, gender, comorbidities, and other covariates, the ADHD group was associated with an increased risk of CRC in comparison to the non-ADHD group (adjusted HR = 3.458, 95% CI = 1.640–7.293, p < 0.001). In addition, the usage of methylphenidate was not associated with the risk of developing CRC in patients with ADHD.Conclusion: This retrospective cohort study depicts the evidence that ADHD was associated with the increased risk of CRC. Further studies are needed to confirm the association and the underlying mechanisms.

scholarly journals Correlation between kidney transplantation and colorectal cancer in hemodialysis patients: A nationwide, retrospective, population-based cohort study

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Han-En Wang ◽  
Yu-Chan Liao ◽  
Je-Ming Hu ◽  
Wen-Chih Wu ◽  
Wan-Yun Chou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Kidney Transplantation ◽  
Cumulative Incidence ◽  
Population Based ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Research Database ◽  
Kaplan Meier ◽  
Increased Risk

Abstract Background Kidney transplantation (KT) correlates with an increased risk of developing several malignancies; however, the risk of colorectal cancer (CRC) after KT remains debatable and has been marginally explored. Hence, in this nationwide, retrospective, population-based cohort study, we aimed to examine the correlation between KT and CRC in a large-scale population-based Chinese cohort. Methods We identified a total of 3739 regular hemodialysis patients undergoing KT (exposed cohort) and 42,324 hemodialysis patients not undergoing KT (non-exposed cohort) between 2000 and 2008 from Taiwan’s National Health Insurance Research Database (NHIRD). Both cohorts were followed up from January 1, 2000, to the date of CRC diagnosis, death, or the end of 2013. Using Kaplan–Meier method, we measured the cumulative incidence of CRC in each cohort. Furthermore, Cox proportional hazards models were used to compute hazards ratios (HRs) and 95% confidence intervals (CIs) to estimate the correlation between KT and CRC in hemodialysis patients. Results The Kaplan–Meier analysis revealed that the cumulative incidence of CRC was significantly higher in the exposed cohort than in the non-exposed cohort (log-rank test, P < 0.001). After adjusting for potential confounders, the exposed cohort exhibited a significantly increased risk of CRC compared with the non-exposed cohort (adjusted HR, 1.34; 95% CI, 1.11–1.62). Conclusions Hemodialysis patients undergoing KT have a significantly higher risk of CRC than those not undergoing KT. Cancer should continue to be a primary focus of prevention during KT.

scholarly journals Helicobacter pylori infection and the risk of colorectal cancer: a nationwide population-based cohort study

QJM ◽  
2019 ◽  
Vol 112 (10) ◽  
pp. 787-792 ◽  
Author(s):  
I-L Liu ◽  
C -H Tsai ◽  
C -H Hsu ◽  
J -M Hu ◽  
Y -C Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Helicobacter Pylori ◽  
Cohort Study ◽  
Cumulative Incidence ◽  
Colorectal Neoplasia ◽  
Population Based ◽  
Research Database ◽  
Increased Risk ◽  
Comparison Cohort ◽  
H Pylori

Abstract Background The role of Helicobacter pylori (H. pylori) infection in the development of colorectal neoplasia has been a matter of scientific debate with controversial findings. Aims This study examined the association between H. pylori infection and colorectal cancer (CRC) in a nationwide population-based Chinese cohort study. Methods A total of approximately 3936 individuals with newly diagnosed H. pylori infection (the H. pylori-infected cohort) and 15 744 age- and sex-matched patients with diagnoses absence of H. pylori infection (the comparison cohort) from 2000 to 2005 were identified from Taiwan’s National Health Insurance Research Database. The Kaplan–Meier method was used for measuring the cumulative incidence of CRC in each cohort. Cox proportional hazards models were used to compute hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) for the estimation of the association between H. pylori infection and CRC. Results The cumulative incidence of CRC was higher in H. pylori-infected cohort than that in the comparison cohort (log-rank test, P < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of CRC (adjusted HR 1.87; 95% CI 1.37–2.57). In addition, the HR of CRC appeared to increase with increasing frequency of clinical visits for H. pylori infection. Conclusions Our study demonstrated that H. pylori infection was associated with an increased risk of CRC, which warrants confirmation and exploration of the underlying biologic mechanisms by future studies.

scholarly journals The Association Between Pleural Empyema and Peripheral Arterial Disease in Younger Patients: A Retrospective National Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Tzu-Yuan Wang ◽  
Hsin-Hung Chen ◽  
Chun-Hung Su ◽  
Sheng-Pang Hsu ◽  
Chun-Wei Ho ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Pleural Empyema ◽  
Arterial Disease ◽  
Population Based ◽  
Rank Test ◽  
Research Database ◽  
Increased Risk ◽  
Using Data ◽  
Peripheral Arterial

Background: To investigate the relationship between pleural empyema (PE) and peripheral arterial disease (PAD).Methods: We conducted a retrospective cohort study using data from the National Health Institute Research Database. Univariable and multivariable Cox's proportional hazard regressions were performed to investigate the association between PE and the risk of PAD. Kaplan–Meier method and the differences were assessed using a log-rank test.Results: The overall incidence of PAD was higher in the PE cohort than in the non-PE cohort (2.76 vs. 1.72 per 1,000 person-years) with a crude hazard ratio (HR) of 1.61 [95% confidence interval (CI) = 1.41–1.83]. After adjustment for age, gender, and comorbidities, patients with PE were noted to be associated with an increased risk of PAD compared with those without PE [adjusted HR (aHR) = 1.18, 95% CI = 1.03–1.35]. Regarding the age-specific comparison between the PE and non-PE cohorts, PAD was noted to be significantly high in the ≤ 49 years age group (aHR = 5.34, 95% CI = 2.34–10.1). The incidence of PAD was higher in the first 2 years, with an aHR of 1.35 (95% CI = 1.09–1.68) for patients with PE compared with those without PE.Conclusion: The risk of PAD was higher if patients with PE were younger than 49 years and within the 2-year diagnosis of PE.

scholarly journals Risk of aortic dissection, congestive heart failure, pneumonia and acute respiratory distress syndrome in patients with clinical vertebral fracture: a nationwide population-based cohort study in Taiwan

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030939
Author(s):  
Feng-You Lee ◽  
Wei-Kung Chen ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao ◽  
Tse-Yen Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Cohort Study ◽  
Health Insurance ◽  
Aortic Dissection ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Research Database ◽  
Increased Risk

ObjectiveStudies on the association between clinical vertebral fractures (CVFs) and the subsequent risk of cardiopulmonary diseases, including aortic dissection (AD), congestive heart failure (CHF), pneumonia and acute respiratory distress syndrome (ARDS) are scarce. Therefore, we used the National Health Insurance Research Database to investigate whether patients with CVF have a heightened risk of subsequent AD, CHF, pneumonia and ARDS.DesignThe National Health Insurance Research Database was used to investigate whether patients with CVFs have an increased risk of subsequent AD, CHF, pneumonia and ARDS.ParticipantsThis cohort study comprised patients aged ≥18 years with a diagnosis of CVF and were hospitalised at any point during 2000–2010 (n=1 08 935). Each CVF patient was frequency-matched to a no-CVF hospitalised patients based on age, sex, index year and comorbidities (n=1 08 935). The Cox proportional hazard regressions model was used to estimate the adjusted effect of CVF on AD, CHF, pneumonia and ARDS risk.ResultsThe overall incidence of AD, CHF, pneumonia and ARDS was higher in the CVF group than in the no-CVF group (4.85 vs 3.99, 119.1 vs 89.6, 283.3 vs 183.5 and 9.18 vs 4.18/10 000 person-years, respectively). After adjustment for age, sex, comorbidities and Charlson comorbidity index score, patients with CVF had a 1.23-fold higher risk of AD (95% CI=1.03–1.45), 1.35-fold higher risk of CHF (95% CI=1.30–1.40), 1.57-fold higher risk of pneumonia (95% CI=1.54–1.61) and 2.21-fold higher risk of ARDS (95% CI=1.91–2.57) than did those without CVF. Patients with cervical CVF and SCI were more likely to develop pneumonia and ARDS.ConclusionsOur study demonstrates that CVFs are associated with an increased risk of subsequent cardiopulmonary diseases. Future investigations are encouraged to delineate the mechanisms underlying this association.

Methylphenidate and mortality in children with attention-deficit hyperactivity disorder: population-based cohort study

2020 ◽  
pp. 1-9
Author(s):  
Vincent Chin-Hung Chen ◽  
Hsiang-Lin Chan ◽  
Shu-I Wu ◽  
Mong-Liang Lu ◽  
Michael E. Dewey ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Attention Deficit ◽  
Population Based ◽  
Research Database ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder

Background Little is known about methylphenidate (MPH) use and mortality outcomes. Aims To investigate the association between MPH use and mortality among children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. Method This population-based cohort study analysed data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 68 096 children and adolescents aged 4–17 years with an ADHD diagnosis and prescribed MPH between 2000 and 2010 were compared with 68 096 without an MPH prescription, matched on age, gender and year of first ADHD diagnosis. All participants were followed to death, migration, withdrawal from the National Health Insurance programme or 31 December 2013. MPH prescriptions were measured on a yearly basis during the study period, and the association between MPH use and mortality was analysed using a repeated-measures time-dependent Cox regression model. The outcome measures included all-cause, unnatural-cause (including suicide, accident and homicide) and natural-cause mortality, obtained from linkage to the National Mortality Register in Taiwan. Results The MPH group had lower unadjusted all-cause, natural-, unnatural- and accident-cause mortality than the comparison group. After controlling for potential confounders, MPH use was associated with a significantly lower all-cause mortality (adjusted hazard ratio AHR = 0.81, 95% CI 0.67–0.98, P = 0.027), delayed use of MPH was associated with higher mortality (AHR = 1.05, 95% CI 1.01–1.09) and longer MPH use was associated with lower mortality (AHR = 0.83, 95% CI 0.70–0.98). Conclusions MPH use is associated with a reduced overall mortality in children with ADHD in this cohort study, but unmeasured confounding cannot be excluded absolutely.

scholarly journals Association of gout and colorectal cancer in Taiwan: a nationwide population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028892
Author(s):  
Jen-Pin Chuang ◽  
Jenq-Chang Lee ◽  
Tzeng-Horng Leu ◽  
Atik Choirul Hidajah ◽  
Ya-Hui Chang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
Incidence Rate ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Secondary Outcome ◽  
Research Database ◽  
Increased Risk

ObjectivesThis study aimed to determine colorectal cancer (CRC) risks among patients with gout through a follow-up study on a nationwide population-based cohort that included patients with gout and the general population in Taiwan.ParticipantFrom the Taiwan National Health Insurance Research Database, we identified 28 061 patients who were newly diagnosed with gout between 2000 and 2010 as the study cohort. We randomly selected 84 248 subjects matching in gender, age and baseline year as comparison cohort. The cohorts were followed up until CRC occurrence, withdrawal from the system of National Health Insurance, or Dec. 31, 2013.Primary and secondary outcome measuresCumulative incidences and incidence rate ratios (IRRs) of CRC between two cohorts were examined. The Cox proportional hazards model was used to evaluate risk factors associated with CRC development.ResultsDuring the 13-year follow-up, the incidence rate of CRC development in the gout cohort reached 2.44 per 1000 person-years, which was higher than the 2.13 per 1000 person-years in the control cohort (IRR=1.15; 95% CI 1.04 to 1.26). After adjusting for age, gender, urbanisation status and comorbidities, including hypertension, diabetes and hyperlipidaemia, gout showed no significant association with increased risk of CRC occurrence (adjusted HR=1.03; 95% CI 0.93 to 1.14).ConclusionsSimilar risks of CRC incidence were observed in patients with and without gout in Taiwan. Allopurinol and colchicine are commonly used as urate-lowering drug and anti-inflammation medication in Taiwan and had been shown to reduce the risk of CRC incidence. Thus, further pharmaco-epidemiological studies should be carried out to specifically assess the role of allopurinol in the relationship between gout and CRC.

scholarly journals Risk for Irritable Bowel Syndrome in Patients with Helicobacter Pylori Infection: A Nationwide Population-Based Study Cohort Study in Taiwan

2020 ◽  
Vol 17 (10) ◽  
pp. 3737
Author(s):  
Chia-Ming Liang ◽  
Chih-Hsiung Hsu ◽  
Chi-Hsiang Chung ◽  
Chao-Yang Chen ◽  
Lin-Yin Wang ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Irritable Bowel Syndrome ◽  
Cohort Study ◽  
Cumulative Incidence ◽  
Eradication Therapy ◽  
Research Database ◽  
Increased Risk ◽  
Comparison Cohort ◽  
H Pylori ◽  
Irritable Bowel

Background: The association between Helicobacter pylori (H. pylori) infection and the risk of developing irritable bowel syndrome (IBS) has yet to be investigated; thus, we conducted this nationwide cohort study to examine the association in patients from Taiwan. Methods: A total of approximately 2669 individuals with newly diagnosed H. pylori infection and 10,676 age- and sex-matched patients without a diagnosis of H. pylori infection from 2000 to 2013 were identified from Taiwan’s National Health Insurance Research Database. The Kaplan–Meier method was used to determine the cumulative incidence of H. pylori infection in each cohort. Whether the patient underwent H. pylori eradication therapy was also determined. Results: The cumulative incidence of IBS was higher in the H. pylori-infected cohort than in the comparison cohort (log-rank test, p < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of IBS (adjusted hazard ratio (aHR) 3.108, p < 0.001). In addition, the H. pylori-infected cohort who did not receive eradication therapy had a higher risk of IBS than the non-H. pylori-infected cohort (adjusted HR 4.16, p < 0.001). The H. pylori-infected cohort who received eradication therapy had a lower risk of IBS than the comparison cohort (adjusted HR 0.464, p = 0.037). Conclusions: Based on a retrospective follow-up, nationwide study in Taiwan, H. pylori infection was associated with an increased risk of IBS; however, aggressive H. pylori infection eradication therapy can also reduce the risk of IBS. Further underlying biological mechanistic research is needed.

scholarly journals Deep Venous Thrombosis and Risk of Consequent Sepsis Event: A Retrospective Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7879
Author(s):  
Ying-Tung Yeh ◽  
Sheng-En Tsai ◽  
Ying-Cheng Chen ◽  
Shun-Fa Yang ◽  
Han-Wei Yeh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Population Based ◽  
Chronic Obstructive ◽  
Research Database ◽  
Obstructive Pulmonary Disease ◽  
Adequate Treatment ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Patients At Risk

Deep vein thrombosis causes several acute and chronic vessel complications and puts patients at risk of subsequent sepsis development. This unique study aimed to estimate the risk of sepsis development in DVT patients compared with non-DVT patients. This population-based cohort study used records of a longitudinal health insurance database containing two million patients defined in Taiwan’s National Health Insurance Research Database (NHIRD). Our study included patients aged over 20 years with a new diagnosis of DVT with at least two outpatient department visits or an admission between 2001 and 2014. Patients with a diagnosis of sepsis before the index date were excluded. Propensity score matching (PSM) was used to homogenize the baseline characteristics between the two groups. To define the independent risk of the DVT group, a multivariate Cox proportional hazard model was used to estimate the hazard ratios. After PSM, the DVT group (n = 5753) exhibited a higher risk of sepsis (adjusted hazard ratio, aHR, 1.74; 95% CI, 1.59–1.90) compared with non-DVT group (n = 5753). Patients with an increased risk of sepsis were associated with being elderly aged, male, having diabetes, chronic kidney disease, chronic obstructive pulmonary disease, stroke, malignancy, and use of antibiotics. In conclusion, this population-based cohort study demonstrated an increased risk of sepsis in DVT patients compared with non-DVT patients. Thus, early prevention and adequate treatment of DVT is necessary in clinical practice.

scholarly journals Association between Abdominal Obesity and Incident Colorectal Cancer: A Nationwide Cohort Study in Korea

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1368
Author(s):  
Ga Eun Nam ◽  
Se-Jin Baek ◽  
Hong Bae Choi ◽  
Kyungdo Han ◽  
Jung-Myun Kwak ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Health Insurance ◽  
Cancer Risk ◽  
Abdominal Obesity ◽  
Proportional Hazards ◽  
Asian Population ◽  
Cox Proportional Hazards ◽  
Colorectal Cancer Risk ◽  
Increased Risk

Background: We investigated the association of w May aist circumference (WC) and abdominal obesity with the incident colorectal cancer risk in Korean adults. Methods: This nationwide population-based cohort study was based on health insurance claims data. We analyzed data from 9,959,605 participants acquired through health check-ups of the Korean National Health Insurance Service in 2009 who were followed up until the end of 2017. We performed multivariable Cox proportional hazards regression analysis. Results: During 8.3 years of follow up, 101,197 cases (1.0%) of colorectal cancer were recorded. After adjusting for potential confounders, there was a positive association between WC and colorectal cancer risk (p for trend <0.001). Abdominal obesity was associated with an increased risk of colorectal (hazard ratio: 1.10, (95% confidence interval: 1.08–1.12)), colon (1.11, 1.09–1.13), and rectal cancer (1.08, 1.05–1.10). These associations were independent of body mass index and were more pronounced in men and elderly individuals. Conclusion: We revealed that higher WC is related to colorectal cancer risk, thus suggesting that abdominal obesity may be a risk factor for colorectal cancer in this East Asian population.

scholarly journals The Effect of Cholecystectomy on the Risk of Colorectal Cancer in Patients with Gallbladder Stones

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 550 ◽  
Author(s):  
Chien-Hua Chen ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cumulative Incidence ◽  
Positive Association ◽  
Rank Test ◽  
Study Cohort ◽  
Research Database ◽  
Gallbladder Stones ◽  
Log Rank Test

To evaluate the risk of colorectal cancer (CRC) after cholecystectomy for gallbladder stones (GBS). Methods: This nationwide population-based cohort study analyzed the inpatient data from the Taiwan National Health Insurance Research Database. The study cohort comprised of 83,963 patients aged ≥ 20 years undergoing cholecystectomy for GBS between 2000 and 2010. The control cohort comprised the GBS patients without cholecystectomy, who were propensity matched with the study cohort at a 1:1 ratio based on age, sex, comorbidities, and the index date for cholecystectomy. Results: The cumulative incidence of CRC within 6 months of follow-up was higher in the cholecystectomy cohort than that in the non-cholecystectomy cohort (aHR (adjusted hazard ratio) = 7.90, 95% confidence interval (CI) = 6.27–9.94; log-rank test, p < 0.001). The cumulative incidence of CRC after 6 months of follow-up was lower in the cholecystectomy cohort than that in the non-cholecystectomy cohort (aHR = 0.66, 95% CI = 0.60–0.73; log-rank test, p < 0.001), but the reduced risk of CRC for the cholecystectomy cohort was statistically significant only in rectal cancer after separately considering females (aHR = 0.64, 95% CI = 0.46–0.88) and males (aHR = 0.59, 95% CI = 0.44–0.79). Conclusions: The positive association between cholecystectomy and the CRC risk within the first 6 months after cholecystectomy might be due to a detection bias or pre-existing CRC. However, cholecystectomy is associated with a decreased risk of rectal cancer, rather than proximal or distal colon cancer, after more than 6 months of follow-up.

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