scholarly journals The Effect of Statins in Cancer Risk Reduction in Patients on Dialysis: A Population-Based Case-Control Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5602
Author(s):  
Po-Huang Chen ◽  
Hong-Jie Jhou ◽  
Chi-Hsiang Chung ◽  
Cho-Hao Lee ◽  
Yi-Ying Wu ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Cox Regression ◽  
Population Based ◽  
Cox Regression Analysis ◽  
Defined Daily Doses ◽  
Risk Of Malignancy ◽  
History Of ◽  
Risk Of Cancer ◽  
Hematopoietic Cancer ◽  
The Relationship

Background: To realize whether statins reduce the risk of cancer in susceptible dialysis populations, this study analyzed the relationship between statin use and cancer risk in patients on dialysis. Methods: Patients having a history of chronic kidney disease with hemodialysis or peritoneal dialysis and receiving statin prescriptions or not were enrolled. The main outcome was cancer diagnosis. This study used univariate and multivariate Cox regression analyses. Results: In total, 4236 individuals in the statin group and 8472 individuals in the statin nonuser group were included in the study. Multivariate Cox regression analysis revealed that statin users are significantly less likely to develop cancer than statin nonusers (adjusted hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.78–0.90). Subgroup analyses revealed that statin cumulative defined daily doses >365 were associated with a significantly decreased risk of cancer incidence (adjusted HR 0.59, 95% CI 0.45–0.87), and statin users have a reduced risk of respiratory, soft tissue and connective tissue, breast, gynecological, prostate, central nervous system, and lymphatic and hematopoietic cancer than nonusers. Conclusions: Our population-based cohort study provides an association that statins reduce the risk of malignancy in patients on dialysis, especially with a longer treatment duration, and certain types of cancer.

scholarly journals Rotating Nightshift Work and Hematopoietic Cancer Risk in US Female Nurses

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Yin Zhang ◽  
Brenda M Birmann ◽  
Kyriaki Papantoniou ◽  
Eric S Zhou ◽  
Astrid C Erber ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Hodgkin Lymphoma ◽  
Cox Regression ◽  
Statistical Tests ◽  
B Cell Lymphoma ◽  
Health Study ◽  
Increased Risk ◽  
Work Duration ◽  
History Of ◽  
Hematopoietic Cancer

Abstract Background Nightshift work is a plausible risk factor for hematologic cancer, but epidemiological evidence remains sparse, especially for individual subtypes. We prospectively examined the association of rotating nightshift work with hematopoietic cancer risk. Methods This cohort study included US women from the Nurses’ Health Study (NHS: n = 76 846, 1988–2012) and Nurses’ Health Study II (NHSII: n = 113 087, 1989–2013). Rotating nightshift work duration was assessed at baseline (both cohorts) and cumulatively updated (NHSII). Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for overall hematopoietic cancer and specific histologic subtypes. All statistical tests were two-sided. Results We documented 1405 (NHS) and 505 (NHSII) incident hematopoietic cancer cases during follow-up. In NHS, compared with women who never worked rotating nightshifts, longer rotating nightshift work duration was associated with an increased risk of overall hematopoietic cancer (HR1–14y = 0.93, 95% CI = 0.83 to 1.04; HR≥15y = 1.28, 95% CI = 1.06 to 1.55; Ptrend = .009). In NHSII, results were similar though not statistically significant (HR1–14y = 0.99, 95% CI = 0.82 to 1.21; HR≥15y = 1.41, 95% CI = 0.88 to 2.26; Ptrend = .47). In the subtype analyses in the NHS, the association of history of rotating nightshift work with risk of diffuse large B-cell lymphoma varied by duration (HR1–14y = 0.71, 95% CI = 0.51 to 0.98; HR≥15y = 1.69, 95% CI = 1.07 to 2.67; Ptrend = .01) compared with those who never worked rotating nightshifts. Women reporting a longer history of rotating nightshifts also had suggestive (statistically nonsignificant) increased risks of overall non-Hodgkin lymphoma (HR≥15y = 1.19, 95% CI = 0.95 to 1.49), Hodgkin lymphoma (HR≥15y = 1.32, 95% CI = 0.43 to 4.06), and multiple myeloma (HR≥15y = 1.42, 95% CI = 0.85 to 2.39). Conclusions Longer duration (≥15 years) of rotating nightshift work was associated with increased risks of overall and several subtypes of hematopoietic cancer.

scholarly journals Clinical Efficacy of Ruxolitinib in Patients with Myelofibrosis: A Nationwide Population-Based Study in Korea

2021 ◽  
Vol 10 (20) ◽  
pp. 4774
Author(s):  
Byung-Hyun Lee ◽  
Hyemi Moon ◽  
Jae-Eun Chae ◽  
Ka-Won Kang ◽  
Byung-Soo Kim ◽  
...  
Keyword(s):  
Propensity Scores ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Previous History ◽  
Population Based ◽  
Population Based Study ◽  
Cox Regression Analysis ◽  
History Of ◽  
Korean National Health Insurance ◽  
Insurance Database

Previous studies have reported the survival benefit after ruxolitinib treatment in patients with myelofibrosis (MF). However, population-based data of its efficacy are limited. We analyzed the effects of ruxolitinib in MF patients with data from the Korean National Health Insurance Database. In total, 1199 patients diagnosed with MF from January 2011 to December 2017 were identified, of which 731 were included in this study. Patients who received ruxolitinib (n = 224) were matched with those who did not receive the drug (n = 507) using the 1:1 greedy algorithm. Propensity scores were formulated using five variables: age, sex, previous history of arterial/venous thrombosis, and red blood cell (RBC) or platelet (PLT) transfusion dependence at the time of diagnosis. Cox regression analysis for overall survival (OS) revealed that ruxolitinib treatment (hazard ratio (HR), 0.67; p = 0.017) was significantly related to superior survival. In the multivariable analysis for OS, older age (HR, 1.07; p < 0.001), male sex (HR, 1.94; p = 0.021), and RBC (HR, 3.72; p < 0.001) or PLT (HR, 9.58; p = 0.001) transfusion dependence were significantly associated with poor survival, although type of MF did not significantly affect survival. Considering evidence supporting these results remains weak, further studies on the efficacy of ruxolitinib in other populations are needed.

scholarly journals Skin autofluorescence predicts cancer in subjects with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e001312
Author(s):  
Ninon Foussard ◽  
Alice Larroumet ◽  
Marine Rigo ◽  
Kamel Mohammedi ◽  
Laurence Baillet-Blanco ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cox Regression ◽  
Skin Autofluorescence ◽  
Cox Regression Analysis ◽  
Screening Programs ◽  
Biological Studies ◽  
History Of ◽  
Risk Of Cancer

IntroductionSubjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by measuring the skin autofluorescence. We searched whether the skin autofluorescence could predict new cancers in persons with type 2 diabetes.Research design and methodsFrom 2009 to 2015, we measured the skin autofluorescence of 413 subjects hospitalized for uncontrolled or complicated type 2 diabetes, without any history of cancer. The participants were followed for at least 1 year and the occurrences of new cancers were compared according to their initial skin autofluorescences.ResultsThe participants were mainly men (57.9%), with poorly controlled (HbA1c 72±14 mmol/mol or 8.7%±1.8%) and/or complicated type 2 diabetes. Their median skin autofluorescence was 2.6 (2.2–3.0) arbitrary units. Forty-five new cancer cases (10.9%) were registered during 4.8±2.3 years of follow-up: 75.6% of these subjects had skin autofluorescence higher than the median (χ2: p=0.001). By Cox regression analysis adjusted for age, gender, body mass index, history of smoking and renal parameters, skin autofluorescence >2.6 predicted a 2.57-fold higher risk of cancer (95% CI 1.28 to 5.19, p=0.008). This association remained significant after excluding the eight cancers that occurred in the 4 years after inclusion (OR 2.95, 95% CI 1.36 to 6.38, p=0.006). As a continuous variable, skin autofluorescence was also related to new cancers (OR 1.05, 95% CI 1.01 to 1.10, p=0.045).ConclusionsSkin autofluorescence, a potential marker of glycemic memory, predicts the occurrence of cancer in subjects with type 2 diabetes. This relation provides a new clinical argument for the role of AGEs in cancer. Their estimation by measuring the skin autofluorescence may help select subjects with diabetes in cancer screening programs.

scholarly journals Neuroendocrine Cell Carcinoma of Unknown Primary Arising in Long Standing History of Multiple Sclerosis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Stergios Boussios ◽  
Vasiliki Kostadima ◽  
Anna Batistatou ◽  
Ioannis Tourkantonis ◽  
George Fotopoulos ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cancer Risk ◽  
Population Based ◽  
Unknown Primary ◽  
Carcinoma Of Unknown Primary ◽  
Clinical Disorder ◽  
Increased Risk ◽  
Risk Of Malignancy ◽  
History Of ◽  
Register Studies

Multiple sclerosis (MS) is a chronic autoimmune disease that targets myelinated axons in the central nervous system (CNS). Cancer of unknown primary site (CUP) is a well-recognised clinical disorder, accounting for 3–5% of all malignant epithelial tumors. CUP is clinically characterised as an aggressive disease with early dissemination. Studies of cancer risk in MS patients have shown inconsistent findings. An increased risk of malignancy in patients with MS has been suggested, but recently serious questions have been raised regarding this association. Use of disease-modifying therapies might contribute to an increased cancer risk in selected MS patients. The concurrence of MS and CUP is exceptionally rare. Here we describe the case of a neuroendocrine carcinoma of unknown primary diagnosed in a male patient with a nine-year history of MS. The discussion includes data from all available population-based register studies with estimates of certain malignancies in patients with MS.

scholarly journals Cancer Risk of Patients With Overweight and Obesity: A Predictive Model

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A6-A6
Author(s):  
Alexander Turchin ◽  
Fritha Morrison ◽  
Maria Shubina ◽  
Shraddha Shinde ◽  
Nadia Ahmad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Risk ◽  
Predictive Model ◽  
Cox Regression ◽  
Overweight And Obesity ◽  
Training Dataset ◽  
Additional Patient ◽  
History Of ◽  
Risk Of Cancer ◽  
History Of Cancer

Abstract Obesity is the most common chronic disease in the U.S. Patients with obesity have many risk factors for cancer, often modifiable. It is important to identify patients with obesity at high risk of cancer to be able to appropriately direct treatment and resources. Given that the risk pool is large, it is imperative to identify a clinically meaningful metric for risk stratification to help guide interventions. We conducted an observational study of electronic medical records data for 394,161 adults aged between 18 and 80, with BMI ≥ 25 kg/m2 and without baseline history of cancer between 2000 and 2019. We first identified a literature-based pool of risk factors for cancer onset and conducted variable selection by applying least absolute shrinkage and selection operator (LASSO) penalized Cox regression with ten-fold cross-validation on an 80% training dataset. Effects of the selected variables on risk of cancer (excluding non-melanoma skin cancer) onset were assessed using Cox regression on the 80% training dataset. The resulting model accuracy was evaluated using Cox regression on a withheld 20% validation dataset. Participants had a mean age of 46.7 (SD: 15.5) years and mean body mass index (BMI) of 30.5 (SD: 5.4) kg/m2; 51.9% were women. Over a mean of 7.5 years of follow-up, 34,679 (8.8%) of study patients developed cancer. The predictive model achieved a Harrell’s C-statistic of 0.73. The greatest risk of cancer incidence was associated with HIV infection (HR 2.22; 95% CI 1.88–2.63; 0.27% of patients), older age (HR 2.05 per 1 SD = 15.5 years; 95% CI 2.01- 2.09), hepatitis C infection (HR 1.48; 95% CI 1.34–1.63; 0.96% of patients), and family history of cancer (HR 1.44; 95% CI 1.41–1.48; 42.5% of patients). Additional patient characteristics found in &gt;5% of patients that also carried risk included proteinuria (5.8% of patients; HR 1.23; 95% CI 1.18–1.29) and history of smoking (40.7% of patients; HR 1.20; 95% CI 1.17–1.23). Each standard deviation increase in BMI (5.4 kg/m2) was associated with a hazard ratio of 1.06 (95% CI 1.05–1.07) for incident cancer. It is feasible to use predictive modeling to identify patients with overweight and obesity at high cancer risk. This approach could be utilized to guide population management and clinical treatment decisions.

scholarly journals Glucose Intolerance and Cancer Risk: A Community-Based Prospective Cohort Study in Shanghai, China

2021 ◽  
Vol 11 ◽  
Author(s):  
Juzhong Ke ◽  
Tao Lin ◽  
Xiaolin Liu ◽  
Kang Wu ◽  
Xiaonan Ruan ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Glucose Intolerance ◽  
Cox Regression ◽  
Baseline Survey ◽  
Cluster Sampling ◽  
Oral Glucose ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Risk Of Cancer

BackgroundCancer becomes the leading cause of premature death in China. Primary objective of this study was to determine the major risk factors especially glucose intolerance for cancer prophylaxis.MethodsA cluster sampling method was applied to enroll 10,657 community-based adults aged 15-92 years in Shanghai, China in 2013. A structured questionnaire and physical examination were applied in baseline survey. Prediabetes was diagnosed using 75-g oral glucose tolerance test. After excluding 1433 subjects including 224 diagnosed with cancer before and 1 year after baseline survey, the remaining 9,224 subjects were followed-up to December 31, 2020.ResultsA total of 502 new cancer cases were diagnosed. The cancer incidence was 10.29, 9.20, and 5.95/1,000 person-years in diabetes patients, those with prediabetes, and healthy participants, respectively (p&lt;0.001). The multivariate Cox regression analysis indicated that age, prediabetes and diabetes, were associated with an increased risk of cancer in those &lt;65 years, the hazard ratios (95% confidence interval) for prediabetes and diabetes were, 1.49(1.09-2.02) and 1.51(1.12-2.02), respectively. Glucose intolerance (prediabetes and diabetes) were associated with increased risks of stomach cancer, colorectal cancer, and kidney cancer in those &lt;65 years. Anti-diabetic medications reduced the risk of cancer caused by diabetes. The multivariate Cox analysis showed that age, male, &lt;9 years of education, and current smoking were associated with increased risks of cancer in those ≥65 years independently.ConclusionsGlucose intolerance is the prominent cancer risk factor in adults &lt;65 years. Lifestyle intervention and medications to treat glucose intolerance help prevent cancer in this population.

scholarly journals History of anemia and long-term mortality due to infection: a cohort study with 12 years follow-up in South Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tak Kyu Oh ◽  
Kyung-Ho Song ◽  
In-Ae Song
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Cox Regression ◽  
Population Based ◽  
Cox Regression Analysis ◽  
Risk Of Mortality ◽  
Moderate Anemia ◽  
History Of ◽  
Anemia Group

Abstract Background Anemia, which is a condition with reduced healthy red blood cells, is reported to be closely related to the development of infectious diseases. We aimed to investigate the association between history of anemia and 12-year mortality rate due to infections, and compare it with that among non-anemic individuals. Methods Data from the National Health Insurance Service Health Screening Cohort were used in this population-based cohort study. Adults who underwent standardized medical examination between and 2002–2003 were included, and the mortality rate due to infection between 2004 and 2015 was analyzed. Individuals were considered to have a history of anemia if the serum hemoglobin level in 2002–2003 was < 12 g/dL for women and < 13 g/dL for men. The severity of anemia at that time was categorized as mild (12 g/dL > hemoglobin ≥11 g/dL in women and 13 g/dL > hemoglobin ≥11 g/dL in men), moderate (hemoglobin 8–10.9 g/dL), or severe (hemoglobin < 8 g/dL). Propensity score (PS) matching and Cox regression analysis were used as statistical methods. Results Overall, 512,905 individuals were included in this study. The mean age of the participants was 54.5 years old (range: 40–98), and 49,042 (9.6%) individuals were classified in the anemic group, which comprised of 36,383 (7.1%), 11,787 (2.3%), and 872 (0.2%) participants in the mild, moderate, and severe sub-groups, respectively. After PS matching, 49,039 individuals in each group were included in the analysis. The risk of mortality due to infection in the anemic group was 1.77-fold higher (hazard ratio [HR]: 1.77, 95% confidence interval [CI]: 1.52–2.60; P < 0.001) than that in the non-anemic group. In the subgroup analysis, the mild and moderate anemia groups had 1.38-fold (HR: 1.38, 95% CI: 1.23 to 1.55; P < 0.001) and 2.02-fold (HR: 2.02, 95% CI: 1.62 to 2.50; P < 0.001) risk of mortality due to infection compared to that of the non-anemic group, respectively. The severe anemia group did not have a significantly different risk of mortality due to infection (P = 0.448). Conclusions History of anemia was associated with increased mortality rate due to infection at 12-year follow-up.

Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

2015 ◽  
Vol 24 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Petra A. Golovics ◽  
Laszlo Lakatos ◽  
Michael D. Mandel ◽  
Barbara D. Lovasz ◽  
Zsuzsanna Vegh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cox Regression ◽  
Diagnostic Procedures ◽  
Population Based ◽  
Disease Course ◽  
Inception Cohort ◽  
Disease Extent ◽  
Cox Regression Analysis ◽  
Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

scholarly journals Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhao Ding ◽  
Deshun Yu ◽  
Hefeng Li ◽  
Yueming Ding
Keyword(s):  
Marital Status ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Cox Regression ◽  
Group Analysis ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Prognostic Effect ◽  
The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

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