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Cancer risk and mortality in asthma patients: A Swedish national cohort study.

Liu, Xiangdong LU ; Hemminki, Kari LU ; Försti, Asta LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Ji, Jianguang LU (2015) In Acta Oncologica 54(8). p.1120-1127
Abstract
Background. Previous studies found an increased risk of cancer in hospitalized asthma patients, but it is not known whether patients from primary health care show a similar risk pattern. In addition, it is unclear whether the diagnosis of asthma can influence the prognosis of subsequent cancer. Methods. Asthma patients were identified from Swedish inpatient, outpatient, and primary health care registers, and were linked to the Swedish Cancer Registry to identify subsequent diagnoses of cancer. Standardized incidence ratios (SIRs) were used to examine the risk of cancer in asthma patients compared with subjects without asthma. In addition, we used Cox proportional hazards regression to estimate hazard ratios (HRs) for mortality in patients... (More)
Background. Previous studies found an increased risk of cancer in hospitalized asthma patients, but it is not known whether patients from primary health care show a similar risk pattern. In addition, it is unclear whether the diagnosis of asthma can influence the prognosis of subsequent cancer. Methods. Asthma patients were identified from Swedish inpatient, outpatient, and primary health care registers, and were linked to the Swedish Cancer Registry to identify subsequent diagnoses of cancer. Standardized incidence ratios (SIRs) were used to examine the risk of cancer in asthma patients compared with subjects without asthma. In addition, we used Cox proportional hazards regression to estimate hazard ratios (HRs) for mortality in patients with both asthma and cancer. Results. A total of 10 649 cancers were diagnosed in patients with previous asthma, with a SIR of 1.19 (95% CI 1.17-1.21). A total of 15 cancer sites showed an increased incidence, whereas two cancer sites showed a decreased risk. Non-allergic asthma showed the highest risk of cancer (SIR = 1.25, 95% CI 1.18-1.32), followed by unspecified asthma (SIR = 1.22, 95% CI 1.19-1.25), status asthmaticus (SIR = 1.19, 95% CI 1.02-1.39), and allergic asthma (SIR = 1.14, 95% CI 1.06-1.22). The risk of cancer was similarly increased in asthma patients diagnosed in primary health care and those diagnosed in hospitals. Cancer patients with previous asthma had increased mortality, with a HR of 1.55 (95% CI 1.50-1.60). HRs ranged from 1.09 to 1.94 for different sites/types of cancer. Conclusions. Patients with asthma, irrespective of whether they were treated in primary health care or hospitals, had an increased risk of cancer. In addition, cancer patients with previous asthma had a worse prognosis compared with those without asthma, suggesting that these patients may require a multidisciplinary approach to manage the comorbidity. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Oncologica
volume
54
issue
8
pages
1120 - 1127
publisher
Taylor & Francis
external identifiers
  • pmid:25608824
  • wos:000361285500005
  • scopus:84940538081
ISSN
1651-226X
DOI
10.3109/0284186X.2014.1001497
language
English
LU publication?
yes
id
e1107b5d-40f7-45e0-adfa-14936a6c9d91 (old id 5040046)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25608824?dopt=Abstract
date added to LUP
2015-02-03 20:22:33
date last changed
2017-09-17 04:11:01
@article{e1107b5d-40f7-45e0-adfa-14936a6c9d91,
  abstract     = {Background. Previous studies found an increased risk of cancer in hospitalized asthma patients, but it is not known whether patients from primary health care show a similar risk pattern. In addition, it is unclear whether the diagnosis of asthma can influence the prognosis of subsequent cancer. Methods. Asthma patients were identified from Swedish inpatient, outpatient, and primary health care registers, and were linked to the Swedish Cancer Registry to identify subsequent diagnoses of cancer. Standardized incidence ratios (SIRs) were used to examine the risk of cancer in asthma patients compared with subjects without asthma. In addition, we used Cox proportional hazards regression to estimate hazard ratios (HRs) for mortality in patients with both asthma and cancer. Results. A total of 10 649 cancers were diagnosed in patients with previous asthma, with a SIR of 1.19 (95% CI 1.17-1.21). A total of 15 cancer sites showed an increased incidence, whereas two cancer sites showed a decreased risk. Non-allergic asthma showed the highest risk of cancer (SIR = 1.25, 95% CI 1.18-1.32), followed by unspecified asthma (SIR = 1.22, 95% CI 1.19-1.25), status asthmaticus (SIR = 1.19, 95% CI 1.02-1.39), and allergic asthma (SIR = 1.14, 95% CI 1.06-1.22). The risk of cancer was similarly increased in asthma patients diagnosed in primary health care and those diagnosed in hospitals. Cancer patients with previous asthma had increased mortality, with a HR of 1.55 (95% CI 1.50-1.60). HRs ranged from 1.09 to 1.94 for different sites/types of cancer. Conclusions. Patients with asthma, irrespective of whether they were treated in primary health care or hospitals, had an increased risk of cancer. In addition, cancer patients with previous asthma had a worse prognosis compared with those without asthma, suggesting that these patients may require a multidisciplinary approach to manage the comorbidity.},
  author       = {Liu, Xiangdong and Hemminki, Kari and Försti, Asta and Sundquist, Jan and Sundquist, Kristina and Ji, Jianguang},
  issn         = {1651-226X},
  language     = {eng},
  number       = {8},
  pages        = {1120--1127},
  publisher    = {Taylor & Francis},
  series       = {Acta Oncologica},
  title        = {Cancer risk and mortality in asthma patients: A Swedish national cohort study.},
  url          = {http://dx.doi.org/10.3109/0284186X.2014.1001497},
  volume       = {54},
  year         = {2015},
}