Association of Dialysis with the Risks of Cancers
نویسندگان
چکیده
BACKGROUND To increase the survival span after dialysis in patients with end-stage renal disease (ESRD), identifying specific cancer risks is crucial in the cancer screening of these patients. The aim of this study was to investigate the risks of various cancers in an incident dialysis group in comparison with a non-dialysis group. METHOD We conducted a nationwide cohort study by using data from the Taiwan National Health Insurance Research Database. Patients who initially received long-term dialysis between January 1997 and December 2004, were selected and defined as the dialysis group and were matched with the non-dialysis patients (control group) according to age, sex, and index year. Competing risk analysis was used to estimate cumulative incidence and subdistribution hazard ratios (SHRs) of the first cancer occurrence. RESULTS After consideration for the competing risk of mortality, the dialysis group showed a significantly higher 7-year cancer incidence rate than did the control group (6.4%; 95% confidence interval [CI], 6.0%-6.7% vs 1.7%; 95% CI, 1.4%-2.1%; P <0.001).The modified Cox proportional hazard model revealed that the dialysis group had significantly association with increased risks for all cancers (SHR, 3.43; 95% CI, 3.02-3.88). The risk of cancers was dominated in younger and female patients. Specific cancer risks were significantly higher in the dialysis group particularly in the development of oral, colorectal, liver, blood, breast, renal, upper urinary tract, and bladder cancer than in the control group. Multivariable stratified analyses confirmed the association between long-term dialysis and cancer in all subgroups of patients. CONCLUSIONS Dialysis is associated with a higher risk of cancer in patients with ESRD. However, cancer screening in ESRD population should be a selective approach, based on individual patient health condition and life expectancy.
منابع مشابه
Estimating the Radiation-Induced Cancer Risks in Pediatric Computed Tomography
Introduction One of the central questions in radiological protection is the magnitude of the risks from low doses of radiation, related to the justification and optimization of the diagnostic medical exposures. Therefore, the aim of this study was to estimate the cancer incidence and mortality risks in children of different ages, sizes, and ethnicities undergoing computed tomography examination...
متن کاملAn Ecological Study of the Association between Opiate Use and Incidence of Cancers
Background: Cancer is the second leading cause of death after cardiovascular disease. In recent years it has been hypothesized that opiate use could be a risk factor for cancer. This study aimed to evaluate a possible association between opiate use and common cancers using ecological statistics from around the world.Methods: To investigate the association we used ordinary linear regression mode...
متن کاملRelation between Malnutrition–Inflammation–Atherosclerosis (MIA complex) in Diabetic Patients with Peritoneal Dialysis
Objective: Atherosclerosis disease, inflammation and malnutrition have strong association with end stage renal disease (ESRD). Diabetes mellitus (DM) is the most commonly ESRD causes. Diabetic nephropathy (DN) could be associated with inflammation. Type 2 diabetic patients with advanced nephropathy show the highest levels of inflammatory markers. This study was designed to determine the associa...
متن کاملAssociation of interleukin-1 gene polymorphism with risk of gastric and colorectal cancers in an Iranian population
متن کامل
The pattern of excess cancer in dialysis and transplantation.
BACKGROUND After transplantation, cancer risk varies from no increase for several common cancers to a many-fold increase for a number of, chiefly virus-associated, cancers. The smaller excess of cancer in dialysis has been less well described, but two studies suggested that impaired immunity might be responsible. METHODS In a population-based cohort study of 28 855 patients who received renal...
متن کامل