Trends in the incidence of urothelial carcinoma in Taiwan after the ban on aristolochic acid-containing Chinese herbal preparations, 2001-2018: a national population-based cohort study.

Autor: Liao CI; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; Department of Obstetrics and Gynecology, Pingtung Veterans General Hospital, Pingtung, 900, Taiwan., Fang HC; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan., Lee PT; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan., Hsu CY; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan., Chen CL; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan., Huang CW; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan., Chen XY; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan., Ou SH; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.; Department of Internal Medicine, Pingtung Veterans General Hospital, Pingtung, 900, Taiwan., Tsai CT; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan., Chou KJ; Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd, 813, Kaohsiung, Taiwan. kjchou@isca.vghks.gov.tw.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan. kjchou@isca.vghks.gov.tw.; School of Medicine, National Sun Yat-sen University, Kaohsiung, 804, Taiwan. kjchou@isca.vghks.gov.tw.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2023 Sep; Vol. 149 (11), pp. 8201-8211. Date of Electronic Publication: 2023 Apr 15.
DOI: 10.1007/s00432-023-04771-6
Abstrakt: Purpose: Urothelial carcinoma (UC) of the bladder (BUC) and the upper urinary tract (UTUC) are the two most common UCs. The incidence of UTUC in Taiwan is the highest worldwide. Aristolochic acid (AA) was identified as the main cause of UTUC in Taiwan. To explore trends in the incidence of UC in Taiwan after the ban on Chinese herbal preparations containing AA in 2003.
Methods: We used data from the Taiwanese National Health Insurance Research Database-linked Taiwanese National Cancer Registry for 2001-2018. UC was defined in accordance with the International Classification of Disease for Oncology. The age-standardized incidence was calculated on the basis of the World Health Organization standard population. Trends in the incidence were calculated as the annual percent change (APC) by using the Joinpoint regression program.
Results: Over the investigated period, the incidence of UC decreased at an average annual percent change (AAPC) of - 1.19% (95% CI - 1.47 ~ - 0.91, P < 0.001). However, the incidence in UTUC significantly increased, with the AAPC being 1.47% (95% CI 1.03 ~ 1.90, P < 0.001). In contrast, the incidence of BUC significantly decreased, with the overall AAPC being - 1.92% (95% CI - 2.3 ~ - 1.54, P < 0. 001). From 2001 to 2018, the overall incidence of UCs and BUC decreased in Taiwan, but the incidence of UTUC significantly increased.
Conclusion: We suggest to apply the same review standards of new drug development process to herbal preparations and incorporate them into the adverse drug reaction or poison surveillance system. Most importantly, raise public awareness of the potential toxicity of phytotherapy.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: