Cancer incidence following non-neoplastic medical conditions: a prospective population-based cohort study

Autor: Lauri J. Sipilä, Tomas Tanskanen, Sanna Heikkinen, Karri Seppä, Mervi Aavikko, Janne Ravantti, Lauri A. Aaltonen, Janne Pitkäniemi
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Acta Oncologica, Vol 63, Iss 1 (2024)
Druh dokumentu: article
ISSN: 1651-226X
DOI: 10.2340/1651-226X.2024.40757
Popis: Background and purpose: Many non-neoplastic diseases have been established to be tumorigenic, and cancers are sometimes misdiagnosed as non-neoplastic diseases. We conducted a comprehensive registry-based study of site-specific cancer diagnosis risk following the diagnosis of any preceding medical condition (PMC) encoded by the International Classification of Diseases (ICD)-10 classification. Material and methods: We analyzed healthcare data and cancer data for a random population-based sample of 2.5 million individuals living in Finland on January 1, 2000. Hazard ratios for each PMC and cancer pair were estimated using piecewise constant hazard regression models. P-values were corrected for multiple testing with the Bonferroni method. Results: Several lifestyle-related PMCs were associated with the risk of cancer diagnosis, exemplified by chronic obstructive pulmonary disease and subsequent lung cancer diagnosis risk (female hazard ratio [HR] = 9.91, 95% confidence interval [CI]: 9.18–19.7, p-adj. < 0.0001; male HR = 5.69, 95% CI: 5.43–5.96, p-adj. < 0.0001). Diagnosis risk of ill-defined cancers appeared to increase following diagnosis of Alzheimer’s disease (AD). We identified rare PMCs of potential interest. Interpretation: A considerable proportion of the statistically significant associations were explainable by tobacco smoking and alcohol use. The enrichment of ill-defined cancer diagnoses in persons with AD, together with the overall inverse association between AD and cancer, may reflect underdiagnosis of cancer in this patient population. Our results provide a useful resource for research on the prevention and early detection of cancer.
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