Tamoxifen and endometrial cancer risk among breast cancer patients in Taiwan

Autor: Lee, Hsin-Yi, 李欣怡
Rok vydání: 2018
Druh dokumentu: 學位論文 ; thesis
Popis: 106
Importance: Although data from a number of studies over the last 20 years have discovered association between tamoxifen and endometrial cancer among breast cancer women, there is still rare study discussing this issue taking the mortality, other confounding factors and the dynamic use of drug into account. Objective: The aim of this study is to investigate the association between tamoxifen and endometrial cancer among breast cancer women. Design: This is a population-based retrospective cohort study. The index date is set as the first prescription of tamoxifen + 180 days. Setting: We conduct this study by using the National Health Insurance Database (NHID) and Serious Disabling Diseases (SDD) database in Taiwan. Participants: Female patients with newly-diagnosis of breast cancer during Jan 1, 2000 to Dec 31, 2012 are recruited from registry for SDD in this study (n=99,895). Using exact matching, control (n=20,875) is matched per case by newly-diagnosis year of breast cancer, year of birth, comorbidity and socioeconomic index. Exposure: Female patients with newly-diagnosis of breast cancer and use tamoxifen during Jan 1, 2000 to Dec 31, 2013 include in this study. Tamoxifen defines as Anatomical Therapeutic Chemical (ATC) by WHO is L02BA01, and its Define Daily Dose (DDD) is 20mg Main Outcome Measure: Endometrial cancer classify according to the ICD-9 code is 182.xx from Registry for SDD. Statistics analysis: Chi-square or t tests use to examine differences of women with newly-diagnosis breast cancer in demographic and characteristics between tamoxifen exposure cases and controls. Hysterectomy、other cancer (malignant) and death are taken as competing risks. Using competing risk adjusted Cox regression model (model 1) and Time-dependent competing risk adjusted Cox regression model (model 2), we will evaluate the association between tamoxifen and endometrial cancer among breast cancer patients in Taiwan. Result：This study in model 1 showed that breast cancer patients in Taiwan use less or over 238 DDD tamoxifen per year during follow-up, the risk in endometrial cancer was higher than that of non-users (HR:2.49,95%CI:1.23- 5.03,p=0.011；HR: 16.46, 95%CI: 8.46-31.99, p
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