한빛사 논문
Ala Woo, MD,1,†, Seung Won Lee, MD, PhD,2,†, Hyun Yong Koh, MD, PhD,3, Mi Ae Kim, MD, PhD,4, Man Yong Han, MD,5, Dong Keon Yon, MD,5,6,*
1Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
2Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea
3F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
4Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
5Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
6Armed Force Medical Command, Republic of Korea Armed Forces, Seongnam, Republic of Korea
†Ala Woo and Seung Won Lee contributed equally to this work.
*Corresponding author
Abstract
Background
Evidence regarding the risk of cancer development after asthma diagnosis is controversial and inconclusive.
Objective
To determine if asthma is associated with an increased risk for incident cancer.
Methods
Two independent, population-based, longitudinal cohorts were examined, and estimated hazard ratios were determined using Cox regression. One group consisted of an unmatched cohort of 475,197 participants and a propensity score-matched cohort of 75,307 participants from the National Health Insurance Service-National Sample Cohort (NHIS-NSC; claims-based data from 2003 to 2015). The other group consisted of 5440 participants from the Ansan-Ansung cohort (interview-based data from 2001 to 2014).
Results
The NHIS-NSC matched cohort had 572,740 person-years of follow-up, 6885 people with new asthma diagnoses, and 68,422 people without asthma diagnoses. Adults with asthma had a 75% greater risk of incident cancer overall. The excess risk for incident cancer was greatest during the first 2 years after asthma diagnosis, and this risk remained elevated throughout follow-up. Patients with non-atopic asthma had a greater risk of overall cancer than those with atopic asthma. A high cumulative dose of inhaled corticosteroids among asthma patients was associated with a 56% reduced risk of lung cancer, but had no effect on the risk of overall cancer. The results from the NHIS-NSC unmatched cohort and the Ansan-Ansung cohort were similar to the primary results from the NHIS-NSC matched cohort.
Conclusion
Asthma development was associated with an increased risk of subsequent cancer in two different Korean cohorts. Our findings provide an improved understanding of the pathogenesis of asthma and its relationship with carcinogenesis, and suggest that clinicians should be aware of the higher risk of incident cancer among asthmatic patients.
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